国际生殖健康/计划生育杂志

国际生殖健康/计划生育杂志 ›› 2026, Vol. 45 ›› Issue (3): 196-203.doi: 10.12280/gjszjk.20260008

• 论著 • 上一篇    下一篇

非标准产科抗磷脂综合征患者心理弹性通过应对方式影响妊娠压力的中介效应研究

林银翠, 滕伟, 陈燕, 王善林()   

  1. 510010 广州， 中国人民解放军南部战区总医院妇产科
  • 收稿日期:2026-01-09 出版日期:2026-05-15 发布日期:2026-06-02
  • 通讯作者: 王善林，E-mail：wang83210@126.com

Study on the Relationship among Pregnancy Stress, Psychological Resilience and Coping Styles in Patients with Non-Criteria Obstetric Antiphospholipid Syndrome

LIN Yin-cui, TENG Wei, CHEN Yan, WANG Shan-lin()   

  1. Department of Obstetrics and Gynecology, General Hospital of Southern Theater Command, Guangzhou 510010, China
  • Received:2026-01-09 Published:2026-05-15 Online:2026-06-02
  • Contact: WANG Shan-lin, E-mail: wang83210@126.com

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摘要：

目的： 探讨非标准产科抗磷脂综合征（non-criteria obstetric antiphospholipid syndrome，NCOAPS）患者妊娠压力、心理弹性及其应对方式的关系，并分析应对方式在心理弹性与妊娠压力间的中介作用。方法： 于2022年9月—2025年9月，通过便利抽样法选取收治的NCOAPS患者进行研究调查。运用一般资料调查问卷、妊娠压力量表（pregnancy pressure scale，PPS）、心理弹性量表（connor-davidson resilience scale，CD-RISC）、简易应对方式问卷（simplified coping style questionnaire，SCSQ）进行调查，并分析NCOAPS患者妊娠压力、心理弹性、应对方式三者之间的关系。结果： Pearson相关性分析显示，NCOAPS患者妊娠压力与心理弹性呈负相关（r=-0.624，P<0.001），与消极应对呈正相关（r=0.538，P<0.001），与积极应对呈负相关（r=-0.487，P<0.001）；心理弹性与消极应对呈负相关（r=-0.512，P<0.001），与积极应对呈正相关（r=0.596，P<0.001）。中介效应分析显示，NCOAPS患者心理弹性对妊娠压力的直接效应显著，效应值为-0.489（95%CI：-0.628~-0.350），占总效应的68.39%。消极应对与积极应对在心理弹性、妊娠压力之间存在部分中介效应，间接效应值分别为-0.130（95%CI：-0.209~-0.079）、-0.096（95%CI：-0.163~-0.042），间接效应分别占总效应的18.18%、13.43%，总间接效应为-0.226（95%CI：-0.312~-0.119），占总效应的31.61%。效应量评价结果显示，心理弹性与妊娠压力、积极应对、消极应对之间均存在大效应的相关关系（r≥0.50）。中介效应分析表明，消极应对（标准化效应=-0.164）和积极应对（标准化效应=-0.123）的单独中介效应均达到中等水平，总间接效应（标准化效应=-0.287）达到大效应水平。回归模型效应量评价显示，心理弹性对妊娠压力的预测作用为大效应（f 2=0.637，解释变异38.90%），在控制心理弹性后，消极应对的增量贡献为中等效应（f 2=0.232，增量解释变异14.20%），积极应对的增量贡献为小效应（f 2=0.091，增量解释变异5.60%）。结论： NCOAPS患者妊娠压力、心理弹性、应对方式三者之间关系密切，心理弹性可直接影响妊娠压力，也可通过积极应对和消极应对的中介作用间接影响妊娠压力，临床可通过提升患者心理弹性和积极应对能力、减少消极应对来缓解妊娠压力。

关键词: 应激, 心理学, 心理弹性, 应对方式, 中介效应, 非标准产科抗磷脂综合征, 妊娠压力

Abstract:

Objective: To explore the relationship among pregnancy stress, psychological resilience and coping styles in patients with non-criteria obstetric antiphospholipid syndrome (NCOAPS), and to analyze the mediating effect of coping styles between psychological resilience and pregnancy stress. Methods: From September 2022 to September 2025, the NCOAPS patients admitted to our hospital were selected for investigation by convenience sampling method. The general information questionnaire, pregnancy pressure scale (PPS), connor-davidson resilience scale (CD-RISC), and simplified coping style questionnaire (SCSQ) were used to investigate. The relationship among pregnancy stress, psychological resilience, and coping styles in NCOAPS patients was analyzed. Results: Pearson correlation analysis showed that pregnancy stress in NCOAPS patients was negatively correlated with psychological resilience (r=-0.624, P<0.001), positively correlated with negative coping (r=0.538, P<0.001), and negatively correlated with positive coping (r=-0.487, P<0.001); and that psychological resilience was negatively correlated with negative coping (r=-0.512, P<0.001) and positively correlated with positive coping (r=0.596, P<0.001). Mediation analysis showed that the direct effect of psychological resilience on pregnancy stress in NCOAPS patients was significant, with an effect value of -0.489 (95%CI: -0.628--0.350), accounting for 68.39% of the total effect. Negative coping and positive coping had partial mediating effects between psychological resilience and pregnancy stress, with mediating effect values of -0.130 (95%CI: -0.209--0.079) and -0.096 (95%CI: -0.163--0.042), accounting for 18.18% and 13.43% of the total effect, respectively. The total indirect effect was -0.226 (95%CI: -0.312--0.119), accounting for 31.61% of the total effect. Effect size evaluation showed that there were large effect correlations between psychological resilience and pregnancy stress, positive coping, and negative coping (r≥0.50). Mediation analysis indicated that the individual mediating effects of negative coping (standardized effect= -0.164) and positive coping (standardized effect=-0.123) both reached medium levels, and the total indirect effect (standardized effect=-0.287) reached a large effect level. Regression model effect size evaluation showed that the predictive effect of psychological resilience on pregnancy stress was large (f 2=0.637, explaining 38.90% of variance). After controlling the psychological resilience, the incremental contribution of negative coping was a medium effect (f 2=0.232, incremental variance explained=14.20%), and the incremental contribution of positive coping was a small effect (f 2=0.091, incremental variance explained=5.60%). Conclusions: Pregnancy stress, psychological resilience, and coping styles are closely related in NCOAPS patients. Psychological resilience can directly affect pregnancy stress, and can also indirectly affect pregnancy stress through the mediating effects of positive and negative coping. Clinically, pregnancy stress can be alleviated by enhancing patients' psychological resilience and positive coping abilities, and reducing negative coping.

Key words: Stress, psychological, Mental resilience, Coping styles, Mediating effect, Non-criteria obstetric antiphospholipid syndrome, Pregnancy stress