产妇怀孕压力对分娩后创伤性应激障碍的影响——家庭支持和应对方式的中介效应
Effects of Maternal Pregnancy Stress on Post-Traumatic Stress Disorder after Childbirth—Mediating Effects of Family Support and Coping Style

目的：探讨产妇怀孕压力、家庭支持、压力应对方式及分娩后创伤性应激障碍之间的关系，为制定促进产妇分娩后心理健康的干预方案提供依据。方法：采用便利抽样，选取湖北省十堰市三甲医院的352名产妇，应用怀孕压力量表、简易应对方式问卷、领悟社会支持量表和城市分娩创伤量表对其进行问卷调查，应用AMOS 26.0建立结构方程模型，分析四者之间的关系。结果：怀孕压力和消极应对方式与产妇分娩后创伤性应激障碍均呈正相关(r = 0.463、0.354, P < 0.01)；家庭支持和积极应对方式与产妇分娩后创伤性应激障碍均呈负相关(r = ？0.326、？0.312, P < 0.01)。家庭支持、积极应对和消极应对在产妇怀孕压力和分娩后创伤性应激障碍间起部分中介作用(0.140)，占总效应的28.79%。结论：可以通过增强产妇的家庭支持水平，促进产妇采取积极的压力应对方式和策略，来缓解产妇的压力，进而降低分娩后创伤性应激障碍的发生风险。
Objective: To explore the relationship between maternal pregnancy stress, family support, stress coping style and post-traumatic stress disorder after childbirth, so as to provide a basis for formulating intervention programs to promote maternal mental health after childbirth. Methods: A total of 352 postpartum women from the third-grade class-A hospital in Shiyan City of Hubei Province were selected by convenience sampling. They were investigated with the Pregnancy Stress Scale, Simplified Coping Style Questionnaire, Perceived Social Support Scale and City Birth Trauma Scale. AMOS 26.0 was used to establish a structural equation model to analyze the relationship among the variables. Results: Pregnancy stress and negative coping style were positively correlated with postpartum traumatic stress disorder (r = 0.463, 0.354, P < 0.01); family support and positive coping style were negatively correlated with postpartum traumatic stress disorder (r = ？0.326, ？0.312, P < 0.01). Family support, positive coping and negative coping played a partial mediating role between pregnancy stress and post-traumatic stress disorder (0.140), accounting for 28.79% of the total effect. Conclusion: We can reduce the risk of post-traumatic stress disorder by enhancing the level of maternal family support and promoting the adoption of positive stress coping strategies to relieve maternal stress.