{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T07:14:50Z","timestamp":1783235690103,"version":"3.54.6"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"JSPS KAKENHI","award":["23K19766"],"award-info":[{"award-number":["23K19766"]}]},{"name":"JSPS KAKENHI","award":["24K20334"],"award-info":[{"award-number":["24K20334"]}]},{"DOI":"10.13039\/100019356","name":"SGH Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019356","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat\ufffdCare"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Most children with cancer want clear and honest information about their illness, and effective communication can support coping and reduce distress for children and families. However, in Japan, healthcare professionals face numerous communication barriers when discussing cancer diagnoses with children, and the culturally grounded beliefs and approaches shaping these conversations remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study was aimed at clarifying the beliefs and approaches of Japanese healthcare professionals in communicating cancer diagnoses to children and their families.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An exploratory qualitative design was adopted, involving semi-structured individual interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants included 18 healthcare professionals (9 physicians and 9 nurses) with over seven years of experience. Data were analyzed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five approaches were identified under an overarching commitment to the child\u2019s best interests: 1) honesty balanced with emotional protection, 2) empathetic negotiation with families, 3) information sharing to ensure understanding and hope, 4) being present in suffering, and 5) professional self-reflection and mutual team support. While these themes resonate with international literature on honest and supportive communication, two culturally salient features emerged in Japan: a strong tendency to prioritize families\u2019 wishes in decision making and a relational emphasis on \u201cbeing present\u201d rather than relying solely on structured, protocol-driven conversations. Communication was hampered by a lack of standardized training and a shortage of pediatric oncology nurses due to staff rotation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pediatric cancer diagnosis communication in Japan is shaped by five approaches that prioritize the child\u2019s best interests. Locally grounded strategies highlight the importance of trust, relationship building, and being present, but may limit children\u2019s voices when family preferences dominate. It is essential to employ nurses who specialize in pediatric cancer care. Future research should incorporate the children\u2019s and families\u2019 perspectives and evaluate culturally sensitive communication strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26323524261465677","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:28:10Z","timestamp":1783006090000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Communicating cancer diagnoses with children in Japan: A qualitative study of healthcare professionals\u2019 beliefs and approaches in pediatric oncology"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4212-6723","authenticated-orcid":false,"given":"Noyuri","family":"Yamaji","sequence":"first","affiliation":[{"name":"Showa Medical University"},{"name":"The University of Tokyo"},{"name":"Showa Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Yotani","sequence":"additional","affiliation":[{"name":"National Center for Child Health and Development"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Ikeda","sequence":"additional","affiliation":[{"name":"The University of Tokyo"},{"name":"The University of Tokyo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Showa Medical University"},{"name":"Showa Medical University"},{"name":"Showa Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.5431"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-022-03478-w"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1043454220919711"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-61391-8_4"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)33201-X"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29405"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32637"},{"key":"e_1_3_8_9_2","volume-title":"Integrating palliative care and symptom relief into paediatrics: a WHO guide for health-care planners. implementers and managers","author":"World Health Organization","year":"2018","unstructured":"World Health Organization. Integrating palliative care and symptom relief into paediatrics: a WHO guide for health-care planners. implementers and managers, 2018."},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s41649-021-00201-2"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-021-02038-z"},{"key":"e_1_3_8_12_2","volume-title":"Trajectory equifinality model","author":"Yasuda Y","year":"2012","unstructured":"Yasuda Y, Sato T. Trajectory equifinality model. 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