Construction and empirical study of dual subject-object interdependence model between abortion patients and their spouses
稽留流产患者及配偶二元主客体互倚模型构建与实证研究

摘要

目的 构建稽留流产（MA）患者及其配偶二元关系中，心理韧性在二元评估、二元应对与二元调整间的主客体互倚中介模型，探讨双方在应对疾病时的相互影响机制。方法 将2024年1月至2024年12月在医院确诊为MA的患者及其配偶作为研究对象。通过问卷调查收集二元评估、二元应对、二元调整及心理韧性相关数据，采用主客体互倚模型（APIM）和结构方程模型进行数据分析，检验心理韧性的中介效应及模型可行性。结果 心理韧性在MA患者及其配偶的二元评估、二元应对与二元调整中存在显著的主客体互倚中介效应：患者与配偶的二元评估不仅通过自身心理韧性影响自身二元调整（主体效应），还可通过对方心理韧性影响对方二元调整（客体效应）；二元应对与二元调整的关系也呈现类似的交互影响模式。发展背景应对模型在MA患者及配偶二元关系中具有良好适用性。结论 MA患者与配偶的二元关系存在动态交互影响，心理韧性在双方应对疾病的过程中起关键中介作用。该模型为理解夫妻共同应对MA的机制提供了新视角，可指导临床制定以夫妻为单位的干预方案，助力优生优育体系建设。

Abstract

Objective To construct a subject-object mediation model of psychological resilience in the dyadic relationship between patients with missed abortion (MA) and their spouses, examining the interactive mechanisms between mutual evaluation, coping strategies, and adjustment processes.
Methods The patients diagnosed with MA in the hospital from January 2024 to December 2024, as well as their spouses, were selected as the research subjects. Data on mutual evaluation, coping strategies, adjustment processes, and psychological resilience were collected through questionnaires. The model fit and mediating effects of psychological resilience were analyzed using the Parent-Subject Interaction Model (APIM) and structural equation modeling.
Results Psychological resilience demonstrated significant mediating effects in the evaluation, coping, and adjustment processes: Spousal mutual evaluation influenced both the patient's self-adjustment (subject effect) and the partner's adjustment (object effect) through psychological resilience; similar interaction patterns were observed in coping and adjustment processes. Background The Coping Model has shown good applicability in MA dyads.
Conclusion   The dynamic interactions in MA patients' dyadic relationships highlight psychological resilience as a critical mediator in disease management. This model provides a novel perspective for understanding collaborative MA coping mechanisms, guiding clinical interventions tailored to couples and supporting the development of reproductive health systems.