Maternal experiences of pregnant women affected by natural disasters: A modified grounded theory approach.

Pregnant women experience medical and psychological difficulties in their daily lives during disasters. Since the care provided to them in disaster situations is unclear, it is necessary to better understand their experiences. This study aims to identify the maternal experiences of pregnant women during natural disasters. This research employed a modified grounded theory approach. Twenty-three pregnant women, living in disaster-affected areas, were interviewed. The research methods were utilized and interpretive analysis was conducted, resulting in a diagram and storyline to describe the process. The characteristics of the maternal experiences fluctuated between "being unable to face pregnancy because of the disaster response" and "facing the fact of being pregnant." To maintain a fluctuation between their affected life and their pregnant life, it was necessary to control the weighting between "securing a safe and secure place," "encountering support based on pregnancy," and "signs from the fetus." Clarifying the maternal experiences of pregnant women living in disaster areas revealed a multilayered structure of categories and relationships. This study suggests that understanding the structure of fluctuations and control is critical for the nursing practice.

The incidence of all organ malignancies and overall survival of patient with sustained virological response of HCV-comparable to SMR (standardized mortality ratio) of Japan general population.

OBJECTIVE: This study prospectively observed the incidence of all malignancies and the prognosis of all patients in a population of patients who achieved Sustained Virological Response (SVR) with a 100% capture rate. DESIGN: A prospective study of 651 SVR cases was conducted from July 2013 to December 2021. The primary endpoint was the occurrence of all malignancies, and the secondary endpoint was overall survival. The cancer incidence during the follow-up period was calculated using the man-year method, and risk factors were analyzed. In addition, sex- and age-matched standardized mortality ratio (SMR) was used to compare the general population with the study population. RESULTS: The overall median follow-up was 5.44 years. 107 malignancies occurred in 99 patients during the follow-up. The incidence of all malignancies was 3.94/100 person-years. The cumulative incidence was 3.6% at 1 year, 11.1% at 3 years, and 17.9% at 5 years, and continued to increase almost linearly. The incidence of liver cancer and non-liver cancer was 1.94/100 patient-years vs. 1.81%/100 patient-years. The 1-year, 3-year, and 5-year survival rates were 99.3%, 96.5%, and 94.4%, respectively. This life expectancy was compared to the standardized mortality ratio of the Japanese population, which proved non-inferior. CONCLUSION: It was found that malignancies of other organs occur as frequently as hepatocellular carcinoma (HCC). Therefore, follow-up of patients who have achieved SVR should focus not only on HCC but also on malignant tumors of other organs, and lifelong follow could contribute prolonged life expectancy for the previously short-lived.

Experiences of pregnant people affected by natural disasters: a qualitative systematic review protocol.

OBJECTIVE: This qualitative systematic review will identify, appraise, and synthesize existing qualitative evidence regarding the experiences of pregnant people during a natural disaster to gain a deeper understanding of the complex factors influencing their experiences. INTRODUCTION: During natural disasters, pregnant people would benefit from health workers, including nurses, midwives, and other professionals, considering their needs and providing support to address complex factors, including family relationships, social support, and stress; however, little is known about the experiences of pregnant people during a natural disaster. This study is the first qualitative systematic review of the experiences of pregnant people during a disaster. INCLUSION CRITERIA: This review will include studies that focus on pregnant people's experiences of living in a disaster area during a natural disaster. It will include both published and unpublished qualitative studies, with data collected through interviews and observations, in either English or Japanese. METHODS: The databases and other sources to be searched include MEDLINE, CINAHL, and PsycINFO (in English); and CiNii and Ichushi-Web (in Japanese). Further, we will cross-check the reference lists of included studies with search outcomes to identify any additional studies suitable for analysis. The search for gray literature will be conducted using Google Scholar and ProQuest. We will use the recommended JBI approach for study selection, critical appraisal, data extraction, and data synthesis. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021265326.

Fathers' Involvement in Rearing Children With Profound Intellectual and Multiple Disabilities.

The aim of this study was to explore father's involvement in rearing a child with profound intellectual and multiple disabilities (PIMD). In-depth, semi-structured interviews were conducted with seven fathers in Japan, and the data were analyzed using a qualitative inductive method. The relationship between the parents, in the context of childrearing, influenced father's involvement with their child with PIMD. Fathers improved their self-confidence in childrearing by discussing and sharing about their child's conditions and caregiving approaches with their spouse. Moreover, fathers' experience of being acknowledged and entrusted by their spouse with childrearing motivated and enhanced their involvement. On the contrary, fathers struggled with concerns regarding their family's future, the balance between childrearing and work, and their own health status. The current findings contribute to nurses' understanding of father's involvement in childrearing a child with PIMD and the development of support focusing on the parental dyadic relationship and coparenting behavior.

How Parents of Adolescents and Young Adults with Biliary Atresia Surviving with Native Livers Transfer the Responsibility of Medical Treatment to Their Children in Japan.

BACKGROUND: This study examines how the parents of adolescents and young adults with biliary atresia, surviving with their native livers, transfer medical treatment responsibility to their children, and how becoming a living liver transplant donor affects this process. The basis for the study was that becoming a living liver transplant donor may influence the transfer of responsibility. METHODS: A qualitative, descriptive design was employed using a modified grounded theory approach. Data were collected from eight parents from November 2016 to August 2017 through semi-structured interviews conducted in two Japanese hospitals. Interpretive analysis from the viewpoint of the analytical theme and analytical focus person was conducted, resulting in a diagram and storyline explaining the process. FINDINGS: Five categories were generated from one father and seven mothers (aged 40-60 years) of outpatients (aged 17-25 years): parental ability to cherish the child's "now" (live in the moment); put the brakes on their child's life; learn as they go; leave the child's life to the child; and openly express reservations about becoming a living liver transplant donor for their child. DISCUSSION: Parental transfer of responsibility for treatment may be influenced by close-knit parent-child relationships, perception of the child's growth, and parental concern about becoming a living donor. APPLICATION TO PRACTICE: Care providers should understand parent-child relationships and the parents' concerns about becoming living donors, thereby enabling them to recognize that medical treatment control must be relinquished to foster children's autonomy as adults.

How Japanese nurses participate in decision making: Infants with congenital life-threatening conditions.

BACKGROUND: In Japan, owing to the progress in medical technology, more children with congenital life-threatening conditions survive than ever before. Nurses who care for these children may also influence decision making in difficult situations. AIM: We aimed to describe Japanese nurses' approach toward medical decision making when caring for families of infants with congenital life-threatening conditions. Frequently, these nurses must care for and support parents with ambivalent feelings. DESIGN: Qualitative descriptive study. METHODS: Participants were recruited from neonatal intensive care unit and paediatric wards at a university hospital in Japan from June to July 2016. Data were collected using semi-structured interviews and qualitatively analysed. RESULTS: Japanese nurses described these situations as "decision making regarding the child's medical care" and "daily life at hospitals." The themes included support of parents and the choices made about their children, nurses giving or holding their opinions about care choices, or withholding their opinions during decision-making events. The narratives included 5 focus areas: the parents; the children, the family as a whole; relationship between families and health care providers; and the effect of the clinical environment on the children and families. CONCLUSION: When caring for children with life-threatening congenital conditions, nurses should develop supportive relationships with parents and contribute to the clinical decision-making process with empathy and based on the most current research data.

Stress and coping in Japanese mothers whose infants required congenital heart disease surgery.

BACKGROUND: With the growing number of severe congenital heart disease (CHD) surgeries, some hospitals in Japan are experiencing difficulty meeting the demand for CHD surgery. As a result, CHD surgery preparation is difficult for mothers of these infants. AIMS: To examine the stress and coping of mothers whose infants needed CHD surgery and to identify the factors that influenced maternal coping. METHODS: Semistructured interviews were conducted with 11 mothers whose infants had undergone CHD surgery. Qualitative analyses of transcribed interviews were performed. RESULTS: The coping of mothers for surgery began when mothers received news of their infant's CHD diagnosis. Maternal stress appraisal and coping changed as surgery approached. In particular, maternal coping was influenced by diagnosis event, symptoms of their child, anticipated number of surgeries, presence of chromosomal abnormality, and infant age. CONCLUSION: The stressors and coping challenges of mothers whose infants needed CHD surgery changed as the surgery date approached, and these were influenced by 5 factors.

Maternal coping with the prospect of liver transplant among their school-age children.

The purpose of the current study was to describe the following: maternal coping with the prospect of becoming the living-donor liver transplant for their child; the daily lives of school-age children surviving biliary atresia with their native liver; and to explore the relationship between these individuals. Semistructured interviews were conducted with 6 school-age children surviving biliary atresia with their native liver and their mothers. The interviews were conducted from June to August 2014, and a qualitative content analysis was used. Results showed that mothers realized a possible need for transplantation in the future, which contributes to emotional and practical uncertainties. The mothers coexisted with this uncertainty and preferred to use a buffering strategy. In contrast, the children did not consider their illness and future and did not adhere to a therapeutic regimen. It is suggested that living with uncertainty about the health and survival of their children is advantageous for mothers. However, problems related to the psychosocial aspect and child's adherence may occur in the future. In addition, problem-solving coping strategies for mothers and the independence of chronically ill children with liver disease should be promoted.

Exploring the beliefs of Japanese mothers caring for a child with disabilities.

The purpose of this study was to describe the beliefs of Japanese mothers caring for a child with disabilities to advance knowledge about beliefs of Japanese families experiencing illness. A semistructured interview was conducted with eight mothers who had a child with disabilities (physical, intellectual, and/or developmental). The interview invited their reflections about "mutual thoughts of family members" and family relationships in the context of daily life of caring for a child with disabilities. Data were qualitatively analyzed inductively and deductively and compared with the Common Tentative Framework of Japanese Family Beliefs developed from previous research. The analyses highlighted new understandings of the influence of Japanese cultural and societal beliefs on the family's experience of having a child with disabilities. Clinical implications are discussed and directions for future research suggested.

The Tokyo Twin Cohort Project: overview and initial findings.

The Tokyo Twin Cohort Project (ToTCoP) is a large-scale longitudinal study of 5 years based on 1619 pairs of infant twins reared together. The purpose of the study is to construct a population-based twin registry in Japan and to investigate human growth and development and twin themselves. It covers behavioral, neurological, physical and environmental variables measured by questionnaire, home visiting and brain imaging technology. The full registry contains over 47,000 multiple births collected from the Basic Resident Register, and the targeted population is 3070 probable twins of 0 to 2 years old. Preliminary analysis of the entry questionnaire data showed no serious sampling biases. Descriptive statistics of parental characteristics (parental age, gestation age, parity and placentation, maternal weight, parenting stress) and children's characteristics (body size at birth, 4 and 10 months of age, milk consumption, and sleeping and social behavior) and their correlations, genetic and environmental contributions and correlations are reported.