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Article(id=1322607958463197874, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202506325, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750348800000, receivedDateStr=2025-06-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793263910164, onlineDateStr=2026-10-29, pubDate=1761321600000, pubDateStr=2025-10-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793263910164, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793263910164, creator=13701087609, updateTime=1793263910164, updator=13701087609, issue=Issue{id=1322607837742747790, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='20', pageStart='3649', pageEnd='3840', issueExtLink='null', onlineDate='null', pubDate='1761321600000', pubDateStr='2025-10-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793263881383, creator='13701087609', updateTime=1793264238791, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322609336933794638, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322609336933794639, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3719, endPage=3724, ext={EN=ArticleExt(id=1322607958932959923, articleId=1322607958463197874, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Investigation on the current situation of disease perceived stress in primary infertility patients of childbearing age and analysis of its relationship with marital support and coping, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the status quo of disease perception stress of primary infertility patients in childbearing age, and analyze the relationship between it and couples’ support and coping.

Methods

A total of 798 primary infertility patients of childbearing age admitted to the hospital from January 2023 to January 2025 were selected for the study. The General information Questionnaire, the Simplified version of the Disease Perception Questionnaire (BIPQ) scale, the Marital Support Coping (DCI) Scale, and the Stigma Scale for Female Infertility Patients (ISS) were used for the investigation.

Results

The BIPQ score of primary infertility in childbearing age was (55.67±6.43), and the pressure of disease perception was high. Pearson correlation analysis showed that BIPQ score was negatively correlated with DCI score (r=-0.243) and positively correlated with ISS score (r=0.309) (P<0.05). The results of multiple linear regression analysis showed that the higher the age, the higher the stress of patients (B=2.996, 95% CI: 2.349-3.642), the higher the educational level, the lower the pressure (B=-2.149,95% CI: -2.831--1.468), the higher the pressure of patients who think that childbirth is the most important thing in life (B=4.969, 95% CI:4.277-5.661), and the worse the relationship between husband and wife, the higher the pressure (B=2.396, 95% CI: 1.692-3.100), the higher the DCI score, the lower the stress (B=-0.044, 95% CI:-0.065--0.022), and the higher the ISS score, the higher the stress(B=0.077, 95% CI:0.055-0.099) (P<0.05).

Conclusion

The primary infertility patients in childbearing age have a high level of disease perception pressure, so we should focus on those who are older, have low educational level, have a traditional concept of fertility, have poor relationship between husband and wife and have a high sense of shame, and formulate corresponding intervention strategies to improve the mental health level of patients.

, authors=Lin-lin QIU, Ying WANG, Hong-li NIU, Li-yang XING, authorsList=Lin-lin QIU, Ying WANG, Hong-li NIU, Li-yang XING, authorCompany=null, correspAuthors=Ying WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322607961592148668, articleId=1322607958463197874, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=育龄期原发不孕患者疾病感知压力现状及其与夫妻支持应对关系的关系分析, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

探究育龄期原发不孕患者的疾病感知压力现状，分析与夫妻支持应对关系的关系。

方法

2023年1月～2025年1月某医院收治的798育龄期原发不孕患者为研究对象，使用一般资料调查表、疾病感知问卷简化版（BIPQ）量表、夫妻支持应对（DCI）量表和女性不孕症患者病耻感量表（ISS）进行调查。

结果

育龄期原发不孕患者BIPQ评分（55.67±6.43）分。BIPQ评分与DCI评分为负相关（r=-0.243），与ISS评分为正相关（r=0.309）（P<0.05）。多元线性回归分析结果显示，年龄越高的患者压力越高（B=2.996，95% CI：2.349～3.642），文化水平越高的患者压力越低（B=-2.149，95% CI：-2.831～-1.468），认为生育是人生中最重要事情的患者压力更高（B=4.969，95% CI：4.277～5.661），夫妻关系越差压力越高（B=2.396，95% CI：1.692～3.100）, DCI评分越高压力越低（B=-0.044，95% CI：-0.065～-0.022），ISS评分越高压力越高（B=0.077，95% CI：0.055～0.099）（P<0.05）。

结论

育龄期原发不孕患者疾病感知压力水平较高，应重点关注年龄较高、文化水平低、传统生育观念、夫妻关系较差及病耻感高的人群，制定相应干预策略以改善患者心理健康水平。

, authors=邱琳琳, 王颖, 钮红丽, 邢黎阳, authorsList=邱琳琳, 王颖, 钮红丽, 邢黎阳, authorCompany=null, correspAuthors=王颖, authorNote=

邱琳琳（1989—），女，本科，主管护师，研究方向：生殖护理

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王颖，E-mail:
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European Journal of Oncology Nursing, 2024, 70: 102622., articleTitle=Relationship between family resilience and dyadic coping in colorectal cancer patients and their spouses, based on the actor-partner interdependence model, refAbstract=null), Reference(id=1322607970400187149, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, doi=null, pmid=null, pmcid=null, year=2020, volume=41, issue=7, pageStart=736, pageEnd=741, url=null, language=null, rfNumber=[31], rfOrder=38, authorNames=李荣, 李婷, 杨贵仙, journalName=广东医学, refType=null, unstructuredReference=李荣，李婷，杨贵仙. 团体心理辅导联合家属陪伴对体外受精-胚胎移植孕妇负性情绪及母婴结局的影响 [J]. 广东医学, 2020, 41 (7): 736-741., articleTitle=团体心理辅导联合家属陪伴对体外受精-胚胎移植孕妇负性情绪及母婴结局的影响, refAbstract=null), Reference(id=1322607970530210574, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, doi=null, pmid=null, pmcid=null, year=2020, volume=41, issue=7, pageStart=736, pageEnd=741, url=null, language=null, rfNumber=[31], rfOrder=39, authorNames=Li R, Li T, Yang GX, journalName=Guangdong Medical Journal, refType=null, unstructuredReference=Li R, Li T, Yang GX. Effects of group psychological counseling and family companionship on negative emotions and mother-infant outcomes in IVF-embryo transfer pregnant women [J]. Guangdong Medical Journal, 2020, 41 (7): 736-741. (In Chinese), articleTitle=Effects of group psychological counseling and family companionship on negative emotions and mother-infant outcomes in IVF-embryo transfer pregnant women, refAbstract=null), Reference(id=1322607970609902351, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, doi=null, pmid=null, pmcid=null, year=2022, volume=26, issue=2, pageStart=13, pageEnd=25, url=null, language=null, rfNumber=[32], rfOrder=40, authorNames=Küçükkaya M, Kılıç M, journalName=African Journal of Reproductive Health, refType=null, unstructuredReference=Küçükkaya M, Kılıç M. The effect of stigma on level of infertility-related psychological distress in women with infertility [J]. African Journal of Reproductive Health, 2022, 26 (2): 13-25., articleTitle=The effect of stigma on level of infertility-related psychological distress in women with infertility, refAbstract=null)], funds=[Fund(id=1322607965727732454, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, awardId=LHGJ20200904, language=CN, fundingSource=河南省医学科技攻关计划联合共建项目(LHGJ20200904), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322607961806058173, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, xref=null, ext=[AuthorCompanyExt(id=1322607961814446782, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, companyId=1322607961806058173, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Reproductive Medicine, Nanyang First People’s Hospital, Nanyang, Henan 473000, China), AuthorCompanyExt(id=1322607961818641087, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, companyId=1322607961806058173, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=南阳市第一人民医院生殖医学科，河南　南阳　473000)])], figs=[ArticleFig(id=1322607963399893724, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, language=EN, label=Table 1, caption=

Current situation of disease perception stress in primary infertility patients of childbearing age

, figureFileSmall=null, figureFileBig=null, tableContent=
项目总分得分条目均分
认知维度32.56±5.426.43±1.08
情绪维度14.58±2.147.18±1.13
理解能力维度6.26±1.036.26±1.03
), ArticleFig(id=1322607963462808285, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, language=CN, label=表1, caption=

育龄期原发不孕患者疾病感知压力现状（，n=798）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目总分得分条目均分
认知维度32.56±5.426.43±1.08
情绪维度14.58±2.147.18±1.13
理解能力维度6.26±1.036.26±1.03
), ArticleFig(id=1322607963529917150, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, language=EN, label=Table 2, caption=

Perceived stress levels of primary infertility patients of childbearing age with different demographic characteristics[n（%），（）]

, figureFileSmall=null, figureFileBig=null, tableContent=
特征n=798BIPQ总分（分）统计值P值
年龄（岁）t=7.611<0.001
20～30337（42.23）54.37±5.21
31～40461（57.77）57.62±6.45
文化水平F=69.347<0.001
初中及以下310（38.85）58.52±7.34
高中及中专305（38.22）55.62±6.42
大专及以上183（22.93）51.28±5.47
居住地F=0.4020.669
农村247（30.95）55.82±6.47
城镇205（25.69）56.14±6.24
城市346（43.36）55.62±6.85
户籍性质t=0.4040.686
农村315（39.47）55.43±6.44
城市483（60.53）55.24±6.53
在职状态F=0.2820.754
待业141（17.67）55.82±6.31
在职444（55.64）55.77±6.78
自由职业/其他213（26.69）56.18±6.62
家庭月收入（元/月）F=1.0260.359
<4 000184（23.06）56.15±6.42
4 000～<6 000224（28.07）55.75±6.24
≥6 000390（48.87）56.53±6.77
婚姻史t=0.5840.559
初婚562（70.43）55.85±6.23
再婚236（29.57）56.14±6.78
婚龄（年）F=1.4530.235
<3173（21.68）56.74±6.34
3～<5251（31.45）55.82±6.41
≥5374（46.87）55.82±6.17
家庭类型F=0.1630.850
只和丈夫居住472（59.15）55.84±6.52
与父母或公婆同住234（29.32）56.07±6.14
混合大家庭92（11.53）55.67±6.13
不孕年限（年）F=0.5440.581
<1233（29.20）56.24±6.11
1～<3377（47.24）55.74±6.33
≥3188（23.56）55.72±6.24
治疗时间（年）F=3.8850.021
<1340（42.61）54.24±5.87
1～<3304（38.10）55.23±6.14
≥3154（19.30）55.72±6.28
生育观念t=8.023<0.001
是499（62.53）59.36±7.14
否299（37.47）55.24±6.82
袒露病情t=0.2980.766
愿意231（28.95）55.73±6.50
不愿意567（71.05）55.88±6.43
希望怀孕的原因t=0.5230.601
喜欢孩子562（70.43）55.82±6.64
家庭压力236（29.57）56.09±6.71
夫妻关系F=56.020<0.001
非常好205（25.69）53.55±6.08
很好268（33.58）56.24±6.37
一般或不好325（40.73）59.54±6.77
是否为独生女F=0.2800.756
双方都是157（19.67）55.96±6.33
一方是392（49.12）56.21±6.51
双方都不是249（31.20）55.83±6.42
), ArticleFig(id=1322607963617997535, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, language=CN, label=表2, caption=

不同人口学特征育龄期原发不孕患者疾病感知压力水平[n（%），（）]

, figureFileSmall=null, figureFileBig=null, tableContent=
特征n=798BIPQ总分（分）统计值P值
年龄（岁）t=7.611<0.001
20～30337（42.23）54.37±5.21
31～40461（57.77）57.62±6.45
文化水平F=69.347<0.001
初中及以下310（38.85）58.52±7.34
高中及中专305（38.22）55.62±6.42
大专及以上183（22.93）51.28±5.47
居住地F=0.4020.669
农村247（30.95）55.82±6.47
城镇205（25.69）56.14±6.24
城市346（43.36）55.62±6.85
户籍性质t=0.4040.686
农村315（39.47）55.43±6.44
城市483（60.53）55.24±6.53
在职状态F=0.2820.754
待业141（17.67）55.82±6.31
在职444（55.64）55.77±6.78
自由职业/其他213（26.69）56.18±6.62
家庭月收入（元/月）F=1.0260.359
<4 000184（23.06）56.15±6.42
4 000～<6 000224（28.07）55.75±6.24
≥6 000390（48.87）56.53±6.77
婚姻史t=0.5840.559
初婚562（70.43）55.85±6.23
再婚236（29.57）56.14±6.78
婚龄（年）F=1.4530.235
<3173（21.68）56.74±6.34
3～<5251（31.45）55.82±6.41
≥5374（46.87）55.82±6.17
家庭类型F=0.1630.850
只和丈夫居住472（59.15）55.84±6.52
与父母或公婆同住234（29.32）56.07±6.14
混合大家庭92（11.53）55.67±6.13
不孕年限（年）F=0.5440.581
<1233（29.20）56.24±6.11
1～<3377（47.24）55.74±6.33
≥3188（23.56）55.72±6.24
治疗时间（年）F=3.8850.021
<1340（42.61）54.24±5.87
1～<3304（38.10）55.23±6.14
≥3154（19.30）55.72±6.28
生育观念t=8.023<0.001
是499（62.53）59.36±7.14
否299（37.47）55.24±6.82
袒露病情t=0.2980.766
愿意231（28.95）55.73±6.50
不愿意567（71.05）55.88±6.43
希望怀孕的原因t=0.5230.601
喜欢孩子562（70.43）55.82±6.64
家庭压力236（29.57）56.09±6.71
夫妻关系F=56.020<0.001
非常好205（25.69）53.55±6.08
很好268（33.58）56.24±6.37
一般或不好325（40.73）59.54±6.77
是否为独生女F=0.2800.756
双方都是157（19.67）55.96±6.33
一方是392（49.12）56.21±6.51
双方都不是249（31.20）55.83±6.42
), ArticleFig(id=1322607963701883616, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, language=EN, label=Table 3, caption=

Correlation between perceived stress of disease and couples’ supportive coping and sense of shame（r value，n=798）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分值（分）BIPQ评分DCI评分ISS评分
BIPQ评分55.67±6.431.000
DCI评分113.24±13.76-0.243a1.000
ISS评分67.52±14.460.309a-0.456a1.000
), ArticleFig(id=1322607963764798177, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, language=CN, label=表3, caption=

疾病感知压力与夫妻支持应对、病耻感相关性（r值，n=798）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分值（分）BIPQ评分DCI评分ISS评分
BIPQ评分55.67±6.431.000
DCI评分113.24±13.76-0.243a1.000
ISS评分67.52±14.460.309a-0.456a1.000
), ArticleFig(id=1322607965413159650, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, language=EN, label=Table 4, caption=

Assignment method

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
年龄20～30岁=0，31～40岁=1
文化水平初中及以下=1，高中及中专=2，大专及以上=3
治疗时间<1年=1，1～<3年=2，≥3年=3
生育观念是=1，否=0
夫妻关系非常好=1，很好=2，一般或不好=3
DCI评分连续型变量
ISS评分连续型变量
), ArticleFig(id=1322607965488657123, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, language=CN, label=表4, caption=

赋值方法

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
年龄20～30岁=0，31～40岁=1
文化水平初中及以下=1，高中及中专=2，大专及以上=3
治疗时间<1年=1，1～<3年=2，≥3年=3
生育观念是=1，否=0
夫妻关系非常好=1，很好=2，一般或不好=3
DCI评分连续型变量
ISS评分连续型变量
), ArticleFig(id=1322607965568348900, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, language=EN, label=Table 5, caption=

Multiple stepwise regression analysis of disease perception stress in primary infertility patients of childbearing age（n=798）

, figureFileSmall=null, figureFileBig=null, tableContent=
因素B值（95% CI）S. E值β值t值P值VIF值
常量41.7252.22918.723<0.001-
年龄（以20～30岁为参照）2.996（2.349～3.642）0.3290.1999.098<0.0011.369
文化水平（以初中及以下为参照）-2.149（-2.831～-1.468）0.347-0.222-6.192<0.0013.693
生育观念（以不认为生育最重要为参照）4.969（4.277～5.661）0.3520.32314.096<0.0011.506
夫妻关系（以夫妻关系非常好为参照）2.396（1.692～3.100）0.3590.2586.680<0.0014.272
DCI评分-0.044（-0.065～-0.022）0.011-0.083-3.927<0.0011.274
ISS评分0.077（0.055～0.099）0.0110.1496.967<0.0011.303
), ArticleFig(id=1322607965627069157, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607958463197874, language=CN, label=表5, caption=

育龄期原发不孕患者疾病感知压力的多元逐步回归分析（n=798）

, figureFileSmall=null, figureFileBig=null, tableContent=
因素B值（95% CI）S. E值β值t值P值VIF值
常量41.7252.22918.723<0.001-
年龄（以20～30岁为参照）2.996（2.349～3.642）0.3290.1999.098<0.0011.369
文化水平（以初中及以下为参照）-2.149（-2.831～-1.468）0.347-0.222-6.192<0.0013.693
生育观念（以不认为生育最重要为参照）4.969（4.277～5.661）0.3520.32314.096<0.0011.506
夫妻关系（以夫妻关系非常好为参照）2.396（1.692～3.100）0.3590.2586.680<0.0014.272
DCI评分-0.044（-0.065～-0.022）0.011-0.083-3.927<0.0011.274
ISS评分0.077（0.055～0.099）0.0110.1496.967<0.0011.303
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育龄期原发不孕患者疾病感知压力现状及其与夫妻支持应对关系的关系分析
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邱琳琳 , 王颖 , 钮红丽 , 邢黎阳
现代预防医学 | 儿少卫生与妇幼保健 2025,52(20): 3719-3724
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现代预防医学 |儿少卫生与妇幼保健 2025 , 52 (20) : 3719 -3724
育龄期原发不孕患者疾病感知压力现状及其与夫妻支持应对关系的关系分析
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邱琳琳, 王颖 , 钮红丽, 邢黎阳
作者信息
  • 南阳市第一人民医院生殖医学科，河南　南阳　473000
通讯作者:
王颖，E-mail:
作者简介:

邱琳琳（1989—），女，本科，主管护师，研究方向：生殖护理

Investigation on the current situation of disease perceived stress in primary infertility patients of childbearing age and analysis of its relationship with marital support and coping
Lin-lin QIU, Ying WANG , Hong-li NIU, Li-yang XING
Affiliations
  • Department of Reproductive Medicine, Nanyang First People’s Hospital, Nanyang, Henan 473000, China
出版时间: 2025-10-25 doi: 10.20043/j.cnki.MPM.202506325
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摘要
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目的

探究育龄期原发不孕患者的疾病感知压力现状，分析与夫妻支持应对关系的关系。

方法

2023年1月～2025年1月某医院收治的798育龄期原发不孕患者为研究对象，使用一般资料调查表、疾病感知问卷简化版（BIPQ）量表、夫妻支持应对（DCI）量表和女性不孕症患者病耻感量表（ISS）进行调查。

结果

育龄期原发不孕患者BIPQ评分（55.67±6.43）分。BIPQ评分与DCI评分为负相关（r=-0.243），与ISS评分为正相关（r=0.309）（P<0.05）。多元线性回归分析结果显示，年龄越高的患者压力越高（B=2.996，95% CI：2.349～3.642），文化水平越高的患者压力越低（B=-2.149，95% CI：-2.831～-1.468），认为生育是人生中最重要事情的患者压力更高（B=4.969，95% CI：4.277～5.661），夫妻关系越差压力越高（B=2.396，95% CI：1.692～3.100）, DCI评分越高压力越低（B=-0.044，95% CI：-0.065～-0.022），ISS评分越高压力越高（B=0.077，95% CI：0.055～0.099）（P<0.05）。

结论

育龄期原发不孕患者疾病感知压力水平较高，应重点关注年龄较高、文化水平低、传统生育观念、夫妻关系较差及病耻感高的人群，制定相应干预策略以改善患者心理健康水平。

育龄期  /  原发不孕  /  疾病感知压力  /  夫妻支持应对关系
Objective

To explore the status quo of disease perception stress of primary infertility patients in childbearing age, and analyze the relationship between it and couples’ support and coping.

Methods

A total of 798 primary infertility patients of childbearing age admitted to the hospital from January 2023 to January 2025 were selected for the study. The General information Questionnaire, the Simplified version of the Disease Perception Questionnaire (BIPQ) scale, the Marital Support Coping (DCI) Scale, and the Stigma Scale for Female Infertility Patients (ISS) were used for the investigation.

Results

The BIPQ score of primary infertility in childbearing age was (55.67±6.43), and the pressure of disease perception was high. Pearson correlation analysis showed that BIPQ score was negatively correlated with DCI score (r=-0.243) and positively correlated with ISS score (r=0.309) (P<0.05). The results of multiple linear regression analysis showed that the higher the age, the higher the stress of patients (B=2.996, 95% CI: 2.349-3.642), the higher the educational level, the lower the pressure (B=-2.149,95% CI: -2.831--1.468), the higher the pressure of patients who think that childbirth is the most important thing in life (B=4.969, 95% CI:4.277-5.661), and the worse the relationship between husband and wife, the higher the pressure (B=2.396, 95% CI: 1.692-3.100), the higher the DCI score, the lower the stress (B=-0.044, 95% CI:-0.065--0.022), and the higher the ISS score, the higher the stress(B=0.077, 95% CI:0.055-0.099) (P<0.05).

Conclusion

The primary infertility patients in childbearing age have a high level of disease perception pressure, so we should focus on those who are older, have low educational level, have a traditional concept of fertility, have poor relationship between husband and wife and have a high sense of shame, and formulate corresponding intervention strategies to improve the mental health level of patients.

Childbearing age  /  Primary infertility  /  Disease perceived stress  /  Husband and wife support coping
邱琳琳, 王颖, 钮红丽, 邢黎阳. 育龄期原发不孕患者疾病感知压力现状及其与夫妻支持应对关系的关系分析. 现代预防医学, 2025 , 52 (20) : 3719 -3724 . DOI: 10.20043/j.cnki.MPM.202506325
Lin-lin QIU, Ying WANG, Hong-li NIU, Li-yang XING. Investigation on the current situation of disease perceived stress in primary infertility patients of childbearing age and analysis of its relationship with marital support and coping[J]. Modern Preventive Medicine, 2025 , 52 (20) : 3719 -3724 . DOI: 10.20043/j.cnki.MPM.202506325
正文
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约有20～30%左右的育龄期女性遭受不孕困扰[1]，15.5%的美国女性患不孕症，我国不孕症女性患者高达25%，不孕症已成为21世纪全球重点关注的热点问题[2-3]。原发性不孕症是指在婚后有规律性生活、未采取避孕措施但仍无法受孕的女性[4]，相较于继发性不孕患者，育龄期原发不孕患者因缺乏成功妊娠的经历，更易陷入到无法完成生育使命的自我否定中，因此遭受的生育压力更重[5]。疾病感知指患者在面对自身疾病症状时对疾病的看法、态度以及应对措施等。大量研究证实，疾病感知是患者行为的关键因素，与患者健康状况、生存质量以及治疗行为有着直接关系[6]。但我国目前关于疾病感知的研究多集中在慢性病及精神障碍患者中，对于育龄期原发不孕患者这一群体疾病感知压力的现状尚存空白[7-8]，同时不孕症属于夫妻共同压力事件，夫妻支持应对即伴侣在应对压力事件时的共同反应与决策是影响心理健康的重要因素[9]。研究表明[10]，夫妻支持应对水平高的患者心理状态更加积极。本研究聚焦于育龄期原发不孕患者，了解疾病感知压力现状，分析其与夫妻支持应对、病耻感的关联，为制定夫妻协同心理干预方案提供依据
1　资料与分析
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1.1　研究对象
选择2023年1月～2025年1月某医院收治的育龄期原发不孕患者。纳入标准：（1）均为年龄20～40岁的育龄期女性，符合原发性不孕症诊断标准[11]；（2）均为已婚女性；（3）未采取避孕措施，夫妻正常一同居住；（4）规律性生活一年以上；（5）能够配合完成调查。排除标准：（1）近期经历重大心理创伤事件；（2）夫妻双方任意一方精神异常；（3）男方因素引起的不孕不育；（4）夫妻长期分居；（5）临床资料缺失。本研究最终纳入798例患者。南阳市第一人民医院医学伦理委员会已批准本研究的进行（审批号：2020-ky-06）。
1.2　调查内容
1.2.1　一般资料
收集患者一般资料，包括年龄、文化水平、居住地、户籍性质、在职状态、月收入、婚姻史、婚龄、家庭类型、不孕年限、治疗时间、生育观念（认为生育是人生中最重要的事情）、袒露病情、希望怀孕的原因、夫妻关系、是否为独生女。
1.2.2　疾病感知压力
使用疾病感知问卷简化版量表（Brief Illness Perception Questionnaire，BIPQ）[12]调查，包括认知维度5个条目、情绪维度2个条目、理解能力维度1个条目，以及1项开放性问题条目，其中开放性问题由患者写出导致患病的主要3个原因，不计入得分。其余条目采用Likert 10级评分法，3、4、7条目为反向计分，分值范围0～80分，患者得分越高则表示患者感知到的疾病负担越重。量表Cronbach α系数为0.770。
1.2.3　夫妻支持应对
使用夫妻支持应对量表（Dyadic Coping Inventory，DCI）[13]调查，共6个维度，压力沟通8个条目、支持应对10个条目、共同应对5个条目以及代办应对维度4个条目为积极夫妻应对方式，消极应对维度8个条目为消极夫妻应对方式，应对质量评价维度2个条目为配偶参与应对总体满意度的评价，不计入得分。采用Likert 5级评分法，分值范围35～175分，患者得分越高则表示夫妻间的支持性应对越强。量表Cronbach α系数为0.848。
1.2.4　病耻感
使用女性不孕症患者病耻感量表（Infertility Stigma Scale，ISS）[14]评估，包括自我贬损7个条目、社会退缩5个条目、周围人群羞辱9个维度、家庭成员羞辱6个条目，采用Likert 5级评分法，分值范围27～135分，患者得分越高则表示病耻感水平越高。量表Cronbach α系数为0.920。
1.3　资料收集
患者在门诊就诊时使用电子问卷对其进行调查。调查开始前确保患者了解研究的目的、意义以及注意事项等，对于患者不了解的部分进行解释，但不干扰其选择和避免诱导性语言。所有问卷均当场发放和回收。本次调查共发放问卷820份，回收有效问卷798例，有效回收率97.32%。
1.4　统计学分析
采用SPSS 26.0软件分析数据。满足正态分布且方差齐的计量资料以均值±标准差（）表示，组间比较采用t检验或单因素方差分析。不满足正态分布的数据以中位数、四分位数[M (P25, P75)]表示，组间比较使用非参数检验。计数资料以例（n）和百分比（%）表示，组间比较用χ2检验。使用Pearson相关性分析疾病感知压力与夫妻支持应对、病耻感相关性，多元线性逐步回归法分析影响疾病感知压力的因素。检验水准α=0.05。
2　结果
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2.1　疾病感知压力现状
育龄期原发不孕患者BIPQ评分范围38～67分，平均（55.67±6.43）分，各维度得分情况见表1。
2.2　不同人口学特征育龄期原发不孕患者疾病感知压力水平
年龄31～40岁、文化水平较低、治疗时间长、认为生育是人生中最重要事情的患者、夫妻关系较差的患者疾病感知压力水平更高（P<0.05），其他特征患者的评分差异则无统计学意义（P>0.05），见表2。
2.3　疾病感知压力与夫妻支持应对、病耻感相关性
BIPQ评分与DCI评分为负相关（r=-0.243），与ISS评分为正相关（r=0.309），DCI评分与ISS评分为负相关（r=-0.456），（P均<0.05），见表3。
2.4　疾病感知压力的多因素分析
将患者育龄期原发不孕患者疾病感知压力得分作为因变量，将年龄、文化水平、治疗时间、生育观念、夫妻关系、DCI评分、ISS评分作为自变量（赋值方法见表4）进行多元线性回归分析，结果显示，31～40岁患者疾病感知压力高于20～30岁患者，文化水平越高的患者压力越低，认为生育是人生中最重要事情的患者压力更高，夫妻关系越差压力越高，DCI评分越高压力越低，ISS评分越高压力越高（P<0.05），见表5。本次构建的模型VIF均<5，D-W处于2附近，且残差基本符合正态分布，模型拟合良好，不存在多重共线性。同时R2=0.322，可解释疾病感知压力总变异的32.2%。
3　讨论
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3.1　育龄期原发不孕患者疾病感知压力现状
本次研究结果显示，调查对象的BIPQ评分为（55.67±6.43）分，其中情绪维度得分最高，这说明育龄期原发不孕患者疾病感知压力处于较高水平，并主要体现在负面情绪认知，这高于马倩雯等[15]和张爱玉等[16]研究中的结果。究其原因：①原发性不孕患者从未成功的生育史强化了其对疾病不可逆性的感知，加剧了情绪困扰；同时原发性不孕患者往往难以明确病因，这使得她们在面对疾病时有着强烈无助感和焦虑情绪，而长期的治疗过程进一步加重了心理负担[17]。②传统生育文化认为生育与女性社会价值和角色完整性紧密联系，因而育龄期原发不孕患者面临巨大社会压力，容易陷入自我否定和羞耻感中，进而转化为内部心理负担[18]。③育龄期女性可能会更早意识到疾病不可治愈的可能性，且临床治疗效果不确定，患者更容易表现出较高的疾病感知压力[19]。
3.2　育龄期原发不孕患者疾病感知压力的影响因素
年龄更高的患者疾病感知压力更高（P<0.05），与刘慧慧等人[20]研究一致。31～40岁女性处于传统观念中适龄生育末期，家庭带来的完成生育使命期待与不孕现实形成尖锐矛盾，长辈催促、同辈妊娠对比等外部压力更易转化为自我否定[21]。同时患者随着年龄的增长对卵巢功能衰退的生理认知更清晰，长期治疗过程中对疾病的不确定性累积心理负担，共同构成了高龄不孕患者疾病感知压力的重要来源[22]。文化水平低的患者疾病感知压力更高（P<0.05），高文化水平患者能通过权威医学文献、专业咨询等渠道理解不孕的生理机制，将问题归因于客观生理条件而非个人价值缺陷[23]。而低文化水平患者更易依赖非专业信息源导致对病因的认知模糊，Ouadrhiri M等[24]研究指出，文化水平低的不孕女性更易受到传统生育观念束缚，进而直接转化为对疾病不确定性的恐惧[25]。认为生育是人生中最重要事情的患者疾病感知压力更高（P<0.05），主要源于生育目标与自我价值认同的深度绑定以及传统观念与现实不孕的剧烈冲突。这类患者往往将生育视为女性身份完整性、婚姻价值乃至人生意义的核心标尺，一旦遭遇不孕便容易陷入自我否定，更易产生强烈的羞耻感和社会压力。夫妻关系是患者疾病感知压力的影响因素（P<0.05），丈夫是不孕症女性重要的社会支持来源，对方的态度与行为直接影响患者疾病认知偏差程度、情绪困扰水平及治疗信心[26]。良好的夫妻关系更易形成共同面对的协作模式，而关系较差的夫妻则可能陷入相互指责或孤立应对的困境。Wang Q等[27]学者研究中同样证实了丈夫的情绪障碍能够影响妻子的沟通模式，进而增加妻子不孕压力。DCI评分更高的患者疾病感知压力越低（P<0.05），夫妻支持应对是双方共同参与的应对模式，配偶的主动参与能增强患者的被重视感，可有效抵消疾病中被排斥的负面体验，其支持行为中如果伴随消极情绪，则会加剧不孕女性消极情绪[28-29]。已有研究证实[30]，夫妻支持应对在癌症患者生理功能、心理状态及关系功能维护中具有重要作用；李荣等[31]学者以夫妻为整体实施认知行为疗法及放松想象等应对训练，可缓解女性焦虑症状。ISS评分更高的患者疾病感知压力越高（P<0.05），部分不孕症女性因病耻感延迟就医，导致治疗延误，进而加剧疾病症状与心理压力；而症状加重与负面情绪的反馈作用又进一步强化病耻感，形成恶性循环，最终可能引发抑郁、婚姻破裂、社会歧视及排斥等后果[32]。可采取以下方式提高不孕女性患者夫妻支持应对水平：鼓励患者及配偶调整支持与关心方式，促进开放沟通、情感表露，减少回避隐瞒行为，共同参与疾病应对；通过支持性谈话干预增进夫妻相互理解与支持，帮助获取疾病信息，降低不确定性，缓解心理困扰；采用以夫妻为基础、应对为导向、沟通技巧提升为核心的干预策略，改善夫妻亲密关系。
综上所述，育龄期原发不孕患者疾病感知压力处于较高水平，并与年龄、文化水平、生育观念、夫妻关系、夫妻支持应对及病耻感有关。但本研究也存在一些不足：本研究为横断面调查，不能确定因果关系，且纳入的影响因素可能不够全面。未来可通过多中心、纵向追踪设计扩大样本代表性，细化变量分类并纳入更多潜在影响因素，以更全面地揭示育龄期原发不孕患者疾病感知压力的形成机制与干预路径。
基金
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  • 河南省医学科技攻关计划联合共建项目(LHGJ20200904)
文献
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参考文献 引证文献
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doi: 10.20043/j.cnki.MPM.202506325
  • 接收时间：2025-06-20
  • 首发时间：2026-10-29
  • 出版时间：2025-10-25
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  • 收稿日期：2025-06-20
基金
河南省医学科技攻关计划联合共建项目(LHGJ20200904)
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    南阳市第一人民医院生殖医学科，河南　南阳　473000

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王颖，E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
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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