Objectives  There are only a few quantitative studies focusing on religious and cultural barriers among non-Japanese-speaking patients and discussing the association in Japanese healthcare institutions. This study aims to clarify the association between the religious and cultural backgrounds of non-Japanese-speaking patients and their difficult experiences in the healthcare institutions.Methods  The Google Forms questionnaire survey was conducted in four languages (Plain Japanese, English, Chinese, Vietnamese) among non-Japanese-speaking patients who had visited a Japanese healthcare institution. Of the 376 respondents (response rate: 19.7%), 350 were included in the analysis while excluding invalid responses. The association between their religions and difficulties were examined by logistic regression analysis with putting their gender, age, Japanese language proficiency, the purpose of visit and the way to communicate in examination rooms as adjustment variables. Results  237 (67.7%) had no religion, 29 (8.3%) were Christian, 12 (3.4%) were Muslim, 22 (6.3%) were Hindu and 50 (14.3%) were Buddhist of those analyzed. Odds ratios for experiencing difficulties were significantly higher for Hindu (odds ratio ［95% confidence interval］＝6.35［1.51-26.77］) and Christian (3.67［1.27-10.61］) compared with those who do not have religion. Regarding difficulties, it was found that the half of Hindu respondents identified “food” (50%) indicating a religious and cultural background, while various difficulties were identified for Christian respondents including “religion” (22%), “culture” (22%), and “medical costs” (22%).Conclusions  This study demonstrated an association between religion and difficulties in Japanese healthcare institutions among non-Japanese patients with a large proportion of outpatients. It was observed that Christian and Hindu respondents were more likely to have difficult experiences in the healthcare institutions. The results of this study suggest a need for religious and cultural consideration in outpatient settings such as the use of healthcare interpreters and the practice of transcultural nursing by medical professionals.

A forties year-old female visited our hospital on March 2011, complaining chest discomfort. Computed tomography (CT) revealed a huge mass in the anterior mediastinum combined with multiple masses in the lungs, the uterus and the bone. Since no abnormal shadow had been noticed on the chest radiograph on January 2011,they seemed to have grown very rapidly in a short period. The pathological diagnosis following needle biopsies of mediastinal and uterine cervix tumors was undifferentiated carcinoma of the thymus metastasizing to the uterus. She was also suffering from the pain on the right femur and intermittent hypogastralgia due to metastases to the bone and uterus. Although NSAIDs and oxicodone relieved the pain on the right femur, they could not significantly reduce the hypogastralgia. Judging from the nature of the frightful hypogastralgia, the cause was estimated to be not somatalgia but splanchnodynia. Ritodorine hydrochloride, which was then adnimistered for the purpose of inhibiting the contraction of the uterine, was remarkably effective in reducing the pain. According to the literatures reviewed concerning metastases of the extrapelvic malignant tumors to the uterus, the median survival period after occurrence of metastases was 14 months. This report suggests that the administration of Ritodorine hydrochloride can keep the quality-of-life of these patients without suffering from the pain due to metastatic tumor to the uterus.

Case: A 40-year-old woman. Clinical diagnosis: Autistic disorder with mild mental retardation. Case report: The patient underwent pancreaticoduodenectomy for the treatment of her pancreatic cancer. We held several conferences with individuals from different medical fields and examined the influence of the patient's autistic disorder on the perioperative conditions. The senior author, a clinical psychologist, conducted repeated individual, acceptive, and sympathetic interviews with the patient and her family and maintained supportive relationships with them as an honorary family member. Thus, the clinical psychologist helped reduce the patient's anxiety about the medical treatment. Conclusion: The participation of a clinical psychologist in the medical conferences enabled the medical staff to understand the complications involved and provide mental support to the patient and her family. Palliat Care Res 2010; 5(2): 323-326