台灣低憂鬱孕產婦正向心理因素初探

Preliminary Study of the Positive Psychological Factors of Pregnant and Postpartum Women with Low Depression in Taiwan

研究目的：孕產期是女性生命中的重要階段，過去研究多聚焦產後憂鬱，缺少正向適應之心理因素探討。本研究以正向心理學觀點，探討台灣低憂鬱孕產婦之正向心理因素。研究方法：以半結構式質性訪談，針對五種孕產期，愛丁堡產後憂鬱量表計分四分以下的低憂鬱孕產婦，每期訪談三位，共十五位，分析訪談內容。研究結果：1.孕產期婦女所知覺的壓力困境共有七項。2.認知與態度的三項壓力調適因素：知命、順命與運命。3.三項提升人我關係的正向行為：保持正向習慣、對自我有正向評價、同理與妥協合作。4.六項正向的社會家庭支持因素：自主性發揮、感受到情緒和實質的支持、夫妻間擁有共識和合作、個人孕期所需調適較少、生活隨孕期變化有正向發展、與靈性/宗教連結。5.六項母職的意義有：權衡生活角色後更投入家庭、勇敢和重新學習、願意改掉負向習慣、感念自己的母親、社會興趣增加、更能理解與體會生命。研究結論：根據研究結果討論正向心理特色。包含：1.對母職具認同度，在壓力知覺上身苦心不苦；2.採取知命、順命、運命的壓力調適方法；3.兼具照顧自我與同理合作的修養；4.知覺個人被尊重與支持，有利孕產期適應；5.個人取向的自我，因孩子存在，轉變為家庭取向的自我。

Purpose: The pregnancy and postpartum periods are important stages in women’s lives. Most previous studies in Taiwan have focused solely on postpartum depression, and lacked an examination of the psychological factors that correspond to positive adaptation. Past research has identified such psychological factors among pregnant and postpartum women in other nations, so we explored whether we could also identify these factors among women in Taiwan. Research method: We conducted semi-structured qualitative interviews with 15 women (mean age 31.4) with low depression (i.e., an Edinburgh Postnatal Depression Scale score less than 4). Three participants were in each of the 3 prenatal periods, and 3 were in each of the 2 postpartum periods. Results: We analyzed the interviews and categorized responses into the following themes: stress dilemmas during pregnancy and childbirth; positive cognition and attitude adjustment; positive habits; positive perception of social and family support; and relevant interpretations of maternal duties. Conclusions: From these themes, we identified 5 common positive psychological factors: 1) interpreting maternal duties as involving a heavy physical burden, but less of a psychological burden; 2) a psychological orientation to submission to fate or destiny, which functioned as a stress-coping strategy; 3) displaying self-care in response to disharmony in interpersonal relationships along with an empathetic attitude and cooperative behavior; 4) a perception of being respected and supported; and, 5) after becoming a mother, the woman’s personally-oriented self transformed into a family-oriented self. Three of these 5 factors are similar to those found in previous studies in other nations, but the 2nd and 5th factors differ from those identified in other nations.