The influence and mechanism of recovery experience, self-disclosure and self-efficacy on negative emotion in pregnant women undergoing cesarean section with intracranial tumor
Abstract
Background: This study aims to explore the effects of maternal recovery experience, self-disclosure, and self-efficacy on negative emotions in women with intracranial tumors undergoing cesarean section and the mechanism of their influence in order to provide a theoretical basis and practical guidance for improving maternal recovery experience and reducing negative emotions. Methods: A total of 118 cases of all mid- to late-stage pregnant women with combined intracranial tumors in pregnancy who underwent cesarean section at Beijing Tiantan Hospital of Capital Medical University from August 2019 to August 2024 were collected as the study subjects, and a cross-sectional survey was conducted by using the General Information Questionnaire, the Recovery Experience Questionnaire, the Depression and Anxiety Scale, the Self-disclosure Index, and the General Self-Efficacy Scale. Model 6 of Hayes’ SPSS-Process program was used for the mediation effect test. Results: Recovery experience had a direct negative predictive effect on negative emotions (β = −0.273, p < 0.001), with a direct effect of 43.72%. Self-disclosure and self-efficacy had a partially mediated effect between recovery experience and negative emotions, with an independent mediation effect of 16.51%, 34.06%, and a chained mediation effect of 5.71%, respectively. The results of stratified linear regression showed that psychological detachment, mastery experience and control experience were influential factors of depression, and relaxation experience, mastery experience and control experience were influential factors of stress. Conclusion: Self-disclosure and self-efficacy have partial mediating effects between recovery experience and negative mood in patients with pregnancy-related tumors. Clinical attention should be paid to patients’ negative emotions and the mediating effects of self-disclosure and self-efficacy should be assessed in order to improve patients’ negative state of mind.
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References
1. Gatson NTN. Managing central nervous system tumors during pregnancy. CONTINUUM: Lifelong Learning in Neurology. 2022; 28(1): 122-146. doi: 10.1212/con.0000000000001107
2. United States and Puerto Rico Cancer Statistics - Cancer Mortality Incidence Rate Ratios 1999-2018: CDC WONDER Online Database. United States Department of Health and Human Services, Center for Disease Control and Prevention and National Cancer Institute; 2019. Available online: http://wonder.cdc.gov/cancer-v2016.html (accessed on 10 December 2024).
3. Molina-Botello D, Rodríguez-Sanchez JR, Cuevas-García J, et al. Pregnancy and brain tumors; A systematic review of the literature. Journal of Clinical Neuroscience. 2021; 86: 211-216. doi: 10.1016/j.jocn.2021.01.048
4. Amant F, Berveiller P, Boere IA, et al. Gynecologic cancers in pregnancy: Guidelines based on a third international consensus meeting. Annals of Oncology. 2019; 30(10): 1601-1612. doi: 10.1093/annonc/mdz228
5. Betchen M, Grunberg VA, Gringlas M, et al. Being a mother after a cancer diagnosis during pregnancy: Maternal psychosocial functioning and child cognitive development and behavior. Psycho-Oncology. 2020; 29(7): 1148-1155. doi: 10.1002/pon.5390
6. Reschke T, Lobinger T, Reschke K. Examining recovery experiences as a mediator between physical activity and study-related stress and well-being during prolonged exam preparation at university. PLOS ONE. 2024; 19(7): e0306809. doi: 10.1371/journal.pone.0306809
7. Steed LB, Swider BW, Keem S, et al. Leaving work at work: A meta-analysis on employee recovery from work. Journal of Management. 2019; 47(4): 867-897. doi: 10.1177/0149206319864153
8. Hobfoll SE. The influence of culture, community, and the nested-self in the stress process: Advancing conservation of resources theory. Applied Psychology. 2001; 50(3): 337-421. doi: 10.1111/1464-0597.00062
9. Sella-Shalom K, Hertz-Palmor N, Braun M, et al. The association between communication behavior and psychological distress among couples coping with cancer: Actor-partner effects of disclosure and concealment. General Hospital Psychiatry. 2023; 84: 172-178. doi: 10.1016/j.genhosppsych.2023.07.005
10. Kim K, Lee J, Yoon J. Effects of emotional regulation, resilience, and distress disclosure on post-traumatic growth in nursing students. International Journal of Environmental Research and Public Health. 2023; 20(4): 2782. doi: 10.3390/ijerph20042782
11. Schlosser AE. Self-disclosure versus self-presentation on social media. Current Opinion in Psychology. 2020; 31: 1-6. doi: 10.1016/j.copsyc.2019.06.025
12. Abusubhiah M, Walshe N, Creedon R, et al. Self-efficacy in the context of nursing education and transition to practice as a registered practitioner: A systematic review. Nursing Open. 2023; 10(10): 6650-6667. doi: 10.1002/nop2.1931
13. Adelstein Yardeni N, Dekel R, Ramon D. The contribution of self-disclosure as a personal and interpersonal characteristic within the couple relationship to recovery from posttraumatic stress. Psychological Trauma: Theory, Research, Practice, and Policy. 2024; 16(1): 125-133. doi: 10.1037/tra0001385
14. Anderson A, Starkweather A, Cong X, et al. Self-efficacy survey study of pain self-management in patients with cancer. Pain Management Nursing. 2022; 23(4): 486-493. doi: 10.1016/j.pmn.2021.10.002
15. Kazlauskas E, Dumarkaite A, Gelezelyte O, et al. Validation of the Recovery Experience Questionnaire in a Lithuanian Healthcare Personnel. International Journal of Environmental Research and Public Health. 2023; 20(3): 2734. doi: 10.3390/ijerph20032734
16. Yue T, Li Q, Wang R, et al. Comparison of Hospital Anxiety and Depression Scale (HADS) and Zung Self-Rating Anxiety/Depression Scale (SAS/SDS) in evaluating anxiety and depression in patients with psoriatic arthritis. Dermatology. 2019; 236(2): 170-178. doi: 10.1159/000498848
17. Kahn JH, Hucke BE, Bradley AM, et al. The Distress Disclosure Index: A research review and multitrait–multimethod examination. Journal of Counseling Psychology. 2012; 59(1): 134-149. doi: 10.1037/a0025716
18. Dahlberg K, Stenberg E, Liang Y, et al. The General Self-Efficacy Scale in a population planned for bariatric surgery in Sweden: a psychometric evaluation study. BMJ Open. 2022; 12(11): e061509. doi: 10.1136/bmjopen-2022-061509
19. Kurdoglu Z, Cetin O, Gulsen I, et al. Intracranial meningioma diagnosed during pregnancy caused maternal death. Case Reports in Medicine. 2014; 2014: 1-3. doi: 10.1155/2014/158326
20. Roberts L, Davis GK, Homer CSE. Depression, anxiety, and post-traumatic stress disorder following a hypertensive disorder of pregnancy: A narrative literature review. Frontiers in Cardiovascular Medicine. 2019; 6. doi: 10.3389/fcvm.2019.00147
21. Shang J, Dolikun N, Tao X, et al. The effectiveness of postpartum interventions aimed at improving women’s mental health after medical complications of pregnancy: a systematic review and meta-analysis. BMC Pregnancy and Childbirth. 2022; 22(1). doi: 10.1186/s12884-022-05084-1
22. Sonnentag S, Fritz C. The Recovery Experience Questionnaire: Development and validation of a measure for assessing recuperation and unwinding from work. Journal of Occupational Health Psychology. 2007; 12(3): 204-221. doi: 10.1037/1076-8998.12.3.204
23. Hoyer J, Wieder G, Höfler M, et al. Do lifetime anxiety disorders (anxiety liability) and pregnancy-related anxiety predict complications during pregnancy and delivery? Early Human Development. 2020; 144: 105022. doi: 10.1016/j.earlhumdev.2020.105022
24. Zachariah R. Social support, life stress, and anxiety as predictors of pregnancy complications in low-income women. Research in Nursing & Health. 2009; 32(4): 391-404. doi: 10.1002/nur.20335
25. Kazlauskas E, Dumarkaite A, Gelezelyte O, et al. Validation of the Recovery Experience Questionnaire in a Lithuanian healthcare personnel. International Journal of Environmental Research and Public Health. 2023; 20(3): 2734. doi: 10.3390/ijerph20032734
26. Headrick L, Newman DA, Park YA, et al. Recovery experiences for work and health outcomes: A meta-analysis and recovery-engagement-exhaustion model. Journal of Business and Psychology. 2022; 38(4): 821-864. doi: 10.1007/s10869-022-09821-3
27. Rook JW, Zijlstra FRH. The contribution of various types of activities to recovery. European Journal of Work and Organizational Psychology. 2006; 15(2): 218-240. doi: 10.1080/13594320500513962
28. Griffin JM, Fuhrer R, Stansfeld SA, et al. The importance of low control at work and home on depression and anxiety: Do these effects vary by gender and social class? Social Science & Medicine. 2002; 54: 783-798. doi: 10.1016/S0277-9536(01)00109-5
29. Lee M, Song Y, Zhu L, et al. Coping strategies and benefit-finding in the relationship between non-disclosure and depressive symptoms among breast cancer survivors in China. American Journal of Health Behavior. 2017; 41(4): 368-377. doi: 10.5993/ajhb.41.4.1
30. Salwen ED, Underwood LA, Dy-Liacco GS, et al. Self-Disclosure and spiritual well-being in pastors seeking professional psychological help. Pastoral Psychology. 2017; 66(4): 505-521. doi: 10.1007/s11089-017-0757-1
31. Lee H, Jeong Y. Self-disclosure in adult patients with cancer. Cancer Nursing. 2023. doi: 10.1097/ncc.0000000000001302
32. Alan Dikmen H, Gönenç İM, Özaydın T. Sexuality during pregnancy: Attitudes, self-efficacy and self-consciousness. Women & Health. 2023; 63(7): 518-530. doi: 10.1080/03630242.2023.2234503
