The children's sentinels: Mothers and their relationships with health professionals in the context of Japanese health care

• Published in: Social science & medicine (1982) Vol. 44; no. 3; pp. 291 - 300
• Main Author: Saiki-Craighill, Shigeko
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.02.1997; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Adolescent; Adult; Biological and medical sciences; Cancer; Caregivers; Caregivers - psychology; Child; Child Health Services; Child, Preschool; Children; Children & youth; crisis management; doctor-patient relationship; Dominance-Subordination; Female; Gender Identity; General aspects; Health Care; health care system; Health Services; Health systems. Social services; Home Nursing - psychology; Hospitals; Humans; Infant; Japan; Male; Medical disorders; Medical personnel; Medical sciences; Medicine; Middle Aged; Mother-Child Relations; Mothers; Mothers - psychology; mothers health care system doctor-patient relationship crisis management terminal illness; Neoplasms - psychology; Practitioner Patient Relationship; Professional-Family Relations; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sick Role; Social research; Terminal Care - psychology; Terminal Illness; United States of America; Women; Womens Roles; Asia; Japan; mothers; doctor-patient relationship; terminal illness; crisis management; health care system; Health system; Health staff family relation; Social interaction; Cultural environment; Caregiver; Family environment; Physician; Hospital environment; Mother child relation; Public health; Care; Social support
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/S0277-9536(96)00098-6

The context of the Japanese health care setting shaped Japanese women's roles as the major and solo caretakers of their ill children, which caused them to be removed from the family unit during the children's illnesses. The mothers became sentinels and tried to protect their children from unnecessary physical and psychological distress and agony in the hospital context. Some of them comforted their children in the home-care context once their children reached the point where no other treatment could help. At the same time, they tried to establish effective relationships with health professionals, especially physicians. One third of the mothers gave the initiative to the physician, but almost half of the mothers shared the initiative to some degree with physicians on an equal or dominant-subordinate basis. Whether the mothers trusted the physicians did not relate to whether they shared the initiative or not, but was a primary factor in deciding whether to change hospitals. The mothers became monitors and advocates of their children during treatment, at first choosing to adapt to their subordinate position in the hospital, but becoming more assertive when they felt their children may be seriously harmed.