Higher child-raising costs due to maternal social isolation: Large population-based study in Japan

Continuous Support from the Same Public Health Nurse and Parental Perception and Use of Health Care Services: A Retrospective Observational Study

OBJECTIVE

Continuity is considered essential for high-quality maternal and child health care services, but studies to show this effect on parental well-being are still rare. We studied whether receiving support from the same public health nurse has a beneficial effect on parental perceptions of health care professionals and the use of childcare support services.

METHODS

Maternal and child health care services were provided by different nurses in a Japanese municipality until March 2019. From April 2019, all families with infants received continuous support from the same assigned nurse. A questionnaire covering parental perception and the use of services was sent by postal mail to 1,341 families with infants. The data were analyzed using χ2-test, t-test and logistic regression producing odds ratios (OR) with 95% confidence intervals (CI).

RESULTS

Parental perceptions of the availability of professionals to discuss children's issues, the degree of understanding about available other childcare support services, the degree of utilizing other services, and satisfaction with health care services were higher in parents who received continuous support from the same assigned nurse compared to those who did not receive continuous support. Continuous support was associated with parental perceptions of the availability of professionals to discuss children's issues (OR = 1.97, 95% CI 1.34-2.91) and the degree of understanding about available other child-care support services (OR = 1.65, 95% CI 1.11-2.44) after adjusting the results for socioeconomic factors.

CONCLUSIONS

Continuous support from the same assigned nurse has benefits for parents. This offers a cost-effective way to improve parental well-being.

Social isolation among mothers caring for Infants in Japan: findings from the Nationwide Survey of healthy parents and children 21

Background

Child-rearing isolation may increase the risk of child abuse and negatively affect child development owing to increased urbanization and a decline in family and community support systems.

Purpose

This study aimed to identify the prevalence of child-rearing isolation and the related sociodemographic factors among mothers in Japan using data from the Final Survey of Healthy Parents and Children 21.

Participants

Mothers of young children attending their health checkups.

Methods

Multivariate logistic regression models assessed the association between child-rearing isolation and socio-demographic variables. Data from 69,337 women were analyzed.

Results

Mothers who experienced child-rearing isolation comprised 0.2% of all participants. Mothers who were 35 to 39 years old at childbirth (OR = 1.6, CI[1.0, 2.4], p = .036), were unemployed (OR = 1.7, CI[1.3, 2.4], p = .001), had experienced financial difficulty (OR = 1.8, CI[1.3, 2.5], p < .001), had husbands with limited participation in child-rearing (OR = 5.7, CI[4.2, 7.9], p < .001), lived in special wards in the Tokyo Metropolis (OR = 4.2, CI[2.2, 8.3], p < .001), had child abuse concerns (OR = 2.1, CI [1.5, 2.9], p < .001), and had no time to relax with their child (OR = 4.5, CI [3.1–6.7], p < .001) exhibited higher odds ratios for child-rearing isolation, compared to mothers who did not exhibit these characteristics.

Conclusions

Findings showed the impact of urban living on maternal health and the influence of isolation on mothers’ anxiety about child-rearing and their potential for child maltreatment. The importance of fathers’ involvement in child-rearing in preventing maternal child-rearing isolation was highlighted.

Supplementary information

The online version contains supplementary material available at 10.1007/s10995-022-03427-0.

Development of a Pediatric Dermatology Screening Tool Based on Two Parent-Reported Skin Symptoms: Comparison of Parental Recognition and Physician Diagnosis of Skin Symptoms of Infants and Toddlers

Aim

The objective of the present study was to develop a tool for mothers to assess their children’s skin condition with the ultimate goal of its wider use in general health checkups for infants and toddlers.

Methods

This was a single-institution, cross-sectional study in Japan, targeting parents of 200 infants and toddlers who visited a dermatology clinic between December 2018 and March 2019. The parents completed a self-administered survey of the mother’s perception of her child’s dermatological symptoms, itchiness, and sleep status, and a quality-oflife assessment, using a nine-question version of the Quality of life in Primary Caregivers of children with Atopic Dermatitis questionnaire (QP9). The attending physician was asked to complete a form about the child’s dermatological condition and the treatment prescribed. The severity of the dermatological condition noted by the physician was compared with the combined response to the 3 perception items (dermatological condition, itchiness, and sleep) reported by the parents, in order to identify the optimal cutoff score.

Results

Of 200 parent questionnaires distributed, 198 (99% response rate) were returned and analyzed, along with the responses from 198 physician records (100% response rate). The optimal cutoff score was 2/3 for the total score (range 0-6) for 2 items, itchiness and sleep status (sensitivity 73%, specificity 64%). There was a significant difference in QP9 scores between the 2 groups categorized by the cutoff score

Conclusions

A pediatric dermatological screening tool based on 2 symptoms reported by the parents of children with atopic dermatitis was developed, and its precision and criterion-related validity were confirmed. This simple tool could help parents become better aware of their children’s skin condition and allow healthcare workers to provide adequate skin care advice. This practical tool could be widely applicable in primary child care and public health service settings.

Association of parental social network diversity with behaviour problems and resilience of offspring in a large population-based study of Japanese children

OBJECTIVES

The current study aimed to elucidate the impact of parental social network diversity on the behaviour problems and resilience of offspring.

DESIGN

We used cross-sectional data from the Kochi Child Health Impact of Living Difficulty study in 2016.

SETTING AND PARTICIPANTS

Participants were first, fifth and eighth grade children living in Kochi prefecture, Japan (N=9653). We calculated parental social network diversity by counting the number of people with whom parents connected on a daily basis (ie, structural social network diversity) and by assessing perceived psychosocial support (ie, functional social network diversity).

PRIMARY OUTCOME MEASURES

Child behaviour problems and resilience were respectively assessed using the Strengths and Difficulties Questionnaire (SDQ) and the Child's Resilient Coping Scale (CRCS), as rated by caregivers.

RESULTS

Diversity in parental structural and functional social networks showed an inverse association with SDQ total difficulties score (B=-0.16 (95% CI -0.25 to -0.07) and -0.20 (95% CI -0.27 to -0.13), respectively), and a positive association with prosocial behaviour score (B=0.11 (95% CI 0.08 to 0.15) and 0.09 (95% CI 0.06 to 0.12), respectively) and CRCS score (B=0.75 (95% CI 0.46 to 1.05) and 1.12 (95% CI 0.88 to 1.35), respectively) in the adjusted model. Parental mental health accounted for 36% and 43% of the total effects of structural and functional social network diversity respectively on the total difficulties score. For prosocial behaviour score, parental involvement accounted for 31% of the effects of functional social network diversity.

CONCLUSION

The results shed light on new strategies to enhance child mental health that do not directly involve children but rather focus on parental social networking.