The objective of this study was to insight their culture was organized people living with dementia spending at a community-based day care facility in Japan and to understand their needs towards dementia-friendly community from the perspectives of people living with dementia. This ethnographic study was conducted at Facility C in Japan, a community-based day care facility promoting and developing dementia-friendly community. The survey period was from June 2018 to July 2019. Data collection included participant observations (approximately 162 hours) and from ethnographic interviews with 10 people living with dementia and were analyzed using Spradley’s (2010) developmental research sequence. The six categories as their needs towards dementia-friendly communities from the perspectives of people living with dementia emerged from this study. Among them, “respect for decision-making,” “respect for roles based on individual strengths,” “ respect for independence that grows out of equal relationships,” and “diverse interactions with the local community” showed the same context as necessary implementation for DFC suggested by the previous study. In addition, this study, “a place where people with dementia can create with other people with dementia” and “temporary release from family ties” were newly emerged as people living with dementia’ needs against for DFC. The findings of this study will promote understanding of the strengths of people with dementia and their needs to nursing professionals working in various communities, including social services, healthcare, and the community care, and will contribute to the development of assessment, intervention, and evaluation in dementia care and nursing practice.

Purpose
This study aimed to assess the effectiveness of “Cross-cultural Care e-Learning (CCL),” an educational intervention initially designed for foreign care workers in nursing facilities, and to examine ways to promote cross-cultural adaptation.
Method
The CCL comprises a brochure and video. Its learning outcomes were evaluated through longitudinal measurement using web-based anonymous questionnaire surveys and care behavior diaries. The evaluation was carried out thrice: before, one month, and three months after the intervention. The effectiveness of CCL was analyzed based on free descriptions of post-course awareness in foreigners’ care behavior diaries, as well as from the Work Engagement Scale (UWES), job satisfaction scale, stress reactions. The CCL educational methods were analyzed based on free descriptions and opinions of post-course, and care behavior diaries.
Results
There were 31 intervention participants, out of which 12 were evaluated at the three time points. The evaluations showed [improved care skills] and [awareness of cultural differences in care] immediately after CCL, and [acceptance of cross-cultural care] and [reconceptualizing care] were extracted from the care behavior diaries. Analysis of variance for the three time point scales showed that scores for psychological workload significantly decreased with the progression of time. The educational method utilized in CCL was evaluated as [easy-to-understand content] and [possible future use].
Discussion
The CCL met the learning needs of foreign care workers, promoted an understanding of work culture and customs that are important for socio-cultural adaptation, and reduced psychological stress. Thus, the CCL may help people adapt to the Japanese work environment and provide clues to building a “culture of collaboration” with Japanese people.

Objectives
The purpose of this study is to describe a nurse’s experiences in efforts to support regional cultural behaviors of hospitalized older adults through nursing activities.
Methods
The author conducted nursing activities to support regional cultural behaviors in four selected older adults. Based on the nursing records of the four patients, the process of nurse-patient relationship development was described in three phases, namely, patient selection, assessment, and plan implementation. Descriptive data were analyzed qualitatively and inductively by asking the question, “What experiences do nursing activities that support patients’ regional cultural behaviors bring to nurses?”
Results
The experiences of nursing activities to support regional cultural behaviors of hospitalized older adults were summarized into three categories from 11 subcategories. The nurses’ attention to the needs of the hospitalized older adults with respect to regional cultural activities and the nurses’ attempts to fulfill those needs led to “activating and deepening the care relationship.” In addition, “embodying the older adults’ social participation” resulted in “generating joy and motivation for living,” while further “activating and deepening the care relationship.”
Discussion
Nursing care that supports the regional cultural behaviors may help older adults, who lack the energy to overcome their own situation due to hospitalization, to form a relationship with nurses and may empower these patients to face their treatment. For the nurses, the repeated experience of deepening the relationship with the older adults and creating joy for them may contribute to the development of the nurses’ view of nursing.