| Infertility has a high incidence and is increasing year by year,while infertility can cause anxiety in women,which in turn can disrupt the female reproductive endocrine balance and cause infertility.Infertility and anxiety interact with each other to form a vicious circle.It has been found that the level of anxiety and the ability to obtain and use social support vary depending on the type of adult attachment,and the level of anxiety also varies depending on the degree of social support,which shows that adult attachment,social support,and anxiety are closely related.However,few studies have applied adult attachment to anxiety in infertile women,and in the tests of mediating effects related to adult attachment,only two dimensions of adult attachment,attachment anxiety,and attachment avoidance,have been used as independent variables,and few studies have examined the type of adult attachment as an independent variable.Therefore,this study will first investigate the influencing factors of anxiety in infertile women,and secondly examine the mediating effect of social support between adult attachment and anxiety using the two dimensions of adult attachment type and adult attachment as independent variables,respectively.Objective:In this study,through a cross-sectional survey,we will first understand the current situation of anxiety in infertile women and analyze its influencing factors,and secondly,we will test the mediating effect by using two dimensions of adult attachment and type of adult attachment as independent variables,social support as mediating variables,and state anxiety and trait anxiety as dependent variables,respectively.Methods:A self-administered questionnaire was selected from 751 infertile women who had established an assisted reproduction file at a tertiary care hospital reproductive medicine center from September 2021 to November 2022,but had not entered a treatment cycle.Excel software was used to enter the questionnaire content,and SPSS 25.0 software,SPSSPROCESS 3.3 plug-in,and R Studio 4.2.1 software were used for data processing and analysis.Results:(1)The state anxiety and trait anxiety scores of infertile women were(41.79±11.26)and(43.04±9.04),respectively.(2)The differences in state anxiety scores of infertile women with different work statuses,place of residence,education level,adult attachment type,attachment anxiety,attachment avoidance,social support,objective support,subjective support,and support utilization were statistically significant(P<0.05);the differences in trait anxiety scores of infertile women with different work status,education level,monthly per capita household income,cause of infertility,natural pregnancy history,adult attachment type,attachment anxiety,attachment avoidance,social support,objective support,subjective support,and support utilization were statistically significant(P<0.05).(3)Subjective support and support utilization were the influencing factors of state anxiety and trait anxiety in infertile women;there were statistically significant differences in state anxiety in fearful,preoccupied,and dismissing infertile women compared with safe ones(P<0.05);there were statistically significant differences in trait anxiety in fearful and preoccupied infertile women compared with safe ones(P<0.05),and there was a statistically significant difference in trait anxiety in women with no history of natural pregnancy compared to those with a history of natural pregnancy(P<0.05).(4)Attachment anxiety and attachment avoidance were positively correlated with state anxiety and trait anxiety(P<0.001);social support,subjective support,objective support,and support utilization were negatively correlated with state anxiety and trait anxiety(P<0.001);attachment anxiety and attachment avoidance were negatively correlated with social support,objective support,subjective support,and support utilization(P<0.001).(5)Social support mediated between the adult attachment’s two dimensions of attachment anxiety and attachment avoidance and state anxiety and trait anxiety in infertile females;social support mediated between the type of attachment and state anxiety and trait anxiety in infertile female adults with attachment.Conclusions:(1)Infertile women have higher levels of anxiety.(2)Subjective support,support utilization,and adult attachment types are influential factors of state anxiety in infertile women,and subjective support,support utilization,and natural pregnancy history are influential factors of trait anxiety in infertile women.(3)Adult attachment can not only directly influence the level of anxiety in infertile women but also indirectly through social support. |
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