中国健康心理学杂志

目的:调查高龄不孕女性心理困顿感的情况，分析夫妻支持应对和生育生活质量与心理困顿感的关系，为临床制定干预措施降低心理困顿感提供依据。方法:于2024年1月至7月收集在某院就诊的254名高龄不孕女性作为调查对象，收集患者一般情况，采用心理困顿感量表、生育生活质量量表和夫妻支持应对量表对高龄不孕女性心理困顿感、生育生活质量及夫妻支持情况进行评估，分析夫妻支持应对和生育生活质量与心理困顿感的关系。结果:高龄不孕女性心理困顿感、生育生活质量、夫妻支持应对平均得分分别为36.84±6.37分、84.52±13.44分、112.96±13.26分；高龄不孕女性生育生活质量水平及夫妻支持应对水平均与心理困顿感水平呈负相关(r=-0.684,-0.538;P<0.01),夫妻支持应对水平与生育生活质量水平呈正相关(r=0.605,P<0.01)。采用多元回归分析对高龄不孕女性心理困顿感影响因素进行分析，结果显示，年龄(OR=4.297,95%CI:1.545～11.955)、不孕时间(OR=4.660,95%CI:1.688～12.862)、生育情况(OR=5.129,95%CI:2.103～12.513)、家庭人均月收入(OR=5.150,95%CI:2.403～11.039)、生育生活质量(OR=0.558,95%CI:0.404～0.771)和夫妻支持应对(OR=0.720,95%CI:0.539～0.963)是其独立影响因素(P<0.05)。结论:高龄不孕女性心理困顿感水平较高，年龄、职业、不孕时间、生育情况、家庭人均月收入是心理困顿感的独立危险因素，生育生活质量和夫妻支持应对是保护性因素，从生育生活质量和夫妻支持应对两方面制定干预措施能有效降低高龄不孕女性的心理困顿水平。

Objective:To understand the current situation of psychological distress among elderly infertile women, and to explore the impact of reproductive quality of life and couple support on psychological distress.Methods:From January to July 2024,254 elderly infertile women attending our hospital were collected as survey subjects, and the general conditions of the patients were collected, and the psychological distress, quality of reproductive life and couple support were assessed by using the Psychological Distress Scale, the Quality of Reproductive Life Scale and the Couple Support Coping Scale to analyse the relationship between the couple support coping and the quality of reproductive life and the sense of psychological distress among the elderly infertile women.Results:The mean scores of psychological distress, quality of reproductive life, and couple support coping for senior infertile women were 36.84±6.37,84.52±13.44,and 112.96±13.26,respectively; The level of quality of reproductive life(r=-0.684)and the level of couple support coping for senior infertile women were inversely proportional to the level of psychological distress(r=-0.538),and the level of couple support coping level was positively related to the level of quality of reproductive life(r=0.605).Multiple regression analysis was used to analyze the factors affecting psychological distress among older infertile women, and the results showed that age(OR=4.297,95%CI:1.545～11.955),duration of infertility(OR=4.660,95%CI:1.688～12.862),fertility(OR=5.129,95%CI:2.103～12.513),per capita monthly family income(OR=5.150,95%CI:2.403～11.039),quality of life in childbearing(OR=0.558,95%CI:0.404～0.771),and couples' supportive coping(OR=0.720,95%CI:0.539～0.963)were the independent influences(P<0.05).Conclusion:The level of psychological distress among elderly infertile women is relatively high.Age, occupation, duration of infertility, fertility status, and family income per capita are independent risk factors for psychological distress.Quality of life in childbearing and support from partners are protective factors.Improving the quality of life in childbearing and supporting couples' coping abilities can help reduce the psychological distress experienced by older infertile women.