An examination of the factor structure of “Ganbatta” in 3- to 7-year-old children undergoing blood sampling or vaccination, as observed by nurses

Abstract

 Purpose: This study aimed to identify the factor structure of “Ganbatta” ―a culturally embedded Japanese term encapsulating perseverance, emotional resilience, and sustained effort-through nurses’ observations of young children (age range: 3-7 years) undergoing blood sampling or vaccination. The goal was to obtain a factor structure with the minimally required internal consistency of “Ganbatta” in pediatric clinical settings. Methods: A cross-sectional survey was conducted on pediatric nurses throughout Japan. Of the 1,865 distributed questionnaires, 1,143 complete responses were analyzed. Exploratory factor analysis was conducted using the principal factor method with promax rotation. Internal consistency was examined using Cronbach’s alpha. Results: The analysis yielded the following 3-factor, 16-item structure: Factor 1 “Sense of relief and joy after needle removal” (7 items), Factor 2 “Proactive participation” (6 items), and Factor 3 “Undesirable emotional expressions” (3 items). Cronbach’s alpha coefficients demonstrated high internal consistency for the total scale (0.927) and each factor (0.904, 0.893, and 0.912, respectively). Conclusion: The extracted factors reflect the core nature of “Ganbatta” ―persistent effort and endurance in the face of stress. Even expressions of fear and distress were recognized as part of this perseverance. These observational items enable nurses to identify and validate children’s efforts, thereby fostering emotional support, offering targeted praise, and strengthening communication with caregivers. Therefore, each factor and its constituent items can be applied as a framework for observing children’s behaviors in practice.