First-time parenting couples' stress associated with at-risk pregnancy and antenatal hospitalization

The goals of this study were: (1) to determine the contribution of the stressors (atrisk pregnancy and antenatal hospitalization), the resources (conjugal adjustment and satisfaction from others) and the perception of the stressors (primary stress appraisal: threat, challenge, centrality; and secondary stress appraisal: control-self, control-others, incontroUable) to first-time parenting couples' global stress associated with at-risk pregnancy and antenatal hospitalization, and (2) to assess congruence between the partners' perceptions of stress in terms of similarities. Three types of similarities are considered, produced from combinations of self-perceptions (a person's direct perception) and metaperceptions (a person's perception of another person): actual similarity, perceived similarity and understanding. The non-probabilistic sample of 109 couples was recruited fi'om 12 perinatal units in the Montreal region. The couples completed four questionnah-es: The Personal and Pregnancy Information Guide, the Dyadic Adjustment Scale, the Support Behaviors Inventory, and the Stress Appraisal Measure. Using Boss' model (1988) The Contextual Model of Family Stress to study the first research goal, 52% of the variance regarding the women's global stress was explained by primary stress appraisal (threat, challenge, centrality), while 60% of the variance regarding the men's global stress was explained by the stressors (gestation, prenatal classes, education) and primary stress appraisal (threat, centrality). For the couples' models, 33% of their global stress at the level of actual similarity was explained by prunary stress appraisal (threat, centrality), while at the level of perceived similarity, 32% of the explained variance was due to primary stress appraisal (threat, centrality) and secondary stress appraisal (controlself, control-others). At the level of understanding, 32% of the explained variance is attributed to the resources (dyadic cohesion) and primary stress appraisal (threat, centrality). Further analyses were conducted on couples' perceptions since primary stress appraisal was found to be a significant predictor of thek global stress (second research goal). In order to attain this, five hypotheses were tested: HI: There is a significant difference in the perceived similarity of global stress appraisal between women and men (confirmed); H2: There is a significant difference in understanding of global stress appraisal between women and men (confirmed); H3: There is congruence between women's and men's perceived smiilarity and actual similarity for global stress appraisal (partially confirmed); H4: There is congruence between women's and men's understanding and actual smiilarity for global stress appraisal (partially confirmed); and, H5: There is congruence between women's and men's understanding and women's and men's perceived smiilarity for global stress appraisal (partially confirmed). Despite the couples' moderate stress appraisal, women perceive at-risk pregnancy and antenatal hospitaUzation as a threat, and their global perception of stress is significantly higher than that of the men. Men perceive the same stressors as a challenge and being in control of the situation. The couples are congruent in actual similarity except for the means of challenge and self-control. Regarding perceived similarity, there are no significant differences for the women whereas for the men, there are significant discrepancies for the means of threat and global stress. For women's understanding, there are significant discrepancies between the means of for threat and global stress, while for the men, there are no significant differences. Women are more stressed by at-risk pregnancy and antenatal hospitalization than the men, resulting in a greater lack of congruence between the different sunilarities. They are less available for the conjugal relationship, while the men are more understanding and more available to devote themselves to the relationship: the men's optimism appears to reduce the women's stress with an impact on the relationship. Regarding couples' stress, there is a gradual shift in perceiving the strcssors as threatening to perceiving them as important for their well-being. Also, control and the conjugal relationship become more unportant at the levels of perceived similarity and understanding respectively. In conclusion, women and men do not perceive the stressors in the same way, and that nurses and other health care professionals should consider both partners' perceptions as weU as that of the couple's in their global evaluation of stress during their interventions. Nurses' greater challenge is to help a couple to be 'a couple' in the hospital setting in order to help them protect their love and intimacy.

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