初产妇分娩前心理状况及相关因素分析

目的　探讨分娩前初产妇焦虑、抑郁等精神障碍发生率及相关因素。方法　采用自制一般状况问卷、症状自评量表 (SCL 90 )、汉米顿焦虑量表 (HAMA)、汉米顿抑郁量表 (HAMD) ,对 2 0 0例临产初产妇心理状态进行调查分析。结果　可能有抑郁症状的 71例 ,占 35 .5 % ,轻中度抑郁的 9例 ,占 4 .5 %。可能有焦虑症状的 6 2例 ,占 31% ,肯定有焦虑的 14例 ,占7% ,有明显焦虑的 1例 ,严重焦虑的 1例 ,各占 0 .5 % .各组量表得分之间相关性良好 (P <0 .0 0 1)。单因素分析显示医疗费支付、家庭经济、公媳关系、对新生儿性别的期望、分娩后经济、社交能力等 6项因素与SCL 90总分有显著相关性。 8项因素与焦虑有相关性。有 6项因素与抑郁有相关性。多元逐步回归分析 ,丈夫职业 ,对分娩的心理准备 ,家中待产准备 ,家庭组成 ,公媳关系 ,对分娩后自身状况的关心与产前焦虑情绪有关。而对分娩的心理准备 ,婆媳关系 ,性格的内在表现 ,外在表现 ,与娘家关系与抑郁呈正相关 (P <0 .0 5 )。结论　产妇在产前存在较高的焦虑、抑郁等精神障碍发生率 ,且互相之间存在密切的相关性。提示妊娠期间进行心理卫生保健工作尤为重要。

The study of mental status and related factors of the antenatal women

Objective To explore the mental status and the related factors during antenatal period. Method 211 primiparae were evaluated by self-compiled questionnaires, Symptom Checklist 90 (SCL-90), Hamilton Anxiety Rating Scale (HAMA),and Hamilton Depression Rating Scale(HAMD).Result The incidence of anxiety or depression one week before delivery were 39% and 40% respectively. Single-factor analysis showed:6 factors were related with SCL-90 scores; 8 factors were correlated with anxiety and 6 factors were related with depression? Multi-factors analysis showed Husband's job, psychological preparation for the delivery, other preparations for the delivery , family type, relation with father-in-law and care for their physical status after delivery had a positive relationship with antenatal anxiety; psychological preparation for delivery, relation with mother-in-law, the inner-show of disposition and outer-show of disposition also positively related with depression; however the history of radioactive-rays contact negatively related with antenatal depression. Conclusion Higher incidence and risk factors of anxiety or depression before delivery were found in our study. They may be useful in antenatal psychological counseling.