Study on significance and educational effect of nursing practicum in international nursing / 国際保健医療

<p><b>Objectives</b></p><p>  This study analyzes Japanese nursing students’ perceptions before and after completing an international nursing practicum (INP) to clear significance and educational effect of practicum in international nursing. </p><p><b>Methods</b></p><p>  We conducted an anonymous, self-administered questionnaire survey for students participating in an INP, including practicum in developing countries, using qualitative and quantitative methodologies.</p><p><b>Results</b></p><p>  In total, 67.0% students completed the pre-practicum questionnaire and 28.4% completed the post-practicum questionnaire. Students interested in international nursing before and after were 54.5% and 59.3%, respectively. Those who perceived benefits from attending the INP for their future nursing activities (benefits) were 88.0% and 85.2%, respectively.</p><p>  In perceptions regarding international nursing, the following four items were significantly higher: “characteristics and diversity of society and culture affecting health,” “understanding of the Japanese health and nursing system,” “understanding of the world health and nursing system,” and “characteristics and diversity of society and culture affecting nursing.” In the perceptions regarding overseas practicum, the following three items included in expectation and achievement were significantly higher: “understanding the effect of society and culture on nursing,” “unable to experience this in Japan,” and “building up relationships with Vietnamese students and teachers.” All significant items included in anxiety were lower. “Language (English) skills” included in preparation was significantly higher. The basis for benefits before and after INP was extracted from six and five categories, respectively. Four categories, i.e., “personal growth,” “cultivation of an international perspective,” “forming views on nursing,” and “preparation for inter-state globalization” were the same for both. The benefits were related to willingness to perform international activities, achievement, and meaningfulness of overseas practicum.</p><p><b>Conclusion</b></p><p>  The results suggest that INP is an effective educational method for basic nursing education, moreover, to foster internationalism. One needs to understand the readiness of students and take their anxieties into consideration, particularly for overseas practicum.</p>

Primary Healthcare Providers’ Perceptions of Non-communicable Disease Prevention and Control in the Western Province of Sri Lanka: A Qualitative Study / 国際保健医療

<b>Objectives</b><BR>  This study aimed at describing primary healthcare (PHC) providers’ opinions and attitudes about non-communicable disease (NCD) prevention in Sri Lanka and to suggest methods to increase their competence in preventing NCDs.<BR><b>Methods</b><BR>  Using purposive sampling, in-depth interviews were conducted among 25 PHC providers: 7 public health nursing sisters (PHNSs), 7 public health inspectors (PHIs), and 11 public health midwives (PHMs) in the western province of Sri Lanka. The interviews were transcribed verbatim and the data were thematically coded. <BR><b>Results</b><BR>  Three major areas regarding PHC providers’ perceptions of NCD prevention and control were identified: insufficient knowledge and training regarding NCD prevention, integrating NCD prevention into MCH activities, and insufficient resources and facilities for NCD prevention. All respondents expressed interest in implementing NCD prevention measures as part of their daily routine. However, insufficient knowledge of NCDs prevented them from playing an active role in NCD prevention and control. PHMs described that they could integrate health education about NCD prevention with their existing duties if they were knowledgeable on strategies to handle it in the field. They recognized that unmet PHNS and PHM quotas caused to hinder their delivery of appropriate services and that they could prevent NCD more effectively by delivering better services if they were provided basic data on NCD of the areas they were in charge of.<BR><b>Conclusion</b><BR>  The PHC providers recognized that they had insufficient knowledge and numbers of PHC providers to deliver services to control and prevent NCDs in the communities. Our findings suggest that it is important to provide sufficient training to PHC providers. In addition, there is a need to increase the numbers of PHC providers and improve facilities of medical officer of health (MOH) office. Moreover, the accessibility of basic NCD data from every administrative division is needed to achieve effective practices regarding NCD prevention and control in Sri Lanka.

Experiences of foreign nurse candidates in Japan under the Economic Partnership Agreement / 国際保健医療

<b>Objectives</b><BR>  This paper describes the diverse experiences in facility training and daily life of foreign nurse candidates who came to Japan under the Economic Partnership Agreement (EPA).<BR><b>Methods</b><BR>  Data were collected through in-depth semi-structured interviews with 16 EPA nurse candidates from Indonesia and the Philippines between 2008 and 2010. Inductive data analysis was performed using the Modified Grounded Theory Approach (M-GTA).<BR><b>Results</b><BR>  Two categories and 11 sub-categories were extracted regarding the working and training experiences of foreign nurse candidates in Japan. The analysis revealed that the candidates, who are registered nurses in their own countries, faced 《fluctuation in nurse identity》 during 〈Japanese nursing practice training〉 and while 〈comparing with practices in their countries〉 at host hospitals, not only because 〈the candidates are not eligible to work as nurses〉 but also because 〈the candidates are concerned about losing sufficient technical nursing skills〉. They were 〈motivated to complete training〉 but 〈faced difficulties in the new environment〉. They experienced 《difficulties in developing human relationships》 due to being 〈confused by the relationship with Japanese staff〉, as they 〈developed a trusting relationship with some staff〉 while also having to deal with 〈heartless attitudes from some Japanese staff〉. Moreover, they underwent a 〈long process to pass the national license examination〉 by counting on 〈individuals in charge of the EPA system〉. This study revealed diverse experiences of EPA nurse candidates and difficulties they faced, as well as their ways of overcoming hardships through personal networks.<BR><b>Conclusions</b><BR>  EPA nurse candidates are required to make every effort to overcome these issues to develop their self-dignity as a nurse candidate in Japan. It is urgently required that host hospitals promote awareness among Japanese staff regarding the needs of EPA nurse candidates, and support them through difficulties in their day-to-day lives. Moreover, sustainable support systems aimed at grasping the difficulties in a thorough and timely manner should be developed for EPA nurse candidates.

Comparison of Japanese nursing students’ perception before and after International Nursing Practicum / 国際保健医療

  This study analyzes Japanese nursing students’ perceptions before and after completing an international nursing practicum (INP). <BR>  Students implementing INP in a developing country completed an anonymous, self-administered questionnaire. Results were analyzed using statistical and qualitative methods. <BR>  66 students completed the pre-practicum questionnaire and 23 completed the post-practicum questionnaire. <BR>  As a result of perceptions regarding INP, three factors “interest in international nursing,” “knowledge necessary for international nursing,” and “understanding of the characteristics of international nursing” were extracted; knowledge necessary for international nursing was found to be significantly higher. Students’ perceptions of benefits of INP for their nursing activities, which were answered through the open-ended question revealed “personal growth,” “cultivation of an international perspective,” “increased understanding of nursing,” “beginning of expansion of views on nursing and nursing activities,” and “interest in exploring the essence of nursing.” <BR>  Perceptions regarding practicum overseas were revealed by three dimensions. Four factors “development of compassion,” “experience only in the practicum field,” “inspiration from achievement of international nursing activity,” and “living experience outside of Japan” were extracted from expectation and achievement. Three factors “environment,” “individual ability,” and “inevitable events in the developing country” were extracted from anxiety. Four factors “fundamentals for achieving INP goals,” “necessity of achieving INP goals,” “nursing knowledge and skill,” and “importance for implementation in the developing country” were extracted from need for preparation. Expectation and achievement regarding experience only in the practicum field was found to be significantly higher. Anxiety about individual ability and inevitable events associated with practicum in the developing country and need for preparation regarding nursing knowledge and skill were significantly lower.<BR>  It was suggested that INP is an effective educational method for basic nursing education and an early exposure for fostering internationalism. Understanding the willingness of students and taking their anxieties into considering were also found to be effective approaches.

The process of building relationships between foreign patients and nurses in Japan / 国際保健医療

 The purpose of this inductive study was to clarify the process of building relationships between foreign patients, who are residents in Japan, with diverse cultural backgrounds and nurses who have cared for hospitalized foreign patients within the past year. Data collection was conducted through semi-structured interviews of eleven Japanese nurses. Analysis of data used the grounded theory methodology. <br> The results of the analysis revealed the following core components of the relationship building process: [Intention to provide appropriate nursing care for foreign patients], [Intention to understand foreign patients’ diverse backgrounds from the perspective of one’s own culture], [Indecision regarding relationships with foreign patients], and [Compromises between nurses and foreign patients]. Furthermore, 25 categories and 110 subcategories of these components were identified.<br> The most important feature of the process of building relationships between foreign patients and nurses was that nurses requested that foreign patients have the same role as Japanese patients<br> Subsequently, the nurses became aware of the differences between their own culture and foreign patients’ diverse cultural backgrounds. Consequently, the nurses had made progress in increasing their awareness of cultural differences.<br> The present results suggest the importance of facilitating Japanese nurses’ recognition of the existence of cultural difference, and improving the process of compromising with accepted cultural difference.

Traditional Health Behaviour of Elderly Population: Comparative Study of Northeast Thailand / 国際保健医療

<B>Introduction and Purpose</B><br> Ratio of elderly people has rapidly increased not only in developed countries but also in developing countries. Especially, the number of elderly people over 60 years old will be three times more than at present in the next 45 years in Asian countries. The 9th five year plan in Thailand focused on strengthening health promotion activities in remote areas. Especially, Thai traditional and alternative medicine has been promoted to develop the quality of elderly people's lives. This study was conducted to compare the traditional health behavior of elderly people in a suburban area and a remote area in northeast Thailand.<br><B>Methods</B><br> Forty three elderly people were interviewed in two villages and semi-structured questionnaires were used to collect data from the year 2006 to the year 2007.<br> Participatory observation was also conducted to obtain information on village atmosphere and national & social environment. <br><B>Results</B><br> People in the remote area practiced traditional health behavior i.e. growing herbs in their home gardens, believing in the concept of 'heat food' and 'cold food' more than the suburban areas. Meanwhile, people in the suburban used herbal soup more than people in the remote area. People in the remote area consumed many kinds of food and believed certain foods as harmful for health more than people in the suburban area did. Approximately 50% of people in the remote area used to get Thai traditional massage compared to only 30% of people in the suburban area.<br><B>Conclusion</B><br> There was a variety of disparities in the consumption of herbs and foods between remote and suburban areas even though they existed only 20 km's apart. <br> People who practiced more traditional health activities suffered from less chronic illnesses than people who did not.

Traditional Health Behavior of foreigners living in Japan / 国際保健医療

Introduction<br>Folk medicine is practiced in most countries for the purpose of treating illnesses, preventing from ailments and promoting health. When people immigrate, they bring and practice their medical experience and knowledge in the new country. They integrate their culture and traditional medical practices to those of their new home country.<br>Methods<br>Forty five foreigners from three different countries i.e. China, Philippine, Brazil, living in Japan were interviewed in-depth, in order to compare the differences of their traditional health behavior.<br>Results<br>The results show that Chinese have more knowledge, practice traditional health behavior more and suffer less from ailments than Philippinos and Brazilians, during the one year period prior to the date of interview. Most respondents practice traditional health behavior for health promotion and prevention from ailments while they chose either traditional or modern medicine for treatment according to the symptoms or diseases. All respondents consciously took certain drinks for promoting and maintaining their health. Only Chinese practice the "hot-cold" classification in illness management and diet. The concepts of opposition and balance are only some of the several approaches used in treating illnesses. Philippinos and Chinese use traditional health practices for maternal and child care more than Brazilians. More than 30% of Philippinos suffered from severe morning sickness and 20% of them gained excess weight rapidly during pregnancy. Respondents from all three countries took special traditional meals to recover from tiredness and produce adequate breast milk after childbirth.<br>Conclusions<br>All three different groups have integrated their own traditional health behavior to the Japanese life style not only for promotion and prevention from illnesses but also to complement medical services in Japan. It was found that some traditional practices were in common and others were very unique among the three countries. Suggestions for further research are made.