Comparison of decision-making in neonatal care between China and Japan

  • Hidehiko MaruyamaEmail author
  • Yuka Shibata
  • Xing-Ge Xia
  • Yun-Xia Sun
  • Shao-Ru He
  • Yushi Ito
Original Article



Various differences between China and Japan in approaches to medical treatment have been noted, but a few studies have examined differences in medical decision-making, especially in neonatal care. The aim of this study was to clarify these differences by means of a questionnaire.


The subjects were physicians on the staff of NICUs in China and Japan. The study questionnaire consisted of three parts dealing with the general characteristics of the participants, questions about treatment strategies for hypothetical, critically ill infants, and general questions about the treatment of foreign patients. The Likert scale was used to assess the treatment strategies and the results were analyzed statistically. Subgroup analysis by age, sex, and medical and NICU experience was also performed.


The proportion of respondents in the Chinese and Japanese groups was 26/26 (100%) and 26/31 (84%), respectively. There was a significant difference between the Chinese and Japanese groups for 8 of 75 questions; Chinese physicians chose the positive treatment or examination options for these eight questions unlike their Japanese counterparts. The responses of the younger, less experienced physicians in both countries were more similar to each other, and more positive than those of their older, more experienced colleagues.


Chinese physicians showed a more positive attitude toward examination and treatment, whereas Japanese physicians showed a more cautious attitude.


Behavioral style China Decision-making Directive style Japan 



We thank the participants for responding to the questionnaire. We also thank Mr. James R. Valera for his assistance with editing this manuscript.

Authors contribution

HM conceived this study, constructed the questionnaire, analyzed the data, and wrote the first draft. YukS, XX, YunS, and SH helped to construct the questionnaire. YI supervised the study.


None declared

Compliance with ethical standards

Ethical approval

This research was approved by the ethical review board of the National Center for Child Health and Development and Guangdong General Hospital.

Conflict of interest

None declared.


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Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2018

Authors and Affiliations

  1. 1.Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive MedicineNational Center for Child Health and DevelopmentTokyoJapan
  2. 2.Division of NICUGuangdong General Hospital Guangdong Academy of Medical SciencesGuangdongChina

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