مجله علوم پزشکی پارس

مدل ساختاری افسردگی پس از زایمان بر اساس حمایت اجتماعی و رضایت زناشویی با میانجی گری استرس والدینی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری، گروه روان‌شناسی، واحد مرودشت، دانشگاه ازاد اسلامی، مرودشت، ایران

2 استادیار، گروه روان‌شناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران

چکیده

مقدمه: شناسایی عوامل روانی ­­اجتماعی مداخله­ گر در ایجـاد افسـردگی پــس از زایمــان می­تواند به کاهش بروز این اختلال، تسهیل رفتارهای ارتقاء سلامتی و تطابق موثر مادر با کودک و خانواده پس از یک دوره استرس­زا منجر شود. هدف پژوهش حاضر ارایه مدل ساختاری افسردگی پس از زایمان بر اساس حمایت اجتماعی و رضایت زناشویی با میانجی­گری استرس والدینی بود.
روش­کار: پژوهش حاضر یک مطالعه مقطعی بود. نمونه­های پژوهش را کلیه زنان تازه­ زایمان­کرده تشکیل می­ دادند ­که 415 مادر مراجعه کننده جهت زایمان طبیعی و سزارین بصورت نمونه ­گیری تصادفی از بیمارستان استاد­­مطهری جهرم جمع­ آوری شده­ اند. ابزارگردآوری داده ­ها شامل مقیاس افسردگی پس از زایمان ادینبرگ، پرسشنامه حمایت اجتماعی شربورن و استوارت، مقیاس رضایت زناشویی انریچ و مقیاس استرس والدینی- فرم کوتاه آبیدین بود که 4 تا 8 هفته پس از زایمان تکمیل شد. آنالیز داده­ ها با استفاده از نرم ­افزار تحلیل ساختارهای گشتاوری (AMOS) نسخه 24 و پایایی ابزارها به روش آلفای­ کرونباخ و با کمک نرم افزارSPSS نسخه 23 بررسی ‌گردید. ساختار عاملی هر ابزار، با روش تحلیل عاملی تاییدی مورد بررسی قرار گرفت.
یافته­ها: حمایت اجتماعی و رضایت زناشویی نمی‏توانند به صورت مستقیم بر افسردگی پس از زایمان اثر داشته باشند. حمایت اجتماعی به صورت غیرمستقیم (0.24-= p=0.03. β) از طریق استرس والدینی بر افسردگی پس از زایمان اثر معنادار دارد و رضایت زناشویی نیز به صورت غیرمستقیم از طریق استرس والدینی (0.59-= p=0.02. β)  می‏ تواند بر افسردگی پس از زایمان موثر باشد.
نتیجه­گیری:
 نتایج این مطالعه بیانگر نقش واسطه‌ای استرس والدینی در رابطه بین حمایت اجتماعی و رضایت زناشویی در پیش­ بینی نشانه‌های افسردگی پس از زایمان است. لذا با کاهش استرس والدینی می­توان علایم افسردگی پس از زایمان را بهبود بخشید.

کلیدواژه‌ها

عنوان مقاله [English]

A structural model of postpartum depression based on social support and marital satisfaction with the mediation of parenting stress

نویسندگان [English]

  • khadiejeh honarmandnejad 1
  • Maryam Kouroshnia 2
  • Nadereh Sohrabi 2
  • Maryam Zarnaghash 2

1 Ph.D. student, Department of Psychology, Marvdasht Islamic Azad University,Marvdasht,Iran

2 Assistant Professor, Department of Psychology, Marvdasht Islamic Azad University, Marvdasht, Iran

چکیده [English]

Introduction:
Many factors can play a role in postpartum depression, which significantly affect the baby, mother, family, and society. The purpose of this study was to present a postpartum depression model based on social support and marital satisfaction with the mediation of parental stress.
Method:
The current research method was descriptive and type of structural equation modeling. The statistical population of the research was all mothers have given birth who referred to Ostad Motahari Jahrom Hospital between April and October 1401, and 415 women were selected using the accidental sampling method from natural delivery and caesarean section and completed the Edinburgh Postnatal Depression scale (EPDS), the MOS Social Support Survey (MOS-SSS) Sherbourne and Stewart, the Enrich Marital Satisfaction Scale (EMS) and the short form of Abidin Parenting stress Index (PSI-4-SF) during four until eight weeks after childbirth.
Results:
Social support and marital satisfaction do not have a significant effect on postpartum depression directly. Also, social support and marital satisfaction can effect on postpartum depression through parental stress.
Conclusion:
Considering the stressful conditions during pregnancy, psychological interventions aimed at reducing parental stress can reduce maternal exhaustion after childbirth, and social support and high marital satisfaction play a significant role in preventing this disorder.
Keywords: postpartum depression, social support, marital satisfaction, parental stress

کلیدواژه‌ها [English]

  • Keywords: Depression
  • Postpartum
  • social support
  • Personal Satisfaction
  • Parents
1.America Psychiiatric Association. Diagnostic and
Statistical Manual of Disorders. 2013.
2. Mahdavy M, Kheirabadi G. The Prevalence of
Postpartum Depression and Its Related Factors
among Women in Natanz City in 2018 (Iran). Qom
Med Sci J. 2020 10;14(2):78-85. (Persian)
3.Shuman CJ, Peahl AF, Pareddy N, Morgan ME,
Chiangong J, Veliz PT, Dalton VK. Postpartum
depression and associated risk factors during the
COVID-19 pandemic. BMC Research Notes.
2022;15(1):1-5.
4. Zahid S, Tehranian N. The effect of covid-19 on
postpartum depression. The second national
conference of interdisciplinary research in
management and medical sciences: 2021. (Persian)
5.Zolfaghari F, Heydari Z, Zamani-Alavijeh F, Araban
M. Determinants of Postpartum Depression
According to the World Health Organization Model:
A Review of Literature. Health Syst Res.
2021;16(4):290-302. (Persian)
6. Kishore MT, Satyanarayana V, Ananthanpillai ST,
Desai G, Bhaskarapillai B, Thippeswamy H, Chandra
PS. Life events and depressive symptoms among
pregnant women in India: Moderating role of
resilience and social support. Int J Soc Psychiatry.
2018;64(6):570-7.
7. Sherbourne CD, Stewart AL. The MOS social support
survey. Social Sci Med. 1991;32(6):705-14.
8. Pourkhaleghi N, Askarizadeh G, Fazilat-Pour M.
predicting Post-Partum Depression of Nulliparous
Women: Role of Social Support and Delivery Type. J
Health Care. 2017; 19 (1): 18-29. (Persian)
9. Qi W, Liu Y, Lv H, Ge J, Meng Y, Zhao N, Zhao F,
Guo Q, Hu J. Effects of family relationship and social
support on the mental health of Chinese postpartum
women. BMC Pregnancy Childbirth. 2022;22(1):65.
10. Fisher TD, McNulty JK. Neuroticism and marital
satisfaction: the mediating role played by the sexual
relationship. J Fam Psychol. 2008;22(1):112.
11. Tambağ H, Turan Z, Tolun S, Can R. Perceived
social support and depression levels of women in the
postpartum period in Hatay, Turkey. Nigerian journal
of clinical practice. Niger J Clin Pract.
2018;21(11):1525-30.
12. Mitnick DM, Heyman RE, Smith Slep AM. Changes
in relationship satisfaction across the transition to
parenthood: a meta-analysis. J Fam Psychol.
2009;23(6):848.
13. Garthus-Niegel S, Horsch A, Handtke E, Von Soest
T, Ayers S, Weidner K, Eberhard-Gran M. The impact
of postpartum posttraumatic stress and depression
symptoms on couples’ relationship satisfaction: a
population-based prospective study. Front Psychol.
2018; 19(9):1728
14. Noury R, Karimi N, Mohammadi M. Relationship
between prenatal depression with social support and
marital satisfaction. Sarem J Med Res. 2017;
2(3):153-7.
153 (Persian)
15. Gotlib IH, Whiffen VE, Mount JH, Milne K, Cordy
NI. Prevalence rates and demographic characteristics
associated with depression in pregnancy and the
postpartum. J Consult Clin Psychol. 1989;57(2):269.
16. Tachibana Y, Fukushima A, Saito H, Yoneyama S,
Ushida K, Yoneyama S, Kawashima R. A new
mother-child play activity program to decrease
parenting stress and improve child cognitive abilities:
A cluster randomized controlled trial. Plos One. 2012
; 2(7): e38238.
17. Parsa P, Ahangpour P, Shobeiri F, Soltanian A,
Rahimi A. The effect of group counseling based on
problem solving on postpartum depression in mothers
attending to health care centers in Hamadan city. Nusr
Midwifery J. 2017 0;15(6):440-8.
18. Khiari Millan M. Marital Satisfaction, Parental
Stress, & Perceived Social Support of Mothers of
Children with Autism Spectrum Disorders. University
of Miami:2022.19.Dong S, Dong Q, Chen H, Yang S. Mother’s
Parenting Stress and Marital Satisfaction During the
Parenting Period: Examining the Role of Depression,
Solitude, and Time Alone. Front Psychol. 2022
1;13:680.
20. Oh HJ, Kim SS. Effects of parenting stress, sleep
quality, self-compassion and family relationship on
mothers’ postpartum depression. J Korean Acad
Fundam Nurs. 2022 31;29(2):150-8.
21. Barlow DA. Clinical handbook of psychological
disorders: A step-by-step treatment manual. New
York: Guilford Publications Inc; 2006.
22. Homan H. The book of structural equation modeling
using Lisrel software, Samt Publications:2012.
23. Tang L, Zhu R, Zhang X. Postpartum depression and
social support in China: a cultural perspective. J
Health Commun. 2016; 21(9):1055-61.
24. Dominic T. Determinants of Postpartum Depressive
Symptomatology—A Prospective Multivariate Study
among Hong Kong Chinese Women. Chine Ment
Health J. 2002; 19:626–31.
25. Harley K, Eskenazi B. Time in the United States,
social support and health behaviors during pregnancy
among women of Mexican descent. Soc Sci Med.
2006;62(12):3048-61.
26. Jennings EA, Ralston M, Schatz E. Support in times
of need: How depressive symptoms can impact receipt
of social support among aging adults in rural South
Africa. SSM-Popul Health. 2020; 12:100-6.
27. Huang HH, Lee TY, Lin XT, Duan HY. Maternal
Confidence and Parenting Stress of First-Time
Mothers in Taiwan: The Impact of Sources and Types
of Social Support. Health Care J. 2022; 10(5):878.
28. Shah Mohammadi N، Mokhtari M. The mediating
role of cognitive emotion regulation in the relationship
between perceived social support and academic
success of high school students. Culture Strateg.2018;
11(42): 181-205. (Persian)
29. Song SM, Park B, Lee WK, Park NS, Kim MN.
Examining the relationship between social support,
parenting stress, and depression in South Korean
single mothers. J Child Fam Stud. 2021; 31(3) :1-4.
30.Lee Y, Hyun MH. The effects of neuroticism on
postpartum depression: A dual mediating effect of
gratitude and parenting stress. Stress J.
2019;27(2):191-8.
31. Odinka JI, Nwoke M, Chukwuorji JC, Egbuagu K,
Mefoh P, Odinka PC, Amadi KU, Muomah RC. Post-
partum depression, anxiety and marital satisfaction: A
perspective from Southeastern Nigeria. SAJ of
Psychiatry. 2018; 24:1109.
32. Korporaal, M., Broese Van Groenou, M. I., &
Tilburg, T. G. V. Health problems and marital
satisfaction among older couples. J Aging Health.
2013; 25(8):1279-98.
33. Mohammad KI, Sabbah H, Aldalaykeh M,
ALBashtawy M, Z Abuobead K, Creedy D, Gamble J.
Informative title: Effects of social support, parenting
stress and self‐efficacy on postpartum depression
among adolescent mothers in Jordan. J Clin Nurs.
2021;30(23-24):3456-65.
34. Cousino MK, Hazen RA. Parenting stress among
caregivers of children with chronic illness: a
systematic review. J Pediatr Psychol. 2013; 38(8):809-
28.
35. Wang Z, Liu J, Shuai H, Cai Z, Fu X, Liu Y, et al.
Mapping global prevalence of depression among
postpartum women. Transl Psychiatry. 2021
20;11(1):640.
36. Veisani Y, Sayehmiri K. Prevalence of postpartum
depression in Iran-A systematic review and meta-
analysis. Iranian J Obstet Gynecol Infertil. 2012
22;15(14):21-9. (Persian)
37. Karacha M, Ranjbar F. Women's quality of life and
postpartum depression, Iranian Nurs J. 2016; 30(110):
68-77. (Persian)
38. Mohamadi M, Mohaqeqi Kamal SH, Vameghi M,
Rafiey H, Setareh Forouzan A, Sajjadi H. A meta-
analysis of studies related prevalence of depression in
Iran. J Research Health 2017, 7(1): 581-93.
مجله علوم پزشکی پارس
دوره 21، شماره 1
فروردین 1402
صفحه 27-37