Dyadic Coping And Anxiety And Depressive Symptoms In Patients With Obstetrical Complications And Their Spouses

Background:The incidence of obstetrical complications continues to rise.Women with obstetric complications are at particularly increased risks for developing anxiety and depressive symptoms.Early detection and remission of prenatal anxiety and depressive symptoms is critical to reducing adverse outcomes in both mother and fetus.Hence,it is necessary to identify the severity of anxiety and depressive symptoms in patients with obstetrical complications and the predictive factors to provide an empirical basis for effective and targeted intervention.Based on the Systemic-Transactional Model,dyadic coping is emerging as a key aspect in patients’ and spouses’ adjustment to diseases.Studies have shown that dyadic coping is associated with depressive symptoms in cancer patients and their spouses However,there is limited evidence regarding whether dyadic coping influences patients’ and couples’ anxiety and depressive symptoms among couples facing obstetric complications.Objective:To compare the anxiety and depressive symptoms between patients with obstetrical complications and matched healthy pregnant women and to explore the effects of patients’ and spouses’ dyadic coping on their anxiety and depressive symptoms.Methods:The present study included a comparative study and a dyadic study.The cross-sectional design was used.Patients with obstetrical complications were selected as the case group and matched healthy pregnant women were selected as healthy groups in the comparative research.Demographic characteristics and medical information,anxiety and depressive symptoms of the subjects were assessed using the general information questionnaire,State-Trait Anxiety Inventory-State(STAI-S)and Edinburgh Postnatal Depression Scale(EPDS).The independent sample t test,Chi-square test and multiple Logistic regression were used to compare the anxiety and depressive symptoms of patients with obstetrical complications group and healthy group.Patients with obstetrical complications and their spouses were selected to examine the dyadic influence of dyadic coping in the dyadic study.Measures included the general information questionnaire,STAI-S,EPDS and Dyadic Coping Inventory(DCI).STAI-S and EPDS are widely-used scales with good reliability and validity that applied to the evaluation of prenatal anxiety and depressive symptoms in pregnant women.Data were analyzed using SPSS 26.0 and Mplus8.3.Statistical methods included descriptive analysis,paired t test,Chi-square test,independent sample t test,analysis of variance,Pearson correlation analysis,and path analysis.Results:1.A total of 197 patients with obstetrical complications and 197 healthy pregnant women completed the survey.The scores of anxiety and depressive symptoms in patients with obstetrical complications were both significantly higher than the scores of those in healthy pregnant women(t=-9.887,P<0.001;t=-6.909.P<0.001).The proportion of anxiety symptom in women with obstetrical complications was significantly higher than that in healthy pregnant women(67.0%vs.24.9%,χ2=70.403,P<0.001).The proportion of depressive symptom in women with obstetrical complications was also significantly higher than that in healthy pregnant women(29.4%vs.10.7%,χ2=21.675,P<0.001).Compared with women in the healthy control group,those with obstetrical complications had a 6.496-fold increased risk of anxiety symptom(OR=6.496,P<0.001),while obstetrical complications was associated with a 4.916-fold increased risk of depressive symptom(OR=4.916,P<0.001).2.The mean scores of anxiety symptom in patients with obstetrical complications and their spouses were 43.41 ± 10.59 and 41.83± 10.33 respectively and there was no statistically significant difference in mean scores and the proportions of anxiety symptom(t=1.838,P=0.068;χ2=2.455,P=0.117).The mean score of the depressive symptom in patients with obstetrical complications was 10.06±4.91,which was significantly higher than that in their spouses(t=4.591,P<0.001).The proportion of depressive symptom in women with obstetrical complications was also significantly higher than that in their spouses(29.4%vs.19.3%,χ2=5.509,P=0.019)3.The mean score of stress communicated by oneself in patients with obstetrical complications was significantly higher than that in their spouses(t=5.235,P<0.001).The mean score of supportive dyadic coping by oneself in patients was significantly lower than that in their spouses(t=-2.500,P=0.013).The mean score of delegated dyadic coping by oneself in patients was significantly lower than that in their spouses(t=-3.166,P=0.002).The mean scores of patients’ and their spouses’ negative dyadic coping by oneself had no statistically significant difference(t=-1.609,P=0.109).The mean score of patients’ common dyadic coping was significantly lower than that of their spouses’(t=-2.724,P=0.007).4.A positive correlation between patients’ and their spouses’ own dyadic coping was found(r=0.479,P<0.001),while patients’ common dyadic coping was significantly positively correlated with their spouses’(r=0.258,P<0.001).The level of anxiety symptom in patients was significantly positively correlated with that in their spouses(r=0.339.P<0.001),while the level of depressive symptom in patients was significantly positively correlated with that in their spouses(r=0.210,P=0.003).5.There were actor effects of one’ own dyadic coping on anxiety symptom both for patients(β=-0.276,P<0.001)and their spouses(β=-0.296,P<0.001).There were no partner effects of one’ own dyadic coping on anxiety symptom both for patients(β=-0.095,P=0.207)and their spouses(β=-0.084,P=0.264).In the actor-partner interdependence model(APIM)of one’ own dyadic coping on depressive symptom,although patients’ own dyadic coping had no actor effect on their own depressive symptom(β=-0.018,P=0,829)and no partner effect on their spouses’ depressive symptom(β=-0.083,P=0.306),spouses’ own dyadic coping had a significant actor effect on their own depressive symptom(β=-0.208,P=0.008)and a significant partner effect on the patients’ depressive symptom(β=-0.163,P=0.046).6.There were actor effects of common dyadic coping on anxiety symptom both for patients(β=-0.1 52.P-0.02)and their spouses(β=-0.1 86,P=0.008).Moreover,there were partner effects of common dyadic coping on anxiety symptom both for patients(β=-0.141,P=0.045)and their spouses(β=-0.151,P=0.031).In the APIM of common dyadic coping on depressive symptom,only spouses’ common dyadic coping had a significant partner effect on the patients’ depressive symptom(β=-0.159,P=0.029).Conclusion:1.Patients with obstetrical complications had severer anxiety and depressive symptoms than healthy pregnant women.2.The use of one’ own dyadic coping in patients with obstetrical complications and spouses are associated with their own anxiety symptom,but not the other’s anxiety symptom.Meanwhile,patients’ use of own dyadic coping is not associated with their own and spouses’ depressive symptom,while spouses’ use of own dyadic coping is associated with their own and their patients’ depressive symptom.3.The use of common dyadic coping in patients and spouses are associated with their own depressive symptom and their spouses’ depressive symptom.Meanwhile,patients’ use of common dyadic coping is not associated with their own and spouses’depressive symptom,while spouses’ use of common dyadic coping is associated with the patients’ depressive symptom,but not their own depressive symptom.