產後疲倦與身心情境因素之相關性

戈依莉

指導教授 ： 呂昌明

國立臺灣師範大學/教育學院/衛生教育學系/博士(2000年)

摘要

摘 要本研究的主要目的是根據不愉快症狀理論，探討重要的人口學、身心情境因素與不同時間序列產後疲倦的關係。立意取樣台北市三所教學醫院，無母嬰合併症產婦189位，於產後第3週時填寫以下六個量表：產後疲倦量表、母乳哺餵經驗量表、憂鬱傾向量表、社會支持量表、睡眠量表及嬰兒氣質量表，並於產後第6、9週繼續追蹤產後疲倦資料。統計方法採用百分比、平均值、二因子變異數分析、相關分析及複迴歸分析法。主要結果如下：一、產後疲倦有90∼96％高發生率，程度屬於輕至中度，以身心混合形式最多；對生活造成輕度或中度的影響，並會隨著產後時間遞減。二、人口學資料（高齡、第一胎、分娩方式、家庭社經等級）與產後疲倦無顯著相關。三、身心情境因素中，憂鬱傾向、母乳哺餵問題、睡眠品質、社會支持低，與產後疲倦呈顯著相關。四、自變項中憂鬱、嬰兒氣質分別與不同時間產後疲倦有交互作用存在，即「憂鬱傾向」、「磨娘精嬰兒氣質」與產後不同時間序列的疲倦有交互作用，而影響母親產後疲倦感。五、本研究架構所選用的人口學、身心情境因素等九項因素，能解釋產後三週疲倦全部變異量之31.4％，其中影響最大的四個因素是「憂鬱」、「年齡」、「哺餵問題」、「分娩方式」；在產後六週時，九項因素能解釋疲倦全部變異量之22.9％，有意義的影響因素是「睡眠品質」；在產後九週九項因素能解釋全部變異量之15.3％，有顯著意義的影響因素是「餵奶問題」和「嬰兒氣質」。本研究之結果可做為評估產後疲倦之重要依據，進而提升產後婦女之生活品質。根據研究結果提出下列幾點建議：在教育方面將不愉快症狀理論推廣至醫院工作人員、一般民眾以父母；未來研究方面，可針對不同影響因素進行大樣本、縱貫性、質量並重的施測，並針對特定的影響因素在產後初期設計介入措施，探討降低產後疲倦之效果。 Psychophysiologic and Situational Correlates of Postpartum Fatigue Abstract The purpose of this study was based on TOUS (Theory of Unpleasant Symptoms) to investigate the relationship among postpartum fatigue and associated psychophysiologic and situational factors (breast feeding experience, depression, social support, sleep and infant behaviors); to investigate the relationship between postpartum fatigue and demographic factors (age, parity, type of delivery, and family's socioeconomic status); to determine which aspects of independent variables predict postpartum fatigue; to describe postpartum fatigue change over time. This study used longitudinal research design. Questionnaires were mailed to a purposive sample of 189 low-risk pureperium women at 3, 6, and 9 weeks postpartum. Six instruments were used to collect data: the Breastfeeding Experience Scale (Warmbach, 1993); the Center for Epidemiologic Studies Depression Scale (Radloff, 1977); the Personal Resources Questionnaire (Weinert, 1987); the Visual Analog Sleep Scale (Verran & Synder-Halpern, 1987); the Neonatal Perception Inventories (Broussard, 1978); and the Postpartum Fatigue Inventory (Yang, 1998). Data were statistically analyzed by means of descriptive analysis, correlation, repeated measure ANOVA, and multiple regression. The prevalence rate of postpartum fatigue was 90-96%. Most mothers experienced mildly to moderate fatigue during the three measures, and gradually decreased. Significant correlations were found among breastfeeding experience, depression, social support, sleep and postpartum fatigue. Six significant predictors of postpartum fatigue were identified: age, type of delivery, depression and breastfeeding experience at three weeks postpartum; sleep at six weeks postpartum; breastfeeding experience and infant behavior at nine weeks. There were interactional effects between depression and postpartum fatigue over time, and infant behavior on postpartum fatigue over time. The total variance explained was 31.4% at three weeks postpartum, 22.9% at six weeks and 15.3% at nine weeks respectively. The results of this study suggested that health staffs should routinely assess and intervene in postpartum fatigue if possible.

關鍵字

不愉快症狀理論 ； 產後疲倦 ； 身心情境因素

並列摘要

Psychophysiologic and Situational Correlates of Postpartum Fatigue
Abstract
The purpose of this study was based on TOUS (Theory of Unpleasant Symptoms) to
investigate the relationship among postpartum fatigue and associated
psychophysiologic and situational factors (breast feeding experience,
depression, social support, sleep and infant behaviors); to investigate the
relationship between postpartum fatigue and demographic factors (age, parity,
type of delivery, and family's socioeconomic status); to determine which
aspects of independent variables predict postpartum fatigue; to describe
postpartum fatigue change over time. This study used longitudinal research
design. Questionnaires were mailed to a purposive sample of 189 low-risk
pureperium women at 3, 6, and 9 weeks postpartum. Six instruments were used to
collect data: the Breastfeeding Experience Scale (Warmbach, 1993); the Center
for Epidemiologic Studies Depression Scale (Radloff, 1977); the Personal
Resources Questionnaire (Weinert, 1987); the Visual Analog Sleep Scale (
Verran & Synder-Halpern, 1987); the Neonatal Perception Inventories (
Broussard, 1978); and the Postpartum Fatigue Inventory (Yang, 1998).
Data were statistically analyzed by means of descriptive analysis, correlation,
repeated measure ANOVA, and multiple regression. The prevalence rate of
postpartum fatigue was 90-96%. Most mothers experienced mildly to moderate
fatigue during the three measures, and gradually decreased. Significant
correlations were found among breastfeeding experience, depression, social
support, sleep and postpartum fatigue.
Six significant predictors of postpartum fatigue were identified:　age, type
of delivery, depression and breastfeeding experience at three weeks postpartum;
sleep at six weeks postpartum; breastfeeding experience and infant behavior at
nine weeks. There were interactional effects between depression and postpartum
fatigue over time, and infant behavior on postpartum fatigue over time. The
total variance explained was 31.4% at three weeks postpartum, 22.9% at six
weeks and 15.3% at nine weeks respectively.
The results of this study suggested that health staffs should routinely assess
and intervene in postpartum fatigue if possible.

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