Purpose: This study aimed to clarify the association with marital relationship in the first trimester and maternal-fetal attachment in the first and the second trimester.

Methods: An online questionnaire was conducted at two time points: the first trimester of pregnancy (10-15 weeks of gestation) and second trimester of pregnancy (20-24 weeks of gestation) among primiparous women who attended prenatal check-ups at four medical institutions in the Tokyo met ropolitan area. Surveys were conducted on marital relationship in the first trimester, maternal-fetal attachment in the first and second trimester, and the basic attributes of the subjects. The marital rela tionship was evaluated using the Quality Marriage Index (QMI), and the maternal-fetal attachment was evaluated using the Prenatal Attachment Inventory (PAI). Each in the first and the second tri mester, a multiple regression analysis was conducted with confounding variables (age, education, weeks of pregnancy, acceptance of pregnancy in the first trimester, etc.) adjusted to investigate the association with marital relationships in the first trimester and the maternal-fetal attachment.

Results: One hundred thirty-eight analysis subjects provided valid responses. The QMI score in the first trimester showed a significant correlation with the PAI score in the first trimester (ρ＝0.29, p＜0.01) and with the PAI score in the second trimester (ρ＝0.28, p＜0.01). Also, the results of multiple regression analysis showed that the QMI score in the first trimester was significantly association with the PAI score in the first trimester (standard partial regression coefficient (β)＝0.20, p＜0.05) and with the PAI score in the second trimester (β)＝0.17, p＜0.05).

Conclusions: Results suggested that a good marital relationship in the first pregnancy may enhanc es maternal-fetal attachment of both the first and the second trimester. Previous studies have reported that the presence of a husband or partner is important as a supporter to increase the maternal-fetal attachment in the third trimester of pregnancy. It was thought that nursing support that enhances the intimacy of marital relationships from first-pregnancy to second-pregnancy may be necessary.

Purpose: The purpose of this study was to identify factors associated with help-seeking preference and tap characteristics of older adults with low help-seeking preference.

Methods: Questionnaire surveys distributed directly to mailboxes of 488 of 508 elderly people living at home in six districts in town B, prefecture A were collected by return mail. Attributes, help-seeking preference, life events (marital status, hospital visits, hospitalization history, health checkups, prior assistance experience), social support status, social frailty items (tendency to seclude oneself, social isolation), subjective sense of health, and health literacy were tested.

Results: Of the 488 questionnaires distributed, 144 responded (29.5% response rate). Of these, 137（male:female＝63:74; Age mean＝75.6y, SD＝6.6） were analyzed. T-tests and one-way ANOVA showed gender, living orientation, and confinement tendency as variables related to help-seeking preference. Partial correlation analyses revealed that social support, social isolation, and health literacy had significant partial associations. Hierarchical multiple regression analysis extracted gender and confinement tendency as influencing factors.

Conclusions: The variables related to help-seeking preference among the elderly were gender, living arrangements, tendency to seclude themselves, social support (instrumental support, emotional support), social isolation, and health literacy.