Health care decision-making among children who first experienced cancer at primary school age

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K02487
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 09030:Childhood and nursery/pre-school education-related
• Research Institution: Sapporo Medical University
• Principal Investigator: Michinobu Ryoko 札幌医科大学, 医療人育成センター, 准教授 (70336410)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 小児がん / 小児がん医療 / 協働意思決定 / 子ども / いのち / 医療福祉学 / 医療人類学 / エスノグラフィ

Outline of Final Research Achievements

The children’s wills for their cancer therapy went through the following three processes: being accustomed to the hospital environment, making friends with those who have the same illness or other illnesses, and sharing promises with physicians and nurses for the treatment goals. We found that shared decision-making in pediatric oncology is a form of clinical communication where children can participate more effectively in cancer therapy. We also found that communication related to decision-making between children and physicians/nurses was based on a broader human relationship in the hospital and even after discharge.

Free Research Field

医療人類学　公衆衛生学　医療福祉学　子ども学

Academic Significance and Societal Importance of the Research Achievements

小児がんの協働意思決定の議論において、国際社会では、医療者や親が考える子どもの存在や権利を擁護する立場からの論考が多い。そこには自律的で明確な自己決定権をもつ「個人」として子どもをとらえる西洋社会の思想がある。本研究では、子どもと周囲の人びととの関係性に光をあてたことにより、子どもの存在の意味が社会や文化によって異なり、協働意思決定のアプローチも日本に特有の様相を見せることを明らかにした。