Anxiety and depressive symptoms and their influential factors among patients with intrauterine adhesions managed by day surgery model_West China Medical Journal

Authors：

HE Jing ^1,2 , YANG Yuqiong ^1,2 ,  LI Mingxuan ^1,2

1. Department of Day Surgery Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Mingxuan, Email: mingxuanli@yeah.net

Keywords：

Intrauterine adhesions; anxiety symptoms; depressive symptoms; influential factors

DOI：

10.7507/1002-0179.202411378

Video：

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Objective To investigate the incidences of anxiety and depressive symptoms among patients with intrauterine adhesions (IUA) managed by day surgery model, and explore their influential factors. Methods Convenience sampling was used to select patients who underwent day surgery at West China Second University Hospital, Sichuan University between January 2021 and December 2022. General information questionnaire and Hospital Anxiety and Depression Scale were used to assess the socio-demographic data and anxiety and depressive symptoms of the participants. Logistic regression was used to analyze the influential factors of anxiety and depressive symptoms. Results A total of 1100 patients were included. The incidence of anxiety and depressive were 16.5% (181/1 100) and 16.9% (186/1 100) among patients undergoing day surgery for IUA respectively. Longer waiting days for admission [odds ratio (OR)=1.012, 95% confidence interval (CI) (1.004, 1.020), P=0.004], married [OR=0.547, 95%CI (0.344, 0.869), P=0.011], more times of adhesion separation [OR=0.826, 95%CI (0.691, 0.986), P=0.034], older age [OR=0.947, 95%CI (0.909, 0.987), P=0.010] were influencing factors for anxiety symptoms in patients with IUA. Unemployment [OR=0.504, 95%CI (0.256, 0.994), P=0.048], university or undergraduate education [OR=0.326, 95%CI (0.208, 0.512), P<0.001], and high school or vocational school education [OR=0.532, 95%CI (0.319, 0.888), P=0.016] were the influencing factors for depressive symptoms in patients with IUA. Conclusions There is a high incidence of anxiety and depressive symptoms among patients with IUA under the management of day surgery mode. The influential factors include socio-demographic factors (age, education level, marital status and occupation) and disease factors (times of adhesion). Medical staff should pay attention to the early screening of mental health status of patients with IUA, and give targeted prevention and treatment measures.

Citation： HE Jing, YANG Yuqiong, LI Mingxuan. Anxiety and depressive symptoms and their influential factors among patients with intrauterine adhesions managed by day surgery model. West China Medical Journal, 2025, 40(2): 211-216. doi: 10.7507/1002-0179.202411378 Copy

1.	段华, 甘露. 宫腔粘连子宫腔整复手术质量控制. 中国实用妇科与产科杂志, 2022, 38(1): 36-40.
2.	Hooker AB, Lemmers M, Thurkow AL, et al. Systematic review and meta-analysis of intrauterine adhesions after miscarriage: prevalence, risk factors and long-term reproductive outcome. Hum Reprod Update, 2014, 20(2): 262-278.
3.	中华医学会计划生育学分会, 中国医药教育协会生殖内分泌专委会. 人工流产术后促进子宫内膜修复专家共识. 中国实用妇科与产科杂志, 2021, 37(3): 322-326.
4.	鲁静洁, 朱慧, 朱湘虹, 等. 宫腔粘连分离术后复发为重度宫腔粘连的因素分析. 实用妇产科杂志, 2017, 33(10): 751-754.
5.	Yu D, Wong YM, Cheong Y, et al. Asherman syndrome--one century later. Fertil Steril, 2008, 89(4): 759-779.
6.	Yu D, Li TC, Xia E, et al. Factors affecting reproductive outcome of hysteroscopic adhesiolysis for Asherman’s syndrome. Fertil Steril, 2008, 89(3): 715-722.
7.	Roy KK, Baruah J, Sharma JB, et al. Reproductive outcome following hysteroscopic adhesiolysis in patients with infertility due to Asherman’s syndrome. Arch Gynecol Obstet, 2010, 281(2): 355-361.
8.	颜彤, 夏智勇, 刘胜凤, 等. 宫腔粘连的影响因素及术后患者心理状况的分析. 生殖医学杂志, 2024, 33(3): 381-385.
9.	孙博, 刘雷, 王东光. 国内日间手术发展进程、存在问题与对策建议. 中国卫生质量管理, 2018, 25(5): 17-20.
10.	廖文娟, 匡雪春, 刘军, 等. 三甲医院日间手术患者焦虑情况调查分析. 实用医院临床杂志, 2016, 13(3): 123-124.
11.	汪向东, 王希林, 马弘. 心理卫生评定量表手册. 中国心理卫生杂志, 1999(增刊): 223-226.
12.	孙振晓, 刘化学, 焦林瑛, 等. 医院焦虑抑郁量表的信度及效度研究. 中华临床医师杂志(电子版), 2017, 11(2): 198-201.
13.	Wang T, Zhou Y, Fu J, et al. Level of depression, anxiety and stress in patients with intrauterine adhesions in Hunan province, China: a cross-sectional study. PLoS ONE, 2020, 15(3): e0229832.
14.	赵慧丽, 姚莉君, 胡龙军, 等. 分散式管理下出入院服务中心在加速康复外科中的实践与效果评价. 中国医院, 2019, 23(1): 12-14.
15.	王筱红, 谢雅琴, 龚娟. 不同不孕年限女性的婚姻调适、社会支持和心理状况的调查分析. 现代泌尿生殖肿瘤杂志, 2019, 11(5): 306-310.
16.	尹亚楠, 陈静, 龙德蓉. 2121 例妇科手术患者焦虑抑郁症状现状和影响因素调查. 现代预防医学, 2018, 45(12): 2293-2296.
17.	王文婕, 刘果, 韩继阳, 等. 工作人群精神卫生影响因素研究进展. 中国神经精神疾病杂志, 2018, 44(10): 637-640.
18.	童然, 余文玉, 施金凤. 不孕女性心理状态影响因素的 Logistic 回归分析及心理状态与生存质量的关系. 中国性科学, 2023, 32(7): 63-66.

1. 段华, 甘露. 宫腔粘连子宫腔整复手术质量控制. 中国实用妇科与产科杂志, 2022, 38(1): 36-40.
2. Hooker AB, Lemmers M, Thurkow AL, et al. Systematic review and meta-analysis of intrauterine adhesions after miscarriage: prevalence, risk factors and long-term reproductive outcome. Hum Reprod Update, 2014, 20(2): 262-278.
3. 中华医学会计划生育学分会, 中国医药教育协会生殖内分泌专委会. 人工流产术后促进子宫内膜修复专家共识. 中国实用妇科与产科杂志, 2021, 37(3): 322-326.
4. 鲁静洁, 朱慧, 朱湘虹, 等. 宫腔粘连分离术后复发为重度宫腔粘连的因素分析. 实用妇产科杂志, 2017, 33(10): 751-754.
5. Yu D, Wong YM, Cheong Y, et al. Asherman syndrome--one century later. Fertil Steril, 2008, 89(4): 759-779.
6. Yu D, Li TC, Xia E, et al. Factors affecting reproductive outcome of hysteroscopic adhesiolysis for Asherman’s syndrome. Fertil Steril, 2008, 89(3): 715-722.
7. Roy KK, Baruah J, Sharma JB, et al. Reproductive outcome following hysteroscopic adhesiolysis in patients with infertility due to Asherman’s syndrome. Arch Gynecol Obstet, 2010, 281(2): 355-361.
8. 颜彤, 夏智勇, 刘胜凤, 等. 宫腔粘连的影响因素及术后患者心理状况的分析. 生殖医学杂志, 2024, 33(3): 381-385.
9. 孙博, 刘雷, 王东光. 国内日间手术发展进程、存在问题与对策建议. 中国卫生质量管理, 2018, 25(5): 17-20.
10. 廖文娟, 匡雪春, 刘军, 等. 三甲医院日间手术患者焦虑情况调查分析. 实用医院临床杂志, 2016, 13(3): 123-124.
11. 汪向东, 王希林, 马弘. 心理卫生评定量表手册. 中国心理卫生杂志, 1999(增刊): 223-226.
12. 孙振晓, 刘化学, 焦林瑛, 等. 医院焦虑抑郁量表的信度及效度研究. 中华临床医师杂志(电子版), 2017, 11(2): 198-201.
13. Wang T, Zhou Y, Fu J, et al. Level of depression, anxiety and stress in patients with intrauterine adhesions in Hunan province, China: a cross-sectional study. PLoS ONE, 2020, 15(3): e0229832.
14. 赵慧丽, 姚莉君, 胡龙军, 等. 分散式管理下出入院服务中心在加速康复外科中的实践与效果评价. 中国医院, 2019, 23(1): 12-14.
15. 王筱红, 谢雅琴, 龚娟. 不同不孕年限女性的婚姻调适、社会支持和心理状况的调查分析. 现代泌尿生殖肿瘤杂志, 2019, 11(5): 306-310.
16. 尹亚楠, 陈静, 龙德蓉. 2121 例妇科手术患者焦虑抑郁症状现状和影响因素调查. 现代预防医学, 2018, 45(12): 2293-2296.
17. 王文婕, 刘果, 韩继阳, 等. 工作人群精神卫生影响因素研究进展. 中国神经精神疾病杂志, 2018, 44(10): 637-640.
18. 童然, 余文玉, 施金凤. 不孕女性心理状态影响因素的 Logistic 回归分析及心理状态与生存质量的关系. 中国性科学, 2023, 32(7): 63-66.

West China Medical Journal

Anxiety and depressive symptoms and their influential factors among patients with intrauterine adhesions managed by day surgery model

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