Background Child-rearing isolation may increase the risk of child abuse and negatively affect child development owing to increased urbanization and a decline in family and community support systems. Purpose This study aimed to identify the prevalence of child-rearing isolation and the related sociodemographic factors among mothers in Japan using data from the Final Survey of Healthy Parents and Children 21. Participants Mothers of young children attending their health checkups. Methods Multivariate logistic regression models assessed the association between child-rearing isolation and socio-demographic variables. Data from 69,337 women were analyzed. Results Mothers who experienced child-rearing isolation comprised 0.2% of all participants. Mothers who were 35 to 39 years old at childbirth (OR = 1.6, CI[1.0, 2.4], p = .036), were unemployed (OR = 1.7, CI[1.3, 2.4], p = .001), had experienced financial difficulty (OR = 1.8, CI[1.3, 2.5], p < .001), had husbands with limited participation in child-rearing (OR = 5.7, CI[4.2, 7.9], p < .001), lived in special wards in the Tokyo Metropolis (OR = 4.2, CI[2.2, 8.3], p < .001), had child abuse concerns (OR = 2.1, CI [1.5, 2.9], p < .001), and had no time to relax with their child (OR = 4.5, CI [3.1–6.7], p < .001) exhibited higher odds ratios for child-rearing isolation, compared to mothers who did not exhibit these characteristics. Conclusions Findings showed the impact of urban living on maternal health and the influence of isolation on mothers’ anxiety about child-rearing and their potential for child maltreatment. The importance of fathers’ involvement in child-rearing in preventing maternal child-rearing isolation was highlighted.

This study aims to determine the approximate number of hospitalizations of persons without family and the medical challenges they encounter in hospitals across Japan. Self-administered questionnaires were mailed to 4,000 randomly selected hospitals nationwide to investigate the actual conditions and problems, decision-making processes, and use of the government-recommended Guidelines for the hospitalization of, and decision-making support for, persons without family. To identify the characteristics of each region and hospital function, chi-square tests were used to make separate group comparisons by hospital location and type. Responses were received from 1,271 hospitals (31.2% response rate), of which 952 hospitals provided information regarding the number of admissions of persons without family. The mean (SD) and median number of hospitalizations (approximate number per year) of patients without family was 16 (79) and 5, respectively. Approximately 70% of the target hospitals had allowed the hospitalization of a person without family. The most common difficulties encountered during the hospitalization were collecting emergency contact information, decision-making related to medical care, and discharge support. In the absence of family members and surrogates, the medical team undertook the decision-making process, which was commonly performed according to manuals and guidelines and by consulting an ethics committee. Regarding the use of the government-recommended Guidelines, approximately 70% of the hospitals that were aware of these Guidelines responded that they had never taken any action based on these Guidelines, with significant differences by region and hospital type. To solve the problems related to the hospitalization of persons without family, the public should be made aware of these Guidelines, and measures should be undertaken to make clinical ethics consultation a sustainable activity within hospitals.

This study aims to determine the approximate number of hospitalizations of persons without family and the medical challenges they encounter in hospitals across Japan. Self-administered questionnaires were mailed to 4,000 randomly selected hospitals nationwide to investigate the actual conditions and problems, decision-making processes, and use of the government-recommended Guidelines for the hospitalization of, and decision-making support for, persons without family. To identify the characteristics of each region and role of hospitals, chi-square tests were used to make separate group comparisons by hospital location and type. Responses were received from 1,271 hospitals (31.2% response rate), of which 952 hospitals provided information regarding the number of admissions of persons without family. The mean (SD) and median number of hospitalizations (approximate number per year) of patients without family was 16 (79) and 5, respectively. Approximately 70% of the target hospitals had experienced the hospitalization of a person without family, and 30% of the hospitals did not. The most common difficulties encountered during the hospitalization were collecting emergency contact information, decision-making related to medical care, and discharge support. In the absence of family members and surrogates, the medical team undertook the decision-making process, which was commonly performed according to manuals and guidelines and by consulting an ethics committee. Regarding the use of the government-recommended Guidelines, approximately 70% of the hospitals that were aware of these Guidelines responded that they had never taken any action based on these Guidelines, with significant differences by region and hospital type. To solve the problems related to the hospitalization of persons without family, the public should be made aware of these Guidelines, and measures should be undertaken to make clinical ethics consultation a sustainable activity within hospitals.

BackgroundChild-rearing isolation may increase the risk of child abuse and negatively affect child development owing to increased urbanization and decline in family and community support systems.PurposeThis study aimed to identify the prevalence of child-rearing isolation and the related sociodemographic factors among mothers in Japan using data from the Final Survey of Healthy Parents and Children 21.ParticipantsMothers of young children attending their health checkups.MethodsMultivariate logistic regression models assessed the association between child-rearing isolation and socio-demographic variables. Data from 69,337 women were analyzed.ResultsMothers who experienced child-rearing isolation comprised 0.2% of all participants. Mothers who were 35- to 39-years-old at childbirth (OR = 1.6, CI[1.0, 2.4], p = .036), unemployed (OR = 1.7, CI[1.3, 2.4], p = .001), experienced financial difficulty (OR = 1.8, CI[1.3, 2.5], p < .001), had husbands with limited participation in child-rearing (OR = 5.7, CI[4.2, 7.9], p < .001), lived in special wards in Tokyo Metropolis (OR = 4.2, CI[2.2, 8.3], p < .001), had child abuse concerns (OR = 2.1, CI [1.5, 2.9], p < .001), and had no time to relax with their child (OR = 4.5, CI [3.1-6.7], p < .001) exhibited higher odds ratio for child-rearing isolation, compared to those who did not.ConclusionsFindings showed the impact of urban living on maternal health, the influence of isolation on mothers’ anxiety about child-rearing and their potential for child maltreatment. The importance of fathers’ involvement in child-rearing for preventing maternal child-rearing isolation was highlighted.SignificancePrevious studies have shown that social isolation is significantly associated with morbidity and mortality. One of the most pressing issues in Japan is child-rearing isolation of mothers with infants. Child-rearing isolation is considered a risk factor for abuse and disruption of healthy parent-child relationships. However, no studies have examined the associated factors of child-rearing isolation among mothers, adjusting for confounding factors. Our results provide evidence that child-rearing isolation is a risk factor for maltreatment. In addition, we found new evidence that maternal child-rearing isolation is significantly associated with age at birth, lack of spousal participation in parenting, and urban living.