以质量求发展，以服务铸品牌

护理学报 ›› 2022, Vol. 29 ›› Issue (9): 58-63.doi: 10.16460/j.issn1008-9969.2022.09.058

• 调查研究 • 上一篇    下一篇

父亲抑郁情绪和家庭功能在早产儿母亲抑郁情绪与母婴情感联结间的中介效应

罗爽, 尹华英, 雷莉, 王海梅   

  1. 重庆医科大学附属儿童医院 儿童青少年生长发育与心理健康中心,重庆 400014
  • 收稿日期:2021-11-01 出版日期:2022-05-10 发布日期:2022-06-09
  • 通讯作者: 尹华英（1964-）,女,四川彭州人,本科学历,教授,硕士研究生导师。E-mail:sarah6524@126.com
  • 作者简介:罗爽（1994-）,女,四川渠县人,本科学历,硕士研究生在读,护士。
  • 基金资助:
    重庆市教委护理学“十三五”重点学科资助项目（2019hlxk03）; 重庆市2020年科卫联合医学科研项目（2020MSXM019）

Mediating Effect of Paternal Depression and Family Function between Maternal Depression and Mother-Infant Bonding after Discharge of Preterm Infants

LUO Shuang, YIN Hua-ying, LEI Li, WANG Hai-mei   

  1. Dept. of Children Development and Psychology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
  • Received:2021-11-01 Online:2022-05-10 Published:2022-06-09

PDF (PC)

656

赞

摘要： 目的 探究父亲抑郁情绪和家庭功能在早产儿母亲抑郁情绪与母婴情感联结的中介效应。方法 便利抽样选取2020年7月—2021年1月在重庆市某三级儿童医院新生儿科治疗后出院的早产儿的父母作为调查对象,母亲完成一般资料调查表、抑郁自评量表、家庭功能量表、中文版母婴依恋量表,父亲完成抑郁自评量表,采用SPSS24.0分析父亲抑郁、母亲抑郁、家庭功能与母婴情感联结之间的相关性;采用AMOS 24.0对中介假设进行检验。结果 早产儿父亲抑郁情绪、母亲抑郁情绪、家庭功能、母婴情感联结总分分别为（49.34±11.69）分、（53.02±11.62）分、（2.28±0.31）分、（78.54±14.73）分;母婴情感联结总分与父亲抑郁、母亲抑郁、家庭功能总分均呈负相关（r=-0.272、-0.331、-0.174,均P<0.01）;母亲抑郁情绪对母婴情感联结有直接负向预测作用（β=-0.299,P<0.001）;父亲抑郁情绪和家庭功能在母亲抑郁情绪与母婴情感联结间起部分中介作用,中介效应值为-0.082,效应占比36.52%。结论 早产儿父母的抑郁情绪显著高于国内常模,家庭功能处于中等偏低水平,母婴情感联结处于中等偏上水平,父母的抑郁情绪和家庭功能可直接或间接影响母婴情感联结,出院后除了要关注患儿的生长发育和疾病康复,还应重视父母的情绪疏导、家庭功能和母婴依恋情感的建立,以期促进早产儿心理行为的发展。

关键词: 早产儿, 出院后, 父母抑郁, 家庭功能, 母婴情感联结, 中介效应

Abstract: Objective To explore the mediating effect of paternal depression and family function between maternal depression and mother-infant bonding after the discharge of preterm infants. Methods With convenience sampling, the parents of premature infants discharged from the neonatal center of a tertiary children's hospital were investigated from July 2020 to January 2021. Mothers completed the Self-rating Depression Scale, Family Assessment Device and Chinese version of Maternal Attachment Inventory and fathers completed the Self-rating Depression Scale. Results The total score of paternal depression, maternal depression, family function and mother-infant bonding were 49.34±11.69, 53.02±11.62, 2.28±0.31, 78.54±14.73, respectively. Paternal depression, maternal depression and family function were negatively correlated with the mother-infant bonding(r=-0.272,-0.331,-0.174,all P<0.01). Maternal depression had a directly negative predictive effect on mother-infant emotional connection (β=-0.299,P<0.001); paternal depression and family function played a partial mediating role between maternal depression and mother-infant bonding, with mediating effect value of -0.082, and the proportion of the mediating effect was 36.52%. Conclusion Depression of parents of preterm infants is significantly higher than domestic norm and family function is at a medium low level. Parents' depression and family function can directly or indirectly affect the establishment of the mother-infant bonding. Medical staff should pay attention to the life care and disease rehabilitation after the discharge of preterm infants as well as parents' emotion counseling, family function and the establishment of mother-infant bonding in order to promote the development of premature infants' physiological and psychological behavior.

Key words: preterm infant, post-discharge, parental depression, family function, mother-infant bonding, mediating effect

中图分类号: 

  • R473.72
[1] Bicking KC, Hupcey JE.State of the Science of Maternal-infant Bonding: A Principle-based Concept Analysis[J].Midwifery,2013,29(12):1314-1320.DOI:10.1016/j.midw.2012.12.019.
[2] Ramsdell EL, Brock RL.Interparental Relationship Quality During Pregnancy: Implications for Early Parent-infant Bonding and Infant Socioemotional Development[J]. Fam Process,2021,60(3):966-983.DOI:10.1111/famp.12599.
[3] Le Bas GA, Youssef GJ, Macdonald JA, et al.Maternal Bonding, Negative Affect, and Infant Social-emotional Development: A Prospective Cohort Study[J]. J Affect Disord,2021,281:926-934.DOI:10.1016/j.jad.2020.11.031.
[4] Loe IM, Heller NA, Chatav M.Behavior Problems and Executive Function Impairments in Preterm Compared to Full Term Preschoolers[J].Early Hum Dev,2019,130:87-95.DOI:10.1016/j.earlhumdev.2019.01.014.
[5] Hee CE, Chou J, Brown KA.Neurodevelopmental Outcomes of Preterm Infants: A Recent Literature Review[J]. Transl Pediatr, 2020, 9(S1):S3-S8.DOI:10.21037/tp.2019.09.10.
[6] 蒋盘华,陶亚琴,凌慧.新生儿ICU早产儿母亲焦虑抑郁及影响因素分析[J].护理学报, 2017,24(17):43-47.DOI:10.16460/j.issn1008-9969.2017.17.043.
[7] Salome S, Mansi G, Lambiase CV, et al.Impact of Psychological Distress and Psychophysical Wellbeing on Posttraumatic Symptoms in Parents of Preterm Infants after NICU Discharge[J].Ital J Pediatr,2022,48(1):13.DOI:10.1186/s13052-022-01202-z.
[8] Pace CC, Spittle AJ, Molesworth CM, et al.Evolution of Depression and Anxiety Symptoms in Parents of Very Preterm Infants During the Newborn Period[J]. JAMA Pediatrics,2016,170(9):863-870.DOI:10.1001/jamapediatrics.2016.0810.
[9] Ramchandani PG, Psychogiou L, Vlachos H, et al.Paternal Depression: An Examination of Its Links with Father, Child and Family Functioning in the Postnatal Period[J]. Depress Anxiety,2011,28(6):471-477.DOI:10.1002/da.20814.
[10] Paulson JF, Bazemore SD.Prenatal and Postpartum Depression in Fathers and Its Association with Maternal Depression: A Meta-analysis[J].JAMA,2010,303(19):1961-1969.DOI:10.1001/jama.2010.605.
[11] Cheng Y, Zhang L, Wang F, et al.The Effects of Family Structure and Function on Mental Health During China’s Transition: A Cross-sectional Analysis[J].BMC Fam Pract,2017,18(1):59.DOI:10.1186/s12875-017-0630-4.
[12] 张清,倪志红,赵雪萍.新生儿重症监护室早产儿家庭功能水平及其影响因素分析[J].现代临床护理,2021,20(7):9-16.DOI:10.3969/j.issn.1671-8283.2021.07.002.
[13] Huang Y, Liu Y, Wang Y, et al.Family Function Fully Mediates the Relationship Between Social Support and Perinatal Depression in Rural Southwest China[J]. BMC Psychiatry,2021,21(1):151.DOI:10.1186/s12888-021-03155-9.
[14] Guan Z, Wang Y, Hu X, et al.Postpartum Depression and Family Function in Chinese Women within 1 Year after Childbirth: A Cross-sectional Study[J]. Res Nurs Health,2021,44(4):633-642.DOI:10.1002/nur.22159.
[15] 中华医学会妇产科学分会产科学组.早产临床诊断与治疗指南(2014)[J].中华围产医学杂志,2015,18(4):241-245.DOI:10.3760/cma.j.issn.1007-9408.2015.04.01.
[16] 倪平,陈京立,刘娜.护理研究中量性研究的样本量估计[J].中华护理杂志,2010,45(4):378-380.DOI:10.3761/j.issn.0254-1769.2010.04.037.
[17] Zung WW.A Self-Rating Depression Scale[J].Arch Gen Psychiatry,1965,12(1):63-70.DOI:10.1001/archpsyc.1965.01720310065008.
[18] Müller ME.Prenatal and Postnatal Attachment: A Modest Correlation[J].J Obstet Gynecol Neonatal Nurs,1996,25(2):161-166.DOI:10.1111/j.1552-6909.1996.tb02420.x.
[19] Chen CJ, Sung HC, Chen YC, et al.The Development and Psychometric Evaluation of the Chinese Version of the Maternal Attachment Inventory[J].J Clin Nurs,2013,22(19-20):2687-2695.DOI:10.1111/jocn.12162.
[20] Epstein NB, Baldwin LM, Bishop DS.The McMaster Family Assessment Device[J]. J Marital Fam Ther,1983,9(2):171-180.DOI:10.1111/j.1752-0606.1983.tb01497.x.
[21] 李荣风,徐夫真,纪林芹,等.家庭功能评定量表的初步修订[J].中国健康心理学杂志,2013, 21(7):996-1000.DOI:10.13342/j.cnki.cjhp.2013.07.003.
[22] 汤丹丹,温忠麟.共同方法偏差检验:问题与建议[J].心理科学,2020,43(1):215-223.DOI:10.16719/j.cnki.1671-6981.20200130.
[23] 吴明隆. 结构方程模型:AMOS的操作与应用[M].重庆:重庆大学出版社.2010:52-53.
[24] 雷莉,尹华英,谭巨丹,等.NICU早产儿住院期间母婴依恋关系现状及影响因素研究[J].护理学杂志, 2020,35(24):77-80.DOI:10.3870/j.issn.1001-4152.2020.24.077.
[25] Zengin AP, Bahtiyar SB,Ilter BE,et al.Longitudinal Changes in Attachment Patterns of Preterm Infants Born in a Non-western Country[J].Infant Ment Health J,2021,42(4):517-528.DOI:10.1002/imhj.21906.
[26] 朱长缨,杨丽全,李真真.新生儿重症监护病房早产儿父母的心理健康状况调查[J].牡丹江医学院学报,2015,36(5):100-104+107.DOI:10.13799/j.cnki.mdjyxyxb.2015.05.040.
[27] 宁时安,李琳琳,王茹霞,等.早产儿父亲创伤后成长体验的质性研究[J].解放军护理杂志,2021,38(7):56-59. DOI:10.3969/j.issn.1008-9993.2021.07.014.
[28] Ohoka H, Koide T, Goto S, et al.Effects of Maternal Depressive Symptomatology During Pregnancy and the Postpartum Period on Infant-mother Attachment[J]. Psychiatry and Clin Neurosci,2014, 68(8):631-639.DOI:10.1111/pcn.12171.
[29] Barnes J, Theule J.Maternal Depression and Infant Attachment Security: A Meta-analysis[J]. Infant Ment Health J,2019,40(6):817-834.DOI:10.1002/imhj.21812.
[30] 姚莉莉,赵敏慧.极低出生体重早产儿出院后父母育儿压力的研究进展[J].中华现代护理杂志,2020,26(33):4707-4711.DOI:10.3760/cma.j.cn115682-20200116-00244.
[31] Hossain Z, Field T, Gonzales J, et al.Infants of “Depressed” Mothers Interact Better with Their Non-depressed Fathers[J]. Infant Ment Health J,1994,15(4):348-357.DOI:10.1002/1097-0355(199424)15:4<348::AID-IMHJ2280150404>3.0.CO;2-Y.
[32] 葛宾倩,李惠玲,万慎娴,等.产褥期在院产妇配偶体验及其护理需求的质性研究[J]. 中华现代护理杂志, 2019(7):900-903.DOI:10.3760/cma.j.issn.1674-2907.2019.07.025.
[33] Stefana A, Padovani EM, Biban P, et al.Fathers’ Experiences with Their Preterm Babies Admitted to Neonatal Intensive Care Unit :A Multi-method Study[J]. J Adv Nurs,2018,74(5):1090-1098.DOI:10.1111/jan.13527.
[34] Granero-Molina J, Fernández Medina IM, Fernández-Sola C,et al.Experiences of Mothers of Extremely Preterm Infants after Hospital Discharge[J]. J Pediatr Nurs,2019,45:e2-e8.DOI:10.1016/j.pedn.2018.12.003.
[35] 段小凤,王燕,李胜玲,等.早产儿母亲心理弹性与家庭功能的关系[J].中华行为医学与脑科学杂志,2020,29(4):356-360.DOI:10.3760/cma.j.cn371468-20190730-00498.
[36] Bick J, Palmwood EN, Zajac L, et al.Early Parenting Intervention and Adverse Family Environments Affect Neural Function in Middle Childhood[J]. Biol Psychiatry,2019,85(4):326-335.DOI:10.1016/j.biopsych.2018.09.020.
[37] de Vries EE, Verlinden M, Rijlaarsdam J, et al. Like Father, like Child: Early Life Family Adversity and Children’s Bullying Behaviors in Elementary School[J]. J Abnorm Child Psychol,2018,46(7):1481-1496.DOI:10.1007/s10802-017-0380-8.
[1] 王利敏, 方继红, 武凤芹, 朱晶, 陈婉宣. 运动恐惧在学龄期四肢骨折患儿自我效能与早期功能锻炼依从性间的中介效应[J]. 护理学报, 2025, 32(3): 1-5.
[2] 王子萱, 原振青, 赵一鋆, 王惠平, 洪菲菲, 邹敏. 体面劳动感在三级甲等医院手术室护士反思能力与创新行为的中介效应[J]. 护理学报, 2025, 32(1): 62-67.
[3] 刘莉, 于卫华, 肖娟, 汪阿慧, 凌雅. 便利蜷曲联合甜味剂棉签减轻早产儿气管内吸痰疼痛的效果研究[J]. 护理学报, 2024, 31(9): 10-14.
[4] 纪锐婷, 林丹娜, 刘小成, 李婷婷, 谢映梅, 胡冰, 应文娟. 早产儿初乳口腔免疫疗法的最佳证据总结[J]. 护理学报, 2024, 31(8): 37-42.
[5] 李爱群, 李利花, 王芳, 蒋源元, 蔡益民. 慢性病资源利用在冠心病PCI术后患者自我超越与自我管理行为间的中介效应[J]. 护理学报, 2024, 31(6): 13-17.
[6] 米娇, 谭煜炜, 唐小燕, 刘蕾, 袁榕. 负性情绪在ICU护士心理负荷与报警疲劳的中介效应[J]. 护理学报, 2024, 31(3): 68-72.
[7] 江艳, 唐文娟, 赵海燕, 范巧玲. 新生儿营养风险筛查工具的研究进展[J]. 护理学报, 2024, 31(22): 26-29.
[8] 罗苏娴, 曾超男, 张静华, 白阳娟, 周洁. 护士长真实型领导与护士角色模糊和离职倾向的关系研究[J]. 护理学报, 2024, 31(2): 44-47.
[9] 魏海霞, 谢小敏, 马姣媚, 李国曦, 罗燕, 江逊. 四步高位灌肠法对早产儿胎粪排出延迟的效果观察[J]. 护理学报, 2024, 31(17): 69-72.
[10] 梁琪, 王冰洁, 刘洋, 张春梅. 智谋在老年结直肠癌造口患者病耻感与社会隔离的中介效应[J]. 护理学报, 2024, 31(14): 19-23.
[11] 齐柯雯, 吴慧颖. 新入职护士的患者安全文化感知在道德敏感性与安全行为间的中介作用[J]. 护理学报, 2024, 31(10): 8-12.
[12] 雷青, 雷小平, 佘桂芳, 李娜, 王娅鑫, 孙鸿燕. NICU中住院早产儿多感官刺激的最佳证据总结[J]. 护理学报, 2024, 31(10): 48-52.
[13] 闵瑰, 汪爱琴, 唐婷. 职业召唤在养老护理员体面劳动感知与工作投入间的中介效应[J]. 护理学报, 2024, 31(1): 69-73.
[14] 罗仕妙, 林美珍, 王慧欣, 练柳兰, 刘杨晨, 胡喜燕, 龚小珍, 魏琳. 新入职护士自主学习能力在组织支持与职业韧性的中介作用[J]. 护理学报, 2023, 30(9): 55-59.
[15] 谭剑, 孔雪二, 侯璇璇. 工作满意度在护士心理弹性与职业倦怠间的中介效应[J]. 护理学报, 2023, 30(8): 69-73.
Viewed
Full text


Abstract

Cited
  Shared   
No Suggested Reading articles found!