Revision and Validation of a Scale to Assess Pregnancy Stress

懷孕壓力量表之修訂與驗證

陳彰惠(Chung-Hey Chen)

《The Journal of Nursing Research》 23卷1期 (2015/03) Pp. 25-32

https://doi.org/10.1097/jnr.0000000000000047

摘要

背景　懷孕是生活壓力事件之一，孕期壓力會造成母體荷爾蒙和免疫系統的改變，導致孕期合併症或產後精神障礙，且有可能影響胎兒健康。本作者於1983年所發表之30題「孕期壓力量表」，是目前全球唯一測量懷孕相關壓力之量表。目的　本研究旨在重新思考和修訂「懷孕壓力量表」，並驗證更新版本之信度和效度。方法　本研究採用橫斷式研究設計，依據臨床經驗和專家意見增加新題數，編製一份符合社會現況之40題新版「懷孕壓力量表」。樣本來源為南部地區某一醫學中心之產前門診，共收集有效樣本300位孕婦完成問卷填寫，以檢定其內部一致性、再測信度、建構效度、聚合效度和辨別效度。結果　新版「懷孕壓力量表」經項目分析和因素分析後，由40題減為36題，此36題中文版具有良好的內部一致性（α=.92）和2週再測信度（r=.82）。進行因素分析的結果證實其建構效度，萃取出五個因素可解釋52.17%的總變異量。本量表與壓力知覺量表和社會支持量表有顯著相關，可顯示其聚合效度和辨別效度。結論　36題新版「懷孕壓力量表」經由驗證後，針對測量現代台灣婦女之孕期壓力程度是一份可信、有效與實用的量表，可作為未來具高度壓力的孕婦介入措施之成效測量工具。建議將此量表譯成英文，並檢定其在西方社會的適用性。

關鍵字

懷孕壓力 ； 孕期照護 ； 量表發展

並列摘要

Background: Pregnancy is a potentially stressful event. Prenatal stress alters maternal endocrine and immune systems, has been implicated in the etiology of prenatal complications or postnatal psychiatric disorders, and may adversely affect fetal health. The 30-item Pregnancy Stress Rating Scale (PSRS), initially developed in 1983 by Chen and colleagues, is the only measure to date designed specifically to evaluate prenatal stress. Purpose: The purpose of this study was to reconsider and revise the 30-item PSRS and validate the new PSRS. Methods: A cross-sectional design was used. Adding new items of pregnancy stress generated from clinical experience and expert recommendations resulted in a 40-item revised PSRS that was more reflective of current social conditions. Three hundred pregnant women, recruited from the antenatal clinic of a medical center in southern Taiwan, completed the revised PSRS to assess its internal consistency, test-retest reliability, construct validity, and convergent and discriminate validity. Results: The final 36-item PSRS (PSRS36) was derived by deleting four items with relatively low item-total correlation coefficients or factor loadings. The resultant 36-item scale showed good internal consistency (α=.92) and 2-week test-retest reliability (r=.82). Factor analysis confirmed construct validity and suggested five prenatal stress dimensions, which explained 52.17% of the total variance. Convergent and discriminate validities were indicated by significant correlations among the PSRS36, Perceived Stress Scale, and Interpersonal Support Evaluation List. Conclusions: The PSRS36 is a psychometrically sound and practical tool for nurses and other healthcare providers to assess prenatal stress and to examine intervention protocols in Taiwanese prenatal women. More research is recommended to determine whether the PSRS36 may be used in other racial-ethnic groups.

並列關鍵字

pregnancy stress ； prenatal care ； instrument development

參考文獻

Affonso, D. D.,Mayberry, L. J.(1990).Common stressors reported by a group of childbearing American women.Health Care for Women International.11(3),331-345.

Beydoun, H.,Saftlas, A. S.(2008).Physical and mental health outcomes of prenatal maternal stress in human and animal studies: A review of recent evidence.Paediatric and Perinatal Epidemiology.22(5),438-466.

Chang, M. Y.,Chen, C. H.,Huang, K. F.(2008).Effects of music therapy on psychological health of women during pregnancy.Journal of Clinical Nursing.17(19),2580-2587.

Chang, S. C.,Chen, C. H.(2005).Effects of music therapy on women's physiologic measures, anxiety, and satisfaction during Cesarean delivery.Research in Nursing & Health.28(6),453-461.

Chen, C. H.,Chen, H. M.,Huang, T. H.(1989).Stressors associated with pregnancy as perceived by pregnant women during three trimesters.The Kaohsiung Journal of Medical Sciences.5(9),505-509.