Korean J Women Health Nurs.  2020 Dec;26(4):318-325. 10.4069/kjwhn.2020.11.12.

Influence of self-differentiation, psychological discomfort, and marital dyadic adjustment on maternal-fetal attachment in primigravida

• Kim BK
• Sung MH

• KMID: 2510368
• DOI: http://doi.org/10.4069/kjwhn.2020.11.12

Abstract

Purpose
The purpose of this study was to identify the effects of self-differentiation, psychological discomfort, and dyadic adjustment on maternal-fetal attachment in primigravidae.
Methods
In total, 108 primigravidae participated in this correlational study. The participants answered self-report questionnaires. Data were collected from January 14, 2020 to May 4, 2020, and were analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression with SPSS for Windows ver. 23.0.
Results
The mean age of the primigravidae was 31.66 years. The mean score for the degree of maternal-fetal attachment was 76.81 out of 96 points. Participants’ scores for maternal-fetal attachment differed significantly based on age (t=2.08 p=.039) and marital status (t=2.05, p=.043). Maternal-fetal attachment was significantly negatively correlated with psychological discomfort (r=–.39, p<.001), and significantly positively correlated with self-differentiation (r=.36, p<.001) and dyadic adjustment (r=.36, p<.001). Self-differentiation explained 24.1% of variance in participants’ maternal-fetal attachment, and its effect was statistically significant (F=7.79, p<.001).
Conclusion
In primigravidae, more self-differentiation was associated with stronger maternal-fetal attachment. To strengthen maternal-fetal attachment in primigravidae, it is necessary to develop an educational program that increases their level of self-differentiation and minimizes their psychological discomfort. Additionally, it is recommended to provide nursing interventions to encourage couples to work together throughout the gestational period.

Keyword

Pregnant women; Maternal-fetal relations; Psychological distress; 임부; 애착; 심리적 불편감

Reference

References

1. Bang MR, Lee JH, Lee JA, Jung JY, Park SY, An OS, et al. Motherhood and role confidence in the immediate postpartum period. J Korean Acad Womens Health Nurs. 2000; 6(2):291–304.

2. Chae JY, Chung HJ. The influences of self-differentiation and psychological discomfort on antenatal attachment of pregnant couples in their third trimester of pregnancy. J Korean Home Manag Assoc. 2015; 33(2):89–102. https://doi.org/10.7466/JKHMA.2015.33.2.89.

3. Cranley MS. Development of a tool for the measurement of maternal attachment during pregnancy. Nurs Res. 1981; 30(5):281–284. https://doi.org/10.1097/00006199-198109000-00008.

4. Lee SA, Lee SH. Factors influencing maternal-fetal attachment among pregnant women. J Korea Acad Industr Coop Soc. 2015; 16(3):2020–2028. https://doi.org/10.5762/KAIS.2015.16.3.2020.

5. Bloom KC. The development of attachment behaviors in pregnant adolescents. Nurs Res. 1995; 44(5):284–289. https://doi.org/10.1097/00006199-199509000-00005.

6. Fuller JR. Early patterns of maternal attachment. Health Care Women Int. 1990; 11(4):433–446. https://doi.org/10.1080/07399339009515913.

7. Kang SK, Choi JH, Chung MR. The effects of personal characteristics, marital intimacy and family support of pregnant couples on parent-fetal attachment. Early Child Educ Care. 2017; 12(2):223–245.

8. Bowen M. Theory in the practice of psychotherapy. In: Guerin PJ, editor. Family therapy: theory and practice. New York: Gamer Press; 1976. p. 42-90.

9. Cho SH, Park CO. Inquiry into parenting experiences based on Bowen’s concept of self-differentiation. Early Child Edu Rev. 2012; 16(2):139–166.

10. van Bussel JC, Spitz B, Demyttenaere K. Anxiety in pregnant and postpartum women. An exploratory study of the role of maternal orientations. J Affect Disord. 2009; 114(1-3):232–242. https://doi.org/10.1016/j.jad.2008.07.018.

11. Pearson RM, Evans J, Kounali D, Lewis G, Heron J, Ramchandani PG, et al. Maternal depression during pregnancy and the postnatal period: risks and possible mechanisms for offspring depression at age 18 years. JAMA Psychiatry. 2013; 70(12):1312–1319. https://doi.org/10.1001/jamapsychiatry.2013.2163.

12. Möhler E, Parzer P, Brunner R, Wiebel A, Resch F. Emotional stress in pregnancy predicts human infant reactivity. Early Hum Dev. 2006; 82(11):731–737. https://doi.org/10.1016/j.earlhumdev.2006.02.010.

13. Spanier GB. Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. J Marriage Fam. 1976; 38(1):15–28. https://doi.org/10.2307/350547.

14. Chung MR, Kang SK, Lee HJ. The relationship between marital quality and parent-fetal attachment by pregnant couples. J Korean Home Econ Assoc. 2012; 50(4):51–61. http://doi.org/10.6115/khea.2012.50.4.051.

15. Baek HJ. Mediation effect of recognition of spousal support and emotional state on the relationship of pregnant women’s attachment to mother and maternal-fetal attachment [dissertation]. Seoul: Hongik University;2009. 96.

16. Mercer RT, Ferketich S, May K, DeJoseph J, Sollid D. Further exploration of maternal and paternal fetal attachment. Res Nurs Health. 1988; 11(2):83–95. https://doi.org/10.1002/nur.4770110204.

17. Park M, Lee S. Effects of an experience-focused prenatal program on stress, anxiety, childbirth confidence, and maternal-fetal attachment on women in their first pregnancy. Korean J Women Health Nurs. 2018; 24(2):126–137. https://doi.org/10.4069/kjwhn.2018.24.2.126.

18. Akbarzade M, Setodeh S, Sharif F, Zare N. The effect of fathers’ training regarding attachment skills on maternal-fetal attachments among primigravida women: a randomized controlled trial. Int J Community Based Nurs Midwifery. 2014; 2(4):259–267.

19. Mehran P, Simbar M, Shams J, Ramezani-Tehrani F, Nasiri N. History of perinatal loss and maternal-fetal attachment behaviors. Women Birth. 2013; 26(3):185–189. https://doi.org/10.1016/j.wombi.2013.04.005.

20. Chung HJ, Cho EK. Korean self-differentiation inventory: development and validation. Fam Fam Ther. 2007; 15(1):19–46.

21. Derogatis LR. Brief Symptom Inventory (BSI-18): administration, scoring and procedures manual. Minneapolis, MN: NCS Pearson;2001.

22. Park KP, Woo SW, Chang MS. Validational study of brief symptoms inventory-18 in college students. Korean J Clin Psychol. 2012; 31(2):507–521. https://doi.org/10.15842/kjcp.2012.31.2.006.

23. Busby DM, Russell CD, Larson JH, Christensen C. A revision of the dyadic adjustment scale for use with distressed and nondistressed couples: construct hierarchy and multidimensional scales. J Marital Fam Ther. 1995; 21(3):289–308. https://doi.org/10.1111/j.1752-0606.1995.tb00163.x.

24. Choi SI. Revision dyadic adjustment scale: reliability and validity [Ko Hwang thesis]. Seoul: Kyung Hee University;2004. 97-114.

25. Chang SB, Kim KY, Kim ES. Changes of maternal-fetal attachment and self efficacy for delivery after the taekyo-perspective prenatal class. Korean J Women Health Nurs. 2001; 7(1):7–17.

26. Lee SH, Lee EY. The influence of anxiety and dyadic adjustment on maternal-fetal attachment in high-risk pregnant women. Int J Softw Eng Appl. 2015; 9(12):361–372. https://doi.org/10.14257/ijseia.2015.9.12.32.

27. Hwang RH. Effects of state-anxiety and dyadic adjustment on pregnant women’s pregnancy stress. J Digit Converg. 2019; 17(5):225–233. https://doi.org/10.14400/JDC.2019.17.5.225.