Relationship‐Building and Care Practices of Home‐Visiting Nurses Caring for Children With Medical Complexity and Their Families in Japan: A Qualitative Study

AIM: Children with medical complexity require ongoing medical and daily care at home, placing substantial demands on their families. In this study, we aimed to elucidate the experiences of home-visiting nurses caring for children with medical complexity, focusing on how they build relationships with primary caregivers and children and deliver care within this relational context. METHODS: This qualitative descriptive study included 22 home-visiting nurses in Japan. Data were collected through semistructured interviews and analyzed using thematic analysis. RESULTS: Four main themes were identified: "Understanding the mother and child within their everyday lives," "Being there for the mother as a professional nurse," "Developing reciprocal relationships within the mother-child-nurse triad," and "Extending relational nursing care through supportive networks." Nurses integrated the mothers' experiential knowledge, children's responses, and their own professional observations to negotiate individualized care. Their relational practice extended beyond the mother-child-nurse relationship to wider family and professional support networks. "Nurses' emotional engagement in relational nursing" was identified as a cross-cutting process. CONCLUSIONS: Pediatric home nursing for children with medical complexity involves relational and negotiated practice in which nurses seek to understand and support mothers and children, develop reciprocal relationships, and extend relational care to wider support networks. The findings of this study highlight the importance of integrating parental experiential knowledge, children's responses, and professional assessment in negotiating individualized care, while maintaining a professional responsibility for children's safety and rights.