不孕污名對不孕夫妻情緒的影響：行動者與伴侶相依模式之探討

Abstract

不孕對夫妻的心理、生理及社會等層面造成持續負面影響，因此其情緒適應是治療中不應被忽視的一環。多數研究指出女性相較其伴侶承受較大的負向影響，如高壓力、憂鬱、焦慮、自責等。此男女差異可能源於不孕違反常規的生育觀念及華人文化的孝道觀念，從而帶來不孕污名，社會形塑的性別角色對生育有著不同意義，讓女性更深受不孕污名之苦。夫妻具有相依特質，不孕亦為夫妻共同經歷，然過去研究多數以女性及個人層面為主，不孕男性及對偶層面少被探討。本研究採用對偶分析—APIM模式來探討不孕夫妻的不孕污名對自己及伴侶之情緒影響。研究對象為台灣不孕症門診初診的170對夫妻，以問卷調查法進行。研究結果發現：（1）相較於丈夫，妻子的不孕污名、負向情緒都較高，而正向情緒較低；（2）夫妻的不孕污名對自己的正負向情緒皆具顯著的行動者效果；（3）妻子的不孕污名對其丈夫的正向情緒具顯著伴侶效果，對其丈夫的負向情緒具接近顯著效果；（4）男性的不孕污名對其妻子的正向及負向情緒的影響皆不顯著。本研究結果支持不孕污名對不孕夫妻之情緒適應的重要性，其具有個人及伴侶間的影響，而伴侶不孕污名的影響具性別差異，反映可能汲及其他如認知評估、因應策略傾向等不同因素的影響。

Infertility brings along extended negative impacts to couples in aspects such as psychological, biological and social, therefore their emotional adjustment should not be overlooked during medical treatment. Infertility is regarded as unfilial in Chinese culture, and it violates the conventional norm about reproduction, thus infertility is stigmatized. Most studies have shown that women suffer a greater negative impact than men, such as higher level of distresses, depression, anxiety, and self-blame. Such difference might be contributed by traditional gender role assumption on fertility, making women more vulnerable to infertility stigma. Infertility is a shared stressor, both members of the infertile couple experience it independently, confront it jointly as interdependent dyadic unit. However, most literatures focused on studying infertile female at personal level, whilst studies focusing on infertile male and examining the impact of infertility stigma using the couple as unit of analysis are lacking. A dyadic approach was adopted in this research and the actor-partner interdependence model (APIM) was used to examine whether and how women and men infertility stigma were associated with their own and their partner’s emotions. A total of 340 Taiwan infertile outpatients (170 couples) had completed self-report questionnaires to assess their infertility stigma, positive and negative emotions. Results indicated that (1) women had higher levels of infertility stigma, negative emotions and lower positive emotions; (2) both men and women’s infertility stigma excreted a significant actor effect on their own positive and negative emotions; (3) women’s infertility stigma exerted a significant and a marginal significant partner effect on their husbands’ positive and negative emotions respectively; (4) however, men’s infertility stigma had no significant partner effect on their wives’ emotions. These findings highlight the importance of infertility sigma in emotional adjustment, as it exerted adversely impact on personal and dyadic levels. On the other hand, the gender differences in partner effect might involve other unexplored factors such as appraisal or coping strategies.