不孕症患者治疗决策冲突的双路径模型:生育压力与健康信念的中介效应OA

Objective:To construct and verify a dual-path model of treatment decision conflict in infertile patients,and to explore the mediating effect of fertility stress and health belief.Methods:A total of 202 female infertility pa-tients who were treated in our hospital from October 2023 to June 2025 were selected by convenience sampling method.The general information questionnaire,decision conflict scale,fertility stress assessment scale and health be-lief model scale were used for investigation.The Process macro program(Model 6)is used to construct a dual-path mediating effect model and test its significance.Results:There were statistically significant differences in the total scores of treatment decision-making conflicts among infertile patients with different ages,children's conditions and infertility years(t/F=14.815,3.212,5.265;P＜0.05).Pearson correlation analysis showed that the total score of treatment conflict scale in infertility patients was positively correlated with the total score of fertility stress(r=0.408,P＜0.05),and negatively correlated with the total score of health belief(r=-0.372,P＜0.05).There was a negative correlation between the total score of fertility stress and the total score of health belief in infertile patients(r=-0.319,P＜0.05).The results of mediating effect showed that age,having children and infertility years had signifi-cant direct effects on treatment decision-making(β=3.252,-2.441,3.619;P＜0.05).Age indirectly aggravated deci-sion-making conflict by increasing fertility pressure(β=0.382)and reducing health belief(β=-0.291),with the me-diating effect value accounting for 14.2％.Having children indirectly reduced conflict by alleviating fertility pressure(β=-0.237)and enhancing health beliefs(β=0.186),and the mediating effect value accounted for 17.1％;the dura-tion of infertility indirectly aggravated the conflict by strengthening fertility pressure(β=0.415)and weakening health belief(β=-0.302),with a mediating effect value of 14.2％.Bootstrap sampling test(repeated 5000 times)showed that the 95％confidence interval of the two mediating paths did not include 0,the fertility stress path(95％CI:0.217～0.709),and the health belief path(95％CI:0.185～0.637).Conclusion:Age,children's condition and in-fertility years are related to the treatment decision-making conflict of infertility patients.The dual-path model re-veals that the treatment decision-making conflict of infertility patients not only affects the decision-making process through the fertility stress path,but also through the health belief path.Clinical attention should be paid to patients'psychology and beliefs,combined with mindfulness decompression,shared decision-making and other measures to help patients optimize the decision-making process and improve the quality of their treatment deci-sions.