Objective: We explored Adverse Childhood Experiences (ACEs) of first-time mothers in their teens and the effects there of on self-esteem, parental feelings, subjective health, and household budget during child-rearing.

Methods: We documented ACEs, and child-rearing emotions and support, using the 10-item Japanese version of the Rosenberg Self-Esteem Scale, with insufficient household budgets. We conducted a mobile-based questionnaire survey of 400 mothers, 200 of whom were teens raising preschool children and 200 of whom were aged over 20 years. The ACE scores of both groups were compared using the Mann-Whitney U-test. Furthermore, path analysis was conducted assuming a causal model in which ACE scores for first childbearing age 10s and 20s and older are associated with self-esteem while raising children and household budget, and with subjective health and parenting feelings via self-esteem.

Results: A total of 289 respondents answered all items. In multiple logistic regression analysis, the ACE items associated with first-time motherhood were Parental violence or physical punishment (OR=2.67, CI=1.08-6.58), Stress from disasters or accidents (OR=2.88, CI=1.33-6.25), Bullying or discrimination outside the home (OR=0.32, CI=0.14-0.69). Path analysis showed a causal relationship between ACE score and self-esteem (β=0.23), and Worried about household budgets (β=－0.55) in teen mothers. Also found between self-esteem and subjective health was the answer “not healthy” (β=－0.76). The model evidenced a good fit.

Discussion: ACEs significantly impacted the physical and mental status of teen mothers. In order to enhance the self-esteem of teen mothers, we should focus on their physical and mental condition and accept their growth as mothers.

Objective: In this study, we clarify the skills used by public health nurses in promoting the residents’ participation in community health activities.

Methods: First, we used a range of published textbooks about public health nursing to define community participation. Next, we collected research papers on community participation (search date: July 2020) and technical items were generated from the literature and analyzed.

Results: From 18 papers, 5 categories and 47 subcategories were extracted. The categories were: motivating participation in community health activities, developing resident organizations, participating in community health activities, strengthening knowledge and skills for participating in community health activities, forming partnerships with residents and establishing a mechanism for resident participation.

Discussion: The skills used by public health nurses to promote participation in community health activities include: increasing the residents’ interest in community health activities and initiating their participation, developing residents’ organizations as core groups, promoting participation in the expansion of health activities, and supporting the formulation of a policy on community health activities on equal footing with participants and professionals and administrative officials. Public health nurses also collaborate with appropriate individuals to create a system that allows residents to participate freely.

Public health nurses were required to encourage systematic participation of residents by making full use of support from district organizations and groups as well as health education technology, and to encourage the government and professionals to have a common understanding, understand the diverse positions of residents, and engage in equal relationships.

Purpose: Demand for elderly people daycare service (DS), a long-term care insurance service that combines primary and tertiary prevention, has been increasing. Autonomy of nurses working in DS implies that they be recognized in their professional roles in working and collaborating with other professionals, be able to act, make decisions, make choices without restraint or restriction from others, and apply decision-making and other skills in practice. We report the results of a survey aimed at clarifying factors associated with the autonomy of DS nurses.

Methods: Among 4,214 registered DS nurses in the Japanese Council of Senior Citizens Welfare Service, we randomly selected 1,771. An anonymous self-rated questionnaire survey, sent to one nurse per DS by post, included questions about personal factors (basic attributes, self-actualization as a nurse, etc.), institutional characteristics (current position, etc.), organizational factors (work environment, etc.), and autonomy as a nurse.

Results: Among the 403 replies (22.8% response rate) received, 344 participants (19.4% valid response rate) agreed to cooperate with the study and were not deficient as per the Japanese version of the Dempster Practice Behaviors Scale (DPBS), which measures nursing autonomy, were included. Total mean±standard deviation of the DPBS score was 93.0±14.5. Logistic regression analysis revealed that personal factors (self-actualization as a nurse), institutional factors (current job titles), and organizational factors (comfortable working environment) were significantly associated with autonomy.

Conclusion: Providing support that encourages self-actualization can improve the practical ability of nurses working in DS and the quality of support for the elderly.

Objective: This study aimed to describe the support needs of parents with mental disabilities during pregnancy and parenting per the parents’ perceptions.

Methods: The qualitative descriptive study with individual semi-structured interviews was conducted with 10 parents (eight female, two male) with mental disabilities who have children under the age of 18. The transcripts were coded from the perspective of “what support do the parents need?” Categories were created at a higher level of abstraction. Support needs were examined at different times by different support personnel.

Results: Six categories were identified: not to discriminate against them because of their disability, need an explanation of medication and preparation for worsening symptoms during pregnancy and breastfeeding, need support to supplement housework and childcare they cannot do due to illnesses or disabilities, need support as a parent despite their disabilities, need cooperation to support parents and children, need caring and empathy. Sixteen subcategories were identified, including “support to prevent children from being hit when parents’ medical condition worsens”.

Conclusion: The following are considered necessary: support to prevent discrimination, support for medication and medical conditions during the perinatal period, reduction of the burden of housework and childcare, recovery-oriented support for parents so that they can live with their children even when their condition worsens, support that enables them to avoid being harsh with their children, support based on the commonality of being parents, support in cooperation with other supporters, sharing information with the parent’s consent, and a system for easy consultation.

Objective: This research aims to develop an evaluation scale to assess the disaster preparedness of families with children with developmental disabilities to enhance disaster resilience, as well as to examine reliability and validity of the scale.

Methods: Items were collected and selected from previous studies, and a 26-item scale was created based on the conceptual framework of disaster resilience. Anonymous self-administered questionnaires were mailed to 453 parents of children with developmental disabilities (including presumed diagnosis) aged 6–18 years. The parents were from 21 parents’ association of children with developmental disabilities throughout Japan.

Result: A total of 172 valid surveys (36.1% of the original) were analyzed. The average age of the children was 12.48±3.13 years. In item analysis, two items were excluded. Exploratory factor analysis identified three subscales among 22 items: sharing risk within family or community, mitigating risk of living, and preparing necessary items. The scale had an overall Cronbach’s alpha coefficient of .923, and Cronbach’s alpha coefficients for the three subscales ranged from .814 to .900. The scale had a significant moderate correlation with the self-assessment of disaster preparedness (ρ = .625).

Discussions: The Disaster Preparedness Scale for Families of Children with Developmental Disabilities satisfied good internal consistency, and construct validity, and criteria-related validity. This study suggests that the scale can be used to self-evaluate disaster preparedness for families of children with developmental disabilities.

Objective: To identify factors associated with scores on the Child-care Happiness Scale (CHS) among mothers of children at different health checkup ages.

Methods: An anonymous, self-administered questionnaire was sent to 1,011 mothers who visited health centers for a health checkup for their infants or children. The questionnaire included respondents’ basic attributes, fathers’ involvement in childcare and housework, mothers’ perception of fathers’ emotional support, parenting (3 areas), and mothers’ CHS scores (8 areas). Multiple linear regression was performed using mothers’ CHS scores as a dependent variable, according to child’s health checkup age.

Results: Of all responses, 388 (38.4%) were valid. For all health checkup ages, the CHS scores were higher among mothers with higher scores on the “state of the parental role,” a subscale of “parenting.” A mother being younger, and a child’s birth order being lower were associated with higher CHS scores among mothers of 18-month-olds and 3-year-olds, respectively. The CHS scores were also higher with higher “mothers’ perception of their child” scores among mothers of infants and 18-month-olds, and with stronger perceptions of fathers’ emotional support among mothers of 3-year-olds.

Conclusion: Having a sense of satisfaction with her role as a parent is found to be important for a mother to have higher CHS scores. This requires that mothers of infants and 18-months-olds have parenting support, while mothers of 18-months-olds should be able to interact with their children in a flexible manner according to the child’s personality. For mothers of 3-year-olds, promoting fathers’ emotional support in parenting is essential.

Objective: We aim to develop a model for public health nursing based on nurse-client relationships. This study aimed to clarify ways of thinking and approaches of public health nurses in their practice, to form the assumptions for our nursing model.

Method: Public health nurses were interviewed and given four cases to put into practice. Persons approached by public health nurses in two out of four cases were interviewed. A structural drawing was then created to show the nurses’ judgments, approaches and reactions as well as changes in person-to-person relationships based on interviews. The public health nurses’ ways of thinking and approaches were then analyzed.

Results: Thirty-four items associated with the nurses’ ways of thinking and approaches were classified into 18 sub-categories. Public health nurses understand that clients are part of a family unit, and are not only the person in front of them. The sub-categories were classified into four main categories: “related to understanding of the subject and nurse-client relationships”, “related to process of practice based on nurse-client relationships”, “related to process of practice based on nurse-nurse relationships”, and “related to public health nurses’ judgement on process of practice”.

Discussion: When explaining public health nursing based on nurse-client relationships, examples of assumption of our model were as follows: a subject is a person in a person-to-person relationship, creating a system for health-problem solving depends on each person and person-to-person relationship, and working on approaches for the client and community helps to achieve goals.

Purpose: This study aims to identify the characteristics of questions used by public health nurses (PHN) to obtain information and make the decisions necessary for mother-child support through case discussions at a newly-appointed PHN training course, and to obtain ideas for PHN assessment skills.

Methods: Questions raised in the case discussions for mother-child support at a newly-appointed PHN training were analyzed. From the transcribed data, questions were extracted and categorized by newly-appointed PHN, preceptors, and managerial PHN.

Results: Twenty-five PHN participated in the study (11 newly-appointed, 7 preceptors, 7 managerial), and organized information into “questions to assess family childcare skills” related to ‘temporal assessments of child growth and development’, ‘balance of mind in the childcare’, ‘uncomfortableness in interactions of mothers with the children’, ‘parent personality and life history’, ‘parent views on childcare’, and ‘family relationships and support skills’. The participants encouraged mothers to use support through “questions to explore opportunities and directions for intervention” by ‘approaches suitable to the childcare skills of the family’, ‘clues for intervention’, and ‘identifying issues based on professional assessment skills’.

Discussion: The case discussions showed that questions by PHN assesses comprehensive family childcare skills by focusing on the mothers, and temporal developments in the support appropriate to child development. The participants assessed the support direction by determining the timing and methods of intervention and shared assessments of professionals. The findings suggest the effectiveness of the case discussions where new and senior PHN participated to promote assessment through multilayered questioning according to the experience as PHN.

The aim of this study was to identify the violence-prevention ideas and intentions of workers in providing the community mental health and welfare services at prefectural public health centers. Methods: A semi-structured interview survey was conducted with 17 mental health and welfare workers at a prefectural public health center. The analysis was conducted through a hierarchical cluster analysis of the verbatim interview data as quantitative text analysis (text mining). Results: Nine clusters were extracted from the analysis and classified into four categories based on the meaning and content of the clusters: “tuning in close proximity with the recipients of support,” “self-defense preparation of risk reduction entities,” “operation of a cooperative system with family and staff,” and “careful deployment of personnel during transfer.” Discussion: the results showed that the best way for mental health and welfare workers, to prevent violence is to focus on reducing the risk of violence, both individually and organizationally, while concentrating on how to interact with the recipients of support.

Purpose: This study investigated the involvement of psychiatric home-visit nurses that led clients to talk about hope, from the clients’ viewpoints.

Method: Semi-structured interviews with three clients of psychiatric home-visit nursing were conducted following an interview guide and analyzed using qualitative descriptive methods.

Results: Three themes relating to involvement were found: building personal relationships, supporting overall daily life and promoting self-care, and working toward the realization of hope. In addition, there were eight categories: clarifying leadership role: sustaining interest in the client beyond the home-visit nurse situation; respecting the feelings of the client and the content and scope of what is said; creating an atmosphere conducive to talking about hopes and using conversation techniques; encouraging self-care through understanding and caring for the client’s overall life; setting up opportunities for reflection aimed at the client’s own disease management; directing the conversation and providing resources toward the client’s hopes and future; and accepting and understanding of the hopes expressed by clients.

Discussion: Building personal relationships influences the choice of the target for talking about hope and leads to self-disclosure of hope and its natural emergence in conversation. Support for overall daily life and promotion of self-care influences the choice of what to tell the nurse that hope as well as activities of daily living and mental status are things to talk about. Working toward the realization of hope can lead to more specific hope narratives and the following hope narratives.