目的：探讨不孕女性生活事件、压力反应、应对方式与生育压力的关系及应对方式的中介效应。方法2015年8月—2016年2月选取在郑州大学第一附属医院生殖医学中心门诊就诊的初诊不孕女性进行调查。应用生活事件量表、压力反应问卷、特质应对问卷和生育压力量表对不孕女性进行调查，共发放问卷310份，收回有效问卷298份。运用结构方程模型分析不孕女性生活事件、压力反应、应对方式与生育压力的关系，分析积极应对和消极应对在不孕女性生育压力中的中介效应。结果生活事件总评分与社会压力、夫妻关系、性压力评分及生育压力总评分呈正相关（P ﹤0.05）；压力反应总评分与社会压力、夫妻关系、有孩子的生活方式、父母角色的需要、性压力评分及生育压力总评分呈正相关（P ﹤0.05）；积极应对评分与社会压力、夫妻关系、有孩子的生活方式、性压力评分及生育压力总评分呈负相关（P ﹤0.05）；消极应对评分与社会压力、夫妻关系、有孩子的生活方式、父母角色的需要、性压力评分及生育压力总评分呈正相关（P ﹤0.05）。生活事件、压力反应、积极应对和生育压力的结构方程模型拟合度较为理想，且积极应对对生育压力的中介效应显著（P ﹤0.05）。生活事件、压力反应、消极应对和生育压力的结构方程模型拟合度较为理想，但消极应对对生育压力的中介效应不显著（P ﹥0.05）。结论生活事件、压力反应、应对方式会影响不孕女性的生育压力，生活事件和压力反应还可以通过积极应对和消极应对影响不孕女性的生育压力，但是积极应对对生育压力的中介效应显著，消极应对对生育压力的中介效应不显著。%Objective To explore the mediating effects of coping strategies in the relationship between life events, stress reaction,coping strategies and infertility - related stress in infertile women. Methods A cross sectional study was conducted in 310 women initially diagnosed with infertility in Reproductive Medical Center of the First Affiliated Hospital of Zhengzhou University from August 2015 to February 2016 with life event scale( LES),stress reaction questionnaire( SRQ), coping strategies questionnaire(CSQ)and fertility problem inventory(FPI). Finally a total of 298 women returned responsive questionnaires. Structural equation model was used to analyze the relationship between life events,stress reaction,coping strategies and infertility - related stress,and the mediating effects of positive and negative coping strategies on infertility - related stress in infertile women. Results The total score of life events was positive correlated with the score of social pressure,marriage relationship and sexual pressure and the total score of infertility - related stress(P ﹤ 0. 05);the total score of coping strategies was positive correlated with the score of social pressure,marriage relationship,children's lifestyles,the need for parenthood and sexual pressure and the total score of infertility - related stress(P ﹤ 0. 05);the score of positive coping strategies was negative correlated with the score of social pressure,marriage relationship,children's lifestyles and sexual pressure and the total score of infertility - related stress( P ﹤ 0. 05);the score of negative coping strategies was positive correlated with the score of social pressure,marriage relationship,children' s lifestyles,the need for parenthood and sexual pressure and the total score of infertility - related stress( P ﹤ 0. 05). The fitting degree of structural equation model of life events,stress reaction,positive coping strategies and infertility - related stress was relatively ideal,and the mediating effects of positive coping strategies on infertility - related stress was significant( P ﹤ 0. 05). The fitting degree of structural equation model of life events,stress reaction,negative coping strategies and infertility - related stress was relatively ideal,but the mediating effects of negative coping strategies on infertility - related stress was not significant( P ﹥ 0. 05) . Conclusion Life events,stress reaction,coping strategies can affect infertility - related stress of infertile women,also life events,stress reaction can affect infertility - related stress of infertile women through positive and negative coping strategies. But the mediating effect of positive coping strategies is significant,while the mediating effect of negative coping strategies is not significant.
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