Psychother Psychosom Med Psychol 2017; 67(09/10): 401-412
DOI: 10.1055/s-0043-100758
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Kinderwunsch bei (permanenter) Infertiliät: Entwicklung und Ergebnisse des „Fragebogens Einstellungen zur Mutterschaft (FEMu)“

The Wish for a Child in the Case of (Permanent) Infertility: Development of the “German Questionnaire on Attitudes Toward Motherhood”
Maike Fliegner
1   Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf
,
Hertha Richter-Appelt
1   Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf
,
Kerstin Krupp
1   Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf
,
Franziska Brunner
1   Institut für Sexualforschung und Forensische Psychiatrie, Universitätsklinikum Hamburg-Eppendorf
› Author Affiliations
Further Information

Publication History

eingereicht 06 August 2016

akzeptiert 09 January 2017

Publication Date:
18 July 2017 (online)

Zusammenfassung

Studie 1 Fragebogenentwicklung Die meisten Fragebögen zu Einstellungen zur Mutterschaft setzen Fertilität voraus und bilden positive und negative Einstellungen zur Mutterschaft auf einer Dimension ab. Häufig liegen zudem keine deutschsprachigen Versionen und Normwerte vor. Ziel dieser Studie ist es zu überprüfen, ob mit der Entwicklung des „FEMu“ ein Instrument zur Verfügung steht, mit dem Einstellungen mehrdimensional erfasst werden und welches unabhängig vom Fertilitätsstatus zu beantworten ist. Der FEMu wurde an einer weiblichen Stichprobe (n=932) mittels Hauptachsenanalyse (oblique Rotation) entwickelt, welche 2 unabhängige Hauptskalen („pro Kind“, „contra Kind“) mit 5 Unterskalen (Entbehrung/Fremdbestimmtheit, Attraktivität/Ausgeglichenheit, Unvollständigkeit, Verbundheit, Akzeptanz) und 4 Prototypen (Idealisierung, Ablehnung, Ambivalenz, Indifferenz) ergab.

Studie 2 Überprüfung an klinischen Stichproben Zur Überprüfung an klinischen Gruppen wurden Personen mit Kompletter Androgeninsensitivität (CAIS, n=12), Mayer-Rokitansky-Küster-Hauser-Syndrom (MRKHS, n=49) und Polyzystischem Ovarsyndrom (PCOS, n=55) befragt, wobei die ersteren unter permanenter Infertilität leiden und bei PCOS eine eingeschränkte Fruchtbarkeit vorliegt. Es wurden die Stärke des Kinderwunsches, die FEMu-Hauptfaktoren sowie die Prototypen ausgewertet. Die Unabhängigkeit der Pro- und Contra-Kind-Scores und die Prototypen ließen sich empirisch bestätigen. Bei CAIS wurde ein geringer Kinderwunsch und eine indifferente Haltung, bei MRKHS ein mittelgradiger Kinderwunsch und Ambivalenz, bei PCOS ein maximaler Kinderwunsch und eine Idealisierung von Mutterschaft festgestellt.

Fazit Mit dem FEMu wird ein Instrument vorgestellt, das Einstellungen zur Mutterschaft mehrdimensional erfasst. Er ist unabhängig vom Fertilitätsstatus beantwortbar und kann zu Forschungszwecken sowie in der Einzelfall-Diagnostik eingesetzt werden. Die FEMu-Ergebnisse können zur gezielten Beratung herangezogen werden – orientierend im Rahmen von Fertilitätsbehandlungen, in der gynäkologischen Praxis, der Schwangerschaftskonfliktberatung oder begleitend zu psychologischen Beratungen. Im psychotherapeutischen Kontext können sie bei der Entwicklung geeignter Interventionen hilfreich sein. Auch außerhalb des klinischen Kontexts ist der Einsatz des FEMu interessant, bspw. bei Themen der Familienplanung oder dem Konflikt von Frauen zwischen Karriere und Familie.

Abstract

Study 1 Development of the questionnaire Most questionnaires on attitudes toward motherhood presume that the subject is fertile and positive and negative attitudes are represented on a one-dimensional scale. Moreover, the questionnaires often do not provide German versions and German norms. The aim of this study is to examine whether the German Questionnaire on Attitudes toward Motherhood (“FEMu”) can be used to describe attitudes toward motherhood multi-dimensionally and whether it is applicable independent of a person’s fertility status. The FEMu was developed based on a female sample (n=932) using principal factor analysis (oblique rotation) which yielded 2 independent main factors (“pro child”, “contra child”) with 5 subfactors (privation/conformation, attractiveness/balance, incompleteness, relation, affiliation) and 4 prototypes (idealization, rejection, ambivalence, indifference).

Study 2 Evaluation of clinical Samples of people with Complete Androgen Insensitivity Syndrome (CAIS, n=12), Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS, n=49) and Polycystic Ovary Syndrome (PCOS, n=55) were included for testing. The first 2 suffer from permanent infertility, in the latter fertility is compromised. The intensity of their wish for a child, the FEMu main factors and the prototypes were analyzed. The independence of pro and contra child scores and the prototypes were emipirically confirmed. Participants with CAIS had a low wish for a child and an indifferent attitude toward motherhood, women with MRKHS had a moderate wish for a child and were ambivalent, women with PCOS had a maximum wish for a child and idealized motherhood.

Conclusion The FEMu represents attitudes toward motherhood in a multi-dimensional way. It is appropriate for use in fertile and infertile individuals and can be applied in research and single-case settings. The FEMu results can be useful in individual counseling, e. g. within the scope of fertility treatmernt, at gynecological consultations, in pregnancy counseling or psychological counseling. In psychotherapy the results can help to develop suited interventions. The FEMu could also bring about valuable insights outside of the clinical setting, e. g., in the realms of family planning and women’s conflict between family and career.

Anhang

 
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