关键词: 抑郁症, 产后；自我接纳；压力感知；分娩；中介效应

Abstract: Background　Increased perceived stress may be associated with higher risk of postpartum depression in puerperas.Although high self-acceptance level can reduce the possibility of developing postpartum depression，there are no studies concerning the effect of perceived stress on the relationship between self-acceptance and postpartum depression.Objective　To investigate the relationships of perceived stress with self-acceptance and postpartum depression，and the mediating role of the former in the association between the latter two.Methods　By use of convenience sampling，300 hospitalized puerperas were recruited from Obstetrics Department，The First Affiliated Hospital of Anhui Medical University during September 2014 to October 2015.The Self-Acceptance Questionnaire（SAQ） was used to evaluate self-acceptance status.The Perceived Stress Scale（PSS） was used to appraise the perceived stress status.The Edinburgh Postnatal Depression Scale（EPDS） was used to examine postpartum depression.Pearson correlation analysis was adopted to analyze the relationships of the three.Bootstrap analysis was performed to measure the mediation effect of perceived stress on the relationship between self-acceptance and postpartum depression.Results　The mean scores of SAQ，PSS，and EPDS obtained by the puerperas were（44.2±4.7）（range，31-59），（28.4±3.0）（range，22-40），and（12.5±3.1）（range，5-21），respectively.The incidence of postpartum depression（defined as EPDS score >10） was 39.7%.Self-acceptance level was positively correlated with perceived stress（r=0.206，P<0.01），but negatively correlated with postpartum depression level（r=-0.366，P<0.01）.Perceived stress level was positively correlated with postpartum depression level（r=0.185，P<0.05）.Perceived stress had mediating effect in the relationship between self-acceptance and postpartum depression.And the effect size was 73.51%.Conclusion　Self-acceptance had an indirect effect on postpartum depression by the mediating role of perceived stress.Perceived stress mediated the relationship between self-acceptance and postpartum depression.

Key words: Depression, postpartum；Self-acceptance；Perceived stress；Parturition；Mediating effect