RELATION OF FATIGUE TO DEPRESSION AND MATERNAL ROLE ATTAINMENT 1 MONTH AFTER CHILDBIRTH IN JAPANESE FIRST- TIME MOTHERS OVER AGE 35 Background and purpose:

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RELATION OF FATIGUE TO DEPRESSION AND MATERNAL ROLE ATTAINMENT 1 MONTH AFTER CHILDBIRTH IN JAPANESE FIRST- TIME MOTHERS OVER AGE 35 Background and purpose: Recently, the number of first-time mothers over age 35 has been increasing in Japan. This study aimed to examine the relation of fatigue to depression and maternal role attainment at 1 month after childbirth in Japanese first-time mothers over age 35. It was part of a longitudinal study on physical and psychosocial health in the 4 months following childbirth. Methods: 【 Subjects 】 Twenty-one first-time mothers over age 35 were surveyed 1 month after childbirth. 【 Date Collection 】 Survey items included the self-report Accumulated Fatigue Checklist ( Ministry of Health, Labour and Welfare,2004 ), Edinburgh Postnatal Depression Scale Japanese version ( EPDS )( Okano et al,1996 ), Maternal Role Confidence Scale and Maternal Role Satisfaction Scale ( Maehara, 2005 ) during the postpartum period, and background and daily life activities of the mothers. 【 Ethical Consideration 】 The Chiba University Graduate School of Nursing Institutional Review Board approved the study. All subjects provided informed consent. Conclusion: Level of fatigue in first-time mothers over age 35 was related to depression, low maternal confidence, and low maternal satisfaction at 1 month after childbirth. Nursing support programs that promote postpartum recovery and maternal role attainment following childbirth should be further developed. Result: ・ Table 1 shows demographic obstetric data of the subjects. ・ Subjects were divided into three groups according to accumulated fatigue scores: ( 1 ) low fatigue, 0 to 4 points ( 33.3% ) ; ( 2 ) moderate fatigue, 5 to 10 points ( 23.8% ) ; and ( 3 ) high fatigue, 11 to 20 points ( 33.3% ). No significant differences were observed in the background factors between groups. ・ EPDS scores in the high fatigue group ( M=8.3, SD=2.4 ) were significantly higher ( p<.01 ) than in the moderate fatigue group ( M=3.4, SD=3.0 ) and low fatigue group ( M=2.6, SD=1.7 ) [ see Figure1 ]. ・ Maternal role confidence scores in the high fatigue group ( M=50.6, SD=8.5 ) were significantly lower ( p<.05 ) than in the moderate fatigue group ( M=51.2, SD=5.1 ) and low fatigue group ( M=64.1, SD=9.4 ) [ see Figure2 ]. ・ Maternal role satisfaction scores in the high fatigue group ( M=27.3, SD=3.7 ) were significantly lower ( p<.05 ) than in the moderate fatigue group ( M=30.2, SD=2.5 ) and low fatigue group ( M=33.3, SD=2.6 ). Table 1. Demographics and obstetric data of the subjects ( N=21 ) Figure 2. Maternal Role Confidence Scale and Maternal Role Satisfaction Scale score according to Accumulated Fatigue ( Maternal Role Confidence Scale score : 20 ~ 80, Maternal Role Satisfaction Scale score : 9 ~ 36 ) Sakajo A., Mori E. , Maehara K. , Iwata H. , Ozawa H. , Morita A. , Maekawa T., Tsuchiya M. Chiba University Graduate School of Nursing, JAPAN M+SD, n ( % ) Age ( years ) 37.0±2.5 Occupation Employed Unemployed 6 ( 28.6 ) 15 ( 71.4 ) Education High school college University or higher 5 ( 23.8 ) 6 ( 28.6 ) 10 ( 47.6 ) Marital status Married Single 21 ( ) 0 ( 0.0 ) History of mental disease Yes No 2 ( 9.5 ) 19 ( 90.5 ) Treatment history for infertility Experience Inexperience 5 ( 23.8 ) 16 ( 76.2 ) Model of delivery Vaginal delivery ( normal ) Vacuum extraction Cesarean section 7 ( 33.3 ) 8 ( 38.1 ) 6 ( 28.6 ) Problems during pregnancy Occur Not 8 ( 38.1 ) 13 ( 61.9 ) Problems during delivery Occur Not 6 ( 28.6 ) 15 ( 71.4 ) Newborn problems Occur Not 3 ( 14.3 ) 18 ( 85.7 ) Type of feeding Breastfeeding Mixed Bottle 2 ( 9.5 ) 19 ( 90.5 ) 0 ( 0.0 ) Times of feeding per day < 10 ≧ 10 9 ( 42.9 ) 12 ( 57.1 ) Support person Husband/mother/ mother-in-law Nobody 14 ( 66.7 ) 7 ( 33.3 ) **p<.01 ( n=19 ) Figure 1. EPDS score according to Accumulated Fatigue ( EPDS score : 0 ~ 30 ) Correspondence: Emi Mori, RN, RM, PhD Professor of Department of Parent and Child Nursing, Graduate School of Nursing, Chiba University Inohana, Chuo-ku, Chiba city, , Japan This study was supported by a Funding Program for the Next Generation World-Leading Researchers ( No. LS022 ), from the Cabinet Office and the Japan Society for the Promotion of Science, Japan. EPDS score * * *p<.05 ( n=19 ) * *