Research Report

Qualitative analysis of group work on child-rearing
for parents of the Michinoku Children’s Cohort
Miyagi Disaster Mental Health Care Center
Naru Fukuchi, Takao Tanno, Shusaku Chiba
1.

Introduction
Previous studies have revealed that the growing environment, including the mother-child relationship ininfancy, is important for the emotional development of children, and that childhood trauma affects the mental
and physical development of children1), 2). After the Great East Japan Earthquake that occurred in 2011, multiple
follow-up surveys were conducted on children who directly experienced the disaster, and the findings wereconsistent with previous research). Meanwhile, while developing community support, we often receive
consultations for children who were born after the earthquake and who had no direct experience of the disaster.
No studies have been conducted that include the development of children or the psychological evaluation ofparents after a large-scale natural disaster, or long-term longitudinal intervention studies on children and theirfamilies. Moreover, no clear knowledge has been obtained regarding what kind of support should be developed.
Given this background, we launched the “Michinoku Children’s Cohort after the Great East Japan Earthquake
Study (MiCCa JEGE Study).”4) Here, we began an initiative to track children born immediately after the disasterand their parents and to provide long-term support while confirming their physical and mental health.
This paper is a report of our initiative in FY2019. In FY2019, instead of conducting face-to-face surveys,
we conducted discussion meetings for parents at four locations in three prefectures of the Tohoku region under
the name of the “Michinoku Children’s Cohort Caravan” (hereinafter, “Caravan”).
2.

ObjectiveThe objective was to understand the physical and mental health of the target parents, and to provide regularsupport to families in high-risk conditions. We also attempted to extract keywords for developing support in the“Michinoku Children’s Cohort” by exchanging opinions with parents in the Caravan. We further aimed toevaluate the psychological burden of the parents themselves as well as self-affirmation, and to provide a venue
for parents to connect with each other.
3.

Methods
Questionnaires were sent to participants in advance and requested them to bring the completed items on theday of the event. Research supervisors (child psychiatrists) from three prefectures of the Tohoku region visitedthe area, where they provided a series of programs that were centered on lectures and group work (Table 1).
Yagi from Iwate Prefecture gave a lecture titled, “Outline of research and explanation of results.” Fukuchi from
Miyagi Prefecture gave a lecture titled, “Development of children of this age.” Finally, Masuya from Fukushima
Prefecture gave a lecture titled, “How to compliment children and find their positive traits.” In the final lecture,group work was conducted using a part of the existing parent program. 5) First, discussions were on “Positiveparts and improving parts of yourself (parent),” after which discussions were held on “Positive parts andimproving parts of children.” This paper is the result of recording and transcribing this group work and analyzing
its contents.
Table 1 Flow of Caravan
10:00
10:00−10:20 (20 min.)10:20−10:30 (10 min.)
10:30−11:00 (30 min.)
11:00−11:30 (30 min.)
11:30−11:50 (20 min.)Start of Caravan
Outline of research and explanation of results (Yagi)
Icebreaker
Development of children of this age (Fukuchi)
How to compliment children and find their positive traits(Masuya)Group work using part of the parent program
Summary- 48 -1)

ParticipantsParticipants were the parents of children in the “Michinoku Children’s Cohort” which began in FY2016.
2) Procedures for survey
We sent information to parents who consented to cooperate with the “Michinoku Children’s Cohort”
and targeted those who wished to participate. We explained during the recording of group work thatparticipation in the survey was voluntary, and that consent could be withdrawn at any time.
3) Implementation period
The study was conducted in the Higashimatsushima City Yamoto Higashi Civic Center during themorning of Sunday, January 26, 2020; and at the Iwanuma City Tamaura Community Center during thesame afternoon.
4) Survey method① Questionnaire about the mental health of participants
We conducted a survey with a questionnaire that used the K6 6) for anxiety, BDI-II7) for depression,and IES-R8) for trauma.
② Qualitative analysis of group work
Upon receiving the participants’ consent, we recorded the discussion in the group work as voice dataand transcribed it as text data. The 30-minute group work for each of the two groups was divided into
the “Positive parts and improving parts of yourself (parent)” and “Positive parts and improving parts ofchildren” and analyzed. The text data was qualitatively analyzed using KH coder, 9) the most frequently
appearing words were extracted, and a co-occurrence network was created.
4.

Results
Table 2 shows the attributes of the participants. Of the potential 65 participants, 13 (20%) agreed toparticipate. The 13 participants included 12 mothers and one father, with an average age of 40.9 years (±5.06).
The average scores of the psychological evaluation scale before the start of the Caravan were 5.08 points(2.43 SD) for K6, 11.7 points (6.03 SD) for BDI-II, and 5.85 points (4.71 SD) for IES-R. The number ofparticipants in the clinical group who exceeded the cut-off value were seven, six, and zero for the K6, BDI-II,and IES-R, respectively.
Table 2 Attributes of Caravan participants and questionnaire results
Female12Participants
Male1
Average age
40.9 (5.06 SD)
Average score
5.08 (2.43 SD)
K6Clinical group
7 participants (53.8%)
Average score11.7 (6.03 SD)
BDI-II
Clinical group
6 participants (46.2%)
Average score5.85 (4.71 SD)
IES−R
Clinical group
0 participants (0%)
There were 4,999 words in total that were extracted from the group work of “Positive parts and improving
parts of yourself,” with the most frequently used words being “children,” “eating,” “waking up,” and “work,” inthat order. The co-occurrence network by the KH coder (Fig. 1) showed that the largest group (green circle) was
the content where the “difficulty of preparing meals for children every day” was shared and parents praised eachother by saying “you’re doing it well.” There were 5,514 words in total that were extracted from the group workof “Positive parts and improving parts of children,” with the most frequently-used words being “myself,” “doing
my best,” “child,” and “homework,” in that order. The co-occurrence network by the KH coder (Fig. 2) showedthat the largest group (green circle) was content evaluating “being on time and going to school / playing games.”- 49 -Family

Doing mybest

EatingChores

After

SurelySubgraph:01Food

Bath02

Mother03

Effort

05
06
07

04
Cleaning

Frequency:
Children
Make

10

Entrance

Child
Myself

Late
Know

20

Lunch

House

Time

Go
out

Break30

Father

Go
home

Sleep
Early
MorningDinnerWaking up

Night

Front

Fig. 1 Good points of parents

Small

Subgraph:

BathEnter

Parent

Body

01
02
03
04
05

Practice

NowFirst

Kind

06
07
08
09

ListenFrequency:
Teacher

Teach

Decide

Goout

4All

Game

Older
sisterPlay

Protect

8

Reaction

EnergyTime

Preparation

MorningGo
12

Wakingup

Study

SchoolChildrenDifficultMultiplication

Homework

16
House

Little
End
Sleep

Front

Go
home20

Put inQuick

FinishLaundryFig. 2 Good points of children- 50 -Like5.

6.

Discussion
The K6 and BDI-II results of the participants suggested that approximately half belonged to the clinicalgroup. This may be because stresses remain high even eight years after the earthquake, or because families
with high stress tended to participate in the Caravan.
There were several aspects that were clear from the qualitative analysis of group work. Most of theparticipants were mothers and were raising children while working. There were feelings of “we are doing ourbest” and “we want to be recognized” regarding their handling of the household chores, like cleaning andwashing, as well as preparing dinner before their children return home. Meanwhile, there was little
participation in the Caravan by fathers, and there were also few words regarding fathers in the group work.
Thus, it appeared that they were not active regarding childcare and household chores. We were unable toobserve whether there was any dissatisfaction toward fathers in the scope of the present work; however, weobserved that mothers were struggling to raise their children while carrying burdens. A venue for recognizingthese efforts was valuable, and the activities in the Caravan may have been helpful. The evaluation points ofthe children were thought to be relatively directed to behavior in lifestyle aspects. Phrases like “being on timeand playing games,” “have them wake up themselves,” “finish homework,” and “practice lessons” were often
heard. Participants at the time of Caravan implementation were families with second-grade elementary school
children. Therefore, the children may have been able to tackle lifestyle-related rules and homeworkindependently because of attending second grade in elementary school.
There were hardly any keywords relating to the Great East Japan Earthquake. We were unable to extract
any current circumstances that were specific to the affected area from the present group work analysis.
However, we were able to extrapolate that the parents were working hard to raise their children and wanted
to raise them properly. We were also able to confirm that the children grew up over time, and that their parents
were watching over them. It is thought that in the future, we will need to remain close to the participants while
continuing the “Michinoku Children’s Cohort” to further understand their difficulties.
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