Appropriate physical activity (PA) enhances health-related quality of life (HRQOL) in the elderly. However, few studies have focused on the physical activity required during grandparenting activities. We investigated the levels of PA and HRQOL in 48 Japanese grandmothers and determined the association between child-rearing assistance and PA and between PA and HRQOL. The study revealed that the grandmothers mainly provided non-daily care, and they showed an appropriate level of PA and good physical and mental HRQOL. These findings suggest that involvement in non-routine care has benefits for grandparents' health.
Objective: This study aimed to clarify the association between sense of filial responsibility, local residents' subjective economic status, and attachment to the local community, and to contribute to local community policies and measures including support systems for elderly in need of care and family. Methods: We conducted in-home interviews in 2015 in Okinawa, Japan. A total of 2,663 local residents were selected, and after invalid responses were excluded, 1,656 responses (62.2%) were analyzed. Participants were asked about demographic variables (sex, age, marital status, birth order, subjective health, living arrangement), subjective economic status, attachment to the local community, and sense of filial responsibility (such as caring for and supporting their elderly parents). Results: Age, marital status, birth order, and attachment to the local community were positively associated with sense of filial responsibility. Participants with low subjective economic status had low sense of filial responsibility. Even if subjective economic status was low, participants with high attachment to the local community had significantly high sense of filial responsibility. Moreover, participants with high attachment to the local community provided and received more instrumental support than participants with low attachment to the local community. Conclusions: Our findings suggest that high attachment to the local community can form a support system in local areas, and that support systems in turn help local residents when they support their parents. In light of these findings, measures for creating networks between local residents, as well as improvement of the physical environment, are necessary for local community planning.Key words: sense of filial responsibility, attachment to the local community, subjective economic status, social support, social capital 親扶養意識,地域愛着,経済状況,ソーシャルサポート,ソーシャル・キャピタル 1 琉球大学医学部保健学科
Background Village health volunteers (VHVs) are responsible for providing primary care in the communities of Laos. Unlike other districts, in Xepon more than 90% of VHVs are male and therefore experience difficulties interacting with pregnant women. To improve outreach to pregnant women, especially among ethnic minorities, a new project was implemented by local municipalities in 2017: newly selected female VHVs were paired to work with existing male VHVs. The objective of this study was to compare the postnatal depressive symptoms of ethnic minority mothers supported by pair-VHVs and single-VHVs in remote rural areas of Lao People’s Democratic Republic (PDR). Methods A cross-sectional study was conducted in March 2019. Mothers who had delivered a baby within 1 year preceding the study were recruited from 36 villages. Of the 305 mothers, 227 responded. The questionnaires included (1) demographic characteristics such as age, economic status, and birth experience; (2) self-decision to go to a health center/hospital to receive antenatal care; (3) type of VHVs (pair or single), support, and information from VHVs during pregnancy, support from husband and relationship with husband; (4) the Edinburgh Postnatal Depression Scale (EPDS). A Mann-Whitney U test, chi-square test, and multiple linear regression analysis were performed. Ethical approval was obtained from the University of the Ryukyus and National Ethics Committee for Health Research of Lao PDR. Results The average total EPDS score was 5.5 among mothers supported by pair-VHV and 7.0 among mothers supported by single-VHV. Results of the multiple linear regression analysis showed that the EPDS score was significantly lower among mothers supported by pair-VHV (β=−1.18, p <0.05) even after adjusting for economic and biological factors. Conclusions Mothers supported by pair-VHV had a significantly lower EPDS score than those supported by single-VHVs in this study area, suggesting that the support of male and female VHV pairs contributed to improving mental health status among ethnic minority mothers in remote rural areas of Lao PDR. Expanding the program to train female VHVs working with male VHVs is necessary for improving maternal and child health in a rural district of Lao PDR.
Purpose This study aimed to investigate the process mothers go through in coming to terms with raising a child with chromosomal structural abnormalities. Methods Sixteen mothers living in Japan were interviewed and a modified grounded theory approach was used for the analysis. Results A total of 35 concepts, nine subcategories, and six categories were extracted. The six categories were: (a) Concern about abnormalities; (b) A healthy child is considered as a standard; (c) Deepening attachment to the child; (d) Acceptance of the child as s/he is; (e) Changing attitude toward disabilities; (f) Creating a frontier for other mothers. The parenting journey meant that parents did not move in a straightforward way from the beginning of the process to the endpoint but instead moved between “Deepening attachment to the child” and “Acceptance of the child as s/he is” before they moved ahead. Conclusion Having support and meeting peers of mothers with similar issues is essential for mothers to review their perspectives that healthy children are the standard against which to measure their child and to motivate them to raise their children, but it was extremely difficult to have such opportunities due to rarity of the disorder. It is crucial to accumulate more practical information so that mothers can access and use it. Mothers also need support to enhance their self‐worth while giving due consideration to the possibility that they may be conscious of being stigmatized. Nurses need to advocate for these children and families to get the appropriate help, understanding and support.
Background: In South Sudan where both maternal mortality rate and infant mortality rate are among the worst in the world, we conducted a qualitative study in the area of midwife in-service training outcomes with an aim to contribute to the in-service training development that fits the local context and serves the needs of midwives in dire environment. Methods: We conducted semi-structured interviews with five graduates of a midwife in-service training program. The interview guide was developed to determine the progress, the facilitators and the bottleneck in the transfer of knowledge from the training program to practicum. The interviews were conducted in Juba, South Sudan, and transcribed verbatim followed by content analysis of data using the ModifiedGrounded Theory Approach. Results:The content analysis of data produced 24 concepts, 5 subcategories and 3 categories. Those categories were "Development of motivation for application, " "Building up midwife skills, " and "Midwife care improvement in the facility. " We found that the midwife leaders' skills building processes were influenced by environmental factors such as community members' perception which impedes safe delivery, lack of pregnancy and birth related knowledge among women in the community, and low level of language skills of colleagues. There were also intrinsic factors including having successful experiences, recognition from others, and confidence in new skills. Conclusion: Overall, the study indicated the incorporation of participant-centered learning methodology and strategies to effectively work through environmental issues and midwives' level of self-efficacy will increase successful application of learning.
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