基于结构方程模型的高龄产妇产褥期疲乏影响路径分析OA

Objective To analyze the influencing path of puerperium fatigue in advanced-age parturients based on struc-tural equation model.Methods A total of 250 advanced-age parturients who attended the 42-day postpartum follow-up at the Department of Obstetrics,Ganzhou Maternal and Child Health Hospital from January 2021 to November 2024 were selected as the study subjects.Data were collected using the general information questionnaire,the Chinese version of the postpartum fatigue scale(PFS),the Pittsburgh sleep quality index(PSQI),the 10-item Connor-Davidson resilience scale(CD-RISC-10),the family APGAR index,and the social support rating scale(SSRS).Univariate analysis and multiple linear regression were employed to identify the influencing factors of postpartum fatigue among these parturients.Structural equa-tion modeling was constructed using AMOS software to analyze the pathway of effects on postpartum fatigue in advanced-age parturients.Results The postpartum fatigue score among the 250 advanced-age parturients was(16.85±2.44)points.Uni-variate analysis results indicated that there were statistically significant differences in PFS scores among parturients with different alcohol consumption and smoking statuses(P＜0.05).Correlation analysis revealed that fatigue was negatively cor-related with family care,psychological resilience,and social support,while positively correlated with sleep quality(P＜0.05).Multiple linear regression analysis demonstrated that psychological resilience(β=-0.481,B=-0.351,95%CI:-0.401--0.301),family care(β=-0.231,B=-0.454,95%CI:-0.602--0.307),social support(β=-0.254,B=-0.133,95%CI:-0.174--0.092),and sleep quality(β=0.136,B=0.321,95%CI:0.145-0.497)were influencing factors of postpartum fatigue in advanced-age parturients(P＜0.05).The structural equation model demonstrated a good fit(Chi-square/degrees of freedom ratio[χ2/df]=0.857,goodness-of-fit index[GFI]=0.997,adjusted goodness-of-fit index[AGFI]=0.976,normed fit index[NFI]=0.997,comparative fit index[CFI]=1.000,root mean square error of approximation[RMSEA]＜0.001).Specifically,sleep quality exhibited a direct positive effect on fatigue(β=0.427,P＜0.05),while family care,social support,and psycho-logical resilience showed direct negative effects on fatigue(β=-0.193,-0.285,-0.232,P＜0.05).Furthermore,family care exerted indirect effects through social support,psychological resilience,and sleep quality,psychological resilience exerted indirect effects through social support and sleep quality,and social support exerted indirect effects through sleep quality.Conclusion The puerperium fatigue of advanced-age parturients is affected by factors such as psychological resilience and family care.Improving sleep quality,psychological resilience and social level and promoting family harmony are effective ways to alleviate fatigue.