Factors Affecting Professional Autonomy of Japanese Nurses Caring for Culturally and Linguistically Diverse Patients

኱ศ┴❧┳ㆤ⛉Ꮫ኱Ꮫ኱Ꮫ㝔 Ặ     ྡ   ᱓㔝⣖Ꮚ Ꮫ ఩ ࡢ ✀ 㢮   ༤ኈ㸦┳ㆤᏛ㸧 Ꮫ ఩ グ ␒ ྕ   ➨ 12 ྕ Ꮫ఩ᤵ୚ᖺ᭶᪥   ᖹᡂ 27 ᖺ 8 ᭶ 5 ᪥ Ꮫ఩ᤵ୚ࡢせ௳   Ꮫ఩つ๎➨㸲᮲➨ 1 㡯ヱᙜ⪅

Ꮫ ఩ ㄽ ᩥ ྡ   Factors Affecting Professional Autonomy of Japanese Nurses Caring for Culturally           and Linguistically Diverse Patients㻌

㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌     ከᵝ࡞ᩥ໬࣭ゝㄒ⫼ᬒࢆࡶࡘᝈ⪅ࡢ┳ㆤ࡟࠾ࡅࡿ᪥ᮏࡢ┳ㆤ⫋ࡢ⮬ᚊᛶ࡬ࡢ           ᙳ㡪せᅉ ᣦ ᑟ ᩍ ဨ   ᮧᔱᖾ௦ Ꮫ㛗 ⚟⏣ᗈ⨾ ᩍᤵ Lee So Woo ࢯ࢘ࣝ኱Ꮫྡ㄃ᩍᤵ           ᑠᔱග᫂ ෸ᩍᤵ    ㄽ ᩥ ᑂ ᰝ ጤ ဨ   ୺ᰝ㸸బ఑ᆂ୍㑻ᩍᤵ ๪୺ᰝ㸸㧗㔝ᨻᏊᩍᤵ࣭ྜྷᮧ໶ᖹ෸ᩍᤵ $EVWUDFW 

Objectives: Globalization, which is a worldwide trend, impacts care by nurses as frontline

practitioners. Japanese nurses are also faced with care of patients from diverse cultural

backgrounds with diverse values and beliefs. To promote the quality of patient care, including

better patient outcomes, professional autonomy is an important concept. This study examined

how Japanese nurses perceive their experiences caring for non-Japanese patients, and then

assessed the professional autonomy of Japanese nurses caring for culturally diverse patients and

identified the factors that contribute to this autonomy. The ultimate aim of this thesis is to

provide a basis for promoting and ensuring the provision of high quality care to culturally and

linguistically diverse patients by Japanese nurses.

Study 1: A qualitative exploratory design with a thematic analysis approach was used to collect

and analyze data. Using purposive sampling, 15 (9 Japanese, 6 Korean) nurses who provided

nursing care to culturally diverse patients within the past year were selected. Data were gathered

using semi-structured interviews. The six steps of Braun and Clarke were followed for data

analysis. The following three themes were identified: challenges regarding the care of culturally

diverse patients; important components regarding the care of culturally diverse patients; and

deficiencies in nursing education for culturally congruent care. Japanese nurses had less

experience and provided fewer descriptions than Korean nurses regarding changes in thinking

gained through experience caring for culturally diverse patients, and they also expressed feeling

anxiety when providing care for such patients.

Study 2: A descriptive cross sectional design was used. Participants included 238 clinical nurses

working at 27 hospitals in Japan. The Intercultural Sensitivity Scale, and the Scale for

Professional Autonomy in Nursing were used to measure intercultural sensitivity and

professional autonomy. Stepwise multiple regression analysis was used to identify the most

significant factors affecting autonomy. Professional autonomy of Japanese nurses caring for

non-Japanese patients was significantly lower than when caring for Japanese patients (142.84 vs

172.85 (p<.001). Contributing factors were: intercultural sensitivity (p<.001), length of nurse

experience (p<.05), and availability of interpretation service (p<.05).

Conclusion: Enhancing the professional autonomy of Japanese nurses caring for culturally

diverse patients and improving the quality of care provided requires the establishment of training

programs that promote intercultural sensitivity and transcultural nursing education. Based on

these conclusions, transcultural education should be incorporated at both the undergraduate and

graduate levels in the educational setting, and in continuing education in the hospital setting.

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኱ศ┴❧┳ㆤ⛉Ꮫ኱Ꮫ኱Ꮫ㝔 ࡼࡾࠊ,QWHUFXOWXUDO6HQVLWLYLW\ ࡸ␗ᩥ໬య㦂࡞࡝ࡢせᅉࡀࠊእᅜேᝈ⪅ࡢ┳ㆤ࡟࠾ࡅࡿ⮬ᚊᛶ࡜ ࡝ࡢࡼ࠺࡟㛵㐃ࡋ࡚࠸ࡿ࠿ࢆከᵝ࡞ศᯒ࡟ࡼࡾ᫂ࡽ࠿࡟ࡋࡓ㔞ⓗ◊✲࡛࠶ࡿࠋࡉࡽ࡟ࡇࢀࡽࡢ⤖ᯝࡼ ࡾࠊእᅜேᝈ⪅࡟㉁ࡢ㧗࠸ࢣ࢔ࢆᥦ౪࡛ࡁࡿ┳ㆤ⫋⫱ᡂࡢࡓࡵࡢᩍ⫱ࡢᅾࡾ᪉࡟㛵ࡋ࡚⪃ᐹࢆຍ࠼࡚ ࠸ࡿࠋ  ᫂☜࡞┠ⓗ࡜༑ศ࡞ㄽ⌮ᛶࢆᣢࡘㄽᩥ࡛࠶ࡿࡀࠊㄪᰝ࡟࠾ࡅࡿࠕእᅜேࠖࡢᐃ⩏࡟ࡸࡸ₍↛࡜ࡋࡓ 㒊ศࡀṧࡉࢀ࡚࠸ࡿⅬࡸࠊ㉁ⓗ◊✲ࡢศᯒࡸᮏேࡀ᪥ᮏㄒ໬ࡋࡓ ,QWHUFXOWXUDO6HQVLWLYLW\ ᑻᗘࡢ ศᯒࡣࠊ௒ᚋࡢࡉࡽ࡞ࡿ᳨ウࢆᮇᚅࡍࡿࡶࡢ࡛࠶ࡿࠋࡇࢀࡽࡢⅬࡣᣦ᦬࡛ࡁࡿࡶࡢࡢ⥲ᣓ࡜ࡋ࡚ᮏ◊ ✲ࡣࠊࢢ࣮ࣟࣂࣝ໬ࡋࡓ♫఍࡟࠾࠸࡚እᅜே࡟ᑐࡋ࡚ࡶࢣ࢔ࡸ஺ὶࡀ࡛ࡁࡿ┳ㆤ⫋ࢆ⫱ᡂࡍࡿ㔜せᛶ ࡜᪉⟇࡟ࡘ࠸࡚ࠊⰋ㉁ࡢ࢚ࣅࢹࣥࢫࢆࡶࡓࡽࡋࡓࡶࡢ࡜ホ౯ࡍࡿࠋ  ௒ᚋࡶࠊ᪥ᮏ࡟࠾ࡅࡿᅜ㝿┳ㆤᏛࡢⓎᒎ࡟ᐤ୚ࡍࡿ◊✲ࢆ᥎㐍ࡋࠊ࢚ࣅࢹࣥࢫࢆ✚ࡳ㔜ࡡࡿࡇ࡜ࢆ ᮇᚅࡍࡿࠋ