Objectives  The objective of this study was to investigate the needs and motivation of nurses regarding training on how to take care of foreign patients at hospitals and to explore related demographic factors.Methods  A questionnaire was distributed to all nurses working at two hospitals in Tokyo, one university and one general, using Google form. The needs and contents of training they would like to participate were summarized using descriptive statistics. Fisher’s exact test, t test, Mann-Whitney U test and Spearman’s correlation coefficients were used to analyze related factors. Results  Responses of 138 nurses were analyzed (98 university and 40 general) with a response rate of 11.3%. More nurses in the university hospital held a bachelor’s degree and higher subjective English ability than the general hospital. In both hospitals, 59.7% answered that they “strongly feel” or “feel” stress/anxiety in dealing with foreign patients and 77.5% answered that training is necessary.   “Language training” was felt most necessary, followed by training regarding “different cultures and religions.” In regard to language training, “daily conversation” was most necessary, followed by “technical terms”; English being most necessary, followed by Chinese. Approximately one-fourth of participants (24.6%) answered in the affirmative for attending such training by adjusting their private schedules and 59.4% answered they only wanted to attend if it fits into their schedule.   Nurses who answered, “unable to speak English”, had a higher desire to improve their ability to take care of foreign patients; also, those who had higher stress/anxiety felt it was necessary to attend the training. Participants who had been studying a foreign language showed higher motivation.Conclusion  Daily conversation in English was felt most necessary regarding training to care for foreign patients. Training during work hours rather than on private time was preferred.

AbstractObjectives  To explore factors related to difficulty in caring for foreign patients among Japanese nurses.Methods  A self-administered online survey was conducted with nurses working in a university hospital and a general hospital in Tokyo using Google Forms. The survey involved participants’ demographics, including language ability and international experiences, and 16 questions on difficulty in caring for foreign patients.Results  A total of 138 nurses completed the survey (response rate of 11.3%). The average nursing experience was 14.1 (±10.6) years, and 50% of the participants had a bachelor’s degree. The higher-difficulty items were predominantly related to communication, followed by insurance or payment. The most difficult item was “communication in a language other than English,” but no factor was associated with it. The path analysis showed that “being able to speak a foreign language” was directly and significantly associated with a lower total difficulty score (β＝−0.313, p＝0.011). Higher educational degree was associated with higher “self-evaluated English level” (β＝0.282, p<0.001), which was associated with “being able to speak a foreign language” (β＝0.396, p<0.001). Higher educational degree was also associated with “international experiences (study)” (β＝0.161, p＝0.044), which was associated with both “self-evaluated English level” (β＝0.256, p<0.001) and “being able to speak a foreign language” (β＝0.286, p<0.001). Lower educational degree was associated with more nursing experience (β＝−0.454, p<0.001), which was associated with a higher “number of foreign patients cared for” (β＝0.291, p<0.001) but not with lower difficulty. Although “international experiences (sightseeing)” was highly correlated with “international experiences (study)” (β＝0.338, p<0.001), sightseeing was not significantly related to higher “self-evaluated English level” or lower difficulty. Conclusion  Learning foreign languages, including English, and international study experiences could reduce difficulty in caring for foreign patients. An intervention study that evaluates the effect of training that includes a language aspect on caring for foreign patients may be necessary.

In 2021, the National Institute of Infectious Diseases, Japan, undertook enhanced event-based surveillance (EBS) for infectious diseases occurring overseas that have potential for importation (excluding coronavirus disease 2019 [COVID-19]) for the Tokyo 2020 Olympic and Paralympic Summer Games (the Games). The pre-existing EBS system was enhanced using the World Health Organization Epidemic Intelligence from Open Sources system and the BlueDot Epidemic Intelligence platform. The enhanced EBS before and during the Games did not detect any major public health event that would warrant action for the Games. However, information from multiple sources helped us identify events, characterize risk and improve confidence in risk assessment. The collaboration also reduced the surveillance workload of the host country, while ensuring the quality of surveillance, even during the COVID-19 pandemic.

The establishment of enhanced surveillance systems for mass gatherings to detect infectious diseases that may be imported during an event is recommended. The World Health Organization Regional Office for the Western Pacific contributed to enhanced event-based surveillance for the Tokyo 2020 Olympic and Paralympic Games (the Games) by using Epidemic Intelligence from Open Sources (EIOS) to detect potential imported diseases and report them to the National Institute of Infectious Diseases (NIID), Japan. Daily screening of media articles on global infectious diseases was conducted using EIOS, which were systematically assessed to determine the likelihood of disease importation, spread and significant impact to Japan during the Games. Over 81 days of surveillance, 103 830 articles were screened by EIOS, of which 5441 (5.2%) met the selection criteria for initial assessment, with 587 (0.6%) assessed as signals and reported to NIID. None of the signals were considered to pose a significant risk to the Games based on three risk assessment criteria. While EIOS successfully captured media articles on infectious diseases with a likelihood of importation to and spread in Japan, a significant manual effort was required to assess the articles for duplicates and against the risk assessment criteria. Continued improvement of artificial intelligence is recommended to reduce this effort.