The following questionnaire asks about your first child or about your relationship with that child. |
1) Please tell us your age. Please enter ◯ in the corresponding item. |
( ) 15 - 19, ( ) 20 - 24, ( ) 25 - 29, ( ) 30 - 34, ( ) 35 - 39, ( ) 40 - 44, ( ) 45 - 49 |
2) How old is your first child? Please enter ◯ in the corresponding item. |
( ) 0-year-old, ( ) 1 year old, ( ) 2 years old, ( ) 3 years old, ( ) 4 years old, ( ) 5 years old, ( ) 6 years old and older |
3) When did you have a hard time physically and mentally after childbirth? Please enter ◯ at the following times. You can select more than one. |
( ) Less than one month, ( ) 1 month, ( ) 2 month, ( ) 3 month, ( ) 4 month, ( ) 5 month |
( ) 6 month, ( ) 7 month, ( ) 8 month, ( ) 9 month, ( ) 10 month, ( ) 11 month |
( ) 1 year old, ( ) 2 year old, ( ) 3 year old, ( ) 4 year old, ( ) 5 year old, ( ) 6 year old |
4) What was the reason why you were physically and mentally difficult after childbirth? Please enter ◯ at the following times. You can select any number of them. |
( ) There was no person to consult. |
( ) I couldn’t balance housework and childcare. |
( ) No one helped with childcare. |
( ) The child didn’t stop crying. |
( ) I struggled with sleep deprivation. |
( ) I didn’t know a childcare method. |
( ) I couldn’t produce breastmilk. |
( ) I didn’t feel well. |
( ) My husband did not understand. |
( ) I abused my child. |
( ) My child was a handful. |
( ) My husband did not help me with childcare. |
( ) I didn’t have time for myself. |
( ) I had to work for financial reasons. |
( ) I could not get the understanding from my family other than my husband. |
( ) Other |
5) Have either you or your husband (person with whom you have an intimate relationship) performed the following actions towards your first child? |
Please enter ◯ for actions you took towards your child and ◎ for actions taken by your husband (person with whom you have an intimate relationship). |
( ) Hitting, ( ) Kicking, ( ) Pinching, ( ) Punching, ( ) Shaking violently |
( ) Swinging around, ( ) Biting , ( ) Squeezing, ( ) Soaking in water, ( ) Burning with fire |
( ) Strangle, ( ) Do not give food or milk, ( ) Do not change clothes |
( ) Do not let him/her go to school, ( ) Leave him/her at a dangerous place |
( ) He/she is sick but do not take him/her to the hospital., ( ) Lock up at home |