In the Pacific island states, in addition to the traditional health issues common in developing countries, such as maternal and child health and communicable diseases, the increase in noncommunicable diseases (NCDs), e.g., obesity and diabetes, has become a serious problem. NCDs account for 80% of all deaths in this region, and the increase in early deaths of people younger than 70 years old is of particular concern. It has also been pointed out that the cost of countermeasures against NCDs are constricting government finances, and enhancing a health system that supports such countermeasures is also an urgent challenge. However, with respect to international health cooperation in Japan, the present status of NCDs and the associated statistical data in the Pacific island states are not likely to be addressed. Therefore, in this report, we comprehensively explain the present status of and approaches to NCDs around the world based on the World Health Organization (WHO), including those in the Pacific island states. By taking advantage of health indicators, we confirm the disease structure present in the 10 Pacific island states that cooperate bilaterally with Japan and then discuss the approaches in these states. As a result, although countermeasures against NCDs have been actively implemented in the Pacific island states in accordance with the WHO strategies, no tendency for the prevalence of NCDs to improve has been seen. To promote countermeasures against NCDs in the Pacific island states in the future, it will be necessary to engage in analysis and discussion of the present situation, to develop human resources, taking into consideration the region-specific characteristics of the islands, and to accumulate sufficient numbers of successful local stories consistent with the local strategies.

Introduction

  This study focused on the many foreign reproductive-age women living in Nagasaki and Sasebo city, and aimed to reveal the elements of “communicative competence in providing perinatal care for foreign women” as thought necessary by nurses and midwives engaged in perinatal care in Nagasaki prefecture.

Methods

  A self-administered questionnaire was posted to 207 nurses and midwives working in 10 out of the 25 medical institutions which provide obstetric services in Nagasaki and Sasebo city of which consent to research cooperation was obtained. The questionnaire consisted of basic demographic information, questions specific to foreigners and 38 questions relating to “communicative competence in providing perinatal care for foreign women”. The questions were to be answered on a scale of 1 to 4: “1-not at all necessary”, “2-not very necessary”, “3-somewhat necessary”, and “4-very necessary”, and were analyzed by factor analysis.

Results

  141 out of 207 nurses and midwives responded to the questionnaire (response rate 68.1%), of which 120 were valid for analysis (valid response rate 58.0%). 111 out of the 120 (92.5%) were experienced in perinatal care for foreign women . Among the 38 questions relating to “communicative competence in providing perinatal care for foreign women”, responses to 36 questions scored an average of 3.0 points or higher. Factor analysis on the responses to these questions revealed the following eight elements: “cross-cultural understanding“, “resource utilization”, “problem solving”, “cross-cultural respect”, “verbal communication”, “non-verbal communication”, “self-cultural understanding”, and “preparation for delivery”.

Conclusions

  Nurses and midwives engaged in perinatal care in Nagasaki and Sasebo city recognize eight elements of “cross-cultural understanding”, “resource utilization”, “problem solving”, “cross-cultural respect”, “verbal communication”, “non-verbal communication”, “self-cultural understanding”, and “preparation for delivery”, as the necessary “communicative competence in providing perinatal care for foreign women”.

Objectives

  This study analyzes Japanese nursing students’ perceptions before and after completing an international nursing practicum (INP) to clear significance and educational effect of practicum in international nursing.

Methods

  We conducted an anonymous, self-administered questionnaire survey for students participating in an INP, including practicum in developing countries, using qualitative and quantitative methodologies.

Results

  In total, 67.0% students completed the pre-practicum questionnaire and 28.4% completed the post-practicum questionnaire. Students interested in international nursing before and after were 54.5% and 59.3%, respectively. Those who perceived benefits from attending the INP for their future nursing activities (benefits) were 88.0% and 85.2%, respectively.

  In perceptions regarding international nursing, the following four items were significantly higher: “characteristics and diversity of society and culture affecting health,” “understanding of the Japanese health and nursing system,” “understanding of the world health and nursing system,” and “characteristics and diversity of society and culture affecting nursing.” In the perceptions regarding overseas practicum, the following three items included in expectation and achievement were significantly higher: “understanding the effect of society and culture on nursing,” “unable to experience this in Japan,” and “building up relationships with Vietnamese students and teachers.” All significant items included in anxiety were lower. “Language (English) skills” included in preparation was significantly higher. The basis for benefits before and after INP was extracted from six and five categories, respectively. Four categories, i.e., “personal growth,” “cultivation of an international perspective,” “forming views on nursing,” and “preparation for inter-state globalization” were the same for both. The benefits were related to willingness to perform international activities, achievement, and meaningfulness of overseas practicum.

Conclusion

  The results suggest that INP is an effective educational method for basic nursing education, moreover, to foster internationalism. One needs to understand the readiness of students and take their anxieties into consideration, particularly for overseas practicum.

Objectives

  The aim of this study was to investigate the knowledge, attitude, and practice (KAP) of healthcare providers regarding the utilization of oxytocin for induction or augmentation of labor.

Methods

  A qualitative study composed of direct observation and individual interview was conducted at a national tertiary maternity hospital in Phnom Penh, Cambodia in January and February 2013. The progress of labor in women who received oxytocin for induction or augmentation of labor was directly observed to confirm the healthcare providers’ management of oxytocin infusion. The attending doctors and midwives were individually interviewed after the women delivered.

Results

  During the study period, 10 women were observed, and 12 healthcare providers (three doctors and nine midwives) were interviewed individually. Indications for labor induction or augmentation seemed to be appropriate for nine women. However, we found discrepancies between the national protocol and healthcare providers’ knowledge and actual practices. For example, 11 healthcare providers had never read the national protocol for the management of labor induction and augmentation, which implied limited access to the correct knowledge. A misconception was noted in that the sudden increase of oxytocin was not dangerous during the second stage of labor, despite the establishment of a good contraction pattern. Furthermore, a lack of unified initial dose and extremely high maximum dose above that recommended by the national protocol were observed. About half of observed women were not monitored for more than 2 hours from the beginning of oxytocin infusion.

Conclusion

  　In the present study, lack of knowledge, misconceptions regarding the management of oxytocin infusion, and a large gap between the national protocol and the actual clinical practices were confirmed. To maximize patient safety and therapeutic benefit, dissemination of the national protocol through in-service training is required.

Objectives

  The purpose of this research is to reveal the organizational citizenship behavior (OCB) of Indonesian nurse candidates at hospitals in Japan.

Methods

  Data were gathered through semi-structured interviews with 13 nurses that worked at hospitals in Japan. The results were analyzed using coded categorization.

Results

  All respondents have OCB in their work place in Japanese hospitals.The research focuses on specific OCB roles and the data was classified into the following 4 categories. (1) nursing care support for other nurses, (2) work place hygiene, (3) preparation for work duties, and (4) maintenance of medical equipment. In addition, in Indonesia the respondents have roles such as “preparation for work duties other than nursing” and “education of other nurses”.

Conclusions

  The paper concludes that Indonesian nurse candidates have the same OCB in their work place as Japanese nurses. However, the scope of their OCB in Japanese hospitals is limited because they cannot work as registered nurses in Japan. The findings suggest that in order to improve and expand the OCB of Indonesian nurses working in Japanese hospitals, it is necessary to not only allow them to work as registered nurses but also to ensure that they continue to work in the same employment conditions as Japanese nurses.

Introduction

  In Sri Lanka, there was ethnic violence in the form of armed conflict that lasted 26 years from 1983 through 2009. The conflict between two ethnic groups were bogged down by terrorism or by foreign military intervention. It destroyed the life of inhabitants and it is thought to have inhibited the health and growth of children.

  A case study was conducted in Sri Lanka to establish the effects of the armed conflict on children’s health, soon after the conflict ended. The case study was aimed at using the result for planning health administration.

Methods

  400 participants aged 12 and above were selected from 10 schools of two out of 11 Divisional Secretariat Divisions in Trincomalee District in Sri Lanka. 10 schools were classified into two DS Divisions, severely devastated and less devastated. Each participant was assessed, using anthropometric techniques and questionnaires including GHQ-12.　Reliability of the questions was confirmed through back translation and the use of an English-Tamil questionnaire. The mean values of the anthropometric measurements, the mean values of score by factor analysis of GHQ-12 response, and various items of social environment were compared between the two regions. These different significances were tested using F-test, t-test and Chi-square test.

Results

  　In comparisons between two regions, body weight, height and BMI among participants in severely affected region were significantly lower. Additionally, susceptibility to infectious and endemic diseases in severely affected were significantly increased.

  Four characteristics of mental health were identified, but there was no significant difference about the state of depression between the two regions.

Conclusion

  Children in conflict zones are susceptible not only to malnutrition, but also infectious diseases caused by unhygienic living conditions. The application of simple anthropometric techniques and relevant knowledge and food distribution are important in evaluating and responding to these children’s health problems.