不孕症患者体外受精-胚胎移植治疗期间心理弹性变化轨迹及影响因素研究

doi:10.3761/j.issn.0254-1769.2026.03.002

摘要/Abstract

摘要：

目的探究不孕症患者体外受精-胚胎移植治疗期间心理弹性变化轨迹及其影响因素，为实施针对性的护理干预提供依据。方法采用便利抽样法，选取2023年6月—2024年8月在湖南省湘潭市某三级甲等医院生殖医学中心就诊的308例不孕症患者为调查对象。在患者入院当天（T1）调查患者的一般资料、心理弹性、社会支持、自我效能感，在进入周期建档日（T2）、取卵日（T3）、查人绒毛膜促性腺激素日（T4）、妊娠1个月（T5）、妊娠3个月（T6）分别调查其心理弹性。运用潜类别增长模型识别不孕症患者心理弹性变化轨迹，采用多元Logistic回归分析其影响因素。结果共276例不孕症患者全程参与6次调查。共识别出4个不孕症患者体外受精-胚胎移植治疗期间心理弹性变化轨迹潜在类别，分别为低心理弹性上升组（25.4%）、低心理弹性平稳组（41.3%）、中心理弹性下降组（23.2%）、高心理弹性平稳组（10.1%）；自我效能感、年龄、BMI、诊断类型、是否存在恐惧或无助是不孕症患者体外受精-胚胎移植治疗期间心理弹性变化轨迹潜在类别的影响因素。结论不孕症患者体外受精-胚胎移植治疗期间心理弹性变化轨迹存在异质性，医护人员可根据不同轨迹类别的影响因素，制订针对性的干预措施，以提升其心理弹性水平。

关键词: 不孕症, 体外受精-胚胎移植, 心理弹性, 变化轨迹, 潜在类别, 影响因素分析, 护理

Abstract:

Objective To explore the resilience trajectories and influencing factors in infertile women undergoing in vitro fertilization-embryo transfer treatment，to provide references for implementing targeted nursing interventions. Methods Using a convenience sampling method，308 infertile women treated at a tertiary hospital reproductive medicine center in Hunan Province，China，from June 2023 to August 2024 were enrolled. General information，resilience，perceived social support，and self-efficacy were collected on the initial consultation day（T1）. Resilience was reassessed at 6 time points：cycle initiation documentation day（T2），ovum retrieval day（T3），HCG testing day（T4），a month of pregnancy（T5），and 3 months of pregnancy（T6）. Latent class growth modeling（LCGM） was used to identify resilience trajectory patterns，and multivariate logistic regression was conducted to analyze influencing factors. Results All 276 participants completed 6 surveys. Totally 4 distinct resilience trajectory classes were identified，including low-resilience ascending group（25.4%），low-resilience stable group（41.3%），moderate-resilience descending group（23.2%），and high-resilience stable group（10.1%）. Self-efficacy，age，BMI，primary infertility，and feelings of fear or helplessness were significant predictors for the latent classes of resilience trajectories. Conclusion Heterogeneity exists in resilience trajectories among infertile women during In Vitro Fertilization and Embryo Transfer treatment. Healthcare providers should develop tailored interventions based on trajectory-influencing factors to enhance psychological resilience.

Key words: Infertility, In Vitro Fertilization and Embryo Transfer, Resilience, Developmental Trajectories, Latent Classes, Root Cause Analysis, Nursing Care

薛晶, 王喆, 成放群, 陈思宇, 贺聪, 徐强, 彭鹏, 成沛玉. 不孕症患者体外受精-胚胎移植治疗期间心理弹性变化轨迹及影响因素研究[J]. 中华护理杂志, 2026, 61(3): 302-309.

XUE Jing, WANG Zhe, CHENG Fangqun, CHEN Siyu, HE Cong, XU Qiang, PENG Peng, CHENG Peiyu. Resilience developmental trajectories and influencing factors in infertile women undergoing in vitro fertilization and embryo transfer treatment[J]. Chinese Journal of Nursing, 2026, 61(3): 302-309.

图/表 3

表1 调查对象的一般资料及心理弹性变化轨迹潜在类别的单因素分析[例（百分比，%）]

Table 1 Univariate analysis of participants’ characteristics and latent classes of psychological resilience development trajectories[cases（percentage，%）]

图1 不孕症患者体外受精-胚胎移植治疗期间心理弹性轨迹类别注：HCG为人绒毛膜促性腺激素。

Figure 1 Categories of psychological resilience trajectories in infertile patients during IVF-ET treatment

表2 不孕症患者体外受精-胚胎移植治疗期间心理弹性变化轨迹潜在类别的多元Logistic回归分析结果（n=276）

Table 2 Multivariate logistic regression analysis results of potential categories of psychological resilience change trajectories in infertile patients during IVF-ET treatment（n=276）

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