Analysis Of The Factors Influencing Psychological Stress And The Mediating Effects Of Psychological Resilience And Social Support In Childbearing Age Han Patients With Polycystic Ovary Syndrome

Objective To analyze the psychological stress status and psychological resilience level of the Han patients with Polycystic ovary syndrome(PCOS)of childbearing age,to explore the influencing factors of the psychological stress of the patients,and to study the correlation among psychological stress,psychological resilience and social support and quality of life,also to study the mediating effects between these factors.To improve the mental health in the patients with PCOS,improve their quality of life,and to provide theoretical basis for the development of PCOS related intervention strategies.Methods In this study,convenient sampling method was used,Patients with polycystic ovary syndrome of childbearing age(20 to 45 years old)were included as the research subjects who were admitted to the First Affiliated Hospital of Kunming Medical University,the First People’s Hospital of Yunnan Province and Yuxi People’s Hospital from December 2019 to December 2020.Healthy women of childbearing age were selected as the control group.The social demographic characteristics and clinical manifestations questionnaire,Psychological Stress Scale(PSS-10),Connor-Davidson Resilience Scale(CD-RISC-25),Social Support Revalued Scale(SSRS),World Health Organization Quality of Life Questionaire abbreviated version(WHOQOL-BREF),the Chinese version of the Modified Polycystic Ovary Syndrome Quality of Life Questionnaire(MPCOSQ)were used as the survey tools in the questionnaire survey.The general sociodemographic characteristics,clinical manifestations,psychological stress,psychological resilience,social support and quality of life of the patients with PCOS and the healthy women of childbearing age were investigated.Epidata3.0 was used to establish the database,and SPSS20.0 and Amos20.0 were used to sort out and analyze the data.Chi-square test was used to compare the socio-demographic characteristics and clinical manifestations between the PCOS group and the control group.t-test or One-way ANOVA of variance were used to compare the psychological stress,resilience,social support and quality of life between the two groups.Pearson correlation was used to analyze the correlation between psychological stress,psychological resilience,social support and life quality of the patients with PCOS.A binary Logistic regression model was used to analyze the influencing factors of the psychological stress in childbearing age patients with PCOS.A multiple linear regression model and a structural equation model were used to analyze the mediating effects of psychological resilience and social support on the psychological stress and quality of life in the childbearing age patients with PCOS.Result 1.A total of 362 people were investigated in this study,including 173 in the PCOS group and 189 in the healthy control group.All were of childbearing age,with an average age of 26.74±2.50 years.There were statistically significant differences in occupation,residence,education level,type of medical insurance and history of negative life events in recent 1 year between the two groups(P<0.05),while no statistically significant differences were found in age,marital status,monthly personal income and monthly family income between the two groups(P>0.05).In terms of clinical manifestations,menstrual disorders were found in 84.40%of the childbearing age patients with PCOS,infertility was found in 35.80%,overweight/obesity was found in 29.50%,acne was found in 49.70%and hirsutism was found in 37.00%of the childbearing age patients with PCOS.The incidences of overweight,menstrual disorders and infertility in the PCOS group of childbearing age were higher than those in the control group(P<0.05).2.In terms of psychological stress,the total score of psychological stress of the childbearing age patients with PCOS was 18.89±5.28 points,while that of the control group was 17.57±4.71 points,indicating the difference in psychological stress scores between the two groups was statistically significant(P<0.05).3.The total score of psychological resilience of the childbearing age patients with PCOS was 62.40±14.48 points,and that of the control group was 66.59±12.75 points.The difference in psychological resilience scores between the two groups was statistically significant(P<0.05).4.The quality of life score of the childbearing age patients with PCOS was 2.55±0.47 points,and that of the control group was 2.67±0.49 points.The quality of life of the PCOS patients of childbearing age was lower than that of the healthy women of childbearing age(P<0.05),which was mainly reflected in the decrease of scores in the psychological domain.5.The results of the binary Logistic regression showed that the influencing factors of the psychological stress level of the childbearing age patients with PCOS were:type of medical insurance,history of negative life events in recent one year,and the number of clinical manifestations(P<0.05).Among them,the history of negative life events in recent one year(OR=3.31,P<0.01)and a bigger number of clinical manifestations(OR=3.52,P<0.05)were the risk factors for the psychological stress level of the childbearing age patients with PCOS.Having an urban employee medical insurance(OR=0.42,P<0.01)was a protective factor of psychological stress level in the PCOS patients of childbearing age.6.Pearson correlation analysis results showed that psychological stress was negatively correlated with quality of life(r=-0.438,P<0.001),psychological stress was negatively correlated with psychological resilience(r=-0.465,P<0.001)and social support(r=-0.198,P<0.05)in the childbearing age patients with PCOS.Psychological resilience(r=0.592,P<0.001)and social support(r=0.403,P<0.001)were positively correlated with quality of life.7.Multiple linear regression analysis and structural equation modeling showed that psychological resilience and social support had common mediating effects on psychological stress and quality of life in the childbearing age patients with PCOS.Among them,psychological resilience had an indirect mediating effect on quality of life through social support,while the direct effect of psychological resilience on quality of life was weakened.Conclusion Childbearing age patients with PCOS had a high level of psychological stress.The influencing factors of psychological stress in the childbearing age patients with PCOS were:history of negative life events in recent one year,the number of clinical manifestations,type of medical insurance and monthly income.The history of negative life events in recent one year and a bigger number of clinical manifestations were the risk factors of psychological stress in the childbearing age patients with PCOS.Having an urban employee medical insurance and a higher monthly income were the protective factors of the patients’ psychological stress.The quality of life of the childbearing age patients with PCOS was reduced mainly in the dimension of psychological domain.Psychological stress of the patients with PCOS can directly predict their quality of life.The higher the level of psychological stress,the lower the quality of life.Common mediating effects of psychological resilience and social support on psychological stress and quality of life could be found in the patients.Psychological stress can indirectly affect the quality of life through psychological resilience and social support,while psychological resilience can indirectly affect the quality of life through social support.Therefore,mental health screening and intervention should be further implemented in the patients with PCOS who had a history of negative life events in recent one year and a bigger number of clinical manifestations.In order to enhance the patients’ mental health and the patients’ quality of life,we should consider improving the patients’ psychological resilience and social support level.