Article(id=1241023939414127334, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202407545, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1722009600000, receivedDateStr=2024-07-27, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812764266, onlineDateStr=2026-03-18, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812764266, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812764266, creator=13701087609, updateTime=1773812764266, updator=13701087609, issue=Issue{id=1241023927812682133, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812761500, creator=13701087609, updateTime=1773812858867, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241024336258200259, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241024336258200260, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=465, endPage=470, ext={EN=ArticleExt(id=1241023939883889417, articleId=1241023939414127334, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Path analysis of fertility behavior influenced by childbirth fear and social support among nulliparous women of reproductive age, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To construct a structural equation model to explore the pathways of factors influencing fertility behavior among nulliparous couples of reproductive ages, providing direction for medical interventions aimed at fertility pathways.

Methods

A cross-sectional study was conducted using convenience sampling, selecting 400 nulliparous couples of reproductive ages from the permanent residents of Chengde city, Hebei Province. Data were collected through general demographic questionnaires, the Childbirth Fear Scale, the Social Support Rating Scale, the Fertility Motivation Questionnaire, and the Fertility Intention-Behavior Questionnaire. Path analysis and mediation effect testing were performed using structural equation modeling.

Results

The constructed structural equation model demonstrated good overall fit. Childbirth fear negatively predicted fertility motivation, intention, and behavior (β values of -0.245, -0.120, and -0.123, respectively), while social support positively predicted fertility motivation, intention, and behavior (β values of 0.247, 0.145, and 0.149, respectively). Fertility motivation positively predicted fertility intention (β value of 0.816), and fertility intention positively predicted fertility behavior (β value of 0.760).

Conclusion

Childbirth fear and social support among nulliparous couples of reproductive ages can indirectly influence fertility behavior through fertility motivation and intention. Medical institutions should strengthen collaboration with community efforts to develop targeted intervention measures that alleviate childbirth concerns among the reproductive population and promote positive fertility behaviors.

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目的

构建结构方程模型,探讨未育育龄夫妇生育行为影响因素的作用路径,为探索生育路径的医学干预手段提供方向。

方法

通过横断面研究,采用便利抽样,选取河北省承德市常住居民中的未育育龄夫妇400名作为研究对象,采用一般资料调查问卷、孕前分娩恐惧量表、社会支持评定量表、育龄青年生育动机问卷、生育意愿-行为问卷进行调查;采用结构方程模型进行路径分析及中介效应检验。

结果

构建的结构方程模型整体适配度较好,分娩恐惧负向预测生育动机、意愿、行为(β值分别为-0.245、-0.120、-0.123),社会支持正向预测生育动机、意愿、行为(β值分别为0.247、0.145、0.149),生育动机正向预测生育意愿(β值为0.816),生育意愿正向预测生育行为(β值为0.760)。

结论

未育育龄夫妇的分娩恐惧与社会支持可通过生育动机、生育意愿间接影响生育行为。医疗机构应加强与社区工作的结合,制定针对性的干预措施,降低育龄人群的分娩之忧,促进积极的生育行为。

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李青,E-mail:
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段婵芝(2000—),女,硕士在读,研究方向:女性健康

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Population Research, 2024, 48(2): 30-43.(In Chinese), articleTitle=The situation, influencing factors, and policy responses to singlehood, childlessness, and low fertility in China: findings from a specialized survey, refAbstract=null), Reference(id=1241023952072536677, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, doi=null, pmid=null, pmcid=null, year=2023, volume=45, issue=4, pageStart=30, pageEnd=40, url=null, language=null, rfNumber=[24], rfOrder=40, authorNames=乐菡, 杨昕, journalName=人口学刊, refType=null, unstructuredReference=乐菡, 杨昕.夫妻生育分歧对家庭生育行为的影响研究——解释生育意愿和生育行为偏离的新视角[J].人口学刊202345(4):30-40., articleTitle=夫妻生育分歧对家庭生育行为的影响研究——解释生育意愿和生育行为偏离的新视角, refAbstract=null), Reference(id=1241023952139645545, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, doi=null, pmid=null, pmcid=null, year=2023, volume=45, issue=4, pageStart=30, pageEnd=40, url=null, language=null, rfNumber=[24], rfOrder=41, authorNames=Yue H, Yang X, journalName=Population Journal, refType=null, unstructuredReference=Yue H, Yang X. The impact of fertility disagreement on behavior of couples: a new perspective to explain the deviation between fertility desire and behavior[J]. Population Journal, 2023, 45(4): 30-40.(In Chinese), articleTitle=The impact of fertility disagreement on behavior of couples: a new perspective to explain the deviation between fertility desire and behavior, refAbstract=null), Reference(id=1241023952210948716, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, doi=null, pmid=null, pmcid=null, year=2024, volume=30, issue=1, pageStart=2, pageEnd=12, url=null, language=null, rfNumber=[25], rfOrder=42, authorNames=王金营, 张龙飞, journalName=人口与发展, refType=null, unstructuredReference=王金营, 张龙飞.生育率回升的公共政策:约束、激励和扶持[J].人口与发展202430(1):2-12., articleTitle=生育率回升的公共政策:约束、激励和扶持, refAbstract=null), Reference(id=1241023952261280365, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, doi=null, pmid=null, pmcid=null, year=2024, volume=30, issue=1, pageStart=2, pageEnd=12, url=null, language=null, rfNumber=[25], rfOrder=43, authorNames=Wang JY, Zhang LF, journalName=Population and Development, refType=null, unstructuredReference=Wang JY, Zhang LF. Public policies for fertility recovery: constraints,incentives and support[J]. Population and Development, 2024, 30(1): 2-12.(In Chinese), articleTitle=Public policies for fertility recovery: constraints,incentives and support, refAbstract=null)], funds=[Fund(id=1241023947941146982, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, awardId=20230205120, language=CN, fundingSource=2023年度河北省社会科学发展研究课题(20230205120), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241023942090093503, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, xref=null, ext=[AuthorCompanyExt(id=1241023942123647937, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, companyId=1241023942090093503, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Nursing School, Chengde Medical College, Chengde, Hebei 067000, China), AuthorCompanyExt(id=1241023942140425154, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, companyId=1241023942090093503, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=承德医学院护理学院,河北 承德 067000)])], figs=[ArticleFig(id=1241023946317951208, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=EN, label=Figure 1, caption=Structural equation model for fertility behavior pathways, figureFileSmall=8a3cpNF134WfJ4w4wXQsfQ==, figureFileBig=3DDYY2KFscp3jg85hnSBqg==, tableContent=null), ArticleFig(id=1241023946422808815, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=CN, label=图1, caption=生育行为路径的结构方程模型

注:图示系数为标准化路径系数。

, figureFileSmall=8a3cpNF134WfJ4w4wXQsfQ==, figureFileBig=3DDYY2KFscp3jg85hnSBqg==, tableContent=null), ArticleFig(id=1241023946653495556, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=EN, label=Table 1, caption=

Score of each scale of childbearing age couples (n=400)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目维度得分范围得分(
分娩恐惧15~1645.91±9.89
恐惧疼痛与失控5~3022.49±5.31
恐惧并发症3~1814.20±3.08
恐惧身体变化2~129.23±2.31
社会支持18~5738.52±7.76
主观支持12~3222.26±3.92
客观支持1~188.54±3.28
社会支持利用度3~117.72±2.08
生育动机24~11569.30±19.19
传统观念类5~2513.66±4.83
效用类6~3015.87±4.22
自尊类5~2513.92±5.74
家庭和谐类4~2013.14±3.70
爱子女类4~2012.71±3.32
生育意愿3~159.13±3.75
理想意愿1~53.32±1.33
实际期望数量1~53.00±1.42
实际期望时间1~52.80±1.36
生育行为具体行为1~63.31±1.48
), ArticleFig(id=1241023946766741769, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=CN, label=表1, caption=

育龄夫妇各量表得分(n=400,分)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目维度得分范围得分(
分娩恐惧15~1645.91±9.89
恐惧疼痛与失控5~3022.49±5.31
恐惧并发症3~1814.20±3.08
恐惧身体变化2~129.23±2.31
社会支持18~5738.52±7.76
主观支持12~3222.26±3.92
客观支持1~188.54±3.28
社会支持利用度3~117.72±2.08
生育动机24~11569.30±19.19
传统观念类5~2513.66±4.83
效用类6~3015.87±4.22
自尊类5~2513.92±5.74
家庭和谐类4~2013.14±3.70
爱子女类4~2012.71±3.32
生育意愿3~159.13±3.75
理想意愿1~53.32±1.33
实际期望数量1~53.00±1.42
实际期望时间1~52.80±1.36
生育行为具体行为1~63.31±1.48
), ArticleFig(id=1241023946896765203, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=EN, label=Table 2, caption=

Correlation analysis among variables (r, n=400)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量社会支持分娩恐惧生育动机生育意愿生育行为
社会支持1
分娩恐惧-0.158**1
生育动机0.228**-0.265**1
生育意愿0.187**-0.271**0.745**1
生育行为0.269**-0.297**0.564**0.715**1
), ArticleFig(id=1241023946997428505, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=CN, label=表2, caption=

育龄夫妇生育路径各变量相关性分析(r, n=400)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量社会支持分娩恐惧生育动机生育意愿生育行为
社会支持1
分娩恐惧-0.158**1
生育动机0.228**-0.265**1
生育意愿0.187**-0.271**0.745**1
生育行为0.269**-0.297**0.564**0.715**1
), ArticleFig(id=1241023947123257635, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=EN, label=Table 3, caption=

Results of model fit evaluation

, figureFileSmall=null, figureFileBig=null, tableContent=
统计检验指标名称适配标准检验结果适配度评价
卡方自由度比(χ2/v<3.002.938理想
近似误差均方根(RMSEA)<0.080.070理想
拟合优度指数(GFI)>0.900.924理想
规范拟合指数(NFI)>0.900.944理想
拟合指数(CFI)>0.900.962理想
增值适配指数(IFI)>0.900.962理想
), ArticleFig(id=1241023947249086768, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=CN, label=表3, caption=

模型适配度评价结果

, figureFileSmall=null, figureFileBig=null, tableContent=
统计检验指标名称适配标准检验结果适配度评价
卡方自由度比(χ2/v<3.002.938理想
近似误差均方根(RMSEA)<0.080.070理想
拟合优度指数(GFI)>0.900.924理想
规范拟合指数(NFI)>0.900.944理想
拟合指数(CFI)>0.900.962理想
增值适配指数(IFI)>0.900.962理想
), ArticleFig(id=1241023947341361465, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=EN, label=Table 4, caption=

Model path coefficient

, figureFileSmall=null, figureFileBig=null, tableContent=
路径BCRPβ
分娩恐惧→生育动机-0.5700.125-4.553<0.001-0.245
生育动机→生育意愿0.2100.0135.706<0.0010.810
生育意愿→生育行为1.0270.0616.758<0.0010.760
社会支持→生育动机0.6930.1664.187<0.0010.247
), ArticleFig(id=1241023947513327946, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=CN, label=表4, caption=

模型路径系数

, figureFileSmall=null, figureFileBig=null, tableContent=
路径BCRPβ
分娩恐惧→生育动机-0.5700.125-4.553<0.001-0.245
生育动机→生育意愿0.2100.0135.706<0.0010.810
生育意愿→生育行为1.0270.0616.758<0.0010.760
社会支持→生育动机0.6930.1664.187<0.0010.247
), ArticleFig(id=1241023947626574166, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=EN, label=Table 5, caption=

Analysis of the mediation effects

, figureFileSmall=null, figureFileBig=null, tableContent=
效应类型效应路径效应值(95%CI
直接效应A→B-0.245(-0.359~-0.130)
B→C0.810(0.752~0.859)
C→D0.760(0.700~0.811)
E→B0.247(0.122~0.369)
间接效应A→B→C-0.120(-0.189~-0.059)
E→B→C0.145(0.070~0.227)
A→B→C→D-0.123(-0.196~-0.061)
E→B→C→D0.149(0.072~0.236)
总效应A→D-0.123(-0.196~-0.061)
E→D0.149(0.072~0.236)
), ArticleFig(id=1241023947781763419, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023939414127334, language=CN, label=表5, caption=

中介效应分析

, figureFileSmall=null, figureFileBig=null, tableContent=
效应类型效应路径效应值(95%CI
直接效应A→B-0.245(-0.359~-0.130)
B→C0.810(0.752~0.859)
C→D0.760(0.700~0.811)
E→B0.247(0.122~0.369)
间接效应A→B→C-0.120(-0.189~-0.059)
E→B→C0.145(0.070~0.227)
A→B→C→D-0.123(-0.196~-0.061)
E→B→C→D0.149(0.072~0.236)
总效应A→D-0.123(-0.196~-0.061)
E→D0.149(0.072~0.236)
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基于分娩恐惧与社会支持的未育育龄夫妇生育行为路径分析
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段婵芝 , 王艳 , 李曼茹 , 李青
现代预防医学 | 儿少卫生与妇幼保健 2025,52(3): 465-470
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现代预防医学 | 儿少卫生与妇幼保健 2025, 52(3): 465-470
基于分娩恐惧与社会支持的未育育龄夫妇生育行为路径分析
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段婵芝, 王艳, 李曼茹, 李青
作者信息
  • 承德医学院护理学院,河北 承德 067000
  • 段婵芝(2000—),女,硕士在读,研究方向:女性健康

通讯作者:

李青,E-mail:
Path analysis of fertility behavior influenced by childbirth fear and social support among nulliparous women of reproductive age
Chan-zhi DUAN, Yan WANG, Man-ru LI, Qing LI
Affiliations
  • Nursing School, Chengde Medical College, Chengde, Hebei 067000, China
出版时间: 2025-02-10 doi: 10.20043/j.cnki.MPM.202407545
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目的

构建结构方程模型,探讨未育育龄夫妇生育行为影响因素的作用路径,为探索生育路径的医学干预手段提供方向。

方法

通过横断面研究,采用便利抽样,选取河北省承德市常住居民中的未育育龄夫妇400名作为研究对象,采用一般资料调查问卷、孕前分娩恐惧量表、社会支持评定量表、育龄青年生育动机问卷、生育意愿-行为问卷进行调查;采用结构方程模型进行路径分析及中介效应检验。

结果

构建的结构方程模型整体适配度较好,分娩恐惧负向预测生育动机、意愿、行为(β值分别为-0.245、-0.120、-0.123),社会支持正向预测生育动机、意愿、行为(β值分别为0.247、0.145、0.149),生育动机正向预测生育意愿(β值为0.816),生育意愿正向预测生育行为(β值为0.760)。

结论

未育育龄夫妇的分娩恐惧与社会支持可通过生育动机、生育意愿间接影响生育行为。医疗机构应加强与社区工作的结合,制定针对性的干预措施,降低育龄人群的分娩之忧,促进积极的生育行为。

生育动机  /  生育意愿  /  生育行为  /  分娩恐惧  /  社会支持
Objective

To construct a structural equation model to explore the pathways of factors influencing fertility behavior among nulliparous couples of reproductive ages, providing direction for medical interventions aimed at fertility pathways.

Methods

A cross-sectional study was conducted using convenience sampling, selecting 400 nulliparous couples of reproductive ages from the permanent residents of Chengde city, Hebei Province. Data were collected through general demographic questionnaires, the Childbirth Fear Scale, the Social Support Rating Scale, the Fertility Motivation Questionnaire, and the Fertility Intention-Behavior Questionnaire. Path analysis and mediation effect testing were performed using structural equation modeling.

Results

The constructed structural equation model demonstrated good overall fit. Childbirth fear negatively predicted fertility motivation, intention, and behavior (β values of -0.245, -0.120, and -0.123, respectively), while social support positively predicted fertility motivation, intention, and behavior (β values of 0.247, 0.145, and 0.149, respectively). Fertility motivation positively predicted fertility intention (β value of 0.816), and fertility intention positively predicted fertility behavior (β value of 0.760).

Conclusion

Childbirth fear and social support among nulliparous couples of reproductive ages can indirectly influence fertility behavior through fertility motivation and intention. Medical institutions should strengthen collaboration with community efforts to develop targeted intervention measures that alleviate childbirth concerns among the reproductive population and promote positive fertility behaviors.

Fertility motivation  /  Fertility intention  /  Fertility behavior  /  Childbirth fear  /  Social support
段婵芝, 王艳, 李曼茹, 李青. 基于分娩恐惧与社会支持的未育育龄夫妇生育行为路径分析. 现代预防医学, 2025 , 52 (3) : 465 -470 . DOI: 10.20043/j.cnki.MPM.202407545
Chan-zhi DUAN, Yan WANG, Man-ru LI, Qing LI. Path analysis of fertility behavior influenced by childbirth fear and social support among nulliparous women of reproductive age[J]. Modern Preventive Medicine, 2025 , 52 (3) : 465 -470 . DOI: 10.20043/j.cnki.MPM.202407545
国家统计局最新数据显示,2023年我国人口自然增长率为-1.48‰,相比2022年再次下降了0.88‰[1]。针对当前生育困境,学术界展开了广泛且深入的研究。然而,研究焦点多聚焦于再生育意愿[2-3],对初育人群的研究相对匮乏。生育动机作为生育逻辑链的先导环节决定了后续的生育意愿和行为[4-6],且与需求满足密切相关[7]。分娩恐惧作为生育过程中的一种情感反应,往往与安全需求的缺失紧密相关。研究显示,分娩恐惧不仅会影响女性在孕前、孕中和分娩后的健康,同样也是无指征剖宫产的常见原因[8]。同时,与分娩有关的恐惧在男性群体中也较为显著[9]。社会支持作为重要的外部因素,能够帮助个体相信自己受到关心、爱护和尊重,对增强生育动机具有重要作用[10]。然而,目前关于分娩恐惧和社会支持对生育行为的影响路径虽有部分理论支持,但缺乏相关实证研究。鉴于此,本研究旨在以医学和社会学相结合的视角,聚焦分娩恐惧和社会支持,采用结构方程模型,以生育动机为起点探讨未育育龄夫妇生育行为的路径机制,为生育政策的落实和具体实施提供参考。
便利抽取河北省承德市未育育龄夫妇400名。纳入标准:(1)年龄介于22~40周岁;(2)已婚;(3)本社区居住时间≥6个月;(4)自愿参与本研究。排除标准:(1)已育;(2)本人(伴侣)正处于孕期;(3)视听障碍者;(4)认知精神障碍者。本研究共计23个变量,样本含量取研究变量的10~15倍,考虑20%的无效问卷,计算样本量为288~431名,最终纳入400名研究对象。本研究已通过承德医学院伦理委员会审查(CYFYLL2023851)。
在査阅相关文献的基础上,结合专家意见,自行设计。主要包括年龄、性别、民族、居住地、兄弟姐妹数量、文化程度、职业和家庭人均月收入。
采用乔佳等[9]于2020年引进汉化版本,包括对疼痛和失控、并发症、分娩后身体变化的恐惧3个维度,10个条目。Likert 6级评分,总分10~60分,得分在第75百分位数或以上的受访者被认为对分娩有高度恐惧。本研究中量表的Cronbach α为0.916,Bartlett球形检验KMO值为0.941(P<0.001),信效度较好。
采用肖水源等[11]于1986年编制版本,包括客观支持、主观支持和支持利用度3个维度,10个条目。Likert 4级评分,得分越高支持水平越高,≤22分低水平,23~44分中等水平,45~64分高水平。本研究中量表的Cronbach α为0.783,Bartlett球形检验KMO值为0.828(P<0.001),信效度较好。
采用方力维[12]等于2017年编制版本,包括传统观念、生活和谐、爱子女、自尊、效用5个维度,24个条目。Likert 5级评分,得分越高,生育动机越强。本研究中问卷的Cronbachα系数为0.930,Bartlett球形检验KMO值为0.947(P<0.001),信效度较好。
参考Miller的TDIB(Traits -Desires -Intentions -Behavior)生育序列模型及相关文献[6],并根据我国生育意愿和生育行为[13]的定义自行设计形成,包括两个维度,4个条目。生育意愿三个条目分别为“理想状态下,您生育意愿的强烈程度”“您实际对多孩家庭的期望程度”“您实际期望生育的紧迫程度”;Likert 5级评分,得分越高,生育意愿越强。生育行为一个条目“您目前是否有生育准备?”;采用6级计分,1~6分别代表“没有,我在避孕”“没有,有时避孕有时不避孕”“没有,没有避孕”“有,被动备孕”“有,有时主动备孕有时被动备孕”“有,主动备孕”,得分越高,生育行为越积极。问卷的Cronbach α系数为0.903,Bartlett球形检验KMO值为0.838(P<0.001),信效度较好。
2023年11月—2024年4月对承德市413名未育育龄夫妇开展问卷调查,问卷当场发放,当场收回。具体地,我们鼓励夫妇双方均填写,以确保数据的全面性和准确性。然而,由于实际操作中的限制,部分问卷可能仅由夫妇中的一方填写。共发放413份问卷,回收有效问卷400份,有效回收率为96.9%。
采用SPSS 26.0进行描述性分析,符合正态分布的计量资料用()描述,计数资料用频数、构成比描述。相关性分析采用Pearson相关系数。采用AMOS 26.0构建结构方程模型,应用Bootstrap法检验中介效应。检验水准α=0.05。
男性159人,占39.8%,女性241人,占60.3%;年龄<30岁者340人,占85%,≥30岁者60人,占15%;汉族386人,占96.5%,其他民族14人,占3.5%;居住地为农村者145人,占36.3%,居住地为城市者255人,占63.7%;独生子女95人,占23.8%,兄弟姐妹数量为1者191人,占47.8%,2者95人,占23.8%,≥3者19人,占4.8%;本科及以上者256人,占64%,专科者93人,占23.3%,高中者36人,占9%,初中及以下者15人,占3.8%;在岗326人,占81.5%,离职17人,占4.3%,无业57人,占14.2%;月收入<3 000元者35人,占8.8%,3 000~5 000元者122人,占30.5%,≥5 000元者243人,占60.8%。
本研究发现,承德市未育育龄夫妇的分娩恐惧得分为(45.91±9.89)分,处于较高水平,其中有230人处于高度恐惧,社会支持得分为(38.52±7.76)分,生育动机得分为(69.30±19.19)分,生育意愿得分为(9.13±3.75)分,生育行为得分为(3.31±1.48)分,均处于中等水平。见表1
Pearson相关性分析显示,未育育龄夫妇分娩恐惧与社会支持、生育动机、生育意愿、生育行为负相关(P<0.05);社会支持与生育动机、生育意愿、生育行为正相关(P<0.001);生育动机与生育意愿、生育行为正相关(P<0.001)。见表2
基于文献回顾和相关性分析结果确定研究变量,通过M.I(modification indices)指数修正后,整体模型适配度检验结果如表3所示,得到了生育行为的结构方程模型,见图1。修正后模型拟合良好,适配指标均满足要求,可进行下一步分析。
非标准化结果显示所有路径均高度显著(P<0.001),为确保各路径效应的可比性,本研究采用标准化路径结果进行分析。结果显示,分娩恐惧对生育动机有直接负向影响(β=-0.245,P<0.001);社会支持对生育动机有直接正向影响(β=0.247,P<0.001);生育动机对生育意愿有直接正向影响(β=0.810,P<0.001);生育意愿对生育行为有直接正向影响(β=0.760,P<0.001);分娩恐惧、社会支持对生育行为有间接影响(β=-0.123、0.149,均P<0.001);分娩恐惧、社会支持对生育意愿见图1表45
本研究显示,未育育龄夫妇生育行为得分为(3.31±1.48)分,属中等水平。与相关研究仅讨论生育结果不同[14-15],本研究探讨了导致生育结果的中介行为,直观地反映了生育行为现状。尽管本研究的调查对象已迈入婚育的初步阶段,却展现出推迟生育的倾向。这与余靖雯等[16]的研究一致,我国育龄青年呈现出明显的晚育趋势。分析原因或许可从生育观念的变迁中探寻,调查对象中高等教育者占比较大,部分个体结婚的主要目的是获得精神价值,而不再将生育作为婚姻的必需品[17]。同时,该群体也并未全然排斥生育,这与我国普婚普育的传统文化相一致,在国家大力建设生育支持服务体系下,部分人群对生育健康、育儿负担等方面的顾虑缓解,促进了意愿向行为的转化[16]。因此,在关注育龄群体生育观念变化的同时,仍要继续完善生育支持政策,合作发挥政府、社区、医疗等组织的优势,为有生育之忧的人群提供支持,并通过文化建设传递积极向上的生育观念。
路径分析显示,分娩恐惧在生育路径中具有直接和间接效应,既直接负向作用于生育动机,还可间接影响生育意愿与行为。作为即将面临生育抉择的未育人群(尤其是女性),高水平的分娩恐惧扩大了她们的不确定感与不安全感[18],促使其产生消极的生育动机与低迷的生育意愿,进而推迟甚至避免妊娠[19]。同时,研究发现,未育人群会参考他人分娩经验[20]。因此,社区医务人员应重视育龄夫妇的心理健康,帮助他们正确认识分娩,对高恐惧者实施干预,通过线上线下相结合的形式,在社区开展讲座、经验分享。同时,还可设立互联网平台供答疑解惑、咨询交流,并对已育人群及时进行心理健康筛查及疏导,减轻分娩恐惧,减少负面信息的传播。
本研究中,社会支持通过增强生育动机提升生育意愿并改变生育行为。研究显示,良好的社会支持意味着社交网络和家庭结构的相对完整,可获取的实质性帮助和情感支持较多[21],是推动和引导意愿转换为行为的有利因素[22]。因此,社区工作者应关注低支持度人群,积极优化生育支持方案。今后可进一步深化医疗与社区的结合,将人民群众可获得的医疗服务扩大化、多样化。同时,针对“想生不敢生”“想生不能生”等人群采取对应的干预措施,充分利用医院、社区提供的相关支持性服务提高其社会支持水平。
在生育行为路径中,动机作为原动力刺激了意愿。本研究中生育动机对生育意愿具有最强直接效应,提示我们需深入探究生育动机的制约与提升因素,建议可从动机的五个维度着手,开展新的研究。此外,研究结果显示,未育育龄夫妇的生育动机与意愿均处于中等水平,这可能是导致生育行为并不积极的一大原因。与先前研究一致[5,23],动机的改变以及意愿的下降会导致生育时间的推迟或生育数量的下降。然而,需要注意的是,生育行为可能受到更多复杂现实因素的影响[24],需进一步的研究来揭示。因此,在强调个人动机与意愿提升的同时,应继续完善社会生育保障体系,加强优生优育服务建设,提供高质量的生育体验服务,增强科学备孕意识。优化生殖健康服务,通过提高避孕服务质量,有效减少意外妊娠的发生,进一步地降低由此导致的人工流产率,降低不孕不育的风险,规范不孕不育诊治服务[25]。同时,继续建设生育友好型社会,通过政策引导和社会宣传,提升生育价值感。
本研究通过构建结构方程模型明确了分娩恐惧、社会支持、生育动机、生育意愿对生育行为的作用路径,发现分娩恐惧负向影响生育动机,社会支持则正向影响,同时,二者通过生育动机和生育意愿间接影响生育行为。鉴于本文研究对象来源单一,样本代表性受限。未来我们将扩大抽样范围,并开展未育与已育人群的对比研究。最后,还可开展纵向研究以进一步探讨生育行为各变量随时间变化的趋势,为未来的研究和实践提供更有力的依据。
  • 2023年度河北省社会科学发展研究课题(20230205120)
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doi: 10.20043/j.cnki.MPM.202407545
  • 接收时间:2024-07-27
  • 首发时间:2026-03-18
  • 出版时间:2025-02-10
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  • 收稿日期:2024-07-27
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2023年度河北省社会科学发展研究课题(20230205120)
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    承德医学院护理学院,河北 承德 067000

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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