Award type：Award from publisher, newspaper, foundation, etc. 

Language：English   Publisher：International Journal for Equity in Health  

Background: Infants and toddlers with complex medical needs often rely on consistent caregiving and health services. However, when such children remain undiagnosed, their needs may be overlooked by health and social support systems, leading to unequal access to care. This study aimed to explore how caregiving time differs according to the complexity of health care needs among children younger than 3 years of age in Japan, with particular attention to those without formal diagnoses. Methods: We conducted a cross-sectional online survey of caregivers raising children younger than 3 years of age in Japan (N = 296). Participants were categorized into three groups based on responses to the Children with Special Health Care Needs (CSHCN) Screener: more complex needs, less complex needs, and non-CSHCN. We examined the distribution and duration of caregiving activities, including medical care, rehabilitation, administrative coordination, commuting, and daily care. Results: Twenty children were classified as having more complex needs despite lacking formal diagnoses. This group exhibited significantly higher time burdens related to rehabilitation, institutional coordination, and hospital visits than non-CSHCN, with minimal time spent on typical childrearing. The caregiving pattern revealed disparities in support and highlighted a high degree of unmet needs in the undiagnosed population. Conclusion: Children with complex medical needs who lack a diagnosis experience substantial caregiving burden that are often unrecognized by existing support systems. Addressing diagnostic barriers and expanding need-based support frameworks is essential for ensuring equitable caregiving conditions and child well-being.

DOI： 10.1186/s12939-025-02655-4

Web of Science

Scopus

PubMed

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： https://doi.org/10.1186/s12939-025-02655-4

Open Access

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Pediatric Reports  

Background/Objectives: Increased burdens on caregivers of infants and toddlers significantly affect caregivers’ quality of life and health. Although adequate care during infancy contributes to child development and special health care needs affect caregiver burden, the risk factors for and protective factors against increased caregiver burden remain unclear. We aimed to evaluate children’s health care needs and required caregiving time and identify factors associated with increased caregiver burden. Methods: We conducted an online survey of 287 Japanese caregivers who were randomly selected from a web panel and were raising children aged <4 years. The survey comprised a sociodemographic data form, Children with Special Health Care Needs (CSHCN) Screener, caregiving time survey form, and questions on increased burden. Needs and caregiving time were evaluated by dividing the participants into CSHCN and non-CSHCN groups. Related factors were analyzed using increased burden as the dependent variable. The chi-square test, Mann–Whitney U test, and modified Poisson regression were used for data analysis. Results: Among the children of the 287 participating caregivers, 16.4% were identified as CSHCN, while 96.9% had no specific diagnosis. Overall, 38.3% of the CSHCN group met only one of the five CSHCN Screener items. The CSHCN group spent significantly more time providing and arranging/coordinating health care. The non-CSHCN group spent significantly more time providing daily care. After adjusting for covariates, increased caregiver burden was significantly associated with a younger age of the child, more caregiving time required 6 months prior to the survey, and providing care for CSHCN. Conclusions: To help reduce the burden of childcare on caregivers of infants and young children, children’s needs should be identified and generous childcare provided from an early age. Early identification of CSHCN and appropriate support for families may help reduce caregiver burden during early childhood.

DOI： 10.3390/pediatric17030068

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Scopus

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Journal of Nursing Science  

Aim: This study evaluated the special healthcare needs of children residing in infant homes, assessed the associated care burden, and identified factors influencing changes and reductions in care burden for these children. Methods: Data were collected from staff members responsible for each of the 213 infants and toddlers in infant homes. Statistical analyses included the chi-square test, Mann–Whitney U test, analysis of covariance, and Wilcoxon signed-rank test to evaluate changes in care needs, care time, and care burden. Logistic regression analysis was conducted to determine factors associated with reductions in care burden over a 6-month period for children with special healthcare needs who had been in care for at least 6 months. Results: Among the 213 infants, 39.9% had special healthcare needs. The highest proportion of care time was allocated to feeding and lulling these children to sleep—activities requiring significantly more time than those for children without special needs. Over several months, the care burden for children with special needs tended to increase; however, it decreased for 19 (26.0%) of these children over a 6-month period. Multivariate analysis revealed that age (OR = 0.86) and total care hours 6 months earlier (OR = 1.13) were significantly associated with reductions in care burden. Conclusions: Age and total care hours 6 months earlier were associated with a reduced care burden. When transitioning these children to family care, assessing the type and intensity of care required rather than the duration of care is crucial. Early intensive care may reduce care burden.

DOI： 10.1111/jjns.70012

Web of Science

Scopus

PubMed

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Medicine United States  

Background: Advances in medical technology have increased the identification of children with special healthcare needs (CSHCN), indicating the need to strengthen care systems. However, existing systematic reviews are outdated, over a decade old, and narrowly focused—primarily on hospital-based comprehensive care programs and family-centered care. This scoping review aimed to organize and integrate existing findings on care and support for CSHCN and their families from the available literature. Methods: We employed an extensive search in December 2023, utilizing databases such as PubMed, Web of Science, CINAHL, ERIC, and The Cochrane Library. Selected articles were thoroughly reviewed, categorized, and organized by the type of care and support addressed. The findings of the included studies were organized and integrated descriptively. Results: Following a comprehensive search and screening process, 49 articles were selected and categorized into 5 themes: care systems based on hospitals and other specialized institutions, specialized personnel or programs for care coordination/ integrated care, support using telehealth technology to enhance and facilitate care, care aimed at reducing the psychological burden on the child and family, and peer and group support emphasizing the role of family and community. Publication years ranged from 1998 to 2023. The studies were conducted in 7 countries, predominantly in the United States, with additional studies from Canada, Australia, the United Kingdom, Japan, India, and Belgium. Conclusions: This study underscores the importance of establishing effective care systems that ensure continuous and smooth care coordination from multiple perspectives for the well-being of CSHCN and their families. To enhance support systems for the well-being of CSHCN and their families, it is necessary to pursue a multi-faceted approach that facilitates continuous and smooth care coordination from various perspectives.

DOI： 10.1097/MD.0000000000041944

Web of Science

Scopus

PubMed

Language：Japanese

Event date： 2025.12

Language：English   Presentation type：Oral presentation (general)  

Event date： 2025.11

Presentation type：Oral presentation (general)  

Event date： 2025.11

Presentation type：Poster presentation  

Event date： 2025.10

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Event date： 2025.10

Language：English   Presentation type：Poster presentation  

Type：Peer review 

Type：Academic society, research group, etc.