Married women’s decision to delay childbearing, and loneliness, severe psychological distress, and suicidal ideation under crisis: online survey data analysis from 2020 to 2021

Matsushima, Midori; Yamada, Hiroyuki; Kondo, Naoki; Arakawa, Yuki; Tabuchi, Takahiro

doi:10.1186/s12889-023-16476-z

Table 1 Characteristics of participants

From: Married women’s decision to delay childbearing, and loneliness, severe psychological distress, and suicidal ideation under crisis: online survey data analysis from 2020 to 2021

	(1) Total (n = 768)							(2) 2020 (n = 420)							(3) 2021 (n = 348)
	Pregnancy postpone							Pregnancy postpone							Pregnancy postpone
	Yes (n = 153)			No (n = 615)				Yes (n = 88)			No (n = 332)				Yes (n = 65)			No (n = 283)
	n	%	Mean (SD)	n	%	Mean (SD)	P- value	n	%	Mean (SD)	n	%	Mean (SD)	P- value	n	%	Mean (SD)	n	%	Mean (SD)	P- value
*Well-being indicators*
*UCLA Loneliness Scale*							< 0.001							0.002							0.009
*Moderate-to-severe loneliness*	77	50.33		204	33.17			41	46.59		97	29.22			36	55.38		107	37.81
*None or mild loneliness*	76	49.67		411	66.83			47	53.41		235	70.78			29	44.62		176	62.19
*Psychological distress*							< 0.001							< 0.001							< 0.001
K6 > = 13	49	32.03		73	11.87			27	30.68		35	10.54			22	33.85		38	13.43
K6 < 13	104	67.97		542	88.13			61	69.32		297	89.46			43	66.15		245	86.57
*Suicidal ideation*							0.001							< 0.001							0.348
*Yes*	44	28.76		103	16.75			29	32.95		52	15.66			15	23.08		51	18.02
No	109	71.24		512	83.25			59	67.05		280	84.34			50	76.92		232	81.98
*Well-being indicators (deterioration after the onset of the pandemic)*
*Loneliness after COVID-19*							< 0.001							< 0.001							0.001
*Yes*	43	28.10		69	11.22			25	28.41		37	11.14			18	27.69		32	11.31
No	110	71.90		546	88.78			63	71.59		295	88.86			47	72.31		251	88.69
*Suicidal ideation after COVID-19*							< 0.001							< 0.001							< 0.001
*Yes*	30	19.61		27	4.39			19	21.59		16	4.82			11	16.92		11	3.89
No	123	80.39		588	95.61			69	78.41		316	95.18			54	83.08		272	96.11
Isolation							0.109							0.198							0.267
Yes	9	5.88		62	10.08			7	7.95		43	12.95			2	3.08		19	6.71
No	144	94.12		553	89.92			81	92.05		289	87.05			63	96.92		264	93.29
Currently having no child							< 0.001							< 0.001							0.144
Yes	61	52.94		224	36.42			51	57.95		121	36.45			30	46.15		103	36.40
No	92	47.06		391	63.58			37	42.05		211	63.55			35	53.85		180	63.60
Income decline							< 0.001							0.001							0.027
Yes	76	49.67		199	32.36			49	55.68		121	36.45			27	41.54		78	27.56
No	77	50.33		416	67.64			39	44.32		211	63.55			38	58.46		205	72.44
Feeling anxious about household financial outlook							< 0.001							< 0.001							0.001
Yes	81	52.94		197	32.03			48	54.55		113	34.04			33	50.77		84	29.68
No	72	47.06		418	67.97			40	45.45		219	65.96			32	49.23		199	70.32
Fear of COVID-19 (score 7–35)			19.50 (5.91)			18.96 (5.81)	0.306			19.61 (5.84)			18.79 (5.90)	0.242			19.35 (6.05)			19.17 (5.70)	0.820
Log of number of COVID-19 positive cases in the residential province			7.69 (1.92)			7.75 (1.94)	0.354			6.84 (1.70)			6.93 (1.86)	0.706			8.83 (1.60)			8.72 (1.53)	0.614
Income:
The poorest quartile (Reference)	39	25.49		140	22.76		0.475	20	22.73		75	22.59		0.979	19	29.23		65	22.97		0.287
The 2nd poorest	38	24.84		161	26.18		0.735	24	27.27		105	31.63		0.431	14	21.54		56	19.79		0.751
The 2nd richest	40	26.14		155	25.20		0.811	24	27.27		73	21.99		0.296	16	24.62		82	28.98		0.481
The richest	36	23.53		159	25.85		0.554	20	22.73		79	23.80		0.834	16	24.62		80	28.27		0.552
Property owner							< 0.001
Yes	49	32.03		316	51.38			24	27.27		177	53.31		< 0.001	25	38.46		139	49.12		0.121
No	104	67.97		299	48.62			64	72.73		155	46.69			40	61.54		144	50.88
Employment status:
Permanent full-time worker (Reference)	63	41.18		220	35.77		0.215	37	42.05		112	33.73		0.147	26	40.00		108	38.16		0.784
Contract full-time worker	10	6.54		28	4.55		0.311	4	4.55		17	5.12		0.826	6	9.23		11	3.89		0.071
Part-time worker	26	16.99		153	24.88		0.039	16	18.18		83	25.00		0.18	10	15.38		70	24.73		0.106
Not working	54	35.29		214	34.80		0.908	31	35.23		120	36.14		0.873	23	35.38		94	33.22		0.739
Age			32.73 (5.76)			36.50 (7.40)	< 0.001			32.38 (6.10)			36.32 (7.30)	< 0.001			33.22 (5.28)			36.70 (7.52)	0.001
Education:
High school or lower (Reference)	19	12.42		130	21.14		0.015	14	15.91		72	21.69		0.232	5	7.69		58	20.49		0.016
Vocational training school/2-years college	47	30.72		201	32.68		0.642	25	28.41		108	32.53		0.46	22	33.85		93	32.86		0.879
University or higher	87	56.86		284	46.18		0.018	49	55.68		162	45.78		0.098	38	58.46		132	46.64		0.086
Fertility treatment							< 0.001							< 0.001							< 0.001
Yes	49	32.03		448	72.85			28	31.82		241	72.59			21	32.31		207	73.14
No	104	67.97		167	27.15			60	68.18		91	27.41			44	67.69		76	26.86

Notes for Table 1
1) Because JACSIS 2020 and 2021 did not have the same social isolation indicators, the social isolation variables constructed for this study were as follows: For 2020, the overall frequency of social contact in the survey month was calculated based on the methodology used in a previous study [20, 21]. Social contact was identified by the following eight questions: (1) ‘How often did you meet your family members or relatives who were not living with you?’ (2) ‘How often did you meet your friends?’ (3) ‘How often did you make contact with your family members or relatives who were not living with you through text messages?’ (4) ‘How often did you make contact with your friends who were not living with you through text messages?’ (5) ‘How often did you connect with your family members or relatives who were not living with you through voice calls?’ (6) ‘How often did you make contact with your friends who were not living with you through voice calls?’ (7) ‘How often did you communicate with your family members or relatives who were not living with you through video calls?’ and (8) ‘How often did you make contact with your friends who were not living with you through video calls?’ These questions could be responded using the following alternatives: almost daily (six to seven times weekly), four to five times weekly, two to three times weekly, once weekly, two to three times monthly, monthly and rarely. Because the average number of weeks in a month is 4.35 (= 365 days in a year/12 months in a year/7 days in a week), the frequency was calculated as 28.28 days per month if the respondent answered ‘almost every day (six to seven times weekly)’. Using the same method, the answers were converted into 19.58, 10.88, 4.35, 2.5, 1 and 0 days for the answer of ‘4–5 times weekly’, ‘2–3 times weekly’, ‘weekly’, ‘2–3 times monthly’, ‘monthly’ and ‘rarely’, respectively. After calculating the frequency for each question, all the questions were summed and socially isolated people were identified as those who had less than once per two weeks of social contact. For the 2021 data, the answer to the following questions were employed: ‘Who have you met or talked to more than once in the past two weeks?’ and ‘Who have you communicated through online tools more than once in the past two weeks?’ An individual was identified as socially isolated when he/she responded ‘none’ to both of these questions, excluding partners, child(ren) and colleagues. By doing this, data for 2020 and 2021 were made compatible. Murayama et al. [23] identified a socially isolated person as one who made contact less than once every week based on the evidence provided by Saito et al. [24] that having social contact less than once a week is associated with greater risks of all-cause mortality, dementia and disability. This was modified to ‘less than once per two weeks of social contacts’ in order to make it compatible with the JACSIS 2021 data. Therefore, the social isolation indicators captured even more severe cases of isolation
2) Fear of COVID-19 was measured using the Fear of Coronavirus-19 Scale (FCV-19S), developed by Ahorsu et al. [25] and validated in Japan [26]. Total scores range from 7 to 35, with higher scores indicating stronger anxiety and fear (cut-off values have not been determined thus far)
3) The number of positive COVID-19 cases in the residential province was the accumulated number of new cases for two months, including the survey months, obtained from the Kyushu Economic Research Centre [27]. The number of cases was limited to those reported during the two months around each survey period to estimate the period that we specified in our question on childbearing delay
4) The income variable was created by using the whole sample of JACSIS data for each year, excluding the ones with discrepancies and/or artificial/unnatural responses. We first calculated equivalent income, then divided it into quartiles
5) Employment status was categorised as: 1: permanent full-time worker, 2: contract/temporary full-time worker, 3: part-time worker and 4: not in labour force. Although unemployment is an important indicator, its rate in Japan is low; the current data did not contain a sufficient number to be examined. Moreover, during the COVID-19 pandemic, people may not search for jobs. Thus, the unemployed people, homemakers, and students were combined into the category of ‘4’
6) Regional dummies were included in the analysis but are not shown here for brevity. The regions were divided into eight regions; Hokkaido, Tohoku, Kanto, Chubu, Kinki, Chugoku, Shikoku, and Kyushu/Okinawa

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