Report Exchange Program Faculty of Health Sciences
Kobe University, Kobe Japan.
May 9ᵗʰ 2015 – June 6ᵗʰ 2015
Ms. Pataraporn Phonwat---------------------------------------------------------------------------------------------------------In the first orientation class, I was introduced to Kobe University, Faculty of Health and Science andsome information about Health and Nursing System and Education in Japan. After that we meet with theAdministrative Assistant for the Formation of Collaborative Programs with ASEAN Universities. I was given
the information and the purpose of the exchange program and given more information about Health andNursing System and Education in Japan and the registration of becoming registered and license nurse.

In the afternoon, I have the meeting with 4th year students of Nursing. This was my first time meeting
new friends in a big group. Which we have discussed so many topics about nursing, culture, Japan, Thailandand so many others topics. Everybody is very nice and friendly.

In the first lecture class, I have attended the fundamental of nursing and basic nursing skills with 2ndyear students: skills for patient transfer. It was one hour lecture. The lecture was about methods of how totransfer patient by hands, wheels chair, stretcher and also how to use cane, walker, wheals chair. Some of themedical appliances are the same as in Thailand. The first impression of this class is the rolling mattress that
help to move the patient also in the same time also help to reduce low back pain for nurse which I find therolling board interesting and very helpful that's inspirer me to use this idea to be one of my inspiration in thefuture. The ways of Japanese moving and transfer patient method is the nurse and patient are really close up
together and gender equality which is very different from Thailand because it is not usual for Thai's to beclose up so that we will lift the patient up by standing by the side of the patient or use more nurses if neededand in Thailand it is not common for male nurses to be close up with female patient and male nurses can't dosome nursing care if not necessarily or urgent situation.
The Welcome and Introduction to Faculty of Health Sciences (FOH), Kobe University program. I
meet with the dean of Health and Science, Kobe University.

Orientation of community health nurse practice in Japan was about the general information oncommunity health system and situation in Japan. I have learn that Japan have Public health nurse but Thailand
only have community nurse. Also were lecture on maternal and child health care. I have learn that Japan
infants mortality rate have been reducing enormously and also the fertility rate is also declined, too. But theunexpected fact was that number of child abuse have been constantly increasing in high number which I findit was hard to understand. As the factors have been explained it’s become clearer due to the single parenting
and nuclear family, lack of support for children rearing and the change of society.

Study Visit in Community Health Nursing: participation in the community-based exercise program
for the healthy elderly in Awaji Island. It's the first time learning outside of the campus. The program is call"100 years exercise". I was very impressed by the atmosphere of the members in the community. At firsteveryone participate in the exercise program by following the video instructions and follow through the whole
program. As the exercises were demonstrating the instructor were also giving explanation and the benefits andits purpose of each exercise which I find it was very easy and understandable to everyone. After the exercise
program, everyone are gather together and have conversations together. The found that the members are very
welcome and friendly. I have talk to many of the members and they have inspired me in so many things andinspired for my future career path.

In the Study Visit: the Awaji Earthquake Memorial Park in Awaji Island, I was amazed and find it’svery scary at the same time. The Earthquake happens quite regularly in Japan so Japanese people are well
prepared and they are so many useful guidelines of how to coop and prepare for disaster. I tried the earthquake
stimulation, I felt that the earthquake is very terrifying and shocking.
Participation in the lecture for graduate students: International Health Cooperation is very new kindof learning field for me. I have learn about current situation of Japanese ODA education situation and Japanaid to Afghanistan, Afghanistan education research, Kenya education research and reference from Kenya. Its
shows how environment can effect education and health professions can related.

Study Visit in Community Health Nursing: participation in the community-based program formothers and children in Nishinomiya City. I have a great opportunity to observe in the meeting session formother and child or children. The age of the children are less than 18 months old. There are many kind ofactivity example of singing a song, massaging baby, introducing names off the baby and the mother,introducing the living area, questions and answer sessions, exchange baby rearing information, and exchange
problem and solution. From the observation, I found that the program have a benefit for both of the children
and especially for the mothers to spend some time outside of the house and have society supports. Some of themother and join the session have eyes contact with their baby, happy and enjoying the session but some of theother mothers are too tired from take care of the baby and it didn't have eye contact with the baby while doing
the activities. So I think this kind of program is very important and helpful for many mothers.
Participation in the practice on newborn baby care with 3rd year students. I have learned newborn
baby care in Thailand. I founded that the lecturer have the similar ideas but only differences in technique. I
really like that that lecture point that the baby poster arms are in the shape off W and their legs are in theshape of M. I think this tip for remembering to posture off the newborn baby is very helpful and easy toremember. In my experience of learning I have never seen the device for measuring jaundice so it's is very
interesting because it is easier and accurate to define dose is it’s a true jaundice or not.
Participation in the lecture for graduate students: Public Health and Demography. This was also oneof the new kind of learning to me. I have some class that I have learn health in statistics but in this class thelecture topic is about World health statistics 2015. It was very impressive of the up to date information andalso to learn about health internationally. Also participated in the lecture of Migration. The topic was about
the definition of migration and issues of difficulty of gathering information and defining of migrants.

Study Visit: Private Maternity Home 'HINATA' in the community. Its influence me positively formidwife altitude. The environment off the private maternity home is very warm and comfortable with theatmosphere of traditional Japanese house. The nurses are carrying, gave useful consultations and understandthe mother in pregnancy checkup. The private maternity home also provide baby and children care for
inpatient and outpatient, exercise classes for mothers and labor. Also provide home cooked healthy fooddepended upon the nutrition needs.
Lecture of Gerontology Nursing: aging in Japan and Thailand is one of the most interesting topic.
Japan is well known as the supper aging population and Thailand is also becomes aging population. As people
are aging dementia also increase. Dementia is less likely to be detected and cured. The summery to the report
was Thailand nursing student have more experience of taking care of dementia patients but Japanese nurse
would want to take care of dementia patients that Thai nurses. Nurses in Japan have more difficulty of taking
care of dementia patients and wanted more courses for taking care of patients with dementia. Thai nurses are
more interested in obtaining a clinical specialist or citified nurse license of caring elderly with dementia orpeople with dementia.

Participation in the research seminar for graduate students in International Health Department. There
was a presentation from doctoral degree of Nursing. The topic is about Disaster prevention for Japan. It was
about applying American earthquake prevention guidelines for Japanese.

Participation in the lecture for occupational therapist course students: Higher Brain Dysfunction. It's
one of the interesting class. The topic are therapy and recover from higher brain dysfunction. The teacher havesmart idea to use one of the video to show a story of a jogger who had felted of the horse back while he is in
the competition. After the first fall the jogger have brain damage on the right side. Doctors said that hecouldn't be able to continue his career but he rejects the doctor statement and think positively of recoveringfrom the accident. With his positive thinking and many help from health professions especially with the hightechnology of higher brain dysfunction therapeutics he was able to fully recover and continue his career as ajogger again. After a few years after the first accident, the second accident happened the injury was more
severe and there is no hope for him to just even walk because loss of balance control but as a result of hissame positives thinking and therapy he can ride horses again. He have to quit his job as a jogger but hebecome reporter interview joggers in the horse races. I find it was incredible and inspired.
In the afternoon, the lecture for explaining about what is occupational therapist from occupational
therapy student. This class really helps me to understand what occupational therapist is. They show theirintervention for disability utensils on everyday life.
Study Visit in Community Health Nursing: orientation of maternal and child health care services in
Nishinomiya City and Observation of infant health examination in the community health center inNishinomiya City. The health examination was for 3 years old children. The parents come with theirs child tothe community health center. There are three part of the health examination. The first session is meeting withpublic nurse to talk and test the ability of the children. Then go to measure weights and high. After that bodyexamine with pediatric doctor then to see dentist to check their mouth and teeth. After that the nurse will
explain the examination results and the parents can ask and consult with the nurse. If the child have specificneed that the nurse will refer to nutritionist or psychiatric if necessary.
Study Visit: Observation of in-patient ward at Kobe Kaisei Hospital. It's an international hospital inKobe. The hospital is very clean and well organizes. There is an international department and assistance sisterto help and interpret of international patient and visitors. Consist of inpatient and outpatient.

Observation of the private elderly nursing home 'Comfort Hills Rokko'. My first impression of the
Comfort Hills Rokko are the place is enormous, well decorated and do not look like elderly nursing home tome. Each of the elder will have their own privet room. Each floor are different depend of care needed. There
are many rooms, dining rooms, exercise rooms and living room.

Observation of the public elderly nursing home 'Uminohoshi'. The atmosphere of the elderly nursing
home is warm and welcoming. The elderly stay together four person in each room. Each person has their own
space divided equally and share shower room. Some of the room, elders’ together help to decorate the roomsigh and inside the room decors.
Lecture of Psychiatric Nursing: overview of mental health care services and welfare of the personwith mental disorder in Japan. Japan is paying a very high costs of medical care each year. Psychiatric costs isthe 7th rank. Number of psychiatric patients is increasing every year. Outpatient mostly have mood disorderbut inpatient is schizophrenia. Age distribution of psychiatric inpatient in Japan, the proportion of age is 65
and over is half of the total number of patients. Japan provide psychiatric beds more than any other countries.
The current state of psychiatric care in Japan is level of psychiatric care is high but there are excessive
psychiatric beds, too long hospitalization, aging of inpatients, huge amount of psychiatric care expenditures,lack of community life support and lack of social to live with people who have psychiatric disorders. The
suicide in Japan is a very big issue. Japan is ranked as number 5 of the world and approximately 30,000
people in each year. Child abuse in Japan is increasing incredibly from the pass 20 years. Dementia is all so
gradually increase as the aging population.

Study Visit: Disaster Reduction and Human Renovation institution. The institute showcases theexperience and lessons of the Great Hanshin-Awaji Earthquake of 1995, and provide information andresources for building a disaster-resistance society. I have acquire many knowledge about disaster and theprevention from the exhibition, films, and the stories told by earthquake survivors. In the first theater the film
is called “Hit at 5:46”. It is about the tremendous destructive power of the Great Hanshin-Awaji Earthquake.
The next theater is call the great earthquake hall. Documentary film call “Living in this town” showing thetown , the people and the problem faced during the recovery and the reconstruction after the earthquake up tothe present day. The last theater I have visit is call the heart theater. Its show 3D movie call “Scars of aTsunami”, the documentary is about the great east Japan Earthquake and Tsunami.

Study Visit of Kobe University Hospital: Orientation of the visiting of today program and meetingwith the organizer nurse of the today program. After that, the observation of in-patient ward and out-patient
clinic for patients with diabetes. The most interesting thing was that it’s my first time to see automatic insulin
dispenser device. The device is from an American company and the langue is in English, after that Japanbought the license and develop a Japanese software for the device so that everyone can use and understand.
After that, accompanying the palliative care team. The objective is to observe. The team is consist of Doctor,
pharmacies, nurse and medical technologist. One the patient was sleeping and the team didn’t disturb and lets
the patient rest. I was very surprise of how think full and understanding of the team members. Finalobservation is in-patient ward, ICU and operating room. The system is well establish, convenient and portable.
There are so many machine and nurses were preparing and being busy. In the operation room, the place isvery clean and hygienic. There are many kind of operation room for many kind of surgery. There are monitors
displaying the activities and the process of every surgery so the staff can prepare for the next surgery.
I am very thankful for all amazing experience and meet new people.