The purpose of this study is to describe issues in use of interpreters when Brazilian residents have an access to the medical care services in Japan. Focus groups were undertaken with three groups of eighteen Brazilian residents in Shizuoka prefecture. Data analysis drew upon the principles of summarizing content analysis.
The participants' proficiency in Japanese language varied; six were intermediate level, eight were basic level, and four were unable to communicate in Japanese. Ten of them used interpreters at medical care services. Those interpreters were usually ad hoc, untrained individual such as members of the family, friends, or outsourced personnel. Summarizing content analysis revealed three themes as follows: When using ad hoc interpreter; The interpreter may omit, add, or substitute some words/phrases therefore the interpretation may be inaccurate. The interpreter may not understand the medical terms because those terms are not used daily. Absence of trained medical interpreters at medical facilities; It is tedious to find an interpreter. The patient cannot provide sufficient information to a physician, nor can he/she understand what a physician explain, nor know the effect/side effect of the medicine. Measures to improve the communication between Brazilian patients and physicians; The presence of a hospital interpreter would be essential. Written notes are highly appreciated.
Communication barriers between a physician and a patient can be seen regardless of the presence of an interpreter. It is important to tell the interpreter to interpret a word/phrase uttered by both a patient and a physician accurately and to explain to him/her of the importance of privacy protection in advance. It is also suggested that a physician needs to avoid to use the technical terms, explain in words which could easily be understood by a patient or give notes to a patient so that there will be a better communication between a physician and a patient.

　Physician–nurse collaboration is essential for realizing the team approach to health care. The current status of this collaboration must be examined from the viewpoints of both physicians and nurses. The present study, part of a larger study, aimed to translate the Jefferson Scale of Attitudes toward Physician–Nurse Collaboration （JSAPNC）, developed by Hojat et al. （1999）, into Japanese and to assess the attitudes of physicians and nurses toward collaboration in Japanese hospitals.
1）A self–administered questionnaire survey was distributed to 520 physicians and 2139 nurses at 4 hospitals in 4 prefectures, and valid responses were received from 51.0％ of physicians and 76.2％ of nurses.
2）Factor analysis revealed that the factorial structure of the Japanese version of the JSAPNC was different from that of the original version. The Cronbach’s alphas of the scale were 0.79 for total scores and 0.5 to 0.7 for subscales.
3）The total score on the JSAPNC was higher for nurses than for physicians. No demographic characteristics of physicians were correlated with their total scores on the JSAPNC. In contrast, nurses’ age, length of clinical experience, qualifications, position, and affiliation were correlated with their total scores on the JSAPNC.
4）The total score on the JSAPNC could be used to compare the attitudes towards collaboration of physicians and nurses between Japan and other countries. The results show that the total score on the JSAPNC of our subjects in Japan was lower than those in previous studies in other countries. Education for facilitating and evaluating collaboration is needed.
5）Further investigation of factors related to physicians’ attitude toward collaboration is required. For nurses, it is necessary to investigate factors related to their attitude in combination with organizational factors.