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Does the Use of Childcare Services Reduce the Impact of Intimate Partner Violence on the Quality of Life of Children?: Multiple-Group Structural Equation Modeling


Children who witness intimate-partner violence (IPV) in their households often suffer serious effects. This study sought to determine if using childcare services, such as public and private daycares, improves quality of life (QOL) for these children. We looked for improvement in the relationships between (1) IPV and children’s QOL, (2) IPV and primary caregivers’ depressive symptoms, and (3) family function that would be associated with children’s QOL. From February–March 2018, a cross-sectional study using self-report questionnaires was conducted throughout Japan with parents of children aged ≤19 years. From this survey, the data from 884 primary caregivers of children <6 years old were used for this study; 520 used childcare services. Relationship aspects were measured using the Woman Abuse Screening Tool-Short, the PedsQL General Core and Infant Scales, the Kessler Psychological Distress Scale, and the Family Apgar Scale. Multiple-group structural equation modeling was used for analysis. For families using childcare services, IPV was only negatively associated with family function (β = −.36). However, for those who did not use childcare services, IPV was negatively associated with children’s QOL (β = −.10), positively associated with primary caregivers’ depressive symptoms (β = .11), and negatively associated with family function (β = −.44). Family function was positively associated with children’s QOL (β = .15). Results indicate that childcare services can buffer both the negative impact of IPV on children’s QOL and depressive symptoms for caregivers exposed to IPV, highlighting these services as important health interventions and the need for policies encouraging abused parents with preschool children to use childcare services.

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  • Arhab, A., Messerli-Burgy, N., Kakebeeke, T. H., Lanzi, S., Stulb, K., Zysset, A. E., Leeger-Aschmann, C. S., Schmutz, E. A., Meyer, A. H., Munsch, S., Kriemler, S., Jenni, O. G., & Puder, J. J. (2018). Childcare correlates of physical activity, sedentary behavior, and adiposity in preschool children: A cross-sectional analysis of the SPLASHY study. Journal of Environmental and Public Health, 9157194, 1–12.

    Article  Google Scholar 

  • Bancroft, L., & Silverman, J. G. (2004). The batterer as parent: Addressing the impact of domestic violence on family dynamics. Tokyo: Kongo Shyuppan (in Japanese).

    Google Scholar 

  • Boyd A, Golding J, Macleod J, Lawlor, D.A., Fraser, A., Henderson, J, .et al (2013). Cohort profile: The ‘children of the 90s’-the index offspring of the Avon longitudinal study of parents and children. International Journal of Epidemiology, 42(1); 111–127.

  • Brown, J. B., Lent, B., Schmidt, G., & Sas, G. (2000). Application of the woman abuse screening tool (WAST) and WAST-short in the family practice setting. Journal of Family Practice, 49(10), 896–903.

    Google Scholar 

  • Cabinet Office (Japan). (2019). A governmental strategy on the fees of daycare and kindergarten. Retrieved October 15, 2019 from (in Japanese).

  • Campbell, J. C., & Lewandowski, L. A. (1997). Mental and physical health effects of intimate partner violence on women and children. Psychiatric Clinics of North America, 20, 353–374.

    Article  Google Scholar 

  • Chan, K. L., Brownridge, D. A., Fong, D. Y., Tiwari, A., Leung, W. C., & Ho, P. C. (2012). Violence against pregnant women can increase the risk of child abuse: A longitudinal study. Child Abuse & Neglect, 36(4), 275–284.

    Article  Google Scholar 

  • Chan, K. L., Chen, M., Chen, Q., & Ip, P. (2017). Can family structure and social support reduce the impact of child victimization on health-related quality of life? Child Abuse & Neglect, 72, 666–674.

    Article  Google Scholar 

  • De Silva-Sanigorski, A., Elea, D., Bell, C., Kremer, P., Carpenter, L., Nichols, M., Smith, M., Sharp, S., Boak, R., & Swinburn, M. (2011). Obesity prevention in the family day care setting: Impact of the Romp & Chomp intervention on opportunities for children's physical activity and healthy eating. Child: Care, Health and Development, 37(3), 385–393.

    Article  Google Scholar 

  • Faisal-Cury, A., Menezes, P. R., d’Oliveira, A. F. P. L., Schraiber, L. B., Lopes, C. S. (2013). Temporal relationship between intimate partner violence and postpartum depression in a sample of low income women. Maternal and Child Health Journal, 17(7), 1297–1303.

  • Finkelhor, D., Turner, H., Ormrod, R., Hamby, S., & Kracke, K. (2009). Children’s exposure to violence: A comprehensive national survey. U.S. Department of Justice, OJJDP, and CDC. Retrieved October 17, 2019 from

  • Furukawa, T. A., Kawakami, N., Saitoh, M., Ono, Y., Nakane, Y., Nakamura, Y., Tachimori, H., Iwata, N., Uda, H., Nakane, H., Watanabe, M., Naganuma, Y., Hata, Y., Kobayashi, M., Miyake, Y., Takeshima, T., & Kikkawa, T. (2008). The performance of the Japanese version of the K6 and K10 in the world mental health survey Japan. International Journal of Methods in Psychiatric Research, 17(3), 152–158.

    Article  Google Scholar 

  • Kawachi, I., & Berkman, L. F. (2001). Social ties and mental health. Journal of Urban Health, 78, 458–467.

    Article  Google Scholar 

  • Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L., Walters, E. E., & Zaslavsky, A. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32, 959–976.

    Article  Google Scholar 

  • Kita, S., Haruna, M., Matsuzaki, M., & Kamibeppu, K. (2016). Associations between intimate partner violence (IPV) during pregnancy, mother-to-infant bonding failure, and postnatal depressive symptoms. Archives of Women's Mental Health, 19(4), 623–634.

    Article  Google Scholar 

  • Kita, S., Haruna, M., Hikita, N., Matsuzaki, M., & Kamibeppu, K. (2017a). Development of the Japanese version of the woman abuse screening tool-short. Nursing & Health Sciences, 19(1), 35–43.

    Article  Google Scholar 

  • Kita, S., Haruna, M., Yamaji, M., Matsuzaki, M., & Kamibeppu, K. (2017b). Associations of mental and behavioral problems among children exposed to intimate partner violence previously and visits with their fathers who perpetrated the violence. Open Journal of Nursing, 7, 361–377.

    Article  Google Scholar 

  • Kita, S., Chan, K. L., Tobe, H., Hayashi, M., Umeshita, K., Matsunaga, M., Uehara, N., & Kamibeppu, K. (2018). A follow-up study on the continuity and spillover effects of intimate partner violence during pregnancy on postnatal child abuse. Journal of Interpersonal Violence. Advance online publication.

  • Kita S., Haruna M., Matsuzaki M., & Kamibeppu K. (2019). Does antenatal social support affect the relationships between intimate partner violence during pregnancy and perinatal mental health? Violence Against Women. Advance online publication.

  • Kobayashi, K., & Kamibeppu, K. (2010). Measuring quality of life in Japanese children: Development of the Japanese version of PedsQL. Pediatrics International: Official Journal of the Japan Pediatric Society, 52(1), 80–88.

    Article  Google Scholar 

  • Kobayashi, K., & Kamibeppu, K. (2011). Quality of life reporting by parent-child dyads in Japan, as grouped by depressive status. Nursing and Health Sciences, 13, 170–177.

    Article  Google Scholar 

  • Kokubu, M., & Kamibeppu, K. (2013). Development of a “family functioning scale”: The Japanese version of family APGAR. The establishment of the family nursing technique and construction of the medical cooperation system model to realize the abuse prevention from the perinatal period (principal researcher: Kamibeppu K). In working report of grant in aid for scientific research in 2009–2011. 34. (In Japanese).

  • Martins, C., Gaffan, E. A. (2003). Effects of early maternal depression on patterns of infant‐mother attachment: a meta‐analytic investigation. Journal of Child Psychology and Psychiatry, 41(6), 737–746.

  • McFarlane, J. M., Groff, J. Y., O’Brien, J. A., & Watson, K. (2003). Behaviors of children who are exposed and not exposed to intimate partner violence: An analysis of 330 black, white, and Hispanic children. Pediatrics, 112, e202–e207.

    Article  Google Scholar 

  • Ministry of Education, Culture, Sports, Sciences and Technology of Japan. (2018). Education at a glance 2018: OECD indicators 2018. Retrieved October 15,

  • Ministry of Health, Labor and Welfare. (2015). What is “Healthy parents and children 21?” Retrieved October 17, 2019 from (in Japanese).

  • Ministry of Health, Labor and Welfare. (2017). Current situation of childcare services in Japan. Retrieved October 15, 2019 from (in Japanese).

  • Ministry of Health, Labor and Welfare. (2018a). The definition of child abuse. Analyses. Retrieved October 11, 2019 from (in Japanese).

  • Ministry of Health, Labor and Welfare. (2018b).Child Welfare Act: Strategies on childcare services. Retrieved February 2020 from (in Japanese).

  • Miura, A., & Fujiwara, T. (2017). Intimate partner violence during pregnancy and postpartum depression in Japan: A cross-sectional study. Frontiers in Public Health, 5, 81.

    Article  Google Scholar 

  • Modanloo, S., Rohani, C., Shirinabadi Farahani, A., Vasli, P., & Pourhosseingholi, A. (2019). General family functioning as a predictor of quality of life in parents of children with cancer. Journal of Pediatric Nursing, 44, e2–e8.

    Article  Google Scholar 

  • O'Hara, M. W., & McCabe, J. E. (2013). Postpartum depression: current status and future directions. Annual Review of Clinical Psychology, 9, 379–407

    Article  Google Scholar 

  • Rahman, M., Poudel, K. C., Yasuoka, J., Otsuka, K., Yoshikawa, K., & Jimba, M. (2012). Maternal exposure to intimate partner violence and the risk of undernutrition among children younger than 5 years in Bangladesh. American Journal of Public Health, 102(7), 1336–1345.

    Article  Google Scholar 

  • Richardson, R. A., Harper, S., Schmitz, N., & Nandi, A. (2018). The effect of affordable daycare on women's mental health: Evidence from a cluster randomized trial in rural India. Social Science & Medicine, 217, 32–41.

    Article  Google Scholar 

  • Schermelleh-Engel, K., & Moosbrugger, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research, 8(2), 23–74.

    Google Scholar 

  • Smilkstein, G. (1978). The family APGAR: A proposal for a family function test and its use by physicians. Journal of Family Practice, 6(6), 1231–1239.

    Google Scholar 

  • Smilkstein, G., Ashworth, C., & Montano, D. (1982). Validity and reliability of the family APGAR as a test of family function. Journal of Family Practice, 15(2), 303–311.

    Google Scholar 

  • Stewart, D. E., MacMillan, H., & Wathen, N. (2013). Intimate partner violence. Canadian Journal of Psychiatry, 58(6), 1–15.

    Article  Google Scholar 

  • Tamiaki K. (2005). Theory of Family Support 11th edition. (edit: Board of Training Program for Daycare Staff). Chapter 3 (pp. 96–108). Tokyo, Japan: Japan National Council of Social Welfare:

  • Trost, S. G., Fees, B., & Dzewaltowski, D. (2008). Feasibility and efficacy of a ‘Move and Learn’ physical activity curriculum in preschool children. Journal of Physical Activity and Health, 5(1), 88.

    Article  Google Scholar 

  • Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient population. Medical Care, 39, 800–812.

    Article  Google Scholar 

  • Varni, J. W., Limbers, C. A., Neighbors, K., Schulz, K., Lieu, J. E., Heffer, R. W., Tuzinkiewicz, K., Mangione-Smith, R., Zimmerman, J. J., & Alonso, E. M. (2011). The PedsQLTM Infant Scales: feasibility, internal consistency reliability, and validity in healthy and ill infants. Quality of Life Research, 20(1), 45–55.

    Article  Google Scholar 

  • Wathen, C. N., & Macmillan, H. L. (2013). Children’s exposure to intimate partner violence: impacts and interventions. Paediatrics & Child Health, 18, 419–422.

    Google Scholar 

  • World Health Organization. (2010). Preventing intimate partner and sexual violence against women-taking action and generating evidence-. WHO Clinical and Policy Guidelines. Retrieved February 13, 2020 from

  • World Health Organization. (2012). Understanding and addressing violence against women. WHO. Retrieved October 17, 2019 from

  • World Health Organization. (2013). Responding to intimate partner violence and sexual violence against women. WHO Clinical and Policy Guidelines.

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This work was supported by a Grant-in-Aid for Young Scientists (A) (JSPS KAKENHI grant number: 16H06275). The authors would like to express our deeply appreciations for the participants of this study.

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All authors contributed to the study conception and design (Principle investigator: Iori Sato). Material preparation and data collection were performed by Iori Sato and Mariko Sakka. Data analysis was performed and the first draft of the manuscript was written by Sachiko Kita and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Sachiko Kita.

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Kita, S., Sato, I., Sakka, M. et al. Does the Use of Childcare Services Reduce the Impact of Intimate Partner Violence on the Quality of Life of Children?: Multiple-Group Structural Equation Modeling. Applied Research Quality Life 16, 1825–1845 (2021).

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