Table 1 Survey items and each response methods

1. Clinical difficulties about consent and assent

[1] patients’ resistance to and refusal of medical treatment (RMT), [2] assessment of and response to patients’ RMT, [3] support for patients’ RMT, [4] informed consent for patients, [5] explanation of illness and treatment for patients, [6] assessment of and response to parents’ RMT, [7] explanation of illness and treatment for parents, and [8] others.

For items [1] through [7], we asked for responses on a five-point scale of “often”, “sometimes”, “neither”, “rarely”, and “never”. Item [8] was an open-ended question.

2. Explanation for the patient

Frequency of patient explanations in medical treatment, target age group, contents of explanations, target conditions, importance of explanations, decision-makers for implementation of explanations, reasons for not providing explanations, main explainers, and methods.

Multiple-choice

3. Patient’s RMT

Factors that may be related to patients’ and parents’ refusal of medical treatment and parents’ refusal to obtain IC/IA.

Multiple-choice

4. Important factors for patient explanation, obtaining consent/assent, and respecting wishes

Six factors related to obtaining IC and IA, such as the patient’s own right to make decisions and the need to respect the patient’s own will and opinion. Age and importance of following the patient’s intentions.

Multiple choice

If “Other” was selected was free description.

Item of age was free description.

5. Assessment of the patient’s understanding

Whether or not an assessment of patient understanding was conducted, who conducted it, and how it was conducted.

Multiple-choice

If “Other” was selected was free description.

Item of “Detail and Contents” was free description.