接受生殖科技懷孕婦女第一孕期身心症狀、因應行為與幸福安寧感之探討

本研究旨在探討生殖科技懷孕婦女第一孕期身心症狀、因應行為與幸福安寧感，並探究其身心症狀、因應行為與幸福安寧感的相關性及預測因子。以立意取樣，生殖科技組取自中部某不孕研究中心及醫學中心接受生殖科技成功懷孕之第一孕期婦女共61位，自然懷孕組取中部某教學醫院及某地區醫院之婦產科門診共78位為對照。研究工具為懷孕之身心症狀量表、Jalowiec因應行為量表、幸福安寧感量表、家庭功能量表之結構式問卷。資料分析以SPSS PC(+)10.0版套裝軟體，以百分比、平均數、標準差、皮爾森相關、因素分析、t檢定、卡方檢定、共變數分析、單因子變異數分析、及逐步複迴歸進行分析。 　　研究結果發現:兩組身心症狀之前十項症狀相似，生殖科技懷孕婦女對懷孕的接受度比自然懷孕組高但自然懷孕組比生殖科技懷孕組易主動尋求社會資源。身心症狀受「宗教信仰」、「教育程度」、「不孕經驗與治療造成的壓力」因素的影響。因應行為類型受與「年齡」、「就業與否」、「家庭功能」、「孕期合併症」「不孕經驗與治療造成的壓力」因素的影響。而孕期的幸福安寧感受「正向情緒」、「主動尋求社會資源」、「認知上接受」、「消極且情緒化的發洩」、「認知上接受」因素的影響。 　　不孕經驗與治療引發的壓力可預測「身體症狀」﹔不孕經驗與治療引發的壓力、宗教信仰可預測「負向情緒」﹔家庭功能、孕期合併症可預測「主動尋求社會資源」行為﹔孕婦年齡、不孕經驗與治療引發的壓力可預測「消極且情緒化的發洩」行為﹔有無孕期合併症、不孕經驗與治療引發的壓力可預測「尋求心靈寄託及轉移注意」行為﹔正向情緒症狀、主動尋求社會資源可預測「總幸福安寧感」。 　　本研究可增進醫護人員對接受生殖科技治療懷孕後婦女的第一孕期身心症狀因應行為及幸福安寧感的相關性更進一步的了解，以提供專業性、全面性的產前照護。

The purpose of this study was to explore the psychosomatic symptoms, the coping behavior and the well being of pregnant women in first trimester, and determinate the relation and predictive factor of the psychosomatic symptoms, the coping behaviors and the well-being. A purposive sampling method was used to collect 61 mothers in their first trimester conceived by assisted reproductive techniques (ART) at a infertility center and a medical center in the central Taiwan as ART group, 78 mothers with nature pregnancy at a teaching hospital and local hospital as control group. There were four instruments used to collect data, including pregnant psychosomatic symptom scale, Jalowiec coping behaviors scale, well-being scale and family APGAR index. The data were analyzed by percentage, mean, standard deviation, Pearson’s correlation, Factor analysis, T-tests, Chi-square, NACOVA, one way ANOVA, and multiple stepwise regression with SPSS PC(+) 10.0 software. The result indicated that the top 10 psychosomatic symptoms of the two group were similar. The degree of acceptation with pregnancy in the ART group were higher than that of the nature pregnancy group. But the nature pregnancy group tend to search more social resource than the ART group. Psychosomatic symptoms were influenced by “ religion”, “education level”, “stress from infertile experience and treatment”. The type of coping behavior were influenced by “age”, “working or not”, “complication of pregnancy”, “stress from infertile experience and treatment”. Well-being were influenced by “positive affection”, “active searching for social resource”, “acceptation of concepts”, “the liberation of pessimism and sentiment mentally release”. The stress from infertile experience and treatment can predict “somatic symptoms”; stress from infertile experience and treatment, and religion can predict “negative affection”; family function and complication of pregnancy can predict “active searching for social resource”; age, and stress from infertile experience and treatment can predict “the liberation of pessimism and sentiment mentally release”; complication of pregnancy, and stress from infertile experience and treatment can predict “the search of repose soul and spirit and the transfer attention”; positive affective symptoms and can predict active searching for social resource can predict total well-being. The study can promote the nursing staff to understand more about the psychosomatic symptoms of mothers conceived by ART and the relation of well-being, to provide professional and thorough antenatal care.