| 摘要 | 国家实施二胎政策后，更多人关注到孕妇这个群体。怀孕是孕妇的一个重大应激性生活事件，会影响孕妇的心理健康，特别是孕期睡眠质量对母婴的身体健康和心理健康均有重要影响。有研究表明，孕期压力和抑郁情绪是影响睡眠质量的两个重要心理因素。本研究旨在考察孕妇的知觉压力、抑郁情绪和睡眠质量现状及其影响因素，并探讨知觉压力、抑郁情绪和睡眠质量之间的关系，以及抑郁情绪在知觉压力和睡眠质量之间是否起到中介作用，从而为孕妇的睡眠质量干预提供进一步的理论依据和新的思路。
本研究的研究对象为387名来自全国各地的孕妇，采用自编问卷对孕妇的一般人口学和产科学资料进行调查，采用知觉压力量表(PSS-10), Zung氏抑郁自评量表(SDS)、匹兹堡睡眠质量指数量表(PSQI)对孕妇的知觉压力、抑郁情绪和睡眠质量进行调查，运用统计分析、单因素方差分析、相关分析、回归分析、中介分析探讨知觉压力、抑郁情绪和睡眠质量的现状及其影响因素，进一步探索三者之前的相关关系及中介作用，得出如下结果:
(1)孕期睡眠质量问题发生率为42.64% 0165/387)，睡眠质量总分的平均值为6.4 ( SD3.446)分。一般人口学变量的工作状态(p=0.002 )、孕周(p=0.001)对睡眠质量总分的影响存在显著性差异。
(2)孕期知觉压力的平均值为14.42 ( SD7.880 )分。一般人口学变量的受教育水平(p=0.001)、工作状态(p <0.001)、家庭年收入(p<0.001)、家庭关系(p<0.001)、孕周(p=0.012 )、新冠感染情况(p=0.027)对知觉压力的影响存在显著性差异。
(3)孕期抑郁情绪的检出率为46% 0178/387)，其中轻度抑郁情绪33.1%，中度抑郁情绪12.4%，重度抑郁情绪0.5%，抑郁情绪得分的平均值为50.88(SD10.378 )分。一般人口学变量的受教育水平(p<0.001)、工作状态(p<0.001) ,家庭年收入(p<0.001)、家庭关系(p<0.001)、妊娠合并症(p=0.036 )对抑郁情绪的影响存在显著性差异。
(4)知觉压力与睡眠质量总分之间存在显著正相关关系(Y=0.239,p<0.001),抑郁情绪与睡眠质量总分之间存在显著正相关关系(r=0.298, p<0.001)，知觉压力与抑郁情绪之间存在显著正相关关系(r=0.699, p<0.001) 。
(5)抑郁情绪在知觉压力与睡眠质量总分之间起到完全中介作用。
上述研究结果说明了孕妇睡眠质量、知觉压力和抑郁情绪的现状及影响因素，也反应了它们之间存在两两正相关关系，孕期抑郁情绪在知觉压力与睡眠质量之间起到完全中介作用，知觉压力对睡眠质量的影响机制之一为可通过中介变量抑郁情绪产生影响。本研究探索性的证明了抑郁情绪在知觉压力和睡眠质量之间起到完全中介作用，进一步丰富了在孕妇心理健康领域的研究成果，为孕妇睡眠质量问题的干预提供了进一步的理论依据和新的思路。 |
| 其他摘要 | With the implementation of the national two-child policy, more attention has been paid to pregnant women as a group. Pregnancy is a major stressful life event for pregnant women, which can affect their mental health, especially the quality of sleep during pregnancy has an important impact on both the physical and mental health of the mother and child. Some studies have shown that pregnancy stress and depression are two important psychological factors that affect sleep quality. The aim of this study was to examine the current situation of perceived stress, depression d and sleep quality in pregnant women and their influencing factors, and to investigate the relationship between perceived stress, depression and sleep quality, and whether depression plays a mediating role between perceived stress and sleep quality, so as to provide further theoretical basis and new ideas for sleep quality intervention in pregnant women.
In this study, 387 pregnant women from China were surveyed using a self-administered questionnaire on general demographic and obstetric data of pregnant women, and the Perceived Stress Scale (PSS一10), Zung's Self-Rating Depression Inventory (SDS), and Pittsburgh Sleep Quality Index (PSQI) were used to investigate perceived stress, depression, and sleep quality of pregnant women, using statistical analysis, One-way ANOVA, correlation analysis, regression analysis, and mediation analysis were used to explore the current status of perceived stress, depression, and sleep quality and their influencing factors, and further explore the previous correlations and mediating effects of the three, and the following results were obtained:
(1) The prevalence of sleep quality problems during pregnancy was 42.64% (165/387), and the mean of total sleep quality score was 6.4 (SD3.446) points. There were significant differences in the effects of general demographic variables of work status (p=0.002) and week of pregnancy (p=0.001) on the total sleep quality score.
(2) The mean value of perceived stress during pregnancy was 14.42 (SD 7.880) points. There were significant differences in the effects of general demographic variables of education level (p=0.001), work status (p<0.001), annual family income (p<0.001), family relationships (p<0.001), week of pregnancy (p=0.012), and new crown infection (p=0.027) on perceived stress.
(3) The detection rate of depression during pregnancy was 46% (178/387), with 33.1%mild depression, 12.4% moderate depression, and 0.5% severe depression, and the mean depression score was 50.88 (SD10.378) points. There were significant differences in the effects of general demographic variables of education level (p<0.001), work status (p<0.001), annual household income (p<0.001), family relationships (p<0.001), and pregnancy comorbidity (p=0.036) on depressed mood.
(4) There was a significant positive correlation between perceived stress and total sleep quality score (Y=0.239, p<0.001), depression and total sleep quality score (Y=0.298, p<0.001), and a significant positive correlation between perceived stress and depression (Y=0.699, p<0.001).
(5) Depression played a fully mediating role between perceived stress and total sleep quality score.
The above findings illustrate the current status and influencing factors of sleep quality, perceived stress and depression in pregnant women, and also reflect the existence of a two-by-two positive correlation between them, with depression during pregnancy playing a fully mediating role between perceptual stress and sleep quality, and one of the mechanisms by which perceived stress affects sleep quality can be influenced by the mediating variable depression. The present study demonstrates that depression plays a fully mediating role between perceived stress and sleep quality, which further enriches the research results in the field of maternal mental health and provides further theoretical basis and new ideas for the intervention of maternal sleep quality problems. |
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