Influence of Fatigue, Depression and Anxiety on Quality of Life in Pregnant Women with Preterm Labor

Hyuna Kang; Ju-Hee Nho; Hyejin Kang; Soojin Lee; Hwangmi Lee; Sunsook Choi

doi:10.4069/kjwhn.2016.22.4.254

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Kang, Nho, Kang, Lee, Lee, and Choi: Influence of Fatigue, Depression and Anxiety on Quality of Life in Pregnant Women with Preterm Labor

Original Article

Korean Journal of Women Health Nursing 2016; 22(4): 254-263.

Published online: 27 December 2016

DOI: https://doi.org/10.4069/kjwhn.2016.22.4.254

Influence of Fatigue, Depression and Anxiety on Quality of Life in Pregnant Women with Preterm Labor

Hyuna Kang¹, Ju-Hee Nho², Hyejin Kang¹, Soojin Lee¹, Hwangmi Lee¹, Sunsook Choi¹

¹Department of Nursing, Asan Medical Center, Seoul, Korea.

²College of Nursing, Chonnam National University, Gwangju, Korea.

Corresponding author: Nho, Ju-Hee. College of Nursing, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea. Tel: +82-62-530-4949, Fax: +82-62-227-4009, jhnho@jnu.ac.kr

Received 19 September 2016 Revised 4 November 2016 Accepted 1 December 2016

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to identify effects of fatigue, depression and anxiety on quality of life in pregnant women with preterm labor.

Methods

With a survey design, data were collected from 138 mothers who were admitted at a hospital in Seoul, between June 2014 and September 2015. Instruments used to collect the data for the study were: Fatigue Continuum Form, Depression anxiety stress scale (DASS-21) and maternal postpartum quality of life (MAPP-QOL).

Results

The mean fatigue score was 68.30 with 50.7% of women being depressed and 79.7% of the 138 women being anxious. The mean quality of life was 18.92 with quality of life being associated with fatigue, depression and anxiety. Depression and fatigue explained 26% of the variance in quality of life.

Conclusion

Depression and fatigue adversely affected women's quality of life. It is important to address appropriate management of depression and fatigue in order to improve quality of life in pregnant women with preterm labor.

Keywords: Fatigue, Depression, Anxiety, Quality of life, Pre-mature labor

Figures and Tables

Table 1

Demographic and Obstetric Characteristics in Subjects (N=138)

Variables		Categories	n (%) or M±SD	Range
Demographic characteristics	Age (yr)		33.3±3.8	23~44
	Job	Yes	79 (57.2)
	Job	No	59 (42.8)
	Level of education	≤High school	17 (12.3)
	Level of education	≥College	121 (87.7)
	Religion	Christian	39 (28.3)
		Catholicism	13 (9.4)
		Buddhism	20 (14.5)
		Others	2 (1.4)
		None	64 (46.4)
	Family type (n=136)	Nuclear family	116 (85.3)
		Large family	15 (11.0)
		Others	5 (3.7)
	Economic condition (n=135)	High class	4 (3.0)
		Middle class	118 (87.4)
		Low class	13 (9.6)
	Number of admission days in the hospital		12.58±13.97	2~91
		≤7	59 (42.8)
		>7	79 (57.2)
Obstetric characteristics	Gestational age (wks)	20+0~27+6	57 (41.3)
	Gestational age (wks)	28+0~36+6	81 (58.7)
	Number of pregnancy	0	57 (41.3)
		1	42 (30.4)
		2	26 (18.8)
		≥3	13 (9.4)
	Artificial insemination	Yes	39 (28.3)
	Artificial insemination	No	99 (71.7)
	Multiple pregnancy	Yes	55 (39.9)
	Multiple pregnancy	No	83 (60.1)
	Previous delivery	Vaginal	38 (27.5)
		Cesarean section	10 (7.3)
		None	90 (65.2)
	Obstetrical complication	Yes	87 (63.0)
	Obstetrical complication	No	51 (37.0)

Table 2

Levels of Fatigue, Depression, Anxiety and Quality of Life (N=138)

Variables	n (%) or M±SD	Min-Max
Fatigue	68.30±15.19	31~112
Low	1 (0.7)
Moderate	63 (45.7)
High	74 (53.6)
Depression	10.96±7.59	0~21
Yes (≥10)	70 (50.7)
No (＜10)	68 (49.3)
Anxiety	14.94±8.84	0~21
Yes (≥8)	110 (79.7)
No (＜8)	28 (20.3)
Quality of life (overall)	18.94±3.84	7.33~29.60
Psychological	19.53±5.04	6.43~30.00
Socioeconomic	18.66±4.67	2.28~29.72
Relation/spouse	20.91±4.68	9.00~30.00
Relation/family friends	19.24±3.90	7.61~30.00
Health and functioning	17.17±4.68	5.14~28.29

Table 3

Comparison of Quality of Life according to Subjects Characteristics (N=138)

Variables	Categori-es	n (%)	Quality of life (overall)		Psychological		Socioecomonic		Relation/spouse-partner		Relation/family friends		Health and functioning
Variables	Categori-es	n (%)	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)
Demographic characteristics
Age (yr)	≤30	28 (20.3)	17.77±4.37	1.30 (.278)	17.88±6.08	1.46 (.229)	17.32±4.44	1.03 (.380)	20.54±5.58	0.74 (.528)	18.34±4.52	1.67 (.176)	15.65±5.84	1.30 (.276)
	31~35	73 (52.9)	19.13±3.80		19.83±4.84		19.12±4.61		20.62±4.62		19.21±3.86		17.48±4.38
	36~40	33 (23.9)	19.32±3.34		19.98±4.02		18.72±4.59		21.55±4.11		19.65±3.33		17.80±4.11
	≥41	4 (2.9)	20.60±4.36		21.80±7.62		19.29±7.83		23.44±3.33		22.66±3.15		16.84±5.11
Job	Yes	79 (57.2)	19.38±3.47	−1.55 (.124)	19.77±4.61	−0.66 (.512)	19.68±4.17	−3.04 (.003)	21.28±4.60	−1.09 (.279)	19.38±3.61	−0.49 (.628)	17.55±443	−1.12 (.264)
Job	No	59 (42.8)	18.36±4.27	−1.55 (.124)	19.20±5.60	−0.66 (.512)	17.30±4.98	−3.04 (.003)	20.40±4.78	−1.09 (.279)	18.05±4.28	−0.49 (.628)	16.65±4.99	−1.12 (.264)
Level of education	≤High school	17 (12.3)	17.42±4.04	−1.75 (.082)	17.78±5.64	−1.54 (.127)	15.84±4.14	−2.72 (.007)	19.67±5.51	−1.17 (.245)	17.90±4.11	−1.51 (.133)	16.54±4.32	−0.59 (.555)
Level of education	≥College	17 (12.3)	19.16±3.79	−1.75 (.082)	19.78±4.93	−1.54 (.127)	19.06±4.62	−2.72 (.007)	21.08±4.55	−1.17 (.245)	19.42±3.85	−1.51 (.133)	17.25±4.74	−0.59 (.555)
Religion	Christian	39 (28.3)	18.76±4.01	0.48 (.752)	19.60±4.89	0.54 (.710)	18.65±4.78	0.42 (.793)	20.64±5.50	1.58 (.184)	19.04±4.11	0.24 (.918)	16.42±4.87	0.58 (.679)
	Catholicism	13 (9.4)	17.88±3.22		18.01±3.50		18.30±4.39		18.11±4.12		18.42±3.31		16.52±3.89
	Buddhism	20 (14.5)	18.75±4.05		19.48±5.43		17.69±5.53		21.09±4.42		19.54±3.89		17.06±5.07
	Others	2 (1.4)	19.28±3.86		22.93±3.33		20.92±0.27		22.50±6.36		19.64±4.05		17.39±8.74
	None	64 (46.4)	20.47±4.01		19.70±5.35		18.98±4.49		21.54±4.18		19.42±3.96		17.78±4.55
Family type	Nuclear	116 (85.3)	19.13±3.55	0.72 (.476)	19.82±4.74	0.65 (.520)	18.90±4.50	0.61 (.542)	20.96±4.44	−0.01 (.996)	19.31±3.73	0.58 (.449)	17.49±4.26	0.66 (.521)
Family type	Large	15 (11.0)	18.73±3.74	0.72 (.476)	18.98±4.76	0.65 (.520)	18.16±3.52	0.61 (.542)	20.94±4.33	−0.01 (.996)	18.53±4.07	0.58 (.449)	16.55±5.30	0.66 (.521)
Economic condition	High	4 (3.0)	21.36±4.65	1.04 (.355)	22.31±4.42	0.78 (.460)	23.13±5.57^a	7.13 (.001) a＞b, c	21.06±6.84	0.02 (.977)	20.72±6.30	1.18 (.311)	18.91±2.11	0.56 (.571)
	Middle	118 (87.4)	18.87±3.67		19.33±4.82		18.85±4.31^b		20.86±4.51		19.00±3.76		17.14±4.58
	Low	13 (9.6)	13.27±4.31		20.03±6.39		14.78±5.16^c		20.60±5.42		20.44±3.08		16.19±5.53
Numbers of admission days in hospital	≤7	59 (42.8)	19.75±3,42	2.16 (.033)	20.48±4.75	1.94 (.055)	19.50±4.18	1.84 (.068)	21.51±4.33	1.32 (.189)	19.98±3.68	1.94 (.054)	17.89±4.16	1.62 (.108)
Numbers of admission days in hospital	＞7	79 (57.2)	18.34±4.05	2.16 (.033)	18.82±5.16	1.94 (.055)	18.04±4.94	1.84 (.068)	20.46±4.90	1.32 (.189)	18.68±3.99	1.94 (.054)	16.63±5.00	1.62 (.108)
Obstetrics characteristics
Gestational age	20+0~27+6	57 (41.3)	18.80±3.49	−0.35 (.725)	19.25±4.96	−0.54 (.588)	19.27±4.09	1.29 (.199)	20.63±4.56	−0.58 (.562)	18.98±3.84	−0.65 (.516)	16.53±4.33	−1.34 (.181)
Gestational age	28+0~36+6	81 (58.7)	19.04±4.10	−0.35 (.725)	19.73±5.12	−0.54 (.588)	18.23±5.02	1.29 (.199)	21.10±4.78	−0.58 (.562)	19.42±3.96	−0.65 (.516)	17.61±4.90	−1.34 (.181)
Artificial insemination	Yes	39 (28.3)	19.52±3.66	−1.11 (.271)	19.42±4.68	0.16 (.870)	19.81±4.18	−1.83 (.070)	21.90±4.43	−1.57 (.120)	19.92±3.81	−1.30 (.195)	17.23±4.83	−0.09 (.925)
Artificial insemination	No	99 (71.7)	18.72±3.91	−1.11 (.271)	19.57±5.20	0.16 (.870)	18.21±4.79	−1.83 (.070)	20.52±4.74	−1.57 (.120)	18.97±3.92	−1.30 (.195)	17.14±4.65	−0.09 (.925)
Multiple pregnancy	Yes	55 (39.9)	19.21±3.37	−0.66 (.513)	20.11±4.80	−1.10 (.273)	19.10±4.39	−0.89 (.378)	21.20±4.26	−0.60 (.550)	19.35±3.30	−0.28 (.783)	16.99±4.55	0.36 (.721)
Multiple pregnancy	No	83 (60.1)	18.77±4.14	−0.66 (.513)	19.15±5.19	−1.10 (.273)	18.38±4.85	−0.89 (.378)	20.71±4.95	−0.60 (.550)	19.16±4.27	−0.28 (.783)	17.28±4.79	0.36 (.721)
Previous delivery	Vaginal	38 (27.5)	18.65±4.17	0.16 (.854)	19.30±5.67	0.08 (.926)	18.39±4.92	0.50 (.607)	20.21±4.42	2.42 (.093)	18.92±4.55	0.33 (.720)	17.07±4.90	0.05 (.953)
	C-section	10 (7.3)	18.91±2.85		19.95±4.64		20.04±3.74		18.53±5.13		18.69±3.75		16.82±4.05
	None	90 (65.2)	19.07±3.83		19.58±4.85		18.63±4.67		20.91±4.68		19.43±3.64		17.25±4.70
Obstetrical complication	Yes	87 (63.0)	19.11±3.87	−0.65 (.514)	19.61±4.91	−0.65 (.514)	19.61±4.91	−0.24 (.810)	21.31±4.52	−1.31 (.194)	19.43±4.04	−0.77 (.443)	17.42±4.53	−0.84 (.402)
Obstetrical complication	No	51 (37.0)	18.66±3.83	−0.65 (.514)	19.39±5.31	−0.65 (.514)	19.39±5.31	−0.24 (.810)	20.23±4.91	−1.31 (.194)	18.90±3.66	−0.77 (.443)	16.73±4.95	−0.84 (.402)

Table 4

Relationships among Fatigue, Depression, Anxiety, and Quality of Life (N=138)

Variables	Fatigue	Depression	Anxiety
Depression	.58 (<.001)
Anxiety	.55 (<.001)	.74 (<.001)
Quality of life	−.40 (<.001)	−.50 (<.001)	−.35 (<.001)

Table 5

Factors Influencing on Quality of Life

Variables	B	SE	β	t	p
(Constant)	23.80	1.37		17.42	<.001
Depression	−0.29	0.07	−.57	−4.37	<.001
Fatigue	−0.05	0.02	−.20	−2.13	.035
	Adjusted R2=.26, F=13.27, p<.001

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