Relationship between the Contentment of Mothers of Infants with Parenting Advice and Their Recognition in Judging Credibility International Journal of Nursing & Clinical Practices

those who are not by examining the contentment of mothers of infants with parenting advice, how they judge the credibility of such advice, and the relationship between such contentment and judgment in terms of credibility. We conducted an anonymous, self-reported questionnaire-based survey during the period April to June 2016, targeting 1,118 mothers of infants in Prefecture A. At six municipal health centers in the Abstract Background: This study sought to clarify the contentment of mothers of infants with parenting advice, judgment regarding credibility of parenting advice, and the relationship between such contentment and judgment. Methods: We conducted an anonymous, self-reported questionnaire-based survey from April to June 2016, targeting 1,118 mothers of infants in Prefecture A. The questions covered basic attributes, contentment with parenting advice, and judging the credibility of such advice. Descriptive statistics were compiled for each factor. A t-test was performed to examine the relationship between contentment with parenting advice and judging the credibility of parenting advice. This study was conducted with the approval of the Ethics Committee of Tokushima University Hospital. Results: The questionnaires were returned by 272 subjects (collection rate of 24.3%), with 265 determined as valid (valid response rate of 23.7%). The mean score for contentment concerning parenting advice was 6.17 (standard deviation: ±1.69). More than 80% of the subjects indicated being able to select credible parenting advice, and more than 70% had sought professional consultation about childrearing. However, among subjects who had not sought professional consultation, some had wanted to seek professional consultation but had not been able to do so. Relating contentment to judging the credibility of parenting advice, the mean contentment scores of the subjects who felt able to select credible parenting advice were significantly higher than the scores of those who did not (p < 0.01). Conclusion: Although study participants’ contentment relating to parenting advice seemed higher than that of teenage mothers, their levels of contentment appeared insufficient. Additionally, some subjects wanted to seek professional consultation about childrearing but could not. Furthermore, mothers who reported being able to select credible parenting advice were found to obtain and apply sufficient parenting advice, compared to those who did not feel the same confidence.


Introduction
Due to the recent trend toward nuclear families and decreasing human connection, the environment surrounding childrearing has undergone change. As a result, childrearing has become an isolated task, leading to such social issues as an increasing number of mothers who find raising their children difficult and rising rates of child abuse [1].
Conventionally, parenting advice is typically available from mothers' close contacts, such as their own parents as well as friends. The rapid popularization of smartphones [2] has provided mothers with the ability to obtain the latest information on childrearing based on diverse perspectives from the Internet, regardless of time or location. While the Internet is undoubtedly a convenient source of information for mothers who are raising children, many mothers have also experienced confusion due to information overload [3], increasing the difficulty in raising children [4]. Additionally, researchers have found an association between the information that mothers have and parental decision-making related to immunizing children [5]. On this basis, an insufficient quantity and quality of parenting advice may affect both mothers' ability and their children's health. However, in today's information-intensive society, finding and applying necessary, credible parenting advice from a vast, diverse pool of information is an arduous process. Most previous studies on parenting advice for mothers aimed at understanding the sources of the childrearing-related information that mothers use [6] and the need for such information [7]. Scholars have pointed to the necessity of examining mothers' contentment in relation to whether they manage Special Issue: Community-Based Participatory Research Practices-Vol II prefecture (two municipalities were selected from each secondary medical region), facility staff or the study's researchers handed out questionnaires when the subject mothers visited the centers for wellbaby checkups. Envelopes were supplied with the questionnaires to allow the participating mothers to return the completed surveys via mail.

Basic attributes
The questions under this category pertained to age, occupation, academic background, family composition, and whether the mother had any one to seek advice from about childrearing.

Contentment with parenting advice
A visual analog scale was employed to determine whether the respondents were able to obtain the parenting advice they required from the vast amount of available information. The scale assessed the questionnaire responses on a scale of 0 to 10, consisting of 11 stages altogether. The closer to 10 a mother was, the more she was managing to obtain necessary parenting advice.

Judgment regarding the credibility of parenting advice
With regard to the mothers' awareness of their ability to judge the credibility of advice, the survey asked respondents whether they were "able to select, " "maybe able to select, " "not much able to select, " or "not able to select" credible advice from a vast quantity of information on childrearing. Furthermore, on the topic of their actions in judging credibility, participants were asked to indicate whether they had sought professional consultation by choosing one of the following responses: "I have sought professional consultation, " "I wanted to but could not, " or "I had nothing to seek professional consultation about. "

Analytical method
For each of the survey items, the basic statistics were calculated. Next, a t-test was carried out to examine the relationship between contentment associated with parenting advice and ability to judge the credibility of such advice. In this analysis, a score of up to 10 (0 to 10) was given to indicate contentment related to such advice. For the topic involving judging the credibility of such advice, the responses "able to select" and "maybe able to select" were classified into the group "Able to select" and the responses "not much able to select" and "not able to select" into the group "Not able to select. " Likewise, with regard to participants' experience in seeking professional consultation about childrearing, the response "I have sought professional consultation" was grouped into "Received professional consultation, " and the responses "I wanted to but could not" and "I had nothing to seek professional consultation about" were classified into the group "Did not receive professional consultation. " For statistical analysis, IBM SPSS Statistics 22.0 was used, and the level of significance was set to 5%.

Ethical consideration
The purpose and method of this study were explained to the relevant managers of the six municipal health centers both orally and with documents requesting cooperation, and their consent was obtained. The subjects received a research explanation document laying out the

Collection rate
The number of subjects who returned questionnaires was 272 (collection rate of 24.3%). Among these, 265 subjects whose questionnaires did not include defects in relation to contentment with parenting advice or judgment of the credibility of such advice were analyzed (valid response rate of 23.7%).

Basic attributes (Table 1)
The mean age of the subjects was 33.3 (standard deviation: ± 4.9) years. The largest age group fell into the age range of 30 to 34 years old, with 92 subjects (34.7%). Concerning participants' occupation, the largest group, 105 subjects (39.6%), were homemakers or selfemployed. Regarding academic background, 104 subjects (39%) had graduated from university or graduate school, representing the largest group for this attribute. Family composition varied as follows: 221 subjects (83.4%) reported nuclear family households, 249 subjects (94.0%) had husbands (partners), and 118 subjects (44.5%) had a single child, all forming the largest groups in these respective classifications. Out of all the subjects, 258 (97.4%) said they knew a person they could seek parenting advice from. Contentment and judging credibility in relation to parenting advice (Figure 1, Table 2) The mean score for contentment with parenting advice was 6.17 ± 1.69, with the highest score being 10 and the lowest being 2. With regard to judging the credibility of parenting advice, 13 subjects (4.9%) stated that they were "able to select" credible advice, while 202 subjects (76.2%) said that they were "maybe able to select" and 50 subjects (18.9%) reported that they were "not much able to select. " None of the subjects chose the response "not able to select. " In answering whether they had sought any professional consultation about childrearing, 202 subjects (76.2%) chose the response "I have sought professional consultation, " 15 subjects (5.7%) said, "I wanted to but could not, " and 48 subjects (18.1%) responded, "I had nothing to seek professional consultation about. "

Relationship between contentment with parenting advice and judgment regarding credibility (Table 3)
In terms of contentment, the mean score of the subjects who were able to select credible parenting advice was significantly higher than that of subjects who were not able to do so (p < 0.01). No relationship was found between whether the subjects had sought professional consultation about childrearing and contentment.

Contentment and judging credibility in relation to parenting advice
In relation to contentment with parenting advice, the mean score was 6.17 ± 1.69, and the distribution of scores shows that a score of 7 was the most common. In comparison, a previous study on teenage mothers points out a low parenting literacy level, indicating that while the teenage mothers who participated in the study were able to obtain information, they were not able to find the information that they really wanted [8]. The average age of the subjects in the present study was 33.3 ± 4.95 years old, implying the likelihood that they would have a higher childcare literacy level compared to teenage mothers. Nonetheless, more than 30% of the current study's respondents had a score of 5 or less, suggesting that their literacy is not high, either.
Concerning the participants' judgment about the credibility of parenting advice, more than 80% of the subjects recognized themselves as able to select credible advice, while approximately 20% reported that they were not much able to do so. Furthermore, although more than 70% of the subjects had sought professional consultation about childrearing, approximately 20% had not. Among those subjects who had not sought professional consultation, a certain proportion had wanted to receive consultation but had not been able to do so. In an earlier study, "not knowing from where to receive advice" and "high threshold" accounted for 80% of the reasons for not being able to seek advice on childrearing from professionals [9]. Research has reported that mothers who are worried about their childrearing tend to find seeking advice difficult, even if they want to, and that, in this situation; they are more likely to have problems with childrearing despite their best efforts [10]. Compared to other times in children's lives, infants' mothers have more opportunities to meet professionals, such as hospital visits for well-baby checkups and vaccinations. Accordingly, ensuring that mother's feel they can use such occasions to seek advice in addition to predesignated parenting consultation opportunities is vital. Communicating with mothers on a routine basis can also create an atmosphere where they feel at ease consulting with professionals.

Relationship between contentment with parenting advice and judgment regarding credibility
Regarding the mothers' ability to judge credibility, a relationship existed between contentment about parenting advice and selecting credible advice on this topic. On this basis, we found that mothers who were able to select credible parenting advice obtained sufficient and necessary parenting advice and applied it in parenting their children, compared to those who were not able to select such advice. This finding suggests that such mothers are able to employ health literacy, a cognitive and social ability that maintains individuals' ability and motivation to obtain and use information to maintain and enhance health [11], in their childrearing. Since its inception in the 1990s, the concept of health literacy has developed at a rapid pace and is regarded as an important concept leading to health action. In recent years, scholars have pointed out the need for different types and levels of literacy according to information types. Moreover, rather than literacy as a concept covering the general idea of health, efforts have been underway to develop scales to measure literacy types that focus on more specific diseases or lifestyle habits [12,13]. Because mothers have a huge impact on infants' health, forming the foundation for the latter's lifelong health; enhancing mothers' literacy has also been indicated as essential to improving the health of the next generation [7,8]. Hence, educating mothers on methods of judging the credibility of parenting advice by using such occasions as well-baby checkups is essential.
In this study, in examining judgment regarding credibility, no relationship was found between contentment with parenting advice and the subjects' experience in seeking professional consultation about childrearing. Some subjects had desired but had not been able to seek consultation, while some had had nothing to seek consultation about; thus, seeking professional consultation is considered not to have necessarily been involved in judging credibility. Today, parenting advice is available from a wide variety of information sources. For that reason, mothers with high childcare literacy can be considered able to obtain highly credible information on child rearing or specialized knowledge even without directly consulting with professionals.

Limitation of this Study
Since this study targeted mothers who had come to well-baby checkups in six municipalities of Prefecture A, generalization represents a study limitation.

Conclusions
In this study, although mothers' contentment with parenting advice appears higher than that of teenage mothers, their levels of contentment do not appear to be sufficient. With regard to judging the credibility of parenting advice, more than 80% of the subjects considered themselves able to select credible advice, while approximately 20% reported that they were not much able to do so. Furthermore, a certain number of subjects asserted that they had wanted to seek professional consultation about childrearing but had not been able do so.
Concerning judging credibility, a relationship existed between contentment with parenting advice and selecting credible parenting advice, while no such relationship was found between such contentment and the subjects' experience in seeking professional Did not receive professional consultation 63 23.8 6.0 1.76 Table 3: Relationship between contentment with parenting advice and judgment regarding credibility. SD: Standard deviation. The two sample t-test, **P<0.01. consultation about childrearing. Mothers who were able to select credible parenting advice thus were found to obtain the parenting advice they needed and use it in their parenting, compared to those who were not able to select such advice. This outcome suggests that the capable mothers successfully exercised their childcare literacy.
Therefore, in the future, educating mothers on methods of judging the credibility of parenting advice by taking advantage of such occasions as well-baby checkups would be valuable.

Funding
This research received a grant in Co-op Research Institute Award.