Community factors to promote parents' quality of child-nurturing life.

OBJECTIVES: The purpose of this study was to clarify the role of community factors in parents' quality of child-nurturing life (QCNL). METHODS: We developed a questionnaire to evaluate the degree of QCNL and determine the structural factors related to QCNL as community factors related to parents' QCNL derived from focus group interviews and the Delphi technique. The questionnaire also included the battery of the self-rating depression scale and Tsumori-Inage Infant's Developmental Test. Using the questionnaire, we then conducted a quantitative survey of parents whose children attended nursery schools in Kumamoto Prefecture. Factor analysis, calculation of the mean score and/or ratio to each item, Pearson's correlation coefficient, t test, multiple regression analysis, and covariance structure analysis were performed. RESULTS: The questionnaire we developed consisted of seven items with 75 elements, involving ten elements as community factors. Subjects included 699 parents (mean age 33.6 ± 5.4 years) and 965 children (age range 0-6 years). Factor analysis revealed that community factors consisted of five factors, such as "lifestyle rooted in the ground," "balance of housekeeping and work," "community network," "amenity," and "regeneration of life". These factors may be dominant in a rural area. Finally, we developed a structural model with "community factors," QCNL, QOL, and "child growth" by covariance structural analysis. The analysis revealed that community factors had a positive relation to parents' QCNL (r = 0.81, p < 0.001) and that parental SDS score had a negative relation to parents' QCNL (r = -0.59, p < 0.001). The analysis did show that community factors were positively related to the sound growth of children. CONCLUSION: The covariance structure analysis revealed that community factors were associated with parents' QCNL, SDS, and "child growth."

Effort-reward imbalance for learning is associated with fatigue in school children.

We examined relationships among fatigue, sleep quality, and effort-reward imbalance for learning in school children. We developed an effort-reward for learning scale in school students and examined its reliability and validity. Self-administered surveys, including the effort reward for leaning scale and fatigue scale, were completed by 1,023 elementary school students (grades 4-6) and 1,361 junior high school students (grades 7-9) at the end of 2006. Effort-reward imbalance for learning was associated with a high incidence of fatigue and sleep problems in elementary and junior high school students of both genders. A good relationship with family was associated with a low fatigue score in junior high school boys, and a good relationship with friends was associated with a low fatigue score in junior high school girls by multiple regression analysis. Fatigue score was associated with effort-reward imbalance and fatigue and quality of sleep in schoolchildren. Fatigue may lead to a decline in school performance, negative health outcomes, or refusal to attend school. These results suggest that it is desirable to consider social support, quality of sleep, and effort-reward imbalance when managing fatigue in school children.

Temperament and character as predictors of fatigue-induced symptoms among school children in Japan: a 1-year follow-up study.

OBJECTIVE: This 1-year follow-up study was performed to examine the association of temperament and character dimensions with new onset of fatigue-induced symptoms among school children in Japan, focusing on the transition from childhood to early adolescence. METHOD: This study prospectively reviewed data from 1512 school children from four elementary and four junior high schools in Japan. The survey was conducted in 2006 and 2007. Multivariate logistic regression analyses were performed to examine the association of psychological dimensions, assessed by the Junior Temperament and Character Inventory, with fatigue-induced symptoms. RESULTS: The correlation between temperament and character dimensions with new-onset of fatigue-induced symptoms differed as the students advanced into higher grades. In terms of physical symptoms in males, traits correlated with fatigue-induced symptoms included Novelty Seeking (headaches OR, 1.36; 95% CI, 1.07-1.73) or Reward Dependence (extreme tiredness OR, 1.84; 95% CI, 1.09-3.12; muscle weakness OR, 2.32; 95% CI, 1.28-4.20) during elementary school, whereas in females, Novelty Seeking was mainly associated with both physical (morning fatigue OR, 1.40; 95% CI, 1.10-1.77; headaches OR, 1.22; 95% CI, 1.04-1.43) and mental (mood changes OR, 1.30; 95% CI, 1.09-1.56) symptoms. Among ninth graders, more mental symptoms of fatigue were associated with Harm Avoidance (males, poor motivation OR, 1.20; 95% CI, 1.02-1.42; females, mood changes OR, 1.25; 95% CI, 1.06-1.49) and Self Directedness (males, poor motivation OR, 0.75; 95% CI, 0.59-0.96; females, difficulty thinking OR, 0.78; 95% CI, 0.62-0.98). CONCLUSION: Confirmation that the correlation between personality traits and fatigue-induced symptoms changes with grade at school has implications for screening susceptible children and adolescents and may help prevent the occurrence of such symptoms at an early stage.

Reliability and validity of the Japanese version of the Chalder Fatigue Scale among youth in Japan.

In the present study, the reliability and construct validity of the Japanese version of the Chalder Fatigue Scale was evaluated as a measure of severity of fatigue among young students in Japan. A healthy group comprised 27 Grade 6 primary school students and 28 Grade 1 junior high school students. The severely fatigued group were hospital outpatients with childhood chronic fatigue syndrome (n = 21). Principal components analysis with varimax rotation identified 4 factors which accounted for 63.2% of the total variance, as in the original English version. Internal consistency (Cronbach coefficient alpha) was .73, and test-retest reliability measured using Spearman rank correlation coefficient was .55. Scale scores of the healthy subjects were lower than those of the patients with childhood chronic fatigue syndrome. The reliability (alpha) and construct validity of the Japanese version of the scale among healthy students in Japan were satisfactory for research studies among healthy school students.

Behavior and lifestyle factors related to quality of life in junior high school students.

OBJECTIVES: To analyze actual conditions of the quality of life (QOL) in junior high school students, we developed a questionnaire based on the PRECEDE-PROCEED model, and we conducted a survey by using this questionnaire. METHODS: We conducted a workshop organized with 29 specialists on school health and community health to develop the questionnaire. The QOL outcome was assessed by the QOL Profile-Adolescent Version (QOLPAV). The subjects of the questionnaire surveys were 1600 general students in four junior high schools. To investigate a correlation between QOLPAV, behaviors and three enhancing factors, two different multiple regression models were constructed. RESULTS: The question battery for QOLPAV was found to be a high value of Chronbach's α. Among present subjects, 16.5% were categorized as "problematic" or "very problematic" classified by QOLPAV scores. In the first multiple regression model, significantly high odds ratios were obtained between the QOLPAV and 4 questions for behaviors, such as "studying with high motivation" (OR 1.64), "getting along well with my friends" (2.72), "having things I am interested in" (1.70), and "making my own decisions" (1.80). In the second model, significantly high odds ratios were obtained commonly between the above 4 questions about behaviors and 2 questions on enabling factors, such as "easy to understand lessons" (1.32-1.71) and "speaking to friends easily" (1.30-3.22). CONCLUSIONS: 1) We developed a questionnaire to analyze the actual condition of QOL in junior high school students with sufficient validity and availability. 2) Among the present subjects, 16.5% were found to be problematic QOLPAV, 3) Among the factors of behaviors, those representing positive willing and high coping ability with the elements of each school life contributed significantly to the QOLPAV. And among enhancing factors, "enabling factors" and "reinforcing factors" were stronger contributors to the behaviors strongly related to the QOLPAV than that of "predisposing factors".