The Effect Of Optimism And Self-Efficacy On Maternal Depression

Objective:As we know,pregnant women and puerpera were prone to have depression.Prenatal depression and postpartum depression had negative impacts on their physical and mental health and even had bad effects on their delivery out come.Optimism,pessimism and self-efficacy had important influences on pregnant women and puerpera’s mental health.This study aimed to describe the present status of pregnant women and puerpera’s optimism,pessimism,some different types of self-efficacy and depression.This study also aimed to anaylze the corelationships between all the variables mentioned above,compare the differences on different demographic data between them and explore the mechanism of how these variables affect prenatal depression by using structural equation modeling.Methods:Descriptive design was used.This study was a longitudinal study.By convenient sampling,we recruited 772 pregnant women who registered in obstetrics of a 3 A hospital in Nanjing.We used general data questionnaire,the optimism-pessimism scale,the general self-efficacy scale,the regulatory emotional self-efficacy scale,the coping self-efficacy scale,the childbrith self-efficacy inventory,the breastfeeding self-efficacy scale and the self-efficacy in infant care scale to assess participant’s optimism-pessimism,self-efficacy and maternal depression.The same questionnaires were used to re-investigate 167 parturients who voluntarily accepted follow-up within 3-42 days after delivery.We used Amos 7.7 to build a structural equation model and investigate the mediating role of general self-efficacy and specific self-efficacy between optimism-pessimism and prenatal depression of pregnant women.Results:(1)Pregnant women with younger age,more advanced degree and higher income had higher level of optimism.Pregnant women with younger age and higher income,who had only once pregnancy and natural conception,had higher regulatory emotional self-efficacy.And pregnant women who were naturally pregnant had lower confidence in successful delivery than those who had children using assisted reproduction.Older,more educated and non-first pregnancy pregnant women had higher breastfeeding self-efficacy,while higher-income and naturally pregnant women had higher self-efficacy in infant care(P<0.05).(2)Pregnant women and puerpera had low levels of general self-efficacy and high incidences of depression.The incidence of prenatal depression was 44%and the incidence of postpartum depression was 28%.Pregnant women with relatively low income were more likely to have severer symptoms of prenatal depression(P<0.05).(3)The total scores of optimism-pessimism,pessimism,the dimensions of focusing on problem solving and avoiding negative emotions,the total scores of regulatory emotional self-efficacy and the dimension of regulating depression/pain and anger/irritability,the total scores of breastfeeding self-efficacy along with the two dimensions it had,the total scores of self-efficacy in infant care and its all dimensions were significantly higher than those before delivery(P<0.05).(4)Significant correlationship had been found between prenatal optimism-pessimism,different types of self-efficacy and depression(P<0.05).Except that the skill dimension of breast-feeding self-efficacy had no significant correlationship with pessimism scores,optimism-pessimism had significant positive correlation with different types of self-efficacy and their scores in all dimensions.Optimism-pessimism had a significant negative correlation with the scores of prenatal and postnatal depression.The scores of different types of self-efficacy and its dimensions were also negatively correlated with the scores of prenatal and postnatal depression.(5)General self-efficacy and specific self-efficacy(including coping self-efficacy,regulatory emotional self-efficacy,childbrith self-efficacy,breastfeeding self-efficacy and self-efficacy in infant care)played mediating roles in the relationship between optimism and prenatal depression.Conclusions:General self-efficacy and specific self-efficacy fit well in the structural equation model between optimism and prenatal depression of pregnant women.Different types of specific self-efficacy of pregnant women are influenced by general self-efficacy,which also has impacts on depression.