This cross-sectional pilot study tested the feasibility of a comparative study of patients with acute coronary syndrome in Japan and the United States, estimated the effect size of perceived control, and compared the strength of association between perceived control and health-related quality of life.
Patients were recruited from a university hospital in Japan and a level 1 trauma center in the United States. The two authors in Japan and a research team member in the US recruited each participant during hospitalization. Data were collected using self-report questionnaires of demographics, acute coronary syndrome symptoms, depression, anxiety, perceived control, and health-related quality of life.
Japanese participants (n=31) were older and their educational level was higher than US participants (n=10) on average. Japanese participants’ perceived control was significantly lower (effect size was 0.787), although they reported higher levels of health-related quality of life in the physical functioning and social functioning domains. Necessary total sample size for liner multiple regression with five predictors was calculated to be 14. The total score of perceived control was significantly lower in Japanese patients compared with US patients after adjusting for age, gender, education and employment. In the US, lower pain (r=0.850) and better emotional role (r=0.818) subscales were significantly correlated with higher perceived control (p < 0.005). In Japanese patients, correlation coefficients between each item of health-related quality of life and perceived control were generally lower (r < 0.5), and were not significantly related each other (p > 0.005).
Perceived control was significantly lower in Japanese participants than US participants with large effect size. The association between perceived control and health-related quality of life with Japanese patients was not clear in this pilot study due to small sample size. Further investigation in a larger representative sample is necessary to determine whether perceived control is related to health outcomes in patients in Japan.

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Purpose:The purpose of this review was to seek International Nursing education contents in Japan and their achievements in order to explore the possibilities of providence to all students.
Methods:The reference search method involved searching for the keywords, “international nursing” and “education,” on the Ichushi, CiNii, and J-STAGE electronic database on October 2020. The reference review standard required that references were published in English/Japanese between January 2001 and September 2020 and displayed international nursing education contents and learning outcomes for undergraduate students. The flow is 1) extract contents about the considerations when promoting international nursing to all students and 2) overseas actions and comparable local educational program for 3) separate reviews of overseas and local actions.
Results:Innovative international nursing education approaches in Japan include 1) recruitment of foreign instructors and students, 2) introduction of remote learning, 3) positioning of the compulsory courses in the first year. Achievements with/without overseas training and placement include 1) understanding of foreign cultures and international nursing targets, 2) improvement of learning motivation, 3) opportunities to think of the career path as nurses. The result assessment is quantitative through hard copy questionnaire before and after the lectures/trainings, as well as qualitative via data from learning portfolio.
Discussions/Conclusions: After studying international nursing, students showed better understanding to foreign cultures and nursing targets as they learnt through real experiences in Japan and overseas. Furthermore, they showed stronger learning motivation, a trained attitude and aspiration to become a nurse. A number of students hesitated for overseas classes for financial concerns or insufficient language confidence, so inviting foreign instructors and students, along with collaborative remote classes with other universities are essential.

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Objective This study evaluates accident prevention using the Portuguese version of the Accident Prevention Educational Tool based on nurses’ narratives.
Methods Semi-structured interviews were conducted with five nurses who used the tool to prevent accidents in hospitalized Brazilian children. The tool was distributed to six children (age 6 months to 9 years old) and their parents.
Results Brazilian parents reacted positively to the translated version of the tool along with the accident prevention behaviors described in the tool. However, the children’s responses did not show any change. Accident prevention behaviors of Brazilian parents showed that the results for Slips and IV removal seemed to be an effect of the use of the tool. However, there was no effect of the tool on Falls [full bed fence lowering].
Discussion: The Brazilian parents responded positively to the translated version of the tool, and their accident prevention behaviors described in the tool, suggesting the significance of using the translated version as an accident prevention measure. However, the effectiveness of the tool could not be confirmed for children, as no changes in their interest in or the understanding of the accident prevention behaviors were noted. In the future, we need to re-evaluate the tool with more children after devising ways to cultivate their interest in it. The accident prevention behaviors of the Brazilian parents appeared to be an effect of using the tools for Slips and IV removal. Since [full bed fence descent] was identified, it was found that the use of tool for Falls did not induce to behavioral change in Brazilian parents, there is a need to emphasize and impress the importance of “bed fence up” as part of the contents of the tool.

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Objective Compared to research on international nurses under economic partnership agreements, there are few studies on international nursing students in Japanese universities. Therefore, the difficulties they face are unclear. Moreover, to clarify and improve the situation, the perspectives of teachers involved in the process are indispensable. Therefore, the purpose of this study was to analyze interviews with nursing faculty members to clarify the difficulties of international nursing students in classes, exercises, and practice, with a view to developing writing materials that are expected to be particularly difficult.
Methods Four nursing faculty members who were in charge of educating international students in the nursing department of a university were interviewed by a Japanese language faculty member. Their utterances, including difficulties in educating international nursing students, were analyzed using the Steps for Coding and Theorization (SCAT) method.
Results As a result, storylines were created with 78 constructs from four perspectives: “problems international students face,” “problems caused by a typical nursing education,” “problems in the educational system and environment,” and “problems of the nursing faculty themselves.” By subdividing each of these storylines, 24 hypotheses concerning the educational difficulties that nursing faculty perceive for international nursing students were developed. The hypothesis of this study suggested the usefulness of incorporating peripheral skills in writing materials for international nursing students. The importance of collaboration between nursing faculty and Japanese language faculty in supporting the learning of international nursing students was also discussed.

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Objective: In September 2019, in order to obtain useful insights for child-rearing support activities for foreign parents and children living in Japan, I visited two offices of Home-Start UK, an international non-profit organization that provides community-based child-rearing support.
Method: In this report, I will explain what I learned at the Home-Start UK, focusing on the three points of (1) facility outline, (2) support system, and (3) volunteer activities.
Results: Home-Start UK has provided home-visiting child-rearing support for a diversity of parents and children, including immigrants and refugees of various backgrounds. Home-Start’s home-visit supporters are well-trained volunteers who cooperate with public health services and professionals. The ethos behind the home-visit services offered by Home-Start is based on child protection from the citizen’s perspectives.
Discussion: In the Japanese context, an effective approach to establishing community-based support systems for foreign parents and their children could also be the promotion of volunteer group-led activities with cooperation from networks of professionals and public health services.

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Purpose: This study aimed to examine the challenges of cross-cultural communication and the measures needed to build effective communication, and to raise suggestions for improving the quality of communication and care for foreign patients.
Method: Japanese and international literature published between 2008 and 2018 was included in the review. Six databases were searched by keywords in Japanese and English. A total of 30 publications, 15 Japanese and 15 international articles met the search criteria, and the search findings were recorded according to the PRISMA protocol.
Result: The challenges identified in cross-cultural communication fell into three main themes: " poor cross-cultural understanding, " " impact on care processes and outcomes, " and " lack of multilingual services and inaccessibility " Furthermore, we identified three main measures for building effective communication, that is, " provision of learning opportunities for nurses ," " effective use of multilingual services, " and " creating rapport and establishing supportive relationships. "
Discussion: To enhance cross-cultural understanding and communication skills among nurses who provide care to foreign patients, a learner-centered approach that provides various educational methods meeting the needs of learners is required. The effective use of multilingual services includes working with certified interpreters and the use of visual aids such as diagrams, pictures, cards, and translation books, which help to provide correct information and promote understanding. Hence, patients and nurses are more reassured, and the quality of care can be improved. To establish rapport with foreign patients, if there is a language barrier, the use of nonverbal communication, having an attitude for understanding the different cultural backgrounds proactively, and accepting differences can be effectively used.

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