Objective

  To identify issues in health communication regarding treatment support for foreign-born who are diagnosed as latent tuberculosis infection (LTBI) in Japan, from the perspective of public health centers (PHCs).

Methods

  A self-administered survey was sent to 469 PHC, between June and July 2020. The survey asked closed and open-ended questions to tuberculosis (TB) program personnel on (1) their experiences of foreign-born patients who were eligible for LTBI treatment but did not start their treatment, and who started treatment but were lost to follow-up, and (2) health communication issues with foreign-born patients. Responses were summarized descriptively for close-ended questions, and analyzed qualitatively for open-ended question.

Results

  We obtained response from 307 PHCs, regarding 315 foreign-born patients. Twenty-five patients did not initiate, and 52 were lost to follow-up after initiating LTBI treatment. Of the 77 patients who either did not start treatment or were lost to follow-up, 45 apparently could hold everyday conversation in Japanese but had difficulties understanding technical terms, and 19 could not even exchange basic conversation, with PHC staff. Barriers to LTBI treatment initiation and completement, as perceived by PHC staff, included “lack of correct knowledge about TB and LTBI”, “different attitudes to health” and “economic difficulties”.

Conclusion

  Issues in health communication between PHC staff and foreign-born patients included not only a language barrier, but also the unconscious mind among PHC staff, which sought reasons for refusal or termination of LTBI treatment in patients. We argue that this mind is based on positivism, whereby health personnel consider themselves as the provider of “scientific knowledge” and that “lay persons” can act rationally once enlightened. However, PHC staff may need to reflect upon such position as the provider of scientific knowledge, but instead, learn from foreign-born patients about how they perceive health, TB or LTBI, to conduct better communication.

Objective

  Everyone has the right to obtain information through understandable language. Nevertheless, it has been pointed out that in Japan, a language barrier prevents it. Plain Japanese (easy Japanese) has been proposed as a solution. Plain Japanese is a language form simplified to be suitable for non-native Japanese peoples’ Japanese abilities. However, there are limited studies on healthcare professionals’ use of plain Japanese. The objectives of this study were to examine changes, moreover associations between knowledge and rephrasing skills among nursing students.

Method

  Eighty nursing students were subjected to this study. We conducted a lesson on “plain Japanese”. Data were collected before and after the lesson using questionnaires. We compared the number of knowledge items and rephrasing scores before and after the lesson. After the lesson, we also compared the number of knowledge items between the high rephrasing score group and the low rephrasing score group. We compared perceptions about communication with non-native Japanese people before and after the lesson.

Results

  Seventy-two nursing students participated in this study. There was a significant difference in the number of knowledge items before and after the lessons（from 2 to 8) (p<0.05). Rephrasing skills scores were increased as well (from 3 to 4) (p<0.05). The positive answers about “plain Japanese” increased after the lesson. However, the median number of knowledge items among the high rephrasing score group was 10 and the median number among the low rephrasing score group was 8 after the lesson. There was no significant difference between the two groups (p>0.05).

Conclusions

  Overall, both the number of knowledge items and rephrasing skills scores were increased. However, it is unknown whether the increase in rephrasing skills were improved based on increased knowledge. Students will more specific knowledge and repetitive practice to improve skills in using plain Japanese.

Objective

  There is a growing need to develop human resources with diverse experience, expertise, and a global perspective who can contribute to global rule-making in health. One of the government’s goals is to increase the number of Japanese personnel working for international organizations, but it has not reached the desired level. This study identified the barriers that medical and non-medical professionals have when applying for or working at international organizations, as well as the support measures they expect from the government, to highlight issues and examine employment support measures.

Methods

  A qualitative and descriptive research was conducted based on semi-structured interviews with 20 physicians, nursing professionals, graduates of public health graduate schools, non-medical professionals, students, etc., who were (1) seeking employment with international organizations, (2) currently employed, and (3) previously employed but left.

Results

  The following seven themes were highlighted as barriers to applying for or working at an international organization: 〈issues specific to Japanese society and people〉, 〈concerns about a career in global health〉, 〈discrepancy between a career as a healthcare professional and a career in global health〉, 〈need to strengthen skills〉, 〈preparation for competitive examinations〉, 〈importance of WLB〉, 〈issues inherent in international organizations〉.

Conclusion

  Possible support measures include individual career counseling, seminars on how to survive in international organizations, and seminars for female applicants of child-rearing age, based on the knowledge and experience of current/former employees of international organizations. As for the issues that hinder the dispatch of medical personnel overseas, the first step would be to compare and verify the positive effects that strengthening the overseas dispatch would have on their skills, the workplace environment, and the acceptance of foreign patients. The development and introduction of systems, such as sabbatical and long-term leave, and reinstatement of employment is especially required of global companies and international hospitals.