Kimura Miyako, Ide Kazushige, Ojima Toshiyuki
Department of Preventive Medicine, St Marianna University School of Medicine.
Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University.
Nihon Koshu Eisei Zasshi. 2022 Apr 26;69(4):273-283. doi: 10.11236/jph.21-058. Epub 2022 Feb 28.
Objectives We examined the relationships between the development of severe mental distress among mothers of young children during COVID-19 and the related factors including difficulties in raising child, concerns about child's development, social support, and capacity to receive support using comparable pre-COVID-19 baseline data. Severe mental distress was defined by a score of K6≧10 on the Psychological Distress Scale.Methods We conducted a baseline survey in February 2020 and obtained responses from 4,700 mothers of young children. A follow-up survey was conducted in June 2020. We obtained responses from 2,489 participants of the original group. The K6 scores (four groups) of two surveys were compared. Thereafter, 521 participants who had severe mental distress at the baseline were excluded, and 1,968 participants were included in the Poisson regression analysis. We adjusted for maternal age, education, marital and employment status, household income, children's age, number of children, and changes during COVID-19 pandemic. The adjusted incident rate ratios (IRRs) were estimated using K6≧10 at follow-up as the dependent variable, and the independent variables were having difficulty in raising a child, concerns about child's development, social support, and capacity to receive support.Results At the baseline, 20.9% of mothers had severe mental distress. At follow-up, this value increased significantly to 25.3%. Mothers who developed severe mental distress by the time of the follow-up survey were 333 (16.9%), and they were more likely to have had difficulty in raising their child, concerns about child's development, lower levels of positive attitudes toward receiving support (capacity to receive support), and lower levels of social support.Conclusions The mental health of mothers caring for young children worsened during the COVID-19 outbreak. Factors related to the development of severe mental distress included having difficulty in raising a child, concerns about child's development, and lower levels of positive attitudes toward receiving support (capacity to receive support) and lower levels of social support. Providing parenting support, consultation and rehabilitation, and exploring approaches to enhance capacity for receiving support are required.
目的 我们利用新冠疫情前具有可比性的基线数据，研究了新冠疫情期间幼儿母亲严重精神困扰的发展与相关因素之间的关系，这些因素包括育儿困难、对孩子发育的担忧、社会支持以及获得支持的能力。严重精神困扰由心理困扰量表K6得分≧10定义。
方法 我们于2020年2月进行了基线调查，获得了4700名幼儿母亲的回复。2020年6月进行了随访调查。我们从原组的2489名参与者那里获得了回复。比较了两次调查的K6得分（四组）。此后，排除了基线时患有严重精神困扰的521名参与者，1968名参与者纳入泊松回归分析。我们对母亲的年龄、教育程度、婚姻和就业状况、家庭收入、孩子年龄、孩子数量以及新冠疫情期间的变化进行了调整。以随访时K6≧10为因变量，以育儿困难、对孩子发育的担忧、社会支持和获得支持的能力为自变量，估计调整后的发病率比（IRR）。
结果 在基线时，20.9%的母亲有严重精神困扰。在随访时，这一比例显著上升至25.3%。到随访调查时出现严重精神困扰的母亲有333名（16.9%），她们更有可能在育儿方面有困难、对孩子发育感到担忧、对获得支持的积极态度较低（获得支持的能力）以及社会支持水平较低。
结论 在新冠疫情爆发期间，照顾幼儿的母亲的心理健康状况恶化。与严重精神困扰发展相关的因素包括育儿困难、对孩子发育的担忧、对获得支持的积极态度较低（获得支持的能力）以及社会支持水平较低。需要提供育儿支持、咨询和康复服务，并探索提高获得支持能力的方法。
