异地不孕不育夫妇IVF-ET治疗期间二元应对与焦虑、抑郁的主客体互倚模型研究

doi:10.12280/gjszjk.20260039

摘要/Abstract

摘要：

目的： 不孕夫妇的心理状态受双方二元应对方式的影响。基于主客体互倚模型（actor-partner interdependence model，APIM），探讨异地居住不孕不育夫妇体外受精-胚胎移植（in vitro fertilization-embryo transfer，IVF-ET）过程中双方二元应对方式对焦虑、抑郁的影响。方法： 选取2024年3月—8月于我院生殖医学科行IVF-ET的异地居住的不孕不育夫妇（187对）为研究对象，调查夫妻双方的年龄、不孕时间、焦虑自评量表（self-rating anxiety scale，SAS）、抑郁自评量表（self-rating depression scale，SDS）、二元应对量表（dyadic coping inventory，DCI），通过相关性分析和构建APIM探讨异地不孕不育夫妇二元应对方式对双方焦虑、抑郁的影响。结果： 女方焦虑者占比19.25%（36/187），抑郁者占比26.74%（50/187）。男方焦虑者占比1.07%（2/187），抑郁者占比15.51%（29/187）。无论男方和女方，不同异地时长组间SAS、SDS标准分均存在差异，异地时长>5年组最高，差异有统计学意义（P<0.05）。夫妻双方的SAS、SDS标准分与自身和配偶的DCI总分呈负相关（P<0.05）。APIM显示，男方负面情绪受到主体效应和客体效应的影响（P<0.05），女方仅受到自身主体效应的影响（P<0.05），客体效应不明显（P=0.128）。结论： 异地居住不孕不育夫妇二元应对方式，对男女双方的负面情绪具有不同程度的主客体效应，临床护理中需要重视男女双方二元应对差异，通过制定针对性护理方案以提升护理质量。

关键词: 体外受精, 胚胎移植, 焦虑, 抑郁, 二元应对, 主客体互倚模型

Abstract:

Objective: The psychological health status of infertile couples is affected by the dyadic coping. This study was designed to explore the impact patterns of dyadic coping on the anxiety and depression in non-cohabiting infertile couples undergoing in vitro fertilization-embryo transfer (IVF-ET), based on the actor-partner interdependence model (APIM). Methods: A total of 187 non-cohabiting infertile couples undergoing IVF-ET at the reproductive medicine department of our hospital from March to August 2024 were selected. Data on age, duration of infertility, self-rating anxiety scale (SAS), self-rating depression scale (SDS) and dyadic coping inventory (DCI) were collected. Correlation analysis and APIM were used to investigate the effects of dyadic coping on their negative emotions. Results: The prevalences of anxiety and depression were 19.25% (36/187) and 26.74% (50/187) in female partners, while 1.07% (2/187) and 15.51% (29/187) in male partners, respectively. In both male and female partners, the statistically significant differences were observed in SAS and SDS standard scores across different long-distance relationship duration groups, with the group of >5 years showing the highest scores (P<0.05). Standard scores of SAS and SDS in both spouses were negatively correlated with their own and their partners' total DCI scores (P<0.05). The APIM indicated that the negative emotions of the male partners were significantly influenced by both actor and partner effects (P<0.05). The negative emotions of female partners were only significantly influenced by their own actor effects (P<0.05), and the partner effects were not significant (P=0.128). Conclusions: Dyadic coping in non-cohabiting infertile couples exerts distinct actor and partner effects on the negative emotions, highlighting the need for tailored and evidence-based nursing interventions.

Key words: Fertilization in vitro, Embryo transfer, Anxiety, Depression, Dyadic coping, Actor-partner interdependence model

杜超, 程旭, 于鑫桐, 孙凯旋, 张倩, 周静. 异地不孕不育夫妇IVF-ET治疗期间二元应对与焦虑、抑郁的主客体互倚模型研究[J]. 国际生殖健康/计划生育杂志, 2026, 45(3): 190-195.

DU Chao, CHENG Xu, YU Xin-tong, SUN Kai-xuan, ZHANG Qian, ZHOU Jing. Research on Dyadic Coping and Anxiety/Depression in Separated Couples with Infertility Undergoing IVF-ET Based on Actor-Partner Interdependence Model[J]. Journal of International Reproductive Health/Family Planning, 2026, 45(3): 190-195.

图/表 6

参考文献 22

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特征	分组	男方	女方
年龄（岁）	<30	33	44
	30~35	110	108
	>35	44	35
学历	初高中	8	26
	大专或本科	166	140
	硕士及以上	13	21
职业	职员	0	87
	个体	0	13
	无业	0	75
	军人	187	12
婚姻状况	初婚	176	174
	再婚	11	13
收入（元/月）	<5 000	0	131
	5 000~10 000	54	40
	>10 000	133	16
DCI总分（分）	<111	20	38
	111~145	101	85
	>145	66	64
SAS标准分（分）	<50	185	151
	50~59	1	31
	60~69	1	3
	≥70	0	2
SDS标准分（分）	<53	158	137
	53~62	25	41
	63~72	4	7
	>72	0	2
异地时长（年）	<3	36
	3~5	119
	>5	32
见面频率（次/年）	<3	71
	3~5	52
	>5	64
沟通方式	电话	183
	视频	167
	信件	5
不孕时间（年）	<1	40
	1~3	83
	>3	64
不孕类型	原发性不孕	124
	继发性不孕	63
曾行IVF次数（次）	0	131
	1	30
	2	14
	≥3	12
治疗费用（元）	<10 000	84
	10 000~30 000	64
	>30 000	39

特征	分组	男方	女方
年龄（岁）	<30	33	44
	30~35	110	108
	>35	44	35
学历	初高中	8	26
	大专或本科	166	140
	硕士及以上	13	21
职业	职员	0	87
	个体	0	13
	无业	0	75
	军人	187	12
婚姻状况	初婚	176	174
	再婚	11	13
收入（元/月）	<5 000	0	131
	5 000~10 000	54	40
	>10 000	133	16
DCI总分（分）	<111	20	38
	111~145	101	85
	>145	66	64
SAS标准分（分）	<50	185	151
	50~59	1	31
	60~69	1	3
	≥70	0	2
SDS标准分（分）	<53	158	137
	53~62	25	41
	63~72	4	7
	>72	0	2
异地时长（年）	<3	36
	3~5	119
	>5	32
见面频率（次/年）	<3	71
	3~5	52
	>5	64
沟通方式	电话	183
	视频	167
	信件	5
不孕时间（年）	<1	40
	1~3	83
	>3	64
不孕类型	原发性不孕	124
	继发性不孕	63
曾行IVF次数（次）	0	131
	1	30
	2	14
	≥3	12
治疗费用（元）	<10 000	84
	10 000~30 000	64
	>30 000	39

组别	SAS			SDS
组别	标准分	F或t	P	标准分	F或t	P
年龄（岁）		0.348	0.706		3.242	0.041
<30	36.88±5.87			43.36±12.74
30~35	35.77±6.37			39.07±11.21
>35	35.91±8.08			36.86±9.83
学历		0.477	0.621		1.654	0.194
初高中	37.50±5.78			43.00±11.14
大专或本科	36.04±6.83			39.51±11.44
硕士及以上	34.62±5.65			34.46±9.06
收入（元/月）		3.548	<0.001		3.278	0.001
5 000~10 000	38.65±6.75			43.46±12.15
>10 000	34.92±6.40			37.62±10.56
异地时长（年）		4.323	0.015		4.483	0.013
<3	34.24±6.22			36.81±10.56
3~5	36.78±5.81			39.42±9.24
>5	37.76±6.34			43.06±9.33
见面频率（次/年）		0.767	0.534		0.292	0.253
<3	35.14±6.18			38.44±11.30
3~5	36.45±5.92			39.83±10.26
>5	35.95±6.55			39.08±11.01
不孕时间（年）		5.551	0.005		4.752	0.010
<1	33.74±6.64			36.07±10.94
1~3	37.64±6.71			41.99±11.01
>3	35.45±6.23			38.05±11.36
不孕类型		0.299	0.765		0.021	0.983
原发性不孕	36.10±6.44			39.32±11.01
继发性不孕	35.79±7.25			39.29±12.01
治疗费用（元）		1.352	0.261		0.012	0.988
<10 000	34.88±7.45			38.71±12.04
10 000~30 000	36.44±6.26			39.00±10.38
>30 000	36.72±5.97			38.85±10.98

组别	SAS			SDS
组别	标准分	F或t	P	标准分	F或t	P
年龄（岁）		0.348	0.706		3.242	0.041
<30	36.88±5.87			43.36±12.74
30~35	35.77±6.37			39.07±11.21
>35	35.91±8.08			36.86±9.83
学历		0.477	0.621		1.654	0.194
初高中	37.50±5.78			43.00±11.14
大专或本科	36.04±6.83			39.51±11.44
硕士及以上	34.62±5.65			34.46±9.06
收入（元/月）		3.548	<0.001		3.278	0.001
5 000~10 000	38.65±6.75			43.46±12.15
>10 000	34.92±6.40			37.62±10.56
异地时长（年）		4.323	0.015		4.483	0.013
<3	34.24±6.22			36.81±10.56
3~5	36.78±5.81			39.42±9.24
>5	37.76±6.34			43.06±9.33
见面频率（次/年）		0.767	0.534		0.292	0.253
<3	35.14±6.18			38.44±11.30
3~5	36.45±5.92			39.83±10.26
>5	35.95±6.55			39.08±11.01
不孕时间（年）		5.551	0.005		4.752	0.010
<1	33.74±6.64			36.07±10.94
1~3	37.64±6.71			41.99±11.01
>3	35.45±6.23			38.05±11.36
不孕类型		0.299	0.765		0.021	0.983
原发性不孕	36.10±6.44			39.32±11.01
继发性不孕	35.79±7.25			39.29±12.01
治疗费用（元）		1.352	0.261		0.012	0.988
<10 000	34.88±7.45			38.71±12.04
10 000~30 000	36.44±6.26			39.00±10.38
>30 000	36.72±5.97			38.85±10.98

组别	SAS			SDS
组别	标准分	F或t	P	标准分	F或t	P
年龄（岁）		1.025	0.361		0.894	0.411
<30	43.59±8.44			46.82±10.86
30~35	41.60±8.86			44.16±11.62
>35	41.09±8.88			44.09±12.51
学历		0.803	0.450		1.062	0.348
初高中	43.58±7.89			47.81±10.74
大专或本科	41.92±8.83			44.36±11.94
硕士及以上	40.33±9.46			43.71±10.23
收入（元/月）		3.080	0.048		2.769	0.065
<5 000	42.98±8.99			45.97±11.93
5 000~10 000	40.03±8.37			42.83±10.54
>10 000	38.63±6.26			39.81±10.05
异地时长（年）		5.024	0.008		6.324	0.002
<3	39.22±8.25			41.17±12.76
3~5	42.48±8.31			45.24±11.03
>5	45.46±7.99			48.37±11.28
见面频率（次/年）		1.785	0.171		0.292	0.253
<3	41.07±6.37			43.90±11.06
3~5	42.46±5.71			46.38±10.26
>5	43.81±6.49			39.08±11.01
不孕时间（年）		1.931	0.148		1.020	0.363
<1	39.91±9.38			42.37±12.31
1~3	42.23±8.85			45.29±11.55
>3	43.24±8.77			44.40±11.32
不孕类型		-2.168	0.031		-3.794	0.034
原发性不孕	40.99±8.26			43.49±11.60
继发性不孕	43.90±9.47			47.29±11.31
治疗费用（元）		2.436	0.090		1.971	0.142
<10 000	40.55±9.12			43.29±11.99
10 000~30 000	42.15±9.64			44.18±12.55
>30 000	43.74±7.66			47.06±10.77