本校學位論文庫
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論文詳情
黄丹
高嵐
大健康學院
應用心理學博士學位課程
博士
2024
成為母親 : IVF女性心理的分析研究
Becoming a Mother:Psychological Analysis of Women Undergoing In vitro Fertilization
母親 ; IVF女性 ; 心理分析 ; 夢的工作
mother ; IVF women ; psychoanalysis ; dream work
公開日期:18/12/2027
在當前中國面臨日益嚴峻的人口老齡化問題和出生率下降的背景下,我們也面臨育齡夫婦不孕率不斷上升的挑戰,除了在醫學領域進行技術創新以提升試管嬰兒(IVF)的成功率和品質,關注IVF女性在成為母親這條道路上的心理狀態也同樣重要,不僅能促進個體的身心健康,還能為整個社會的健康和生育福祉做出貢獻。本研究採用調查問卷、夢的分析和個案研究相結合的研究方法,具體由以下四個研究組成:
研究一選取在廣州某三甲醫院醫院生殖中心進行試管嬰兒(IVF)治療的女性進行問卷調查,共發放問卷451份, 有效回收416份, 回收率為92.2%。調查內容主要包括一般情況調查表、狀態焦慮量表(SAI)、身體欣賞量表II(BAS-2)、簡版親密關係經歷量表(ECR-S)和婚姻主觀感受量表 (MPS),研究結果發現:(1)IVF女性比普通女性更焦慮,尤其是30歲以下和因为家庭壓力而生育的女性,焦慮水準隨治療次數增加而升高。(2)IVF女性的身體欣賞和依戀關係具有一定的穩定性,不會因治療次數的增加而持續波動。(3)IVF女性的婚姻满意度較低,但教育水準和家庭收入水準較高的女性滿意度較高。(4)不孕导致的状态焦虑并不会直接对婚姻主观感受产生影响,而是通过通過身體欣赏和依戀回避仲介而影響婚姻主观感受。
研究二研究對象與研究一同,在胚胎移植後14天左右對IVF女性進行回訪。回訪到的被試363位,缺失53位。其中,成功懷孕的人數為181位(占49.9%),未懷孕的人數為182位(占50.1%)。研究結果發現:(1)年齡因素:隨著年齡的增長,女性的生育能力下降,這在IVF治療中表現為懷孕機會減少。卵巢儲備能力降低和卵子品質下降是主要原因。(2)焦慮水準:不孕原因主要在女性時,焦慮水準對妊娠結局有顯著的負面影響。(3)婚姻质量:不孕原因是夫妻雙方的情況下,婚姻主觀感受對妊娠結局具有正向顯著的預測作用,良好的婚姻關係可能提供必要的情感支持和穩定性,從而有助於提高治療的成功率。
研究三對IVF女性的夢進行分析,通過在生殖科招募的方式,5位IVF女性自願參與夢的研究。研究結果發現:(1)IVF女性在梦中亲人角色的百分比显著高于普通女性,这与她们不安全的依恋关系有关,反映了她们对于安全感和亲密关系的需求更为强烈;(2)IVF女性梦中对女性人物的友好行为显著高于普通女性,这與她們的“母親情结”有关,反映了她們在無意識上對母性角色的探索和對母性滋養和保護的需求;已怀孕的IVF女性在梦中对女性人物的友好行为明显下降,对男性人物的攻击行为明显上升,这反映了她们在怀孕后对母性角色的适应和重新定义。(3)夢是IVF女性在面對不孕症危機時,無意識中尋求個人成長和自我實現的表現。
研究四選取三位IVF女性作為研究對象進行深入的心理分析。研究結果發現:(1)不孕會激活IVF女性的依戀關係模式。(2)不孕是對IVF女性自我身份認同的挑戰。(3)以榮格夢的工作的方式为基础,構建一個IVF女性心理分析的工作模型,瞭解IVF女性在成為母親過程中的心路歷程,重點關注她們在依戀關係和自我身份認同方面的體驗,可以有效支持IVF女性應對面临的心理挑戰。
結論: IVF女性比普通女性更焦慮,尤其是30歲以下和因為家庭壓力而生育的女性,治療次數越多,焦慮水準越高。IVF女性的婚姻滿意度較低,尤其是教育水準和家庭收入水準較低的女性,但她們的身體欣賞和依戀關係具有一定的穩定性。狀態焦慮水準對妊娠結局有顯著的負面影響,婚姻主觀感受對妊娠結局具有正向顯著的預測作用,降低焦慮水準和改善婚姻關係有助於提高治療的成功率。IVF女性的夢反映了她們不安全的依戀關係,夢中與女性人物的關係可能與她們的“母親情結”有關。不孕會激活IVF女性的依戀關係模式;不孕也是對IVF女性自我身份認同的挑戰;以榮格夢的工作的方式為基礎,可以有效支持IVF女性應對面臨的心理挑戰。
In the context of China's increasingly severe aging population and declining birth rate, we are also facing the challenge of a continuously rising infertility rate among couples of childbearing age. In addition to technological innovation in the medical field to improve the success rate and quality of in vitro fertilization (IVF), it is equally important to pay attention to the psychological state of IVF women on their path to motherhood. This not only promotes individual physical and mental health but also contributes to the health and fertility welfare of the entire society. This study employs a combination of survey questionnaires, dream analysis, and case studies, consisting of the following four research components:
Study 1 involved a questionnaire survey of women undergoing in vitro fertilization (IVF) treatment at the Reproductive Center. A total of 451 questionnaires were distributed, with 416 valid responses collected, resulting in a recovery rate of 92.2%. The survey included general situation investigation forms, State Anxiety Inventory (SAI), Body Appreciation Scale II (BAS-2), Brief Experiences in Close Relationships Scale (ECR-S), and Marital Subjective Feelings Scale (MPS). The study found that: (1) IVF women are more anxious than the general female population, especially those under 30 and those who are having children due to family pressure, with anxiety levels increasing with the number of treatment cycles. (2) The body appreciation and attachment relationships of IVF women have a certain stability and do not continue to fluctuate with an increase in the number of treatment cycles. (3) The marital satisfaction of IVF women is relatively low, but women with higher levels of education and family income have higher satisfaction. (4) The state anxiety caused by infertility does not directly affect marital subjective feelings but influences them through body appreciation and attachment avoidance mediation.
Study 2 had the same research subjects as Study 1, conducting follow-ups with IVF women about 14 days after embryo transfer. A total of 363 participants were followed up, with 53 missing. Among them, 181 successfully became pregnant (accounting for 49.9%), and 182 did not become pregnant (accounting for 50.1%). The study found that: (1) Age factor: With increasing age, women's fertility capacity declines, which is manifested in IVF treatment as a reduction in pregnancy opportunities. The main reasons are the decrease in ovarian reserve capacity and the decline in egg quality. (2) Anxiety level: When the cause of infertility is mainly in women, the anxiety level has a significant negative impact on pregnancy outcomes. (3) Marital quality: When the cause of infertility is a situation involving both spouses, marital subjective feelings have a positive and significant predictive effect on pregnancy outcomes. A good marital relationship may provide necessary emotional support and stability, thereby helping to improve the success rate of treatment.
Study 3 analyzed the dreams of IVF women, recruiting 5 IVF women who voluntarily participated in the dream study through the reproductive department. The study found that: (1) The percentage of family members in the dreams of IVF women is significantly higher than that of ordinary women, which is related to their insecure attachment relationships, reflecting a stronger demand for security and intimacy; (2) The friendly behavior towards female characters in the dreams of IVF women is significantly higher than that of ordinary women, which is related to their "mother complex," reflecting their unconscious exploration of the maternal role and the need for maternal nourishment and protection; pregnant IVF women show a significant decrease in friendly behavior towards female characters and an increase in aggressive behavior towards male characters in their dreams, reflecting their adaptation and redefinition of the maternal role after pregnancy. (3) Dreams are an expression of IVF women's unconscious search for personal growth and self-actualization in the face of infertility crises.
Study 4 selected three IVF women as research subjects for in-depth psychological analysis. The study found that: (1) Infertility activates the attachment patterns of IVF women. (2) Infertility is a challenge to the self-identity of IVF women. (3) Based on Jung's dream work method, a psychological analysis work model for IVF women was constructed to understand their psychological journey in becoming mothers, focusing on their experiences in attachment relationships and self-identity, which can effectively support IVF women in dealing with psychological challenges they face.
Conclusion: IVF women are more anxious than the general female population, especially those under 30 and those who are having children due to family pressure, with higher anxiety levels associated with more treatment cycles. The marital satisfaction of IVF women is relatively low, particularly among those with lower levels of education and family income, but their body appreciation and attachment relationships show a certain stability. State anxiety has a significant negative impact on pregnancy outcomes, while marital subjective feelings have a positive and significant predictive effect on pregnancy outcomes; reducing anxiety levels and improving marital relationships can help increase the success rate of treatment. The dreams of IVF women reflect their insecure attachment relationships, and relationships with female figures in dreams may be related to their "mother complex." Infertility activates the attachment patterns of IVF women; infertility is also a challenge to the self-identity of IVF women; using Jung's dream work method as a basis can effectively support IVF women in dealing with the psychological challenges they face.
2024
中文
233
致 謝 I
摘 要 III
Abstract VI
圖目錄 XIV
表目錄 XV
第一章 緒 論 1
1.1 研究緣起 1
1.1.1我國的人口現狀 1
1.1.2 個人體驗:成為母親 3
1.2研究目的與意義 4
1.2.1研究目的 4
1.2.2研究意義 5
1.3研究思路與方法 5
1.3.1 研究思路 5
1.3.2 研究對象與方法 6
1.3.3 伦理审查 7
第二章 文獻綜述 8
2.1 試管嬰兒 8
2.1.1試管嬰兒技術 8
2.1.2 試管嬰兒女性 9
2.2 IVF女性的心理特點 9
2.2.1 情緒狀態的研究概述 10
2.2.2 身體欣賞的研究概述 15
2.2.3依戀關係的研究概述 19
2.2.4婚姻品質的研究概述 24
2.3心理分析在IVF女性中的運用 27
2.3.1 心理分析的概念 27
2.3.2心理分析的方法——夢的工作 28
2.3.3 IVF女性心理分析的意義 32
2.4 心理分析視角下的不孕問題 34
2.4.1不孕與依戀關係 34
2.4.2 不孕與自我身份的認同 37
(1)不孕危機與女性身份的認同 37
2.4.3重複的IVF治療作為轉化的方式 39
2.5 研究述評 40
第三章 研究一:IVF女性的心理特點 42
3.1 研究目的 42
3.2研究對象 42
3.3研究方法 43
3.3.1 研究程式 43
3.3.2 研究工具 43
3.3.3數據處理 45
3.4 研究結果 45
3.4.1共同方法偏差檢驗 46
3.4.2 一般情況問卷的結果 46
3.4.3 IVF女性狀態焦慮的特點 49
3.4.4 IVF女性身體欣賞的特點 51
3.4.5 IVF女性依戀關係的特點 53
3.4.6 IVF女性婚姻主觀感受的特點 56
3.4.7 四個心理因素的關係研究 61
3.5 討論 66
3.5.1 IVF女性的基本情況 66
3.5.2 IVF女性狀態焦慮的討論 68
3.5.3 IVF女性身體欣賞的討論 69
3.5.4 IVF女性依戀關係的討論 71
3.5.5 IVF女性婚姻主觀感受的討論 73
3.5.6 四個心理因素之間關係的討論 76
第四章 研究二:心理因素對IVF女性妊娠結局的影響 79
4.1 研究目的 79
4.2研究對象 79
4.3研究方法 79
4.3.1 研究程式 79
4.3.2 研究工具 80
4.3.3數據處理 80
4.4 研究結果 80
4.5 討論 86
4.5 討論 88
第五章 研究三:IVF女性夢的研究 91
5.1 研究目的 91
5.2研究對象 91
5.3研究方法 92
5.3.1 研究程式 92
5.3.2 研究工具 93
5.3.3 數據處理 94
5.4 研究結果及分析 95
5.4.1 IVF女性夢內容與常模的比較 96
5.4.2 未懷孕與已懷孕IVF女性的夢內容的比較 99
5.5 討論 103
第六章 研究四:IVF女性的個案研究 106
6.1 研究目的 106
6.2 研究方法 106
6.3 個案研究總體情況介紹 109
6.4 個案一:備孕的小柔 110
6.4.1個案基本情況 110
6.4.2 個案心理分析過程 110
6.5 個案二:懷孕的言心 144
6.5.1個案基本情況 144
6.5.2個案心理分析過程 145
6.6 個案三:產後的伊伊 174
6.6.1個案基本情況 174
6.6.2 個案心理分析過程 175
6.7討論 181
6.7.1 不孕會激活IVF女性的依戀關係模式 182
6.7.2不孕對IVF女性自我身份認同的挑戰 184
6.7.3構建IVF女性心理分析的工作模型 186
第七章 研究結論與反思 189
7.1 研究總討論 189
7.2 研究結論 191
7.2.1 研究一的結論 191
7.2.2 研究二的結論 192
7.2.3 研究三的結論 193
7.2.4 研究四的結論 193
7.2.5 研究總結論 193
7.3 臨床實踐指導建議 195
7.4研究反思 196
7.4.1研究創新 196
7.4.2研究的不足與展望 197
參考文獻 199
作者簡歷 217
附 錄 218
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