South-East Asian Nurses' Experiences Under the Economic Partnership Agreement (EPA) in Japan: How Language Ability Affects Self-Confidence and Interpersonal Relationships.

INTRODUCTION: Since 2009, nurses have relocated to Japan from Indonesia, the Philippines, and Vietnam under the auspices of the Economic Partnership Agreement (EPA). We asked why some migrant nurses remain in Japan whereas others leave. METHOD: We applied the methodology of Constructivist Grounded Theory. All participants were internationally educated nurses (IENs) currently or formerly working in Japan after passing the National Nursing Examination. RESULTS: Difficulty in mastering the Japanese language was established as one of the main themes. Initial coding elicited two explanatory sub-categories: lack of confidence in communication and effects of language difficulty on workplace relationships. One explains how practical experience in the workplace affected nurses' confidence in communication. The other explains how levels of Japanese language attainment shaped relationships with colleagues. DISCUSSION: These findings suggest a need to regulate the working conditions of foreign nurses, and a need for training schemes to optimize IEN retention.

Community-based care of the elderly in rural Japan: a review of nurse-led interventions and experiences.

Nurses play a critical role in delivering care to elderly people at primary health care level but there is no synthesis of research knowledge to guide community nursing practice in Japan. This review aims to identify nurse-led interventions that have been found to improve elder health at village level; the barriers and constraints that service providers face when delivering care to the elderly; and the experiences of elderly people and their caregivers. The electronic databases such as MEDLINE, CINAHL and Google Scholar were searched to retrieve peer-reviewed primary research literature. A narrative synthesis of the findings sections of the papers was applied to identify key themes. These themes are: socioculturally appropriate care; health improvements; barriers and constraints to care delivery and; experience of the elderly and families. Seven papers were included in the review. The synthesis identified that nurse-led health care for the elderly in rural Japan can be effective when it is targeted and culturally sensitive. The studies highlight a number of barriers to the provision of care. There is a need for further research to examine the issues affecting access to rural nursing care including health system factors, as well as the needs of the elderly and families themselves. Such studies will better inform the delivery of programs, reduce inequity and provide socio-culturally appropriate care to improve the well-being of the elderly.