内科

目的探讨无法忍受不确定性（IU）在孕晚期女性疲乏与妊娠痛苦之间的中介作用。方法采用便利抽样法，选取2024年5月至9月在南宁市2所三甲医院门诊产检的210名孕晚期女性为研究对象，使用一般资料调查表、蒂尔堡妊娠痛苦量表（TPDS）、简版无法忍受不确定性量表（IUS-12）、疲乏量表（FS-14）对其进行调查。采用Spearman秩相关分析探讨孕晚期女性IU、疲乏、妊娠痛苦之间的相关性；采用Bootstrap法检验IU在孕晚期女性疲乏与妊娠痛苦之间的中介效应。结果共回收有效问卷203份，有效回收率为96.7%。203名孕晚期女性的TPDS总分为（18.95±6.90）分，FS-14总分为［7.00（4.00，9.00）］分，IUS-12总分为（27.68±9.03）分。Spearman秩相关分析显示，TPDS总分与IUS-12总分呈正相关（rs=0.510，P<0.01）、TPDS总分与FS-14总分呈正相关（rs=0.398，P<0.01）、IUS-12总分与FS-14总分呈正相关（rs=0.371，P<0.01）。中介效应分析结果显示，疲乏对妊娠痛苦的总效应值为0.822（P<0.001），其中直接效应值为0.533，占总效应的64.84%；疲乏通过IU影响妊娠痛苦的间接效应值为0.289，占总效应的35.16%，其Bootstrap 95%CI为［0.174， 0.429］（不包含0），效应具有统计学意义。结论 IU在孕晚期女性的疲乏与妊娠痛苦间起部分中介作用。临床医护人员应加强对孕晚期女性心理状况的评估，并通过针对性干预，降低其IU水平，从而有效缓解妊娠痛苦。

Objective To explore the mediating role of intolerance of uncertainty (IU) between fatigue and pregnancy-related distress in women in late pregnancy. Methods By using the convenient sampling method, 210 women in late pregnancy who received prenatal check-ups at the outpatient departments of two Grade A tertiary hospitals in Nanning from May to September 2024 were selected as the research subjects. They were surveyed using a general information questionnaire, the Tilburg Pregnancy Distress Scale (TPDS), the Intolerance of Uncertainty Scale-12 (IUS-12), and the Fatigue Scale-14 (FS-14). Spearman rank correlation analysis was used to explore the correlations among IU, fatigue, and pregnancy-related distress in women in late pregnancy. The Bootstrap method was employed to test the mediating effect of IU between fatigue and pregnancy-related distress in women in late pregnancy. Results A total of 203 valid questionnaires were recovered, with an response rate of 96.7%. Among the 203 women in late pregnancy, the total score of TPDS was (18.95±6.90), the total score of FS-14 was (7.00 [4.00, 9.00]) , and the total score of IUS-12 was (27.68±9.03). Spearman rank correlation analysis showed that the total score of TPDS was positively correlated with the total score of IUS-12 (rs=0.510, P<0.01), the total score of TPDS was positively correlated with the total score of FS-14 (rs=0.398, P<0.01), and the total score of IUS-12 was positively correlated with the total score of FS-14 (rs=0.371, P<0.01). The results of mediating effect analysis indicated that the total effect of fatigue on pregnancy-related distress was 0.822 (P<0.001), among which the direct effect was 0.533, accounting for 64.84% of the total effect; the indirect effect of fatigue on pregnancy-related distress through IU was 0.289, accounting for 35.16% of the total effect, and its Bootstrap 95% CI was (0.174, 0.429), which did not include 0, indicating that the effect was statistically significant. Conclusion IU plays a partial mediating role between fatigue and pregnancy-related distress in women in late pregnancy. Clinical medical staff should strengthen the assessment of the psychological status of women in late pregnancy and reduce their IU level through targeted interventions, thereby effectively alleviating pregnancy-related distress.