Japanese People

Transcultural Nursing

Is all that white powder

good for the skin?

Take a closer look: Children, Food, Lifestyle, and

Tragedy

Primary values of the group

4 key themes:■ Memorialism■ Respect■ Fear of impurity■ Safety and

security“konichiwa”

Ways of living, language, and habits■ Life goals are often to live a self-sufficient

and successful life with a respected and honored reputation.

■ Japanese is the major language which uses kanji utilized and adapted from the silk road

■ Nursing Advice: some common habits are long train commutes, working overtime, not using air conditioner (mostly in elderly)

Traditional perceptions of health and illness

■ Belief and consultation in medicinal, alternative, and religious therapies

■ Anxiety over Yakudoshi-years of life when one is thought to be especially susceptible to illness or misfortune

■ Collective thinking-each person’s success benefits the whole

■Traditional healing methods include various therapies: acupuncture, shaman, religious, medicinal, chiropractic, fortune telling...

Rituals associated with birth & death/dying

■ Importance of ceremonies and spirits for healing and passing of the dead

■ Death rituals and importance of memorializing ancestors ‘senzo’ are the foundational pillars in the top two religions: Shinto and Buddhism

Use of advance directives, informed consent, and client

autonomy ■ All used very steadily in Japan■ High importance placed on patient’s

being incorporated in the decision process and deciding for themselves on the best plan of action

■ Collective thinking decreases client autonomy and it relies on the medical professionals to encourage individual questions and ideas

Nutrition and Diet

■ Low concentration of fat■ Various fermented food options: natto,

miso, kombucha, and vinegared foods■ Small amounts, frequent meals■ Focus on diverse foods - goal to eat at

least 32 different types of food a day for health

■ White rice is a staple food and has been increasing the rate of diabetes in the population

Religious influences impacting health and illness■ Collective thinking-

– What’s better for the group?■ A sin and shame society

– Moral and social order is maintained by social pressure and fear of ‘losing face’ publicly. this moral and social control is preserved through the avoidance of shame, whether that shame is for the individual, the family or the institution to which the person belongs.

Hearing about and discussing negative health information

■ Japanese are very willing to discuss health information and even to hear the negative parts as well.

■ The harder part is that they may not be willing to share negative information. – People’s goals are usually to be self-

sufficient (not a burden), so any problem could be thought of as burdening the other person. ▪Nursing Advice: Open communication

needs to be continually encouraged to prevent this issue.

Perceptions of time, orientation, family roles, and gender issues

■ Decisional authority has typically been placed on the man. However, as marriages and families have lessened women are often involved in the decision making process as well.

■ Women and men are both well equipped in school and given equal opportunity within the workplace.

■ Conversation is less blunt and often ‘steps around the subject’ for politeness.

■ Nursing Advice: Questions need to be asked appropriately to provide with truthful responses

Child rearing practices

■ Childhood is seen as having merit and value

“In fact, Chen points out that in Japanese, the word for cultivating a person is the same as that for cultivating plants. The development of children is analogous to the cultivation of a tree that first begins with the seedling. As the tree grows, the grower’s care is needed in the trimming of its branches and leaves to enable it to grow in the right direction. However, care must also be taken to let the plant’s own “inner tendencies” unfold before such shaping is initiated. Shaping should not be started too early. The parent is essential in starting the child off in the “correct” direction, by providing the proper education, as the child is ready.(Chao, 2002)”

Summary of relationship to the nursing profession

■ Exercise is made a priority- obesity and weight-related disorders are not as prevalent

■ Diet is overall healthier but high in sodium- increase in seafood and pickled foods

■ Mental health is problematic in the cities mostly- increased work stress and an individualistic, quiet society

■ Nursing Advice: Connecting the people to a community helps improve their mental and physical health.

Implications for nursing practice

■ Dietary practices / role of food in health & illness

■ Chronic/Acute disease issues■ Healthcare access■ Governmental Healthcare (Native

Americans■ Insurance

Legal and ethical standards and professional accountability related to health care and safety of the culturally diverse

client

1. What ANA Scope of Practice Standards apply to culturally competent care?

2. What about the new legislation many states including Indiana are pushing through to mandate culturally competent care?

Works CitedVarley, H. P. (2000). Japanese culture. University of Hawaii Press.Ogasawara, C., Kume, Y., & Andou, M. (2003, September). Family satisfaction with perception of and barriers to terminal care in Japan. In Oncology nursing forum (Vol. 30, No. 5, pp. E100-E105). Oncology Nursing Society.Davies, R. J., & Ikeno, O. (Eds.). (2002). The Japanese mind: understanding contemporary Japanese culture. Tuttle

Publishing.Oyama, H., Watanabe, N., Ono, Y., Sakashita, T., Takenoshita, Y., Taguchi, M., ... & Kumagai, K. (2005). Community based suicide prevention through group activity for the elderly successfully reduced the high suicide rate for females. Psychiatry and clinical neurosciences, 59(3), 337-344.Szanto, K., Kalmar, S., Hendin, H., Rihmer, Z., & Mann, J. J. (2007). A suicide prevention program in a region with a very high suicide rate. Archives of General Psychiatry, 64(8), 914.Lands, W. E., Hamazaki, T., Yamazaki, K., Okuyama, H., Sakai, K., Goto, Y., & Hubbard, V. S. (1990). Changing dietary patterns. The American journal of clinical nutrition, 51(6), 991-993.Lewis, D.C. (1993). The Unseen Face of Japan. Monarch Publications: England.Chao, R., & Tseng, V. (2002). Parenting of Asians. Handbook of parenting, 4, 59-93.Omi, S. (2005). Challenges for Family Physicians in the 21st Century.Japanese Journal of Primary Care, 28(4), 284-294.

The Gaijin Toolkit

How NOT to feel and act like a tourist while in Japan. Make the most of every moment in the

land of the rising sun.