摘要目的:编制覆盖妊娠全周期、综合评估正向与负向心理状态的孕产妇心理状态评估量表，并验证其信效度。方法:2020年12月，课题组通过文献检索初步确定量表条目，形成了55个条目的问卷，用于预调查和专家访谈。选择2021年4~5月复旦大学附属妇产科医院的登记孕妇进行预调查。通过信效度分析验证问卷的可行性和可靠性，并根据反馈意见对问卷进行了修订，形成了包含43个条目的量表。量表从关键事件方面分为4个维度（妊娠、分娩、成为母亲、并发症），在心理状态方面分为6个维度（肯定、恐惧、焦虑、抑郁、乐观、自信）。其中肯定、自信、乐观为正向，恐惧、焦虑、抑郁为负向。2021年12月至2022年11月对孕产妇开展正式问卷调查。对问卷各条目进行正态性和共线性检验，以及信度分析、结构效度、聚合效度和区分效度分析。结果:（1）一般资料：共625例孕产妇参与预调查。正式调查时发放问卷8 045份，最终纳入有效问卷6 273份（78.0%）。6 273份有效问卷中，结果为正向和负向者分别为5 694例（90.8%）和579例（9.2%）。心理状态的各个维度均相关（ P值均<0.01），各维度不存在多重共线性［方差膨胀因子（variance inflation factor，VIF）均<10］。关键事件的4个维度均相关（ P值均<0.01），不存在多重共线性（VIF均<10）。（2）信度：问卷总体Cronbach α系数为0.830，去除任一条目后Cronbach α系数均>0.6。肯定、恐惧、焦虑、抑郁、乐观、自信维度的Cronbach α系数分别为0.772、0.724、0.648、0.551、0.257和0.740，妊娠、分娩、成为母亲、并发症维度分别为0.722、0.554、0.621和0.568。（3）拟合效度：心理状态维度模型卡方自由度比（ Chi-square to degrees of freedom ratio， χ2/df）=19.979>3，近似均方根误差（root mean square error of approximation，RMSEA）=0.055<0.08。关键事件维度模型 χ2/df=48.557，RMSEA=0.087，比较拟合指数和增量拟合指数均为0.400<0.9。（4）聚合效度和区分效度：心理状态维度模型中，肯定、恐惧、焦虑、抑郁、乐观和自信维度的平均方差提取值（average variance extraction，AVE）分别为0.407、0.099、0.188、0.223、0.419和0.362，组合信度值（composite reliability，CR）分别为0.822、0.730、0.655、0.584、0.627和0.786；关键事件维度模型中，分娩、妊娠、成为母亲和并发症的AVE分别为0.167、0.287、0.328和0.166，CR分别为0.555、0.832、0.746和0.633。心理状态维度中，除乐观与抑郁，以及自信与焦虑外的各维度之间均具有相关性（ P值均<0.05）。关键事件的4个维度间均有相关性（ P值均<0.05）。 结论:本研究初步建立了孕产妇心理状态评估量表。该量表在信度和效度方面表现良好，可用于孕产妇在妊娠不同阶段的关键事件中的综合心理状态评价。

abstractsObjective:To develop a maternal assessment scale integrating both positive (affirmation, optimism, self-confidence) and negative psychological states (fear, anxiety, depression) throughout the entire pregnancy cycle and evaluate its reliability and validity.Methods:In December 2020, the scale items were preliminarily identified through a literature review, forming a 55-item questionnaire for pilot survey and expert interviews. A pilot survey was conducted among registered pregnant women at the Obstetrics and Gynecology Hospital of Fudan University from April to May 2021. The feasibility and reliability of the questionnaire was validated through reliability and validity analysis, and revisions were made based on the feedback. The finalized version comprised 43 items, categorized into four key event dimensions (pregnancy, childbirth, transition to motherhood, and complications) and six psychological state dimensions (affirmation, fear, anxiety, depression, optimism, and self-confidence). Among these psychological states, affirmation, self-confidence, and optimism represent positive states, while fear, anxiety, and depression reflect negative states. A formal survey was conducted from December 2021 to November 2022. The normality, multicollinearity, reliability, construct validity, convergent validity, and discriminant validity of each item were analyzed.Results:(1) General information: A total of 625 participants were involved in the pilot survey. For the formal survey, 8 045 questionnaires were distributed, with 6 273 valid responses (78.0%). Among the valid questionnaires, 5 694 (90.8%) reported positive psychological states and 579 (9.2%) negative states. All of the psychological state dimensions were correlated (all P<0.01), with no multicollinearity detected [variance inflation factor (VIF)<10]. The four key event dimensions were also correlated (all P<0.01), with no multicollinearity (VIF<10). (2) Reliability: The overall Cronbach's α coefficient of the questionnaire was 0.830, and removing any single item resulted in the value remaining>0.6. Cronbach's α coefficient values for affirmation, fear, anxiety, depression, optimism, and self-confidence were 0.772, 0.724, 0.648, 0.551, 0.257, and 0.740, respectively. The values for the key event dimensions were as follows: 0.722 for pregnancy, 0.554 for childbirth, 0.621 for transition to motherhood, and 0.568 for complications. (3) Model fit: For the psychological states, the Chi-square to degrees of freedom ratio ( χ2/df) was 19.979 (>3), and the root mean square error of approximation (RMSEA) was 0.055 (<0.08). The model of key event dimensions had a χ2/df of 48.557, RMSEA of 0.087, comparative fit index of 0.400 (<0.9), and incremental fit index of 0.400 (<0.9). (4) Convergent and discriminant validity: The average variance extraction (AVE) values for affirmation, fear, anxiety, depression, optimism, and self-confidence were 0.407, 0.099, 0.188, 0.223, 0.419, and 0.362, with composite reliability (CR) values of 0.822, 0.730, 0.655, 0.584, 0.627, and 0.786, respectively. In the model of key event dimensions, the AVE values for pregnancy, childbirth, transition to motherhood, and complications were 0.167, 0.287, 0.328, and 0.166, with CR values of 0.555, 0.832, 0.746, and 0.633, respectively. Significant correlations were observed between all psychological dimensions except optimism-depression and self-confidence-anxiety pairs (all P<0.05). All four key event dimensions were significantly correlated (all P<0.05). Conclusions:This study preliminarily develops a maternal psychological status assessment scale with satisfactory reliability and validity. This scale can be used to evaluate the comprehensive psychological states of pregnant women during critical pregnancy-related events.