Assessment process followed by elementary school teachers in Japan for assessing the support needs of children of parents with cancer: a semi-structured interview

Children of parents with cancer are often affected physically, psychologically, and socially. School teachers are close observers of children’s behavior and emotional stability. Their awareness and judgment are crucial for detecting changes early and linking children to appropriate support. However, the role of school teachers in recognizing these signs and the process by which they determine the need for support remain largely unexplored, particularly in Japan.This study aimed to identify the process by which elementary school teachers in Japan assess the support needs of children whose parents have cancer. The findings of this study contribute to the development of school-based support systems for these children. A descriptive phenomenological design was adopted. Semi-structured interviews were conducted with public elementary school teachers in Akita City. The interview guide covered three main areas: (1) situations in which teachers perceived a need for support, (2) the reasons and contextual factors underlying such judgments, and (3) how teachers interpreted subtle signs and behavioral changes in children. Data were analyzed using Colaizzi’s seven-step descriptive phenomenological method to clarify the essential structure of teachers’ decision-making experiences. Interviews with 24 teachers (conducted between December 2024 and June 2025) revealed four thematic categories: (1) Noticing changes in children, (2) Interpreting those changes and experiencing wavering judgments, (3) Regulating emotional conflicts that hinder offering support; and (4) Recognizing and reaffirming their role as educators in providing support. Taken together, these categories depict a progressively negotiated decision-making structure in which teachers move from intuitive noticing to reflective interpretation and role-based action. The findings clarify that support-related judgments are shaped by ethical hesitation, uncertainty, and gradual consolidation of professional responsibility rather than immediate assessment. The complexity of decision-making in schools regarding support for children of parents with cancer highlights the need for close collaboration with health care professions. Observations and insights gained by teachers through daily interactions can be valuable for the entire health care team, and such collaborations can enhance support quality. Therefore, developing interprofessional systems and educational initiatives that foster mutual understanding of professional roles may enhance timely and comprehensive support for these children.