Background: In medical institutions, accidents are common in pediatric wards, and nursing students are at high risk for accidents due to their inability to understand pediatric characteristics and predict behavior. Objective: The purpose of this study was to clarify the educational effects of incorporating eye movement data into education (reflection). Methods: We presented still images to the subjects, measured their eye movements during observation and administered a questionnaire survey, performed reflection, and again measured their eye movements and administered the questionnaire survey to confirm changes in eye movements and cognition. Results: Before reflection, “other domains” were significantly longer in nursing students (p=0.04). After reflection, there was no difference. The results of the effect size for the second-year students showed that the impact of reflection in the “environment” and “other domains” was high. All students before and after reflection were able to recognize the risk factors of [children and bed fences]. The number of participants who were able to recognize the risk factors of [intravenous drip], [in-bed environment], and [peripheral items outside the bed] increased after the reflection compared to before.

 This study clarified nurses’ experiences in caring for children with severe mental and physical disabilities resulting from abuse. A qualitative descriptive study was conducted involving semi-structured interviews with seven nurses who had experience in caring for these children. Four categories of caregiving styles were identified: “getting involved while assessing the child’s feelings”, “thinking about how to interact with people”, “struggling to maintain the child’s mental and physical well-being”, and “preserving the relationship between the visiting parent and child”. Nurses’ experiences were characterized by their efforts to make the child feel safe and being attentive so that the child would not feel isolated. In nursing practice, it is suggested that children should be supported step-by-step to minimize their physical pain and interact with people, thus creating an environment and relationships that ensure their quality of life.

 This study aimed to investigate nurses’ actual experiences regarding essential practice items in pediatric cardiology nursing. A survey was conducted among nurses with more than one year of experience in caring for children with congenital heart disease. Based on previous studies, this survey included items such as years of service, department affiliation, and experience in 66 important practice areas related to hospitalized children with cardiovascular disease and their families. Out of the 410 distributed questionnaires across 22 facilities, 209 were analyzed. The findings revealed that nurses possessed substantial experience in most of the nursing practice areas pertaining to assessment and involvement for stabilization. Additionally, significant differences were observed in 12 practice items based on years of service, and 30 items based on department affiliation. Specifically, the ward/outpatient group demonstrated higher scores in areas such as explaining to children, whereas the intensive care unit group exhibited higher scores in areas such as judging monitoring data and intraoperative information. The results underscore the need for the pediatric cardiovascular nursing learning program to focus less on the nurses’ years of and instead prioritize the specific disease periods, such as neonatal, perioperative, convalescent, and remote periods, as well as the developmental stages of the children receiving nursing care.

 The purpose of this interventional study was to identify elements of self-care support that promote autonomous health management from early childhood among children with biliary atresia living at home, as well as subsequent changes related to self-care in such children and their parents. Intervention was provided for 3 children aged 5-7 years, aiming to promote their autonomous health management behaviors and their parents’ supportive behaviors. Consequently, the children began to make more decisions about their own bodies, communicate necessary information to others, and act independently, while the parents became able to support the children through supportive observation. Analysis of the actual support revealed 5 directions of support and 14 specific approaches. The changes related to self-care observed in children with biliary atresia in early childhood and their parents highlight the importance of objective nursing assessment, as well as nursing support aimed at enhancing self-efficacy in such children by giving consideration to their and their parents’ feelings, and promoting the former’s awareness and interests.

 Objective: In this study Ⅰ aimed at clarifying specifically how nurses obtain and interpret information, about infants in an acute stage who had been admitted to a hospital in an emergency, from the infant and their accompanying families before engaging with them based on the information. Methods: Leininger’s ethnonursing research method was employed. The key informants were six nurses. The general informants were seven acutely ill infants who had been hospitalized for an emergency, eight family members who attended them, and one physician. Results: Four themes were derived that would be the basis for the major theme: Nurses created space for the child and the attending family members and prepared the hospital room so the environment was as close to home as possible in order to understand the child’s normal demeanor, i.e. symptoms other than their reactions to change of environment due to hospitalization, without exacerbating their condition. Discussion: The nurses created space for parent and child in the hospital room and focused on detecting early signs of abnormalities by observing the natural facial expressions and movements of the child toward the family members. In addition, to prevent the infant’s symptoms from worsening, the nurses made efforts to make the space closer to home, with the attending family members taking the initiative, starting from the acute stage when the infant was hospitalized.

 Purpose: This study focuses on preschool children (4-5 years old) who have been asked to undergo venipuncture, and aims to describe the attitudes when children have to prepare themselves to accept venipuncture through the interaction with nurses and others. Methods: We conducted a participant observation in 30 cases of blood sampling of preschool children, interviewed their parents and nurses, and analyzed the results using the grounded theory method. Results: The attitude of children being asked to prepare themselves to accept blood collection was comprised of seven phenomena: “waiting for the time to come”, “accepting the situation as having to get it done”, “negotiating the method they think they can do”, “facing the start of the procedures”. “following the progress in their own way”, “resisting their unrelenting fear” and “concentrating on getting it done”. This attitude diverged from “waiting for the time to come” and reached “concentrating on getting it done” by way of “facing the start of the venipuncture”. Conclusion: This attitude can be described as the child facing the venipuncture by controlling unstable feelings by themselves with an underlying determination to “get it done”, and it can be interpreted as the preparedness of the children to undergo the venipuncture.

 This research aimed to clarify the experiences in physical activity of adolescents with osteogenesis imperfecta. Semi-structured interviews were conducted with adolescents who have presented with repeated and frequent fractures, use a wheelchair or assistive equipment such as a cane on a daily basis, and are capable of verbally communicating their thoughts and feelings. A verbatim record was created from the recorded interviews and an inductive qualitative analysis was carried out. As a result, 118 codes were extracted and 4 categories generated from 28 subcategories: “day-to-day physical activity impacted by the environment and limitations on physical movement”, “putting my own limits on physical activity because of the constant fear of breaking bones”, “feeling distanced from others because I can’t be active in the same way as others and can’t gain their understanding”, and “learning how to do things my own way and feeling that I grow mentally and physically by engaging in physical activity that I make sure I’m capable of doing”. The following kinds of support were also suggested: creating opportunities for the adolescent to repeatedly practice physical movements in a way that they find acceptable, having the people around them who provide support give consideration to the content of activities, and encouraging the adolescent to seek support on their own.

 The purpose of this study was to clarify the characteristics of nursing practice for families by certified nurse specialists in child health nursing (CNSCs). A questionnaire survey was administered to 168 CNSCs working at hospitals and other facilities in Japan. The questionnaire contained 77 items regarding the content of their nursing practice for families. Exploratory factor analysis identified the following items: [Confirmation and judgment of the family’s condition and resources], [Determining the family’s ability to cope with the situation and identifying the need for comprehensive support], [Caring and emotional support for the family], [Support for the family to express and make decisions for the best care of the child], [Promotion of interaction among family members], [Family education to promote involvement with the child], [Provision of resources to the family], and [Support for the family]. The CNSC’s nursing practice was characterized by support aimed at promoting family responsiveness to the best interests of the child, addressing and resolving concerns of nurses and the organization, and organizational change based on collaboration.

 This study aims to investigate nurses’ perceptions about the actual conditions of respite care nursing for children receiving medical care in hospitals. This study distributed a self-administered questionnaire among full-time hospital nurses who were involved in respite care for children receiving medical treatment. Responses of 173 nurses (valid response rate: 29.6％) were then analyzed. The questionnaire containing information exchanged with parents before and after acceptance, contact and consultation for parents’ requests, and care related to children’s security were answered with “I think” by＞80％ of the participants, but with lower responses for support for growth and development, checking about siblings, and nursing interventions to encourage home care. The comparison of the number of items answered as “5: I think so” revealed a higher median of≥5 years of experience in a pediatric ward and nursing respite care. Incorporating perspectives on growth and development and the enrichment of home life into care, as well as devising ways to deepen knowledge and experience, particularly nursing interventions with more experienced nurses and participating in training, was considered necessary.

 We aimed to explore nurses’ perceptions and behaviors in caring for hospitalized children requiring long-term medication. Semi-structured interviews were conducted with five nurses who had worked in the pediatric ward for 7 to 19 years and analyzed qualitatively inductively. As a result, 11 categories of nurses’ perceptions in caring for hospitalized children requiring long-term medication were extracted, such as a trusting relationship with the child is the foundation of assistance, oral medication is distressing for the child, the child is the principal individual in medication, the child has the potential to take medication, and the accumulation of daily medication is of value. In addition, the following five categories of nurse behaviors were identified: checking the status of medication, explaining the need and prospects for medication, empowering the child’s ability to take medication, collaborating with parents to ensure the appropriate medication for the child, and consulting with multiple professions on how to provide medical assistance. Nurses should implement multifaceted assistance that includes not only the medication situation but also its impact on treatment and daily life, to promote children’s autonomy in taking medication.

 Understanding a child’s perceptions of the disease and medical treatment behaviors can be helpful in supporting children with type 1 diabetes. This interview survey aimed to describe the understanding and medical treatment behavior management of early elementary school-aged children with type 1 diabetes. We analyzed qualitatively the data of 21 early elementary school-aged children with type 1 diabetes. The results showed that regarding their understanding of the disease, seven (33.3％) responded with the diagnosis name as type 1 diabetes and five (23.8％) described subjective symptoms and the necessity for injections. Moreover, nine (42.9％) stated they have not heard about their disease. Regarding the implementation of medical treatment behaviors, ＞80％ of the patients performed blood glucose monitoring and insulin injections alone. Regarding the understanding of the association between disease and medical treatment behaviors, six (28.6％) described a consistent understanding, while 13 (61.9％) were partial. Accordingly, if the child’s ability to implement the medical treatment behaviors has improved and stabilized, healthcare providers should be encouraged to deepen the understanding of medical treatment behaviors for children.

 This study aimed to investigate the performance of oral care and its education for pediatric patients and their families among nurses working at the pediatric wards, neonatal intensive care unit (NICU), and growing care unit (GCU), as well as identify the factors associated with those performances. Questionnaires regarding the performance of oral care and its education were distributed to 380 nurses in six university hospitals. Among them, 280 nurses participated in the survey. The percentage of oral care performance for pediatric patients was 11.4％-24.8％ among pediatric ward nurses and 27.3％ among NICU or GCU nurses. Regarding the performance of oral care education for their guardian, pediatric ward nurses attained 1.4％-29.3％, and NICU or GCU nurses attained 0.7％-41.0％. The performance of oral care and its education were associated with perceptions of the importance of performing these tasks and cooperation with other professionals and were interrelated.

 Semi-structured interviews were conducted with ten childhood cancer survivors (CCS), and qualitative and inductive analyses were performed to understand their thoughts and experiences regarding the risk for decreased fertility. As a result, nine categories were created. Regarding the risk for decreased fertility, some CCS felt “shocked and worried about its impact,” while others felt “not so concerned when they became aware of the risk.” When the risk for decreased fertility became a reality for the CCS because of its impact on their living conditions or developmental stages, they felt “anxiety on realizing their own risks,” “the weight and frustration of facing decreased fertility,” and “suspicion and antagonism regarding the timing and methods through which they learnt the information.” In this phase, the CCS felt a “desire for specialized information and support,” but sometimes “gave up on consulting someone because of environmental or interpersonal barriers.” “Assurance and confidence from surviving cancer and support from others” and “embracement of their history of childhood cancer and risk for decreased fertility and reflection on life and existence” helped them navigate through this phase. This shows that the CCS need support in finding meaning in their history of surviving cancer, as well as people to support them.

 The purpose of this study was to identify the empowerment structures that families with children needing constant medical care established to make their lives go smoothly. To understand the current situations that the families faced, I conducted semi-structured interviews with eight mothers and analyzed the qualitative data inductively. In my analysis, I tagged the data with symbols, and I identified six themes that contributed to the mothers having a smooth life: (1) realization: acknowledging the importance of life, (2) experience: accumulating successful experiences in childcare, (3) empathy: paying equal attention to each family member, (4) expansion: alternating roles in childcare, (5) learning: growing interactively with fellow caregivers, and (6) persistence: having endurance to achieve a desirable daily life. In this parental empowerment structure, the mothers acknowledged the importance of life, having witnessed their child’s tenacity in dealing with their own life-threatening experiences. Having this acknowledgment as a foundation, the mothers experienced repeated successes in childcare. While raising children who needed constant medical attention after being discharged from the NICU, parents expanded and developed themselves through positive phases such that they could pay equal attention to each family member, alternate roles with other caregivers, and learn interactively with other families with sick children. In addition to these themes, having the ability to keep on trying over the long period of time was also necessary for mothers to establish a smooth daily life while dealing with the sudden changes in their child’s health condition.

 We interviewed seven parents administering home injections to school children with articular juvenile idiopathic arthritis (hereinafter referred to as “articular JIA” ) with the aim of clarifying difficulties experienced in the early stages of induction and how to cope with such difficulties. As a result of a qualitative descriptive analysis, the following data was extracted: difficulties [Facing the fact that the child has a grave illness whose symptoms cannot be improved by oral medication], [having second thoughts about administering an injection with which you have no experience], [having difficulty in encouraging the child to make a decision], [swinging between anxiety and expectations over the treatment], [experiencing bitterness by inflicting pain on the child], [Finding it difficult to incorporate long-interval injections into daily life] ; how to cope [becoming determined to take on the responsibility for administering injections to the child], [improving conditions to facilitate smooth administration], [waiting until the child can make a decision], [encouraging the child to make a decision in accordance with the child’s traits], [becoming relieved by the child’s efforts for injections and improvement in the child’s condition], [seeking ways to alleviate the pain inflicted on the child and the pain of the injection itself], and [incorporating injections into daily life]. Our findings suggest the need to explore measures to inform parents about their children’s illnesses and the implications of therapeutic effects to encourage the children’s decision to receive injections.

 This study aimed to elucidate familial perceptions among parents of children diagnosed with cancer, focusing on various familial subsystems, such as husband-wife, parent-child, and sibling. Furthermore, this study aims to explore nursing interventions that support the holistic well-being of entire families. Semi-structured interviews were conducted with five mothers and one father of children with childhood cancer, followed by a qualitative inductive analysis that revealed 11 categories. It was inferred that the parents were anxious about the experience of childhood cancer and wanted to protect their children, while the couples were centered around their children, accepting each other’s reactions and facing the disease, and through their children, “intersubjectively knowing parents and children, husband and wife, and children with childhood cancer and siblings”. Siblings had a sense of bonding with each other. In addition to bonding and feeling more united as a family, family relationships were maintained. The subsystem perspectives of parents and children, husband and wife, and siblings suggested the importance of supporting the family’s sense of remaining a family.

 This study evaluated nurses’ perceived difficulties when providing end-of-life care for children with cancer and their families by conducting semi-structured interviews with 16 nurses. Through qualitative analysis, the following 9 categories, with 18 subcategories, were extracted: interacting with the child and family, respecting the child’s statements, coordinating the relationship between children and their families, working together as a team, knowing the progress, current situation, and future outlook, coping with the nurse’s feelings, approaching the child to alleviate distress, continuing to support the family after mourning the loss of the child, and responding to other children and families in the ward. Our findings highlight the need for educating young nurses to help reduce the difficulty caused by their lack of knowledge and experience and help them coordinate with the children, respect their wishes, discuss with the team conflicts that arise during the process, carefully observe the child who has sensed the death of a friend, and intervene with other professionals.

 The study aimed to clarify the actual conditions of nursing practice of follow-up outpatient of infants discharged from neonatal intensive care unit (NICU). It also examined nursing practice issues and ideals of follow-up outpatient of infants discharged from NICU. We conducted an anonymous self-administered questionnaire survey among 544 practicing nurses for follow-up outpatient of infants discharged from NICU. An analysis of 220 (40.4%) valid responses revealed that 169 (76.8%) nurses believed a need exists for better engagement with infants and their families than currently exists for follow-up outpatient of infants. Eight categories for nursing practice were extracted, such as “Continuous support for focusing on life in the community.” Nine categories of nurses’ thoughts on nursing practice were extracted, such as “I want to know strategies for high-quality nursing practice regardless of NICU work experience.” The results showed that the actual condition of nursing practice of follow-up outpatient of infants discharged from NICU differed by facility. This finding suggests the necessity for developing strategies that enable high-quality nursing practice.

 This study aimed to understand the level of nursing support available to pediatric patients with cancer, and their families, when returning to school following discharge from a pediatric ward. An anonymous questionnaire survey was conducted. Participants included nurses who worked in pediatric wards and had experience caring for pediatric patients with cancer aged <15 years. Qualitative data were categorized into similar groups based on the inferred meaning obtained from the survey response of participants discussing problems in the support available to pediatric patients returning to school. A total of 136 participants were included in this study. Participant responses revealed that 32.4% of the nurses explained late complications to the children every time they were treated, which was the lowest among all items in the practice status. In addition, the following challenges were found regarding supporting pediatric patients with cancer returning to school: difficulty in enabling affected children and their families to view return to school positively; a paucity of information, system, and support from schools to ensure a smooth transition for these patients returning to school; and difficulty for medical professionals in providing continued support during the return-to-school period following patient hospitalization and their subsequent discharge. Although nurses provided the necessary supports for returning to school to the patient and family, they encountered some challenges. It is necessary to create a tool that can be used by all medical professionals involved in supporting pediatric patients with cancer returning to school to achieve seamless support.

 This study aimed to understand how medical professionals in mixed outpatient care for children and adults perceive, which are as follows: 1) children’s feelings and 2) supports for children. To accomplish this, we used a hypothetical case study of stress relief support. A questionnaire was administered to 431 participants of this study, including doctors, nurses, medical radiologists, and clinical laboratory technicians. The results showed that medical professionals understood children’s feelings of pain and fear of an unknown medical treatment and considered using support methods to alleviate the pain and anxiety. However, a low percentage of the participants considered explaining the treatment procedure based on the children’s desires. In selecting the order of examination, 80% of the medical professionals believed the painful examination should be the last step because it can be extremely stressful for the children. Furthermore, medical professionals were conscious of efficiency, including reducing outpatient care time and diagnostic priorities. Therefore, nurses must practice responses that consider the wishes of each child and create opportunities for shared meaning-making with other professionals while considering the focus of other professionals working in the outpatient setting.

 This study aimed to conduct a literature review on self-concept formation in children with congenital heart disease in Japan, focusing on puberty and adolescence, to identify issues and suggest future research direction. A literature search was conducted using ICHUSHI (web version) and CiNii Research, and 15 papers were analyzed. Furthermore, the following three conceptual themes were identified through organization of contents: “Self with illness”, “Self in society”, and “Self in the family”. The first issue was that the “Self with illness” theme was unclear while the “Self in society” theme had negative factors related to the self-concept formed during puberty. Therefore, it is necessary to clarify the children’s overall self-concept to facilitate the provision of support that is in line with their development. Additional issues included difficulties in social adaptation during adolescence, as described in the “Self in society” theme. Thus, it is necessary to promote self-concept formation, including having future visions during puberty. Moreover, supportive parent-child relationships, building the gradual transition of the child toward independence within the context of “Self in the family”, are crucial.

 In this study, we aimed to assess the perceptions of mothers raising children with trisomy 18 requiring medical care at home. We conducted semi-structured interviews with six mothers. A qualitative descriptive data analysis identified five categories of perceptions, namely: “Fulfillment from normal daily life with family despite uncertainties about the course”, “Relief gained through peers and social connections”, “Difficulties with advanced medical care for complications”, “Psychological burden of acute deterioration of life-threatening or worsening condition”, and “Suffering due to inadequate social resources and medical provision for children with trisomy 18”. Subsequently, we suggested several support measures. These included ensuring that fathers share in the joy of caregiving at home; providing information and support so that social connections can be maintained; providing respite support, social resources, and medical technical assistance; providing practical skills, means of communication in emergency situations, and emotional support to help mothers to continue caregiving at home; and increasing opportunities for discussion to ensure that treatment is acceptable to the entire family. These supports are expected to contribute to reducing the burden on mothers raising children with trisomy 18 requiring medical care at home.

 This study aimed to elucidate the challenges home care nurses face in supporting school-age children with medical needs and their families, as well as the current state of the support provided. The study also examined the role of home care nurses in facilitating community integration of these children and their families. Semi-structured interviews were conducted with nine home care nurses, and the data were analyzed using qualitative and descriptive methods. The current state of support was divided into eight categories, including “cannot provide care alone or provide developmentally informed interaction even after studying” “having anxiety about, and difficulty with, practicing nursing by themselves relying only on their previous experience” and “rehabilitation and oversight becoming central to the children’s care as they grow.” Support challenges were divided into seven categories, including “increasing the role of health nurses in cooperating with special-needs schools and hospitals” and “securing enough human resources so that family members would not have to give up.” The findings of this study indicate that home care nurses fulfill an important role in supporting the family members of children with medical needs in their preparation for the developmental changes associated with the children’s life cycles. Home care nurses are also expected to serve as coordinators with a specialized perspective on school-age children, the period when children’s social involvement increases.

 This study aimed to clarify differences in feelings of difficulty regarding child-rearing in late childhood experienced by mothers of children who remained of short stature after being born small-for-gestational age (SGA) and by mothers of healthy children. An anonymous, self-administered survey was conducted with mothers of SGA children of short stature who regularly visited pediatric care facilities for growth hormone treatment and with mothers of healthy children, using a questionnaire examining child rearing support, prepared by the Japan Child and Family Research Institute (for three-to six year-olds). Analysis of respondents showed no significant differences in total scores of feelings of difficulty experienced in child rearing between mothers of SGA children of short stature and mothers of healthy children. However, the sub-item analysis revealed that mothers of SGA children had significantly higher scores in “worrying about many things regarding child-rearing” (p＝.01). Among mothers of SGA children, this item was negatively associated with gestational weeks at birth (r＝－.40、p＝.04), as was “feeling unfit as a mother” negatively associated with height at birth (r＝－.45、p＝.01). Mothers of SGA children appeared to experience psychologic feelings of difficulty regarding child rearing. Further analysis of associated factors and examination of support measures to reduce difficulties are necessary.

 The purpose of this study was to clarify the current status of discharge support by nurses for families of children requiring medical care. Semi-structured interviews were conducted with 7 nurses involved in supporting discharge of children with medical care to home, and date was analyzed using the qualitative integrative method (KJ method). As a result, nurses considered the following as important in providing discharge support to families of children with medical care: [attending mothers: mental support by listening to their thoughts and feelings], [interprofessional approaches: providing information and support for families to gain self-confidence], [collaboration and cooperation: sharing information at conferences and collaborating], [connective opportunities: coordinating social resources by assessing family situations], and [community-based support: providing nursing interventions in daily life]. The results suggested the importance of promoting collaboration among nurses with different specialties, as well as collaboration and cooperation with educational, welfare, and other institutions.

 OBJECTIVE: To clarify the role of nurses and the multidisciplinary team approach as perceived by the facility and nurse managers of child development support centers. METHODS: A questionnaire survey was distributed to the administrators and nurse managers of 156 facilities with well-established nursing staff. Simple tabulations were performed, and χ-squared tests were conducted to evaluate the findings. RESULTS: In total, 38 letters (24.4％ response rate) from facility managers and 36 letters (23.1％ response rate) from nurse managers were analyzed. The most common age group of children using the facilities was 3-4 years old, and children at 30 facilities (76.9％) required medical care. Regarding the roles of nurses, facility administrators and nurse managers had a high percentage of items related to guidance in the healthcare of children. In addition, significant differences (p＜0.05) were found in “creating a safe environment for the child,” “supporting daily life,” “playing with the child,” and “discovering what makes children happy.” Difficulties in multidisciplinary collaboration include poor understanding other medical workers of other individuals’ specific expertise. DISCUSSION: As members of teams that support children, nurses must work with other professionals. They must collaborate with other professionals, providing a link between consultation support staff and different medical care providers to meet the children’s health needs.