Factor Structure of Behaviors Demonstrating “Ganbatta” in Young Children Undergoing Blood Sampling/Vaccine Injection Perceived by Nurses: Exploratory Factor Analysis by a Cross-Sectional Survey in Japan

Abstract

Ganbatta ("Well done!") is a term used frequently in Japan to praise children in medical settings when they have worked hard or made a courageous attempt. Therefore, the aim of this study was to clarify the factor structure of behaviors associated with ganbatta in young children (age 3-7 years) undergoing blood sampling or vaccine injection. A crosssectional questionnaire survey was carried out on 150 selected pediatric nursing educators holding a nursing license (age ≥20 years). An exploratory factor analysis was then conducted using the principal factor method with promax rotation to confirm the construct validity. Cronbach's α coefficients were calculated for each identified factor to verify the internal consistency of the item. The mean (standard deviation) lengths of pediatric nursing and pediatric nursing education experience were 7.8 (4.7) and 9.9 (8.1) years, respectively. The cumulative contribution rate was 70.4%. The KMO measure of sampling adequacy was 0.927. The p value of Bartlett's test of sphericity was <0.001%. Finally, among the children's behaviors, 5 factors were identified and 25 items were selected: Factor 1, Proactive participation, containing 7 items; Factor 2, Sense of relief and joy after needle removal, 6 items; Factor 3, Negative emotional expression, 4 items; Factor 4, Information-seeking, 5 items; and Factor 5, Moving on from the needle procedure, 3 items. These findings indicate that ganbatta is a complex concept that encompasses a variety of aspects in young children in relation to needle procedures. Evaluating a young child's ganbatta behaviors during a needle procedure can serve as an indicator to evaluate the quality of care provided by nurses. Sharing the evaluated results with children and their parents may serve as a foundation to open discussions in regard to higher-quality care. In addition, observing ganbatta behaviors during a needle procedure and providing feedback to the child could help them feel like they have done a good job.

Simplified Scale for Assessing Behaviors Regarding “Ganbatta” Concept in Children Aged 3–7 Years Undergoing Blood Sampling and Vaccination

“…"Ganbatta": The verbal expressions and behaviors exhibited by young children who undergo blood sampling or vaccination. Speci c behaviors were measured using the 25-item Ganbatta Scale [34] and the 5 associated factors developed by a previous study.…”

“…A previous study has qualitatively analyzed behaviors associated with the "ganbatta" concept in young children who undergo needle procedures [33]. Using factor analysis, 5 factors containing 25 items assessing behaviors associated with "ganbatta" have been identi ed [34]. The speci c factors are as follows.…”

“…Therefore, healthcare providers and parents must evaluate these behaviors on their behalf. This study simpli ed the 25-item Ganbatta Scale [34] to objectively evaluate behaviors associated with "ganbatta" in young children aged 3-7 years who undergo needle procedures in a clinical setting. This study conducted a survey among pediatric nursing staff members.…”