Care needs and factors reducing caregiver burden for children with special health care needs in out-of-home care in Japan: An observational study

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.