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 (4): 276-281.doi: 10.12280/gjszjk.20260108

• 论著 • 上一篇    下一篇

高龄流产患者心理弹性的潜在转变及影响因素分析

刘薇薇, 罗少连, 孔燕清, 刘克玄()   

  1. 510515 广州， 南方医科大学护理学院（刘薇薇）；佛山市第一人民医院（南方科技大学附属佛山医院）计内妇科（刘薇薇，罗少连， 孔燕清）； 南方医科大学南方医院麻醉科（刘克玄）
  • 收稿日期:2026-03-06 出版日期:2026-07-15 发布日期:2026-07-27
  • 通讯作者: 刘克玄 E-mail:liukexuan705@163.com
  • 基金资助:
    佛山市自筹经费类科技创新项目(2420001003777)

Analysis of the Potential Changes in Psychological Resilience and Influencing Factors in Advanced Age Patients Undergoing Abortion

LIU Wei-wei, LUO Shao-lian, KONG Yan-qing, LIU Ke-xuan()   

  1. School of Nursing, Southern Medical University, Guangzhou 510515, China (LIU Wei-wei); Department of Internal Gynecology, The First People's Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), Foshan 528000, Guangdong Province, China (LIU Wei-wei, LUO Shao-lian, KONG Yan-qing); Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China (LIU Ke-xuan)
  • Received:2026-03-06 Published:2026-07-15 Online:2026-07-27
  • Contact: LIU Ke-xuan E-mail:liukexuan705@163.com

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摘要：

目的：调查高龄流产患者心理弹性随时间改变的类别转变，并分析影响类别转变的因素。方法：采用目的抽样法选择2024年2月—2025年2月在佛山市第一人民医院妇科门诊治疗的210例高龄流产人群为调查对象，应用心理弹性量表、社会支持评定量表、情绪调节策略问卷及家庭关怀度指数问卷在人工流产术后1周（T1）及6个月（T2）对患者进行追踪调查。采用潜在剖面分析和潜在转变分析探究高龄流产患者心理弹性的潜在类别及不同时间点的转变概率。采用多因素Logistic回归探讨社会支持、家庭关怀度及情绪调节策略对高龄流产患者心理弹性类别转变的影响。结果：高龄流产患者心理弹性可分为低弹性组、中等弹性组和高弹性组3个潜在剖面类别，各组在T1和T2时间点的占比分别为80.5%和13.4%、10.7%和35.6%、8.8%和51.0%。潜在转变分析结果显示，高弹性组在T2时间点保持原组的概率为100%，稳定性最强；中等弹性组稳定性最差，在T2时间点转变为高弹性组的概率为100%；低弹性组的稳定性较差，在T2时间点保持原组的概率为26.3%，向中等弹性组转变的概率为73.7%。多因素Logistic回归分析显示，社会支持、家庭关怀度和认知重评会促进低弹性向中等弹性（OR分别为1.306、2.165、1.171，均P<0.05）、中等弹性向高弹性（OR分别为1.169、2.195、1.426，均P<0.05）转变；表达抑制会阻止低弹性向中等弹性、中等弹性向高弹性转变（OR分别为0.862、0.889，均P<0.05）。结论：高龄流产患者心理弹性术后早期较差，多数患者可向更高弹性水平发展，但仍有部分低弹性患者未出现改善趋势。临床应关注其术后早期心理状态，通过改变社会支持、家庭关怀度及情绪调节策略等途径提高个体心理弹性水平。

关键词: 高龄, 流产, 心理弹性, 潜在类别分析, 纵向研究

Abstract:

Objective: To investigate the changes in the categories of psychological resilience in the advanced age patients with abortion over time, and to analyze the factors influencing the category transitions. Methods: A purposive sampling method was used to select 210 advanced age patients with abortion who were treated in the gynecology outpatient department of The First People's Hospital of Foshan from February 2024 to February 2025. The Connor-Davidson Resilience Scale, Social Support Rating Scale, Emotion Regulation Questionnaire and Family APGAR Index were used to conduct follow-up investigation at one week (T1) and six months (T2) after induced abortion. Latent profile analysis and latent transition analysis was employed to explore the latent categories of psychological resilience and the transition probabilities. Multivariate logistic regression was used to investigate the effects of social support, family care, and emotional regulation strategies on the category transitions of psychological resilience. Results: The psychological resilience of the advanced age patients with abortion can be classified into three potential profile categories: the low resilience group, the medium resilience group, and the high resilience group. The proportions of each group at the time points of T1 and T2 were 80.5% and 13.4%, 10.7% and 35.6%, and 8.8% and 51.0% respectively. The results of the latent transition analysis showed that the high resilience group had a 100% probability of remaining in the original group at the time point of T2, indicating the strongest stability; the medium resilience group had the poorest stability, with a 100% probability of transforming to the high resilience group at the time point of T2; the low resilience group had poorer stability, with a 26.3% probability of remaining in the original group and a 73.7% probability of transforming to the medium resilience group at the time point of T2. Multivariate logistic regression showed that social support, family care, and cognitive reappraisal would promote the transformations from low resilience to medium resilience (ORs of 1.306, 2.165, and 1.171, respectively, all P<0.05), and from medium resilience to high resilience (ORs of 1.169, 2.195, and 1.426, respectively, all P<0.05); and that expression inhibition would inhibit the transformations from low resilience to medium resilience, and from medium resilience to high resilience (ORs of 0.862 and 0.889, respectively, both P<0.05). Conclusions: The psychological resilience of advanced age patients who have undergone abortion is poorer in the early postoperative period. Most patients can develop to a higher level of resilience, but there are still some patients with low resilience who have not shown any improvement trend. Clinically, attention should be paid to their psychological state in the early postoperative period. By changing social support, family care, and emotional regulation strategies, the levels of individual psychological resilience can be improved.

Key words: Advanced age, Abortion, Psychological resilience, Latent class analysis, Longitudinal study