Healthcare needs and experiences of foreign residents in Japan by language fluency

The Development and Psychometric Testing of the Scale of Cultural Sensitivity of Health Care Professionals in Japan

INTRODUCTION

The development of cultural sensitivity is essential for health care professionals but there are few tools to measure this quality in Japan. The purpose of this study was to develop a scale of cultural sensitivity for Japanese health care professionals and examine its reliability and validity.

METHOD

A draft scale was created through conceptual analysis and a questionnaire was completed by 515 health care professionals and 1,322 college students. Exploratory and confirmatory factor analyses were used to determine suitable scale items and examine model fitness.

RESULTS

The four-factor 18-item scale showed acceptable model fitness. Cronbach's α coefficient exceeded .90 and correlation coefficients for criterion-related validity were over .29. Construct validity was confirmed by the significantly higher score of the cross-culturally experienced groups. The intraclass correlation coefficient was .642 (professionals) and .722 (students).

DISCUSSION

This reliable and valid scale for Japanese health professionals and college students may be used to evaluate training programs to increase their cultural sensitivity.

Comparative Analysis of Allogeneic Bone Marrow Transplantation Outcomes Between Japanese and Non-Japanese Populations

BACKGROUND

As the Japanese population may have less genetic diversity than other ethnic groups, treatment outcomes may be affected when allogeneic hematopoietic cell transplantation is performed in other races. However, evidence explaining the effect of racial differences is limited.

METHODS

We used the Japanese National Database to examine the outcomes of first allogeneic bone marrow transplantations (BMTs) performed between Japanese and non-Japanese patients from 1996 to 2021. We performed propensity score matching using sex, age group, underlying disease group, HLA mismatch, conditioning regimen intensity, and BMT implementation age to select Japanese-to-Japanese BMT patients as the controls.

RESULTS

The numbers of non-Japanese-to-Japanese and Japanese-to-non-Japanese BMT cases included in the analysis were 48 and 75, respectively, and the following outcomes were compared: overall survival, non-relapse mortality, acute graft-vs-host disease (GVHD) ≥ grade II, chronic GVHD, and engraftment of neutrophils and platelets. Most parameters did not differ when comparing BMTs according to ethnicity; only platelet engraftment was delayed in Japanese-to-non-Japanese BMT but not in non-Japanese-to-Japanese BMT.

CONCLUSIONS

The results of this study suggested that BMT performed in Japanese and non-Japanese patients has little effect on treatment outcomes. The results of this study may be useful for donor selection in Japan, where internationalization has progressed in recent years.

Bridging the Language Gap: The Role of Human-Mediated Translation in Japanese Medical Settings

Introduction Foreign residents in Japan often face challenges accessing healthcare due to language barriers, potentially leading to health inequities. This study aimed to assess the utilization and impact of human-mediated translation services in a specific medical setting in Tokyo. Methods A retrospective investigation was conducted on medical records of foreign patients who utilized human-mediated translation services at Navitas Clinic Tachikawa (Tachikawa, Tokyo, Japan) from November 2017 to December 2021. Data on age, gender, language used, department visited, diagnosis, insurance status, and booking methods were analyzed. Results Out of the 124 foreign patients who utilized the human-mediated translation services during the study period, 69 (56%) were male, and 55 (44%) were female. The median age was 35 years, with a range from 3 to 61 years. English was the predominant language used by 34 patients (59%), followed by Chinese for nine patients (16%) and Spanish for four patients (7%). The majority, 107 patients (86%) visited the internal medicine department, nine patients (7%) consulted dermatology, and six patients (5%) visited pediatrics. Regarding insurance status, 47 patients (81%) were insured, three patients (5%) were uninsured by the Japanese national health insurance system, and eight patients (14%) were self-pay. The primary mode of appointment booking was at the reception desk, with 112 patients (90%) using this method, while 12 patients (10%) made reservations online. Conclusions The findings of this study underscore the importance of human-mediated translation services for improving healthcare accessibility for foreign residents in Japan, emphasizing the need to address language barriers and promote health equity in clinical settings. Future studies should also explore challenges faced in patient-physician interactions from a linguistic perspective and potential technological solutions to enhance these services.

The Importance of “Easy Japanese”: Communicating Health Information to Foreigners in Japan

The number of foreign workers in Japan has been increasing in recent years. In Shimane Prefecture, people from non-English speaking countries account for most of the foreign resident population. Language barriers pose numerous challenges for this population. Their problems communicating in the medical context, in particular, contribute to their avoidance of hospitals. In addition to translation machines and English, "Easy Japanese" has been found to help Japanese healthcare workers communicate with foreign patients. “Easy Japanese" refers to easy-to-understand Japanese that involves rephrasing words and sentences. The use of Easy Japanese should be promoted among medical professionals in Japan as it is considered a communication skill that can be improved through practice. A voluntary study group was formed among medical students. During the first session, students were presented with background information, explaining why the need for Easy Japanese is increasing. In the second session, they practiced paraphrasing words. Finally, in the third session, they conducted simulated medical communication and practiced Easy Japanese with foreign residents to determine whether they were able to convey their intentions. Participants were recruited via social networking service, with five participants in the first session, five in the second, and eight in the third. Through this project, it became clear that for participants, the usual way of speaking Japanese came first in practice and that it was difficult for them to produce easy-to-understand phrases at the spur of the moment without practice. Additionally, medical students reported that the expressions they acquired through several practice sessions were helpful when talking with international students on campus. The final session involved a student-led Easy Japanese study group. Based on the students’ comments, we found that this study group was useful for them. Accordingly, Easy Japanese education should be continued and expanded to more students in the medical field and to the local community, including foreign residents, to measure its effectiveness.