S . Ito and A . Goto : Radioprotection 2024 , 59 ( 2 ), 95 – 103 97
2.2.8 Perceptions of the risk of radiation health effects
A screening tool was adapted from the Fukushima Health Management Survey ( Fukushima Prefecture & Fukushima Medical University , 2011 ; Yabe et al ., 2014 ) to assess the perceptions of the risk of radiation health effects using the following two items : ‘ What do you think is the likelihood of damage to your health ( e . g ., cancer onset ) in later life as a result of your current level of radiation exposure ?’ and ‘ What do you think is the likelihood that the health of your future ( i . e ., as yet unborn ) children and grandchildren will be affected as a result of your current level of radiation exposure ?’ The first question concerns delayed effects , and the second concerns genetic effects . Response options are offered on a four-point Likert-type scale , from 1 = very unlikely to 4 = very likely , with higher scores indicating a greater perception of adverse health effects .
2.3 Statistical analyses
Chi-square and independent sample mean t-tests were used to compare differences by gender and place of residence at the time of the Great East Japan Earthquake ( Fukushima Prefecture vs . other prefectures ). Multiple regression analysis ( stepwise method ) was conducted after calculating Pearson ’ s correlation coefficients to examine factors affecting anxiety about childbirth and child-rearing associated with radiation exposure by gender and region ( Fukushima Prefecture and other prefectures ). The dependent variables were the measures of future reproductive confidence in “ Caring for a baby ” and “ Giving birth to a baby .” The independent variables were future child desires , depressive symptoms , stress in daily life , availability of a radiation consultant , knowledge of nuclear power and radiation , radiation effects on a partner , perception of radiation risks , the WHO-5 , the Communicative and Critical Health Literacy Scale , the RSES , and the ATSPPH-SF . The adjustment variables were age , marital status , presence of children , and cohabitation . All analyses were performed using IBM SPSS ver . 25.0 for Windows ( IBM SPSS Japan , Tokyo , Japan ).
2.4 Research ethics
This study was approved by the Kitasato University School of Nursing Ethics Committee ( No . 2018-9-2 ). The respondents were informed that the questionnaire responses were anonymous . The goals of the study were explained to the respondents in a cover letter accompanying the questionnaire . The cover letter asked the respondents to return a blank questionnaire if they were not interested in participating . The respondents were also told that there would be no adverse consequences resulting from any of their responses or a refusal to participate .
3 Results
The results of the comparison between genders and place of residence at the time of the Great East Japan Earthquake ( Fukushima Prefecture and other prefectures ) are shown in Table 1 . The respondents ranged in age from 18 to 35 yr . The men living in Fukushima Prefecture were more likely to indicate “ unmarried ,” “ have no children ,” “ knowledge of nuclear power and radiation ,” and “ perception of radiation risk : unlikely .” In addition , the scores for “ Giving birth to a baby ” were significantly lower among men in Fukushima Prefecture than among women in other prefectures . The men living in other prefectures were more likely to indicate “ living alone ” and “ radiation consultant absent .” The women living in Fukushima Prefecture were more likely to indicate “ married ,” “ have children ,” and “ living together ,” whereas the women living in other prefectures were more likely to indicate “ desire to have children ,” “ no depressive symptoms ,” “ radiation consultant present ,” “ no knowledge of nuclear power and radiation ,” and “ perception of radiation risk : likely .”
To clarify the strength between items before conducting a multiple regression analysis , we calculated correlation coefficients by gender and prefecture ( Tabs . 2 and 3 , respectively ). Then , we performed multiple regression analyses to identify associations between “ Giving birth to a baby ” and “ Caring for a baby ” and items in the FPAM ( Tabs . 4 and 5 , respectively ). For “ Giving birth to a baby ,” “ Radiation effects on partners ” was significantly associated in all groups . “ Perception of radiation risk : Delayed effects ” was significantly associated for women in both prefectural groups . Next , “ Future child desires ” was significantly related to “ Caring for a baby ” for all groups . “ Perception of radiation risk : Genetic effects ” was significantly related to “ Caring for a baby ” for all groups , and “ Perception of radiation risk : Genetic effects ” was significantly related to “ Caring for a baby ” for both men and women living in Fukushima Prefecture .
4 Discussion
The results of this survey indicate that anxiety about future childbirth and childcare related to radiation exposure varies by gender and among prefectures . First , men in Fukushima Prefecture considered themselves knowledgeable about nuclear power and radiation , thought that their children and grandchildren had a slight chance of experiencing health effects from radiation , and had confidence in their future childbearing . Conversely , women in other prefectures did not know much about radiation , thought that their children and grandchildren had a high chance of experiencing health effects from radiation , and lacked confidence in their future childbearing . Second , perceptions of radiation effects ( genetic and / or delayed ) were associated with anxiety about childbirth and rearing children among all participants except men who resided outside of Fukushima Prefecture . Third , regardless of gender or prefecture , the respondents who were anxious about the effects of radiation exposure on a partner were also more anxious about future childbirth , and the respondents who did not want children were more anxious about rearing them .
The second and third results are in line with our previous studies that showed an association between child-rearing anxiety and health risk anxiety toward radiation exposure among female college students who had experienced radiation exposure living in Fukushima Prefecture ( Ito et al ., 2023 ). On the other hand , the lack of an association between perceptions about radiation risks and childbirth- and childcare-related anxiety among men outside of Fukushima Prefecture might be associated with their low desire to have children and their lack