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Relationship among the nursing practice environment, occupational career, and work engagement of Chinese nurses employed in Japan: A cross-sectional study

Yang, Yuchun 大阪大学

2023.12.01

概要

Japan’s 2006 Plan for Promoting Regulatory Reform and Opening to the Private Sector allowed nurses who had graduated abroad
to appear for the Japanese National Nursing Examination through the Ministry of Health, Labour and Welfare’s certification of
eligibility. In 2008, Japan began accepting foreign nurse candidates under a bilateral Japan-Indonesia Economic Partnership
Agreement, followed by the Japan-Philippines and Japan-Vietnam Economic Partnership Agreement in 2009 and 2014, respectively
(Ministry of Health, Labour, and Welfare, 2019). Furthermore, private organizations also began employing nurses from China and
other Asian countries through intermediaries (Kamimoto, 2013). For example, the Nurture Organization of International Medical
Welfare Human Resource was established in 2012 and trains an average of 97 Chinese nurses working in Japan per year (What is the
Nurture Organization of Human Resources, n.d.). However, the number of foreign workers with only a nursing-related qualification is
unknown. According to residence status statistics from the Japanese Ministry of Justice, December 2018 ‘Medical,’ the majority of the
1500 Chinese residents in Japan are employed as nurses (Ishikawa, 2019). Although the number of Chinese nurses working in Japan
has been increasing, research on Chinese nurses employed in Japan is scarce.
Owing to differences in culture and nursing practice, Chinese nurses in Japan experience numerous difficulties in the workplace.
Researchers previously revealed that Chinese nurses were confused about when to speak, even when they could speak Japanese (Bu,
2017). Additionally, Japanese nurses provided daily and medical care for patients, whereas in China, nurses relied on the patients’
families to provide daily care, such as feeding and toilet assistance, and nurses provided medical care (Zhou, 2014). Therefore, Chinese
nurses must adjust their perceptions of nursing roles while working in Japan. Further, nonverbal communication is a characteristic
tendency in Japanese culture, especially in clinical situations. Nurses and medical staff, as well as the patients and their families, tend
to "guess" the patients’ feelings and thoughts without uttering a word (Ishigaki et al., 2008).
Chinese nurses who have difficulties in understanding Japanese find it even harder to understand this type of nonverbal
communication (Lin, 2017). Thus, Chinese nurses are unable to form relationships with patients and colleagues and easily fall into
isolation. Moreover, in Japanese culture, individuals pay more respect to seniority, hierarchy, and authority (Healee and Inada, 2016).
Since Chinese nurses are unfamiliar with the culture, they experience problems in communicating with patients and colleagues. Prior
research revealed that Chinese nurses expressed their thoughts to their preceptors directly when they thought that their preceptors had
teaching issues and that this direct expression caused the Japanese preceptor to feel shocked and cry (Gong, 2020). These differences in
communication style and culture may cause friction between Chinese nurses in Japan and their colleagues and patients. This friction
also causes stress for these nurses.
Although the number of Chinese nurses working in Japan is increasing, research on their psychological conditions while working in
Japan is lacking. Recent studies shifted their focus from psychological distress to positive emotions at work, especially on work
engagement. Hence, we focused on work engagement, a positive psychological state, rather than a negative aspect, such as stress. Work
engagement is defined as a positive work-related state of fulfillment that is characterized by vigor, dedication, and absorption
(Schaufeli et al., 2006). Work engagement influenced nurses’ quality of care (Dong et al., 2020) and job satisfaction (Keyko et al.,
2016), promoted innovative behaviors (Wang et al., 2019; Yang et al., 2019), and decreased turnover intentions (Cao and Chen, 2021;
Wan et al., 2018a). From these studies, we inferred that increasing work engagement could benefit individual nurses and organizations
as a whole. ...

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