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Aim We evaluated the effectiveness of a nursing intervention program for Chinese women who are giving birth in Japan to reduce cross‐cultural stressors during the postpartum period and prevent postpartum depressive symptoms. Methods A prospective, before‐and‐after study incorporating a longitudinal mixed‐method design was conducted. Thirty‐eight participants underwent this program from August 2016 to July 2017. The program comprised a maternity class, conversation cards, and a social‐network group. Data collection was initially performed using questionnaires administered in the third trimester (T1)—before the intervention—to obtain participants' basic information, stress levels, depressive symptoms, and cognitive appraisals. Then, stress levels, depressive symptoms, and social support were measured during hospitalization after having given birth (T2) and during the first month postpartum (T3). Finally, through semi‐structured interviews, cognitive appraisal, coping, stress, social support, participants' evaluations of the intervention were determined. Results Post‐intervention, all participants showed positive cognitive appraisals, although eight also showed some negative appraisals. At T3, 36 participants did not report experiencing stress owing to cross‐cultural stressors. Furthermore, post‐intervention, participants who returned scores that were suggestive of depression remained identical to that at pre‐intervention (21.1%). Among the eight participants who showed postpartum depressive symptoms during T3, seven did not report experiencing cross‐cultural stressors, but did report encountering maternity stressors. Conclusion The nursing intervention program may be effective for preventing postpartum depressive symptoms in Chinese women who give birth in Japan. Since this was a pre‐post study in which one group was measured pre‐intervention and again post‐intervention, we did not register in a publicly assessible database.

Aim To compare the factors that affect maternal confidence at 1 month post-partum between older (≥35 years old) and younger (20–34 years old) primiparous Japanese mothers. Methods A multicenter prospective study of mothers who gave birth to live singleton infants in Japan was conducted. Following ethics approval, the participants completed questionnaires 1 day before discharge and 1 month after childbirth. The questionnaires included the Postpartum Maternal Confidence Scale, demographics and background information, prenatal and obstetric data, situational variables and perceptions of daily life, and social support. The obstetric data were extracted from the hospital medical records. Data from the older primiparae (n = 479) and the younger primiparae (n = 1033) were analyzed by using multiple stepwise regressions, controlling for the delivery mode. Results Maternal confidence at 1 month post-partum was positively associated with emotional support for the older primiparae and appraisal support and exclusive breastfeeding for younger primiparae. In both groups, feeling overwhelmed by daily life, a lack of communication with their partner about the parenting role, and a lack of prior experience in caring for babies were negatively related to maternal confidence. Family budget instability was negatively related to maternal confidence in the younger group. Conclusion Providing care that is based on an understanding of the unique support needs of first-time mothers in different age groups could promote more effective parenting.

Aim Older maternal age has become more common in Japan. Studies suggest that older maternal age and primiparity are associated with post-partum depression. The present study aimed to identify predictors of post-partum depression in older Japanese primiparas at 1 month post-partum. Methods Participants were 479 primiparas aged 35 years and over, drawn from a prospective cohort study. Data were collected using self-report questionnaires. Depression was measured with the Japanese version of the Edinburgh Postnatal Depression Scale. Stepwise logistic regression analysis was conducted on binary outcome variables of depression at 1 month post-partum, along with a stratified analysis based on the risk status of depression. Results Five predictors were identified: (i) the depression score during hospital stay; (ii) financial burden; (iii) dissatisfaction with appraisal support; (iv) physical burden in daily life; and (v) concerns about infant caretaking. Stratified analysis identified dissatisfaction with instrumental support in the low-risk group, and the Child-care Value Scale score as unique predictors in the high-risk group. Conclusion These results highlight the importance of early assessment of depressive symptoms and the provision of continuous care.

Aim Post-partum fatigue is a serious concern for mothers worldwide. The aim of this study was to identify age-specific determinants of self-perceived fatigue after childbirth among Japanese primiparous women. Methods A multicenter prospective cohort study was conducted in Japan. The degree of fatigue was assessed using the Postnatal Accumulated Fatigue Scale during the hospital stay after childbirth. Associated factors were stratified into two age groups (

Aim The number of older primiparas is increasing in Japan. These women have been shown to be more vulnerable to post-partum depression. This study aimed to identify factors for predicting post-partum depressive symptoms during hospitalization after childbirth in Japanese primiparas aged 35 years and over. Methods The present authors used the data of 479 primiparas aged 35 years and over from a prospective cohort study. Data were collected using self-report questionnaires on the day before hospital discharge. The questionnaire consisted of: demographics and background information; depressive symptoms; fatigue; maternal confidence and maternal satisfaction; child-care values; physical symptoms; perceptions of daily life during hospitalization; concerns about child care and daily life; and infant feeding. Additionally, vital records data were obtained from the hospitals. A stepwise logistic regression analysis was performed on the binary outcome variable of depressive symptoms, measured by the Japanese version of the Edinburgh Postnatal Depression Scale. Women who scored 9 or more were considered to be at high risk for post-partum depression. The authors obtained informed consent from all participants and institutional ethics approvals before initiating the study. Results The following six variables reliably predicted the risk of post-partum depression: emergency cesarean section, lower satisfaction with birth experience, higher physical burden in daily life, long-term complications with the newborn, more concerns about newborn caretaking after discharge, and more concerns about one's own life after discharge. Conclusion Recognition of women with these factors will help nurses to identify those at risk for developing post-partum depression and to provide appropriate care during hospitalization after childbirth.

Aim: The purpose of this study was to develop the Maternity Portfolio to promote maternal role attainment in women who underwent artificial reproductive treatment. Methods: The following procedures were undertaken to develop the Maternity Portfolio: (i) a literature review was conducted to identify studies and articles related to maternal diary or portfolio usage; (ii) the research members discussed objectives and usages of the Maternity Portfolio; (iii) a trial product was developed in collaboration with two pregnant women (one following artificial reproductive treatment and one infertility patient) and seven nurses, and after feedback was completed, the product was revised; and (iv) the final product of the Maternity Portfolio was patented. Results: The final Maternity Portfolio product consisted of a 40-page booklet; it contained an information section and a patient comments section. Following artificial reproductive treatment, this booklet can be provided to women during the first trimester. Women would then be instructed to bring the Maternity Portfolio to their prenatal checkups, where a nursing intervention program would be conducted by certified nurses. Through this program and the Maternity Portfolio, participating women are expected to obtain necessary information and maternal role attainment. Conclusions: The Maternity Portfolio was developed to promote maternal role attainment for women who have undergone artificial reproductive treatment. The intervention study with the Maternity Portfolio is a work in progress; therefore, a future evaluation of the study will clarify both positive and negative aspects, which should facilitate refinement of the functions and qualities of the Maternity Portfolio.