{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:35:54Z","timestamp":1780331754920,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,5,10]],"date-time":"2020-05-10T00:00:00Z","timestamp":1589068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["Grant Number 16K20811"],"award-info":[{"award-number":["Grant Number 16K20811"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Japan Journal Nursing Sci"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>As patients with cleft lip and\/or palate grow older, the main decision\u2010making process for treatment is likely to shift from a parent\u2010centered to a patient\u2010centered process. However, many adolescent patients have difficulty in treatment decision\u2010making. This study aimed to clarify the decision\u2010making process regarding undergoing surgery among adolescent patients with cleft lip and\/or palate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were adolescent patients with cleft lip and\/or palate aged 14\u201318\u2009years who were admitted to a hospital in Japan for surgery. Fourteen patients (six boys, eight girls) and their parents agreed to participate in this study. Data were collected in face\u2010to\u2010face semi\u2010structured interviews. Data were analyzed qualitatively with inductive content analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen categories were classified into three themes for adolescent patients' decision\u2010making processes regarding undergoing surgery. The three themes were: (a) a doctor's recommendation for surgery, (b) psychological conflict about surgery, and (c) a final decision about surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study's findings suggest that adolescent patients with cleft lip and\/or palate were not adequately involved in the decision\u2010making process before undergoing surgery. Medical staff need to explain other treatment options, the risks and benefits of surgery with materials and methods that adolescent patients can understand as part of \u201ca doctor's recommendation for surgery.\u201d Medical staff and parents need to encourage adolescent patients to communicate their preferences and values to reduce patients' \u201cpsychological conflict about surgery\u201d and adolescent patients' intentions should be considered in \u201ca final decision about surgery.\u201d<\/jats:p><\/jats:sec>","DOI":"10.1111\/jjns.12342","type":"journal-article","created":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T02:40:40Z","timestamp":1589164840000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Decision\u2010making process to undergo surgery among adolescent patients with cleft lip and\/or palate"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4519-4254","authenticated-orcid":false,"given":"Eriko","family":"Matsunaka","sequence":"first","affiliation":[{"name":"Department of Nursing Japanese Red Cross Kyushu International College of Nursing  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukari","family":"Kumagai","sequence":"additional","affiliation":[{"name":"Nursing Department Osaka University Dental Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miho","family":"Ike","sequence":"additional","affiliation":[{"name":"Nursing Department Osaka University Dental Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Takano","sequence":"additional","affiliation":[{"name":"Nursing Department Osaka University Dental Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikihiko","family":"Kogo","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery 1 Graduate School of Dentistry, Osaka University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2834.2012.01457.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1109283"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1055665619866552"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2009.03.019"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2010.07.006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016350902720888"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1597\/07-048.1"},{"key":"e_1_2_9_9_1","first-page":"134","volume-title":"Shitsuteki kenkyu no kiso: grounded theory kaihatsu no gihou to tejun","author":"Corbin J. 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