How Japanese nurses participate in decision making: Infants with congenital life-threatening conditions

Background: In Japan, owing to the progress in medical technology, more children with congenital life-threatening conditions survive than ever before. Nurses who care for these children may also influence decision making in difficult situations.

Aim: We aimed to describe Japanese nurses' approach toward medical decision making when caring for families of infants with congenital life-threatening conditions. Frequently, these nurses must care for and support parents with ambivalent feelings.

Design: Qualitative descriptive study.

Methods: Participants were recruited from neonatal intensive care unit and paediatric wards at a university hospital in Japan from June to July 2016. Data were collected using semi-structured interviews and qualitatively analysed.

Results: Japanese nurses described these situations as "decision making regarding the child's medical care" and "daily life at hospitals." The themes included support of parents and the choices made about their children, nurses giving or holding their opinions about care choices, or withholding their opinions during decision-making events. The narratives included 5 focus areas: the parents; the children, the family as a whole; relationship between families and health care providers; and the effect of the clinical environment on the children and families.

Conclusion: When caring for children with life-threatening congenital conditions, nurses should develop supportive relationships with parents and contribute to the clinical decision-making process with empathy and based on the most current research data.