Korean J Women Health Nurs.  2023 Dec;29(4):302-316. 10.4069/kjwhn.2023.11.13.1.

An explanatory model of quality of life in high-risk pregnant women in Korea: a structural equation model

• Park M
• Ahn S

• KMID: 2550994
• DOI: http://doi.org/10.4069/kjwhn.2023.11.13.1

Abstract

Purpose
This study aimed to develop and validate a structural model for the quality of life (QoL) among high-risk pregnant women, based on Roy’s adaptation model. Methods: This cross-sectional study collected data from 333 first-time mothers diagnosed with a high-risk pregnancy in two obstetrics and gynecology clinics in Cheonan, Korea, or participating in an online community, between October 20, 2021 and February 20, 2022. Structured questionnaires measured QoL, contextual stimuli (uncertainty), coping (adaptive or maladaptive), and adaptation mode (fatigue, state anxiety, antenatal depression, maternal identity, and marital adjustment). Results: The mean age of the respondents was 35.29±3.72 years, ranging from 26 to 45 years. The most common high-risk pregnancy diagnosis was gestational diabetes (26.1%). followed by preterm labor (21.6%). QoL was higher than average (18.63±3.80). Above-moderate mean scores were obtained for all domains (psychological/baby, 19.03; socioeconomic, 19.00; relational/spouse-partner, 20.99; relational/family-friends, 19.18; and health and functioning, 16.18). The final model explained 51% of variance in QoL in high-risk pregnant women, with acceptable overall model fit. Adaptation mode (β=–.81, p=.034) and maladaptive coping (β=.46 p=.043) directly affected QoL, and uncertainty (β=–. 21, p=.004), adaptive coping (β=.36 p=.026), and maladaptive coping (β=–.56 p=.023) indirectly affected QoL. Conclusion: It is essential to develop nursing interventions aimed at enhancing appropriate coping strategies to improve QoL in high-risk pregnant women. By reinforcing adaptive coping strategies and mitigating maladaptive coping, these interventions can contribute to better maternal and fetal outcomes and improve the overall well-being of high-risk pregnant women.

Keyword

High-risk pregnancy; Nursing; Psychological adaptation; Quality of life; Uncertainty

Figure

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  Figure 1. Conceptual framework of quality of life in high-risk pregnant women based on Roy’s model.

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  Figure 2. Theoretical model of quality of life in high-risk pregnant women.

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  Figure 3. Path diagram of the modified model. x1: uncertainty; y1: putting into perspective; y2: refocus in planning; y3: acceptance; y4: positive refocusing; y5: positive reappraisal; y6: self-blame; y7: blaming others; y8: rumination; y9: catastrophizing y10: fatigue; y11: state anxiety; y12: antenatal depression; y13: maternal identity; y14: marital adjustment; y15: psychological/baby; y16: socioeconomic; y17: relational/spouse-partner; y18: relational/family-friends; y19: health and functioning.

Reference

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