A Mixed Methods Study Exploring Difficulties in Child Care Among Japanese Mothers with Depression

Background: Depression causes mothers to experience difficulties in child care and increases stress, which can influence the development of the child. Japan currently has insufficient support for mothers with depression. Objectives: We aimed to reveal the difficulties in child care and related factors of three Japanese mothers with depression by examining their narratives. Methods: A mixed method design was applied. We conducted in-depth, semi-structured interviews with mothers with depression and analyzed the data using both the grounded theory approach and text mining software (KH Coder). Results: As a result of focus coding, 11 focus codes were extracted. In addition, as a result of multi-dimensional scaling, two codes (“Physical burden caused by family and child care” and “The mother coping with difficulties by herself”) were in close proximity and formed a unit. Another two codes (“Anxiety over not having complete control over child care” and “One-sided coping methods”) were in close proximity, creating a second unit. Conclusion: This study suggested the following: 1) in spite of being aware of their excessive burden, mothers with depression believed that they should take care of their children by themselves; 2) because of the desire to be a perfect mother, mothers with depression tended to have extremes in their child care. We need further research based this result for the developing support systems.