首次行试管婴儿助孕夫妻的婚姻调适和抑郁的关系

王婕妤; 唐王琴; 吴景梅; 王丹妮; 王吟霜; 陈嫦娥; 罗桂英; 曹云霞; 洪静芳

doi:10.16462/j.cnki.zhjbkz.2022.09.020

首次行试管婴儿助孕夫妻的婚姻调适和抑郁的关系

doi: 10.16462/j.cnki.zhjbkz.2022.09.020

1.
230032 合肥，安徽医科大学护理学院
2.
230032 合肥，安徽医科大学公共卫生学院预防医学教学中心
3.
230022 合肥，安徽医科大学第一附属医院妇产科生殖医学中心

基金项目:

国家自然科学基金 72004001

安徽高校自然科学研究项目 KJ2020A0203

安徽医科大学护理学院青苗项目 hlqm2021018

详细信息

通讯作者:
洪静芳，E-mail: hongjingfang@ahmu.edu.cn

中图分类号: R711.6
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- 被引次数: 0
出版历程
- 收稿日期: 2021-12-12
- 修回日期: 2022-02-13
- 网络出版日期: 2022-09-17
- 刊出日期: 2022-09-10

Relationship between marital adjustment and depression in infertile couples undergoing in vitro fertilization treatment for the first time based on the actor-partner interdependence model

1.
School of Nursing, Anhui Medical University, Hefei 230032, China
2.
Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, China
3.
Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China

Funds:

National Natural Science Foundation of China 72004001

Natural Science Research Project of Anhui Universities KJ2020A0203

Qingmiao Project of School of Nursing, Anhui Medical University hlqm2021018

More Information

Corresponding author: HONG Jing-fang, E-mail: hongjingfang@ahmu.edu.cn

摘要

摘要: 目的探讨首次行试管婴儿助孕的不孕不育夫妻婚姻调适和抑郁的主客体效应。方法采用一般资料问卷、医院焦虑抑郁量表(Hospital Anxiety and Depression Scale, HADS)、Locke-Wollance婚姻调适测定量表(the Locke Wollance Marital Adjustment Test Scale, LWMAT)对374对不孕不育夫妻进行调查, 通过主客体互倚模型分析夫妻双方婚姻调适与抑郁的路径关系。结果丈夫和妻子的婚姻调适能预测各自的抑郁(β=-0.378, P<0.001;β=-0.223, P<0.001)。丈夫和妻子的婚姻调适也能预测对方抑郁(β=-0.331, P<0.001;β=-0.161, P<0.001)。通过平等约束检验, 婚姻调适与抑郁间的主客体效应相似。结论不孕不育夫妻的抑郁与主体和客体的婚姻调适密切相关。因此, 应把不孕不育夫妻双方视为一个整体, 可为后期以夫妻为单位的干预方案提供理论依据。
- 不孕不育 /
- 试管婴儿胚胎移植技术 /
- 抑郁
Abstract: Objective To investigate the actor-partner effects of marital adjustment and depression on infertile couples who underwent in vitro fertilization (IVF)-assisted treatment for the first time. Methods A total of 374 infertile couples were investigated by general data questionnaire, hospital anxiety and depression scale (HADS) and the Locke Wollance marital adjustment test scale (LWMAT).The relationship between marital adjustment and depression was analyzed by the actor-partner interdependence model. Results Marital adjustment of husbands and wives predicted their own depression (β=-0.378, P<0.001;β=-0.223, P<0.001).The marital adjustment of husbands and wives also predicted their partners'depression (β=-0.331, P<0.001;β=-0.161, P<0.001).The actor-partner effects of marital adjustment and depression was similar tested by equality constraint. Conclusions There is a close relationship between the depression and marital adjustment of actor and partner among infertile couples, therefore they should be treated as a whole.The study has provided a theoretical basis for the later intervention program of couples as a unit.
- Infertility /
- In vitro fertilzation and embryo transfer /
- Depression

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图 1 主客体互倚模型示意图

注：APIM模型包涵4个变量，Y1(妻子抑郁)和Y2(丈夫抑郁)分别是个体A(妻子)和个体B(丈夫)的因变量，X1(妻子婚姻调适)和X2(丈夫婚姻调适)分别是妻子和丈夫的预测变量；a1和a2分别表示妻子和丈夫的主体效应，p21是妻子对丈夫的客体效应，p12是丈夫对妻子的客体效应；E1和E2分别是Y1和Y2的残差，C1和C2分别指两个自变量的相关性和两个残差项的相关性。

Figure 1. Schematic diagram of the actor-partner interdependence model

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表 1 374对不孕不育夫妻的一般资料[n(%)]

Table 1. General information of 374 infertile couples [n(%)]

变量	妻子	丈夫	t/X²	P值
年龄(x±s, 岁)	30.52±4.02	31.83±4.81	-8.384	＜0.001
文化程度			5.791	0.215
本科及以上	97(25.9)	114(30.5)
大专、高中及中专	158(42.3)	159(42.5)
初中及以下	119(31.8)	101(27.0)
就业状况			11.227	＜0.001
非在职	196(52.4)	74(19.8)
在职	178(47.6)	300(80.2)
结婚年限[M(P₂₅, P₇₅), 年]	4(3，6)	―
不孕年限[M(P₂₅, P₇₅), 年]	3(2，5)	―
家庭人均月收入(元)
0~5 000	205(54.8)	―
＞5 000~10 000	125(33.4)	―
＞10 000	44(11.8)	―
不孕原因
男方因素	56(14.9)	―
女方因素	179(47.9)	―
双方因素	75(20.1)	―
不明原因	64(17.1)	―
现存有无子女
有	78(20.9)	―
无	296(79.1)	―

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表 2 不孕不育夫妻的抑郁和婚姻调适的相关性分析

Table 2. Correlation analysis of depression and marital adjustment in 374 infertile couples

变量	抑郁 (妻子)	抑郁 (丈夫)	婚姻调适 (妻子)	婚姻调适 (丈夫)
抑郁(妻子)	1.000
抑郁(丈夫)	0.345 ^a	1.000
婚姻调适(妻子)	-0.363 ^a	-0.218 ^a	1.000
婚姻调适(丈夫)	-0.160 ^a	-0.316 ^a	0.337 ^a	1.000
注：^aP＜0.001.

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表 3 不孕不育夫妻的抑郁和婚姻调适得分情况(x±s)

Table 3. Depression and marital adjustment scores of infertile couples(x±s)

变量	妻子	丈夫	t值	P值
抑郁	5.80±3.78	5.97±3.65	-1.074	0.284
婚姻调适	100.43±25.96	105.51±23.73	-3.426	0.001

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表 4 374对不孕不育夫妻婚姻调适对抑郁的影响

Table 4. Effects of marital adjustment on depression in 374 infertile couples

变量	模型1		模型2		模型3		模型4
变量	偏回归系数	标准误	偏回归系数	标准误	偏回归系数	标准误	偏回归系数	标准误
主体效应
MATm→HADm	-0.378 ^a	0.048	-0.290 ^a	0.023	-0.307 ^a	0.027	-0.254 ^a	0.023
MATf→HADf	-0.233 ^a	0.042	-0.319 ^a	0.026	-0.304 ^a	0.021	-0.278 ^a	0.020
客体效应
MATm→HADf	-0.331 ^a	0.045	-0.223 ^a	0.029	-0.238 ^a	0.025	-0.267 ^a	0.020
MATf→HADm	-0.161 ^a	0.048	-0.246 ^a	0.027	-0.234 ^a	0.028	-0.265 ^a	0.024
模型拟合
X²值	―		2.618		1.797		3.637
df值	―		1.000		1.000		2.000
P值	―		0.998		0.180		0.162
X²/df值	―		2.618		1.797		1.814
CFI	―		0.998		0.999		0.986
TLT	―		0.990		0.995		0.977
RMSEA	―		0.071		0.050		0.105
SRMR	―		0.023		0.019		0.020
注：^a P＜0.001；―：空白项；MATm：丈夫的婚姻调适；HADf：妻子抑郁；MATf：妻子的婚姻调适；HADm：丈夫抑郁。

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