Introduction
It is important for nursing students to learn about diverse cultures and develop a positive attitude toward patients from different backgrounds. This study investigated factors that related to their participation in study abroad programs.
Method
We designed and conducted a mixed-methods cross-sectional study using an online self-reported questionnaire. We collected data as a part of class activities from 2nd, 3rd, and 4th year nursing students (n = 165) during the 2020 spring semester at a medical university in Tokyo, Japan. The university’s Institutional Review Board approved this study.
Result
We analyzed data from 156 students, with an effective response rate of 94.5%. Overall, the median of their intercultural sensitivity score was 79.0. Students who had participated in the program (n=10) demonstrated a significantly higher intercultural sensitivity score (84.0) than those who had not (79.0). Factors related to participation in the program included the willingness to study or work abroad, length of stay abroad, and the number of foreign nationals in social vicinity. The most common reason for non-participation was a lack of confidence in English proficiency (n=75). The categorized conditions that could facilitate participation in the program comprised an improving support system (with increased financial and linguistic support), diversified content (increased program options and form of program), and flexible requirements for participation (expanding students’ awareness of the program, increasing the pool of eligible participants, and improving conditions for participation).
Discussion
The nursing students in our study, who had participated in the program, showed a higher level of intercultural sensitivity than those who had not. However, it remained inferior to that of their Turkish and American counterparts. It is necessary for Japanese nursing students to learn about and interact with people from different cultural backgrounds. The study abroad program could be an effective method to improve cultural sensitivity and competence.

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Objective
To clarify the elements of books published as international nursing textbooks after the 1996 revision of the Nursing Law.
Method
The National Diet Library of Japan and Amazon websites were searched for 20 textbooks, using the keyword “international nursing”. The table of contents (elements) of the textbooks was classified into three categories: “purpose”, “object”, and “method”. After this classification, each element was qualitatively classified according to semantic similarity.
Results
The first textbook was published in 1999, and the remaining 19 after 2001. There were 14 independent editions of international nursing, two of which were classified under international nursing and disaster nursing, and four were classified under international nursing and international health. “Purpose” was classified into 6 categories: [Definition/concept/necessity of international nursing], [Internationalization (globalization) and nursing], [Place and target of international nursing], [Definition/concept/necessity of international health], [Intercultural understanding, Cross-cultural nursing, multicultural coexistence], [History of international nursing and health]. “Target” was classified into 12 categories: such as [Foreigners Residents], [Japanese residents abroad], [Maternal and child health, reproductive health, gender], [Infectious diseases], [Non-Communicable Diseases (NCDs)], [Poverty and disparity], [MDGs, SDGs, UHC], [Foreign nurses]. “Method” was classified into 5 categories: [Place and target of International Health/Nursing], [Abilities/Roles required for International Nursing], [Methods and Theories used in International Nursing and International Cooperation], [Approach in cross-cultural nursing], [Directions and issues of international nursing and international cooperation].
Discussion
The international nursing textbooks contained a wide range of topics for teaching, including “international health” and “international cooperation”. In addition, there were differences in the contents depending on the authors. In the future, it will be necessary to identify the important elements and their frameworks and include these in international nursing books.

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