Purpose: To clarify the thoughts of independent midwives who do not deliver babies on their activities.

Methods: Semi-structured interviews were conducted involving 10 independent midwives who do not deliver babies, and the obtained data were analyzed using a qualitative and inductive approach. This study was conducted with the approval of the ethics committee of Kagawa University Faculty of Medicine.

Results: The midwives who do not deliver babies began to run their own business by considering that “they could provide breastfeeding care”. They realized the importance of “spending more time providing mothers with emotional support” and the fact that they were able to “work in the community as a midwife being supported by mothers”. They were also keenly aware of the “sense of security in working with other professions” because they have experienced anxiety and hesitation of working alone. They, however, wished to “continue their activities at their current pace”.

Discussion: For independent midwives who do not deliver babies, support from local residents and other professions will promote trust and increase their job satisfaction. Continuous breastfeeding support and postpartum care services that require a great deal of time will be needed in the community. We believe that seamless maternal and child health support in the community can contribute to lifelong health support for women.

Conclusion: The independent midwives who do not deliver babies were keenly aware that their activities are supported by local residents and other professions. Continuous breastfeeding support and postpartum care services requiring their expertise will be needed by the community.

Aim: To explore the effects of kangaroo care on heart rate variability among preterm infants in the neonatal intensive care unit.

Methods: We evaluated heart rate variability in preterm infants who received kangaroo care. This included heart rate (HR), low-frequency power (LF), high-frequency power (HF), and LF/HF ratio during the pre-kangaroo-care period (before 32-34 weeks of gestation), before kangaroo care, and while kangaroo care was being performed.

Results: HR during kangaroo care decreased 8 out of 14 times compared to that during the pre-kangaroo-care period and decreased 4 out of 11 times compared to that before kangaroo care was performed. LF/HF ratio during kangaroo care decreased 6 out of 14 times compared to that during the pre-kangaroo-care period and decreased 6 out of 11 times compared to that before kangaroo care was performed. The LF and HF power spectra only showed peaks in the LF power and lows in the HF power compared with the LF power. The mean HR value was 155.5±12.45 beats/min and the LF/HF ratio was 6.16±1.78.

Conclusions: There were no high or low trends in the HR and LF/HF ratio between before kangaroo care and while kangaroo care was being performed. The HF power was lower than the LF power, suggestive of immature control of breathing in preterm infants. The mean values of HR and the LF/HF ratio while kangaroo care was being performed suggested that the sympathetic/parasympathetic balance was similar to that in a sleeping state in preterm infants.

Objective To clarify mid-career ward and visiting nurses' thoughts toward home care support after making initial post-discharge home visits through collaboration.

Methods Semi-structured interviews were conducted with four mid-career ward nurses and four visiting nurses, who had made initial post-discharge home visits through collaboration, and the contents of the interview data were qualitatively and inductively analyzed. The study was approved by the Ethics Committee of Kagawa University Faculty of Medicine and the Nursing Research Ethics Committee of the Nursing Department of Takamatsu Red Cross Hospital.

Results Mid-career ward nurses' thoughts were represented by “reflecting on one's nursing approaches to home care support” and realizing the importance of “ patients' and families' emotions”. Visiting nurses' thoughts, on the other hand, were represented by “promoting patients' and families' sense of security by making home visits with mid-career ward nurses”, “feeling secure about direct collaboration between nurses” and they realized “the need of making use of patients' post-discharge conditions to nursing ”.

Discussion The reflection performed by mid-career ward nurses on their own nursing approaches to home care support may facilitate specific discharge support, and the conveying of the patients' and families' conditions by visiting nurses to ward nurses may be important for the transition from hospital treatment to home care. Furthermore, direct collaboration between these nurses may also provide an important basis for the continuation of home care, as it makes them feel secure while promoting patients' and families' sense of security.

Conclusion Direct collaboration between ward and visiting nurses for post-discharge home visits promotes a sense of security among both nurses and patients/ families.

Purpose: To clarify the parenting experience of fathers with twins on how they felt and thought from the time of pregnancy to the present.

Methods: Semi-structured interviews were conducted involving 10 fathers raising twins, and the obtained data were analyzed using a qualitative and inductive approach. This study was conducted with the approval of the ethics committee of Kagawa University Faculty of Medicine.

Results: As a result of analysis, 6 categories were obtained. When the fathers of twins found out that their wives were pregnant, they were both [happy that she was expecting twins and worried about raising twins]. As they began to raise twins, [support from their parents and information about raising twins made them feel secure]; however, looking at their wife struggling to take care of twins, they realized the importance of [showing appreciation to their wife for her hard work in raising twins], which made them determined to [cooperate in raising their twins]. While [struggling to manage work and childcare], they then started to wish to [raise twins as individuals] as they gradually understood the role of a father.

Discussion: The fathers raising twins tried to seek a work-life balance by sharing the hard task of raising twins with their wife, while at the same time envisioned an ideal family that values the individuality of each child in their own way.

Conclusion: The experience of fathers raising twins had an impact on the changes in their sense of values and perception of their role as the father of twins.

Objective: To clarify the emotions of working mothers who supported daughters to give birth in their hometown.

Methods: Eight working mothers, who had supported daughters to give birth in their hometown, were examined through semi-structured interviews after the daughters' deliveries in a single hospital. The obtained data were qualitatively and inductively analyzed. The study was approved by the Ethics Committee of Kagawa University Faculty of Medicine.

Results: While the working mothers desire to help their daughters as they were helped by their parents when they gave birth, they were anxious about such support, but they were finally prepared “to support the daughters to give birth in their hometowns with other family members”. However, when the daughters actually returned to their hometowns, and the mothers' daily lives completely changed, they found it “burdensome to support the daughters while working”. After the daughter's delivery, their daily lives returned to normal, and they felt “relieved while developing a sense of loneliness due to ending of support”. On the other hand, the daughter's appreciative statement and positive attitude toward parenting led to their “satisfaction with the personal growth of the daughter and oneself having fulfilled her role as a mother”.

Discussion: The working mothers felt conflicted about the necessity of supporting their daughters while working. However, being appreciated by the daughters who had grown personally, they felt relieved and satisfied, as they may have realized that they had fulfilled their role as a mother.

Conclusion: The working mothers found it burdensome to provide support while working, but they felt relieved and satisfied when they were appreciated by their daughters, who had grown personally.