The purpose of this study is to clarify the change that the child who has received repetitive painful procedures is recognizing. The participants were 8 Japanese school-aged children who had received lumbar puncture or bone marrow aspirations. Semi-structured interviews were conducted for qualitative analysis. The study shows the following five categories. :Expansion of concern, Clarification of problem, Development of coping strategy, Deeper understanding, Continuation of fear and disgust. Children were recognizing the change that these four categories. However, children had "Continuation of fear and disgust " to painful procedures as well as initial. The results suggested that it be necessary for the child who had received repetitive painful procedures as care different from the initial care.

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Based on Mishel's uncertainty in illness theory, we clarified parents' intentions toward informing their children with cancer treated on an outpatient basis and the contents of parents' uncertainty developing in the process of evaluating their own intention. In addition, parents' perception of uncertainty was analyzed to obtain clues for the provision of support for parents' decision-making. A semi-structured interview was performed in 15 parents of children with cancer treated on an outpatient basis. As a result, parents' intentions toward informing their cancer children as outpatients were: "I have no intention of informing", "I will not keep the disease secret when my child asks me but will not disclose it first.", "I should inform but can not make up my mind.", and "There is no need to keep the disease secret." When the parents decide whether they inform their children, they first evaluated whether informing is necessary and whether there are conditions appropriate for informing. The parents considered that informing is important when their children leave them because of the necessity of self-management. When they considered informing necessary, they needed information on informing methods and support after informing. Agreement on informing between the father and mother, or between the parents and primary-care physician was necessary, but the parents hesitated to inform because of few opportunities, places, and persons for frank consultation.

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The purpose of this study is to identify the body image of children with congenital heart disease. This study was an inductive qualitative research conducted by interviewing 12 adolescences. The body image of children with congenital heart disease composed of three themes: 1) The base theme was "be aware of own heart function", a sense that reflected disease characteristic; 2) A sense of restriction bounded by the heart disease; and 3) a sense of liberation despite the illness. These images are affected by the children's disease symptoms, treatment behaviors, activities, and perceptions of the public. Companions in the patient support group seemed to have influenced the sense of liberation. The body images that could not be judged from physical appearances and are specific to these children give a new perspective of how to provide comprehensive understanding and support to the children with congenital heart disease.

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[in Japanese]

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The purpose of this study was to identify the urologic self-care in the school life of children with spina bifida and discuss nursing implications for the promotion of urologic self-care. Thirteen school children and parents and eight school teachers were administrated questionnaires and semi-structured interviews. Thirteen school children with spina bifida performed clean intermittent catheterization (CIC) for urination management. When they "can perform urologic self-care in their natural style", they had no trouble with friends, and received proper support from teachers in many cases. Children who were teased by classmates after the classmates knew of their urination trouble had negative feelings concerning school life and urination self-care. In cases where they had negative feelings about school life or depended on others for urologic self-care behavior, they had only a limited number of occasions to experience CIC in school, and urine contamination continued. In developing nursing intervention that aims at promoting urologic self-care of school children with spina bifida, it is of great importance to examine methods for performing urologic self-care in a natural style in the context of school life. What must also be considered are children's friendships and their need to experience a pleasant school life, as well as coordination to receive the proper support from teachers .

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[in Japanese]

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