Analysis of influencing factors of perceived uncertainty in the process of re-pregnancy in patients with recurrent abortion and nursing implications

doi:10.3761/j.issn.0254-1769.2025.14.002

Abstract

Abstract:

Objective To investigate the status of perceived uncertainty in the process of re-pregnancy in patients with recurrent abortion，and to systematically explore the influencing factors based on the health ecology model，to inform a reduction in the level of perceived uncertainty about their re-pregnancy and improve their quality of life. Methods A convenience sampling method was used to investigate 260 patients with recurrent spontaneous abortion during re-pregnancy from 2 reproductive clinics of a tertiary A hospital in Suzhou，from December 2023 to June 2024，and they were investigated by a self-designed general data questionnaire，Intolerance of Uncertainty Scale-12，Generalized Anxiety Disorder Scale and Simple Coping Style Questionnaire. The single factor analysis and multiple linear regression methods were used to analyze the influences factors of perceived uncertainty in patients with recurrent spontaneous abortion during re-pregnancy. Results A total of 256 valid questionnaires were collected，with a recovery rate of 98.5%. The score of intolerance of uncertainty in patients with recurrent spontaneous abortion during re-pregnancy was（35.18±9.23）. Multiple linear regression analysis found that average monthly family income，residence，history with assisted reproductive therapy，anxiety and coping were the factors influencing the feeling of perceived uncertainty in patients with recurrent spontaneous abortion during re-pregnancy（P<0.05）. Conclusion The level of perceived uncertainty in patients with recurrent spontaneous abortion during re-pregnancy is at a medium level. Medical workers should pay attention to the early identification of the perceived uncertainty in patients，enhance the psychological support for patients，and improve their mental health.

Key words: Uncertainty, Recurrent Spontaneous Abortion, Health Ecology Model, Anxiety, Coping, Obstetrical Nursing

摘要：

目的调查复发性流产患者再妊娠过程不确定性感知现状，并基于健康生态学模型系统探究其影响因素，为降低其再妊娠过程不确定性感知水平、提高生活质量提供参考。方法采用便利抽样法，于2023年12月—2024年6月，选取在苏州市某三级甲等综合医院2个院区生殖门诊就诊的260例复发性流产再妊娠患者作为调查对象，使用一般资料调查表、无法忍受不确定性量表简版、广泛性焦虑障碍量表、简易应对方式问卷进行调查，通过单因素分析及多元线性回归分析探讨复发性流产患者再妊娠过程不确定性感知的影响因素。结果共回收256份有效问卷，有效问卷回收率为98.5%。复发性流产再妊娠患者无法忍受不确定性量表简版得分为（35.18±9.23）分。多元线性回归分析结果发现，家庭人均月收入、居住地、辅助生殖技术助孕史、焦虑与应对方式是复发性流产患者再妊娠过程不确定性感知的影响因素（P<0.05）。结论复发性流产患者再妊娠过程不确定性感知处于中等水平，医护工作者应重视其不确定性感知并及早识别，增强心理支持，改善心理健康。

关键词: 不确定性, 复发性流产, 健康生态学模型, 焦虑, 应对, 产科护理

ZHANG Meng, LI Ying, XUE Haiyan, TAN Liping. Analysis of influencing factors of perceived uncertainty in the process of re-pregnancy in patients with recurrent abortion and nursing implications[J]. Chinese Journal of Nursing, 2025, 60(14): 1677-1683.

张梦, 李颖, 薛海燕, 谭丽萍. 复发性流产患者再妊娠过程不确定性感知的影响因素及护理启示[J]. 中华护理杂志, 2025, 60(14): 1677-1683.

Figures/Tables 2

References 30

[1]	Green DM, O’Donoghue K. A review of reproductive outcomes of women with two consecutive miscarriages and no living child[J]. J Obstet Gynaecol, 2019, 39(6):816-821. DOI PMID
[2]	Dimitriadis E, Menkhorst E, Saito S, et al. Recurrent pregnancy loss[J]. Nat Rev Dis Primers, 2020,6:98.
[3]	Bhattacharya S, McCall SJ, Woolner AMF. Recurrent pregnancy loss and subsequent preterm birth:association or causation?[J]. Fertil Steril, 2022, 117(4):820-821. DOI PMID
[4]	Ogasawara M, Aoki K, Okada S, et al. Embryonic karyotype of abortuses in relation to the number of previous miscarriages[J]. Fertil Steril, 2000, 73(2):300-304. DOI PMID
[5]	赵霞, 朱政, 余旻虹, 等. 反复入院未明确诊断患者无法忍受不确定性的质性研究[J]. 中华护理杂志, 2020, 55(4):488-493. DOI
	Zhao X, Zhu Z, Yu MH, et al. The experience of intolerance of uncertainty in patients with repeated hospital admission and no clear diagnosis:a qualitative study[J]. Chin J Nurs, 2020, 55(4):488-493. DOI
[6]	Sahib A, Chen J, Cárdenas D, et al. Intolerance of uncertainty and emotion regulation:a meta-analytic and systematic review[J]. Clin Psychol Rev, 2023,101:102270.
[7]	Causse M, Péran P, Dehais F, et al. Affective decision making under uncertainty during a plausible aviation task:an fMRI study[J]. Neuroimage, 2013,71:19-29.
[8]	Wilson EJ, Abbott MJ, Norton AR. The impact of psychological treatment on intolerance of uncertainty in generalized anxiety disorder:a systematic review and meta-analysis[J]. J Anxiety Disord, 2023,97:102729.
[9]	Hunt C, Exline JJ, Fletcher TL, et al. Intolerance of uncertainty prospectively predicts the transdiagnostic severity of emotional psychopathology:evidence from a Veteran sample[J]. J Anxiety Disord, 2022,86:102530.
[10]	McLeroy KR, Bibeau D, Steckler A, et al. An ecological perspective on health promotion programs[J]. Health Educ Q, 1988, 15(4):351-377. DOI PMID
[11]	中华医学会妇产科学分会产科学组, 复发性流产诊治专家共识编写组. 复发性流产诊治专家共识(2022)[J]. 中华妇产科杂志, 2022, 57(9):653-667.
	Obstetrics and Gynaecology Group of the Obstetrics and Gynaecology Section of the Chinese Medical Association,Expert Consensus Writing Group on the Diagnosis and Treatment of Recurrent Miscarriage. Chinese expert consensus on diagnosis and management of recurrent spontaneous abortion(2022)[J]. Chin J Obstet Gynecol, 2022, 57(9):653-667.
[12]	Freeston MH, Rhéaume J, Letarte H, et al. Why do people worry[J]. Pers Individ Dif, 1994, 17,791-802.
[13]	Carleton RN, Asmundson GJG. Fearing the unknown:a short version of the Intolerance of Uncertainty Scale[J]. J Anxiety Disord, 2007, 21(1):105-117.
[14]	张亚娟, 宋继波, 高云涛, 等. 无法忍受不确定性量表(简版)在中国大学生中的信效度检验[J]. 中国临床心理学杂志, 2017, 25(2):285-288.
	Zhang YJ, Song JB, Gao YT, et al. Reliability and validity of the Intolerance of Uncertainty Scale-Short Form in university students[J]. Chin J Clin Psychol, 2017, 25(2):285-288.
[15]	Spitzer RL, Kroenke K, Williams JBW, et al. A brief measure for assessing generalized anxiety disorder:the GAD-7[J]. Arch Intern Med, 2006, 166(10):1092-1097. DOI PMID
[16]	何筱衍, 李春波, 钱洁, 等. 广泛性焦虑量表在综合性医院的信度和效度研究[J]. 上海精神医学, 2010, 22(4):200-203.
	He XY, Li CB, Qian J, et al. Reliability and validity of a Generalized Anxiety Disorder Scale in general hospital outpatients[J]. Shanghai Arch Psychiatry, 2010, 22(4):200-203.
[17]	解亚宁. 简易应对方式量表信度和效度的初步研究[J]. 中国临床心理学杂志, 1998, 6(2):114-115.
	Xie YN. Preliminary study on the reliability and validity of Simple Coping Measures[J]. Chin J Clin Psychol, 1998, 6(2):114-115.
[18]	白璐, 房玉英, 贾冬梅, 等. 接受体外受精胚胎移植助孕女性患者的无法忍受不确定性及相关因素[J]. 中国心理卫生杂志, 2024, 38(5):400-406.
	Bai L, Fang YY, Jia DM, et al. Intolerability of uncertainty and related factors in women receiving in vitro fertilization and embryo transfer[J]. Chin Ment Health J, 2024, 38(5):400-406.
[19]	Ticconi C, Pietropolli A, Specchia M, et al. Pregnancy-related complications in women with recurrent pregnancy loss:a prospective cohort study[J]. J Clin Med, 2020, 9(9):2833.
[20]	Eleje GU, Oguejiofor CB, Oriji SO, et al. and stress and adverse pregnancy outcomes in pregnant women with history of recurrent pregnancy loss in Nigeria[J]. Int J Psychiatry Med, 2024, 59(3):303-324.
[21]	刘翠婷, 陈良英, 陈春莺, 等. 青年女性乳腺癌患者生育忧虑特征的潜在剖面分析及护理对策[J]. 中华护理杂志, 2023, 58(16):1989-1995. DOI
	Liu CT, Chen LY, Chen CY, et al. Latent profile analysis of reproductive concerns characteristics in young female breast cancer patients[J]. Chin J Nurs, 2023, 58(16):1989-1995. DOI
[22]	Hung HM, Kuo PL, Lee CS, et al. Effectiveness of mental health website intervention on stress and depression for women with recurrent miscarriage:a randomized controlled trial[J]. Health Care Women Int, 2023, 44(4):496-508.
[23]	伊若男, 刘伟伟, 马文元, 等. 结直肠癌术后病人无法忍受不确定性现状及影响因素[J]. 护理研究, 2023, 37(7):1266-1273.
	Yi RN, Liu WW, Ma WY, et al. Status quo and influencing factors of intolerance of uncertainty in patients with colorectal cancer after surgery[J]. Chin Nurs Res, 2023, 37(7):1266-1273.
[24]	史艳萍, 陈丹丹, 郑蔚. 辅助生殖技术助孕患者的信息需求及其影响因素[J]. 解放军护理杂志, 2020, 37(5):53-56.
	Shi YP, Chen DD, Zheng W. Health information needs of patients underwent assisted reproductive technology and its influencing factors[J]. Nurs J Chin PLA, 2020, 37(5):53-56.
[25]	Piazza MF, Galletta M, Portoghese I, et al. Meeting psychosocial and health information needs to ensure quality of cancer care in outpatients[J]. Eur J Oncol Nurs, 2017,29:98-105.
[26]	杨孟叶, 张艳, 钮芳芳. 辅助生殖技术助孕患者健康信息需求及干预的研究进展[J]. 中华护理杂志, 2021, 56(1):143-148. DOI
	Yang MY, Zhang Y, Niu FF. Research progress on health information needs and interventions for patients receiving assisted reproductive technology for pregnancy[J]. Chin J Nurs, 2021, 56(1):143-148. DOI
[27]	Huntley C, Young B, Tudur Smith C, et al. Testing times:the association of intolerance of uncertainty and metacognitive beliefs to test anxiety in college students[J]. BMC Psychol, 2022, 10(1):6.
[28]	Dugas MJ, Marchand A, Ladouceur R. Further validation of a cognitive-behavioral model of generalized anxiety disorder:diagnostic and symptom specificity[J]. J Anxiety Disord, 2005, 19(3):329-343.
[29]	郭雪洁, 刘红霞, 韩梦汐, 等. 肾移植受者疾病不确定感现状及其与应对方式的相关性研究[J]. 中华全科医学, 2021, 19(5):863-866,886.
	Guo XJ, Liu HX, Han MX, et al. Status quo of uncertainty in illness and its correlation with coping in kidney transplant recipients[J]. Chin J Gen Pract, 2021, 19(5):863-866,886.
[30]	Yao NS, Yang Y, Jiang Y, et al. Intolerance of uncertainty relates to anxiety and depression through negative coping and worry:evidence from a repeated-measures study[J]. Int J Cogn Ther, 2022, 15(1):42-56.