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題名 | 婦女流產及死胎後之心身適應=Psychiatric Morbidity and Associated Psychosocial Characteristics of Women with Pregnancy Loss |
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作者 | 陳映燁; 李明濱; 李宇宙; 曾美智; | 書刊名 | 臺灣精神醫學 |
卷期 | 12:3 1998.09[民87.09] |
頁次 | 頁22-34 |
分類號 | 419.74 |
關鍵詞 | 懷孕失敗; 心理社會因素; 因應策略; 精神病理; Pregnancy loss; Psychosocial factors; Coping strategy; Psychiatric morbidity; |
語文 | 中文(Chinese) |
中文摘要 | 目的:探討婦女懷孕失敗後易併發的心身症狀,並試圖尋找影響心身適應相關之心 理社會因素。方法:針對1994年6月至1997年7月因懷孕失敗(包括流產、胎死腹中、子宮外 孕、葡萄胎等)至婦產科住院處理之305位個案,以郵寄問卷的方式,寄發與心身適應相關 內容之問卷,問卷內容除基本資料外,尚包括系列標準化之評量表,評量個案之精神病理 (Brief Symptom Rating Scale, BSRS)、性格特質(MPI)、疾病因應策略(coping strategy) 與家庭功能(Family APGAR Index);匿名回函資料完整之個案共60位,為本研究之分析對象 。結果:以簡式症狀量表(BSRS)之一航症狀指數(GSI)得分與無精神科診斷之身體疾病住院 病人相對照,發現本研究對象中有28.3%的個案有明顯之心身症狀,得分最高之症狀向度為敵 意及強迫症狀,各佔28.3%。影響心身適應之主要因素包括性格特質、有無宗教信仰與因應策 略類型;神經質傾向較明顯、無宗教信仰或使用宿命-屈從之因應策略者,其精神症狀較為 嚴重,此三變項可解釋精神症狀嚴重度68.0%的變異量。此外,家庭功能差者敵意較強; 75.0%的婦女覺得在住院過程中家人能給予支持,僅有46.7%之婦女覺得醫護人員曾給予支持 。結論:本研究顯示懷孕失敗容易造成婦女之心身適應障礙;神經質傾向、無宗教信仰與使 用宿命-屈從之因應策略者為發生精神症狀之危險因子。本研究結果提示成立婦產科-精神 科聯合照會小組之迫切性,以提供懷孕失敗婦女更專業、更全面性之照護。 |
英文摘要 | Objectives:Pregnancy loss has been reported to be associated with a high risk of psychiatric morbidity in western populations. This study examined the psychiatric morbidity and associated psychosocial features of women who experienced pregnancy loss within the three years prior to study. Methods: Three hundred and five women hospitalized for treatment of pregnancy loss in the obstetric wards of National Taiwan University Hospital between June 1994 and July 1997 were selected and sent a set of questionnaire by mail. The questionnaire contained personal and basic clinical information as well as standardized reliable self-rating scales for assessing psychopathology (Brief Symptom Rating Scale, BSRS), personality traits (modified MPI), family function (Family APGAR Index), and coping strategies. A total of sixty subjects who returned and completed the questionnaire were included in the analysis. Results : The results of measures based on the general severity index (GSI) of the BSRS, compared with those of medically ill inpatients without a formal diagnosis of psychiatric disorder, indicated that 28.3% of the subjects experienced significant psychiatric morbidity. The prevalence of marked psychiatric symptoms were in the following order: hostility (28.3%), obsession (28.3%), interpersonal sensitivity (23.3%),suspiciousness (20%), depression (21.7%), and phobia (20.0%). Psychosocial features including specific personality traits, religious beliefs and coping strategies were significantly associated with the severity of psychiatric morbidity. Subjects with a higher neuroticism score had a greater frequency of using the coping strategy of fatalism-resignation. Subjects without religious beliefs presented with psychopathology of significantly greater severity. These three features accounted for 68% of the total variance in the severity of psychopathology based on GSI of BSRS. In addition, seventy-five percent of the subjects felt their family members were supportive and only 46.7% thought the medical staff gave them adequate support during their hospital stay. Conclusion: Pregnancy loss was associated with higher incidence of psychiatric morbidity. Subjects with neuroticism, without religious belief and using the coping strategy of fatalism-resignation were at increased risk of developing psychiatric morbidity. The findings of the study suggest the importance of the implementation of psychiatric-obstetric consultation liaison services for women with pregnancy loss.(Full Text in Chinese) |
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