S . Ito and A . Goto : Radioprotection 2024 , 59 ( 3 ), 211 – 219 213
2.2.6 Attitudes towards seeking professional psychological help scale-short form ( ATSPPH-SF )
The self-administered 10-item ATSPPH-SF assesses attitudes toward mental health treatment ( Elhai et al ., 2008 ). Response options are rated on a four-point Likert-type scale , from 0 = disagree to 3 = agree . Total scores range from 0 to 30 , with higher scores indicating a more positive attitude .
2.2.7 Depressive symptoms
The following two items were used to screen for depressive symptoms : “ During the past month , have you often felt down , depressed , or hopeless ?” and “ During the past month , have you often found little interest or pleasure in doing things ?” ( Mishina et al ., 2009 ). Participants who answered yes to at least one of these questions were classified as displaying depressive symptoms .
2.2.8 Perceptions of the risk of radiation effects on health
A screening tool composed of two items related to delayed health effects and genetic effects associated with radiation exposure was adapted from the Fukushima Health Management Survey ( Fukushima Prefecture & Fukushima Medical University , 2011 ; Yabe et al ., 2014 ). The response options were rated on a four-point Likert-type scale , from 1 = very unlikely to 4 = very likely . Total scores ranged from 1 to 4 , with higher scores indicating perceptions of more adverse health effects .
2.3 Statistical analysis
The following five types of statistical analyses were performed in the present study . First , a chi-square test ( residual analysis ) and one-factor analysis of variance ( Tukey ’ s method ) were conducted to examine factors affecting childbearing and child-rearing anxiety related to radiation exposure by gender and place of residence at the time of the Great East Japan Earthquake ( Fukushima Prefecture , neighboring prefectures , and other prefectures ). Second , Pearson ’ s product-rate correlation coefficients were obtained to examine the strength of the relationship between the presence or absence of hope for future children and radiation-related factors . Third , to examine the strength of the relationship between hope for future children and radiation-related factors , we used hope for future children as the dependent variable , radiation-related factors as the independent variable , and other factors as adjustment variables in the logistic regression analysis . Fourth , Pearson ’ s correlation coefficients were calculated to examine factors associated with childbearing and parenting anxiety related to radiation exposure and health risk perception related to radiation exposure among those who wanted to have children in the future . Finally , to examine the factors affecting childbearing and child-rearing anxiety related to radiation exposure among those who wanted to have children in the future , multiple regression analysis was conducted using the forced entry method with the FPAM scale as the dependent variable , radiation-related factors as the independent variable , and demographic items as adjustment variables . All analyses were conducted 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 . 2021-9-2 ). The purpose of the study was fully explained to respondents in a cover letter to the questionnaire . All respondents were informed that they would not be disadvantaged by responding or refusing to participate . All respondents were also asked to confirm their consent to participate in the study .
3 Results
A total of 985 individuals responded to the questionnaire : 240 ( 67 males and 173 females ) from Fukushima Prefecture , 305 ( 143 males and 162 females ) from prefectures neighboring Fukushima Prefecture , and 440 ( 212 males and 228 females ) from other prefectures .
The percentages of the results of each scale score by gender and by place of residence at the time of the Great East Japan Earthquake are shown in Table 1 , and the mean values are shown in Table 2 . Basic attributes of respondents that could not be fully described in Tables 1 and 2 were added in Supplement 1 . A significantly higher proportion of women answered in neighboring prefectures “ Likely ” for “ Perception of radiation risk : Genetic effects ” compared with the other groups ( n = 63 [ 38.9 %]; adjusted residuals = 2.4 ). Regarding “ Giving birth to a baby ,” women in Fukushima Prefecture ( mean [ M ] = 8.0 , standard deviation [ SD ] = 2.0 ) had significantly higher scores than did men in all three groups : Fukushima ( M = 7.2 , SD = 1.7 ), neighboring prefectures ( M = 7.3 , SD = 1.8 ), and other prefectures ( M = 7.2 , SD = 1.8 ). Moreover , women in other prefectures ( M = 7.8 , SD = 2.1 ) had significantly higher scores than did men in other prefectures ( M = 7.2 , SD = 1.8 ; p < 0.001 ). Regarding the FPAM item “ Caring for a baby ,” men in other prefectures ( M = 7.4 , SD = 2.3 ) had significantly higher scores than did women in neighboring prefectures ( M = 6.9 , SD = 2.6 ; p = 0.036 ).
The distribution of the main independent and dependent variables is also shown in Table 1 and 2 . The variable with a significant difference in distribution across four groups was the numbers of those who answered that they were not confident in giving birth . The proportions were 17 ( 25.4 %) men and 74 ( 42.8 %) women in Fukushima Prefecture , 38 ( 26.6 %) men and 57 ( 35.2 %) women in neighboring prefectures , and 52 ( 24.5 %) men and 84 ( 36.8 %) women in other prefectures ( p < 0.001 ).
To examine radiation-related factors affecting desired future offspring , Pearson ’ s product-rate correlation coefficients were calculated ( Supplement 2 ), and logistic regression analysis using the forced entry method was conducted with desired future offspring as the dependent variable , radiationrelated factors as the independent variable , and other factors as adjustment variables . The items for which significant differences were found are shown in Table 3 , and the results for all items that were entered are shown in Supplement 3 . The factors associated with the desire to have children in the future were “ Presence of a person to give advice about radiation ( odds ratio