The present study aimed to clarify how the stress coping strategy of upper-grade elementary school children differ based on Sense of Coherence (SOC) level and sex. A cross-sectional and observational survey was conducted using an anonymous, self-administered questionnaire on all 4-6th grade pupils (n=402) at B Elementary School in A City, Kanagawa Prefecture, in urban area. The questionnaire categorized items related to SOC, 12 items of stress coping strategy, 12 symptoms of physical and mental status, grade and sex. Of the 391 questionnaires collected (collection rate, 97.3%), the 318 questionnaires with complete responses (valid response rate, 79.1%) were analyzed. Analysis was conducted by sex. At first, pupils were divided into low-SOC group and high-SOC group (boys, 68 in low group and 77 in high group ; girls, 91 and 82), and the proportion of pupils adopting each stress coping strategy was compared between the high and low SOC groups. Multiple logistic regression analysis was then conducted with each stress coping strategy as the dependent variable, SOC level as the independent variable and physical and mental symptoms and grade as control variables. Among boys, a significant correlation was observed between SOC and the coping strategy of“ask someone what to do” (odds ratio[OR], 2.48 ; 95% confidence interval[CI], 1.03-5.96 ; p=0.043), clarifying that this coping strategy was easier to adopt for the high-SOC group compared to the low-SOC group. Conversely, among girls, a significant correlation was observed between SOC and“spend time alone” (OR, 0.40 ; 95% CI, 0.19-0.83 ; p=0.014), clarifying that the high-SOC group was less likely to adopt this coping strategy than the low-SOC group. The present findings indicate that the relationship between SOC and stress coping strategy among upper-grade elementary school children differs between boys and girls. Boys with high SOC easily adopt the coping strategy of asking for help from those around them, while girls with high SOC find it harder to adopt the coping strategy of spending time alone.
Objectives : This study was performed to evaluate the factors associated with the components of maternal health knowledge among pregnant women in remote Paraguay. Methods : Structured interviews were conducted to evaluate the maternal health knowledge of pregnant women during their first, second, and third antenatal care (ANC) visits in Caazapá Region, Paraguay. Multiple linear regression analysis was performed to evaluate the associations between individual maternal health knowledge score and improvement in the score, their sociodemographic characteristics, and type of health facility chosen to receive ANC. Results : Statistically significant improvement in maternal health knowledge score was observed among rural women who received ANC at least three times during their pregnancy (paired t test, P<0.001). Type of health facility (such as hospital vs. health post) was a possible predictor of higher maternal health literacy (t test, P<0.001). However, educational status was also a significant predictor of higher maternal health literacy (t test, P<0.001), especially risk assessment during pregnancy (t test, P<0.001). In addition, currently being with partner was a significant predictor of greater maternal health literacy (t test, P=0.001), especially related to healthy and unsuitable diet during pregnancy (t test, P=0.003, P=0.016, respectively). Conclusions : It is important to consider the appropriateness of various approaches to improve maternal health literacy depending on components, including maternal health knowledge, regarding risk signs, lifestyle, and diet, obtained by formal education as well as those related to experience from daily life.