不孕症夫妻成為父母後的心理反應變化

Psychological Responses of Previously - Infertile Parents

為探討不孕症夫妻在成功懷孕而成為父母後，其心理壓力反應是否有所變化，本研究以1991年12月至1992年2月在台灣中部某醫學院附設醫院接受人工生殖科技治療之50對不孕症夫妻為樣本，施以結構式問卷面訪調查（原始測量），內容包括夫妻基本資料、不孕及治療資料，及台大症狀量表。1997年3月再次以郵寄方式進行相同問卷調查（追蹤測量），但內容增加懷孕情形調查，此次計有24對夫妻回覆問卷，回覆率48.0%。其中已成為父母組有14對夫妻，仍然不孕組有10對夫妻。結果顯示：已成為父母組與仍然不孕組之夫與夫，妻與妻之原始測量基本資料、不孕及治療資料間並無顯著差異。已成為父母組的先生其身體化症狀、憂鬱、焦慮、恐懼、精神官能症及覺得身體有嚴重毛病等分量尺之追蹤測量平均壓力得分較原始測量增多，但認為自己的心理有問題該項追蹤測量值則顯著地低於原始測量值(p < 0.05)。而妻子之身體化症狀、憂鬱、敵意、精神官能症及覺得身體有嚴重毛病等分量尺之追蹤測量平均壓力得分亦較原始測量增加。比較已成為父母組與仍然不孕組夫妻之原始與追蹤測量值變化情形間的差異；已成為父母組先生，其心理壓力反應上昇情形高於仍然不孕組先生者為身體化症狀、恐懼及精神官能症三分量尺，而已成為父母組妻子，其心理壓力反應上昇情形高於仍然不孕組妻子者為身體化症狀、憂鬱及敵意三分量尺。本研究結論為不孕症夫妻在成為父母後，其心理壓力反應仍可持續或惡化，且夫妻改變情形也不盡相同，醫護人員應重視長期不孕對已成為父母者的某些心理層面之持續影響及成為父母後養育與婚姻生活改變所帶來之新影響，並提供專業的協助。

The purpose of this study was to assess the psychological responses of previously infertile couples after becoming parents. Fifty couples attending an assisted reproduction program at a college hospital between December,1991 and Feburary,1992 were included in this study. The couples were initially interviewed during the treatment course by a self-administered structured questionnaire regarding demographic data, infertility history, and psychological responses, based on the Taita Symptom Check List. A follow-up questionnaire containing the same elements plus questions on pregnancy was mailed to subjects in March,1997. Twenty-four couples (14 who had become parents and 10 who were still infertile) completed both the initial and follow-up interviews, for a response rate of 48%. In the initial interviews, couples who became parents and those who did not were similar in terms of demographic characteristics and infertility history. Compared with the initial interview at follow-up husbands who had become parents had slightly elevated mean scores on the subscales of somatization, depression, anxiety, phobia and neurosis, while wives who became parents had slightly elevated mean scores on the subscales of somatization, depression, hostility, and neurosis. Compared with couples who were still infertile, husbands who became parents had a greater increases in the mean scores of the somatization, phobia and neurosis subscales on the follow-up questionnaire, while wives had greater increases in the subscales of somatization, depression and hostility. We conclude that psychological distress can persist or become exacerbated in previously infertile couples who become parents. The exact causes and possible demands for long-term nursing intervention deserve further attention and investigation.