Academic journal article Nursing Education Perspectives

Developing a Culturally Competent Health Care Workforce in JAPAN: IMPLICATIONS FOR EDUCATION

Academic journal article Nursing Education Perspectives

Developing a Culturally Competent Health Care Workforce in JAPAN: IMPLICATIONS FOR EDUCATION

Article excerpt


In recent years, the population of foreign nationals and individuals from diverse cultural, racial, ethnic, and linguistic populations has consistently increased in Japan. An apparent failure by the health care workforce to deliver culturally congruent health care services has resulted in dissatisfaction with the health care system on the part of foreign nationals and increased potential for negative health care outcomes. Primary hindrances to the development of a culturally competent health care workforce include limited exposure to foreigners, cultural factors, and language difficulties. Recommendations are proposed for strategic educational actions to address these obstacles and develop in Japan a culturally competent health care workforce.

Key Words Culturally Competent Workforce - Cultural Competence Education - Japanese Health Care - Foreign Residents Japanese Culture

THROUGHOUT THE 20TH CENTURY AND INTO THE 21ST, THE POPULATION OF FOREIGN NATIONALS AND PATIENTS FROM DIVERSE CULTURAL, RACIAL, ETHNIC, AND LINGUISTIC BACKGROUNDS INCREASED CONSISTENTLY IN JAPAN. According to statistics reported by the Ministry of Justice Japan, Immigration Bureau (1), the number of foreign residents registered in Japan exceeded 1.97 million by 2004. This population cohort currently constitutes nearly 1.5 percent of the Japanese population and is predicted to increase by midcentury. Indeed, the percentage growth of the overall Japanese population between the years 1994 and 2004 was 1.9 percent, in contrast to 45.8 percent for foreign residents. * IT IS GENERALLY UNDERSTOOD THAT Japanese culture values homogeneity. However, given the rapid growth in the foreign resident population, health care organizations can no longer focus solely on meeting the needs of the Japanese population. Culturally competent care providers are needed to meet the needs of the minority population, including a high percentage of foreign residents (2). * IN JAPAN, the preparation of culturally competent health care providers remains a challenge. Unlike their counterparts in other developed countries, Japanese health care workers have failed to embrace the multifaceted concept of culturally competent health care service. This article reviews contemporary issues in Japan and offers recommendations for strategic educational actions that will improve the ability of Japanese health care providers to offer culturally competent care.

The Culturally Competent Organization The challenges that face health care organizations today include ensuring that quality of care reflects cultural competence (3). Culturally and linguistically competent care contributes to patient safety and ultimately leads to improved health outcomes. When care lacks cultural and linguistic competence, results can include patient misunderstanding and mistrust of treatment procedures, which will possibly lead to misdiagnosis and harm to the patient (3). Patients who expect to face a language barrier and feel disrespected may avoid accessing needed health care services. Among those most affected are patients from marginalized populations such as immigrant and foreign residents (4). To provide patient-centered care that takes patient preferences into account, it is important for health care organizations to ensure that practitioners are prepared to function with cultural and linguistic competence (4,5).

The US Department of Health and Human Services, Office of Minority Health defines the culturally and linguistically competent organization as one in which culturally congruent behaviors, attitudes, and policies foster effective approaches to address cross-cultural, ethical, and legal conflicts in the delivery of health care (4). The office further defines cultural competency for health care organizations as the ability to effectively treat any patient from any cultural background differences (6). This term often refers to groups of individuals from differing racial and ethnic origins but it is much broader. …

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