No. 5

Presented by International Research Institute in Cross-Cultural Nursing (IRC)of Nagano College of Nursing (NCN)

Active Members of IRC in the Year 2007

Greetings
I feel so happy to bring this International and Cross-Cultural Nursing Newsletter 5th Anniversary Special Edition toyou. This newsletter contains summarized entire back issues and reports on activities and events done in the school year of
2007. Tracing back through its history, IRC was originally established as an independent center of NCN in the year 2002.
After that, we started with a new organization as one of the institutes, because NCN restructured existing two centers ofthat time including IRC into one single center. In 2003, which was the first year of the new organization, Asia-PacificRegional Conference on Collaboration in Cross-Cultural Nursing titled "Windows on the World" was held. At the conference,
many nursing leaders and researchers from the Asia-pacific regions assembled at NCN campus, and vigorous discussions on
issues related to nursing were conducted. Five years have passed very quickly. Some research projects and exchanges
evolved with this conference as a start and still continue to date. Student exchange programs with National University of
Samoa, University of California San Francisco, and University of San Francisco have been held every year, and therelationship between NCN and these universities is getting closer and closer. Of course, we have achieved new relationships
for the past five years. Looking back on the year of 2007, it was no exaggeration to say that it was a year of China. We hadguests from China Medical University (CMU) in July and in November, and a guest researcher from Hong Kong Polytechnic
University in July. In September, some of our BScN students visited CMU for about one week, and they had wonderfulexperiences with nursing and medical students at CMU. From May to June, ICN conference was held in Yokohama, Japan.
Not a few faculty members and students took part in the conference, and many papers of NCN researchers were presented
at the conference. Moreover, we planned NCN get-together there and many people associated with NCN sat around the tableand enjoyed a pleasant lunch.
I hope such network will develop more than ever, and the activities of IRC will contribute to enhancement and deepeningof our mutual understanding. If you flash an idea into your mind to realize that reading this newsletter, please feel free tocontact us.
Jukai Maeda, Director of IRC

Table of Contents
I. IRC Activities from 2004 through 2007 ………………………………………………………………………………………………………… 2
1. Collaborative Study with the National University of Samoa (NUS) …………………………………………………………………… 2
2. Health Promotion Project for Foreign Residents …………………………………………………………………………………………… 3
3. Exchange Program with University of California, San Francisco (UCSF) and University of San Francisco (USF)………… 5
4. Promotion of Academic Exchange with Chinese Universities ………………………………………………………………………… 8
II. International Collaborative Activities at NCN from 2004 through 2007 ……………………………………………………………… 9
1. Undergraduate and Graduate Education……………………………………………………………………………………………………… 9
2. NCN Hosted International Colleagues ……………………………………………………………………………………………………… 12
3. IRC-Related Papers and Presentations ……………………………………………………………………………………………………… 13
III. Miscellaneous International Activities of IRC Members from 2004 through 2007 ……………………………………………… 15
Words, words, words. - Letters from Members ………………………………………………………………………………………………… 19
Officers and Members of IRC (stand 2007) ……………………………………………………………………………………………………… 20
About IRC ……………………………………………………………………………………………………………………………………………… 20−1−

I. IRC Activities from 2004 through 2007
1. Collaborative Study with the National
University of Samoa (NUS)

Collaborative Study with NUS in 2004
The collaborative study between NCN and The National University of Samoa (NUS) was carried out as a JICA funded
project in the form of two training courses for NUS teachers
and the dispatch of experts. The first training course opened
from 24 July 2004 to 7 August 2004 with NUS lecturers, Ma
Fulu Aiolupotea Fiu and Murray Faresa, as participants. IRC
members, Tagaya, Maeda, Uchida, Matsuzaki, and Kuroyanagi,in cooperation with non-IRC members Profs. Akio Kitayama,and Hideshi Nawa, held workshops for the study of children's
lifestyle and both quantitative and qualitative methods fornursing research. The second training course opened from 19
February 2005 to 4 March 2005 when Fulisia Pita-uo Aiavao,
Dean of Faculty of Nursing and Lecturer Eseta Hope camethrough the Chubu International Airport just after it opened.
A workshop for summarizing the study of children's lifestyleand that on fundamental statistics for nursing research were
held by IRC members Tagaya, Uchida, Maeda, Tanaka, andKuroyanagi in cooperation with a non-IRC member Prof.
Kitayama. The plan for the future was also discussed. The
dispatched experts were Tagaya, Uchida, and Tanaka. They
visited NUS from 29 November 2004 and came back on 11
December 2004 and had a workshop on the interpretation anddescription of the results of the analyses of children's lifestyledata.
(Akira Tagaya)

and emergency nursing, infection control, and dialysis forstaff development and also for making their profession more
attractive.
Both of the primary schools we visited had in theirneighborhood the people who were making their lives by
selling junk food, which suggested the necessity of involving
both the schools and the community for prevention of children's obesity.
(Akira Tagaya/Yuko Mikoshiba)b) Presentation of the Results of the Collaborative Research
at ICN Congress
In may, 2005, some findings of the collaborative research
between NCN and NUS were presented at the Quadrennial
A
Congress of ICN held in Taipei, under the title ofcompareative study on the health related lifestyle of Samoan
and Japanese children: Suggestions from characteristics of
BMI distributions, by Maeda J, coauthored by Hope E,
Aiolupotea MF, Uchida M, Tagaya A, Kuroyanagi Y, Maiava
V, Lees T, Faresa M, Enoka MI, and Aiavao FP.
The collaborative research began after several informal mutual visits and the establishment of the relationship in theform of MOA for academic interchange signed in July 2001.
Its focus has been the lifestyle of children in both countries
since then. The paper featured the comparison of the distribution of children's BMI and the children's perceptions about
their own and adult's figures between Japan and Samoa. Dean
Fulisia Aiavao of the Faculty of Nursing, NUS, traveled all theway from Samoa to Taipei to join the NCN delegates for thispresentation and confirmed the academic and humanfriendship between them.
(Jukai Maeda/Akira Tagaya)

Academic Exchange with NUS in 2006:
Collaborative research for prevention of lifestyle-relateddiseases of children

Collaboration with NUS in 2005a) Visiting Samoa in Cooperation with JICA
We (Tagaya and Mikoshiba) visited Samoa with two transfer
students (Akiko Shibasaki and Masako Mizuguchi) who had
worked as JICA volunteers and two other students (Yuhki
Kubo and Tomoyo Kobayashi) as the volunteers dispatchedby the JOCV Backup Program in the beginning of April, 2005,
to investigate the possibility of further activities for cooperation. Accompanied by Mr. Kuramata of JICA KTC, we left
Japan on April 2 to arrive in Apia in Upolu, on the same day
beyond the dateline, and stayed four days in Samoa. We madea one day trip to the rural island of Savai'i on April 3, visited
the Apia JICA Office and NUS on April 4, National Hospital on
April 5, and two primary schools on April 6, and returned toJapan on April 8.
In Savai'i, we visited the Satupaiatea Day Center, which
was in charge of as many as 9,000 inhabitants and was run by
only one RN and two ENs. The RN, Maria, in the middle ofher sixties, was working busy for home visit, healtheducation, inoculation, health check of expectant mothers,
medical examination, prescription, and even some sort ofsurgery. According to her, the frequency of DM and hypertension are very frequent, and child birth is mostly done athome by TBA there although they were recommending every
expectant mother to give her first two births in the hospital.
The head nurse of the National Hospital, June, who hadtaken a training course in Keio University Hospital, was eager
to send her selected nurses to Japan for training in disaster

NCN and NUS have collaborated in this research since 2001.
In this academic year, we collected the information about
Samoan health care system and children's health problems in
Samoa in order to make a plan for the new stage of ourresearch.

〔Project Meeting with Mr. Toshiaki Suzuki, second left in the front row〕

In July 2006 we invited Ms Telesia Lafaele, the head nurseof the pediatric ward of the National Hospital of Samoa who
was staying in Tokyo as a JICA trainee, and Ms Yoshiko
Furukawa, who had been working in Ms Lafaele's ward as a
JICA volunteer. In January 2007 we invited Mr. Toshiaki
Suzuki who had been a JICA senior volunteer working as a−2−

lecturer at the Faculty of Nursing and Health Sciences(FNHS) of NUS. They gave us recent valuable information
about public health in Samoa and enabled us to discuss on thenext step of our research.
In late August to early September, we visited NUS to have a
research meeting with the teachers of FNHS and collectedmaterials for the collaborative research. We also attended the13th South Pacific Nurses Forum to present the findings ofour collaborative research and exchanged information withnurses from different island countries of the South Pacific,
which gave us valuable implications for our research.
(Akira Tagaya/Yuko Mikoshiba)

Collaboration with NUS in 2007a) Project for Health Promotion in Samoa Funded by JICA
JICA decided to fund our three-year project from 2007 to2009 entitled comprehensive approach to prevent obesityand lifestyle-related diseases in Samoa. The project includes
the following two missions：
1) NCN send ｓ professionals who collaborate with the National University of Samoa (NUS), the Ministry of Health, andthe Ministry of Education of Samoa to develop a system forevaluating the baseline of, and monitoring the transition of,
Samoan children's health condition focused on obesity.
2) NCN accepts Samoan health professionals such as NUS
teachers, community nurses, and school nurses as trainees
who will learn knowledge and methodology for nursing andeducational intervention in children to prevent obesity.
At present, we are preparing for accepting trainees from
Samoa.
(Akira Tagaya/Yuko Mikoshiba)

this program was supported by many people.

Contents of the health checkup:
This health checkup was provided with translators and healthassessment sheets translated into 10 different languages. The
fee was 1,500 yen for adults, and items of a health checkup
were measurements of height/weight/blood pressure, bloodand urine tests, X-ray, medical consultation (internal
medicine, pediatrics and dentistry) and health consultation.
The total number of foreign clients was 476, which isgreater number compared with last year. The number offoreign clients in South Nagano area was 270, and it wasalmost half of all foreign clients. It seemed that the need ofhealth checkups for foreign residents in South Nagano area
was high, because 270 foreign clients in South Nagano area
were over the half the numbers of foreign clients in all cites.
669 volunteers participated in this health checkup program.
The total of 141 volunteers supported health checkup in
Kamiina, about the half of numbers was volunteers from
NCN, including students, faculties and staff of NCN.

〔Foreign clients waiting for taking their blood pressure〕b) Presentation of the Results of the Collaborative Research
between NCN and NUS
We gave a poster presentation about the results of questionnaire surveys carried out on children in Komagane andSamoa entitled a comparative study to describe the healthrelated lifestyle of Samoan and Japanese children: Suggestions from characteristics of eating habits. The conference
participants seemed to be interested in the comparison ofpreference and dislike of food between Samoan and Japanesechildren.
(Akira Tagaya/Yuko Mikoshiba)

The average age and length of their stay were 31.5 and 5.8.
Of 476 foreign clients, one in five was a child. Half of foreignclients were Brazilian and others were foreign clients of 27
diverse nationalities. Three in four noticed some subjective
symptoms such as headache, stiffness in the shoulder,backache, etc. One in two was suspected some disease and one
in three was advised to medical consultation. Most ofsuspected diseases were hyperlipemia, hepatic function disorder hypertension, etc. The results showed that the healthproblem of foreign clients was mainly lifestyle-relateddiseases than infectious diseases as same as last year.

Toward the future:

2. Health Promotion Projectfor Foreign Residents

Health Checkup Program for Foreign Residents in
Prefecture in 2004

The result of the health checkup:

NaganoThe second health checkup for foreign residents in Kamiina
area was held at Ina Central Hospital on December 12, 2004.
This health checkup program was given as a Nagano prefecture commissioned project in seven sites (Nakano,Matsumoto, Saku, Iida, Chino, Nagano-shi, and Kamiina) in
Nagano and aimed to reduce the anxiety of foreign residents'
health. In academic year 2004, Health Promotion Project for
Foreign Residents' Health of IRC worked with members of
Ina International Fellowship Association as a secretariat of
the executive committee of health checkup for foreign
residents in Kamiina. The student executive committee of
health checkup for foreign residents was also launched, andThis health checkup program provides a good opportunity not
only to find their disease early, but also to have an interchange among people of different cultures in Kamiina area.
We, the member of this project, would like to act to make ourcommunity a more comfortable place to live for foreign
residents and Japanese.
(Yoshie Kuroyanagi)

Birth Preparation Class in Portuguese for Brazilian Mothers
in 2004
The Foreign Mothers & Children Supporting Network in
Kamiina District called to form a project team for preparing aBirth Preparation Class for Brazilian mothers as the first experiment in March, 2003. The members of the project committee consist of 3 Public Health Nurses from prefecture &municipal offices, 2 Portuguese interpreters, 2 Midwives from−3−

a local hospital and 2 faculty members (1 from IRC) & 1
student (Midwife) from NCN. This project was planned basedon the research findings from the study of Health Behaviorand Accessibility to Health Services of Brazilian Women in
Perinatal period by Tashiro.
The purposes of the Birth Preparation Class for Brazilian
Mothers were 1) to provide information to those who plan togive a birth in Japan for the first time including both primi &multi-para Brazilian mothers, 2) to introduce Japanese waysof birth preparation methods and systems without imposing
on the information to Brazilian mothers, and 3) to inform legal
registration procedures related to newborn babies as
foreigners. The class took place on November 8th, and we had
11 attendants including 2 men. The attendants expressed
their great interests in the sessions and raised a long list ofquestions, so that we had to extend one hour from ourplanned schedule. The project team discusses to have the nextclass knowing the big demand in conducting such a class in
Portuguese for Brazilian mothers.

〔A midwife explaining Japanese custom of wearing Sarashi (a long
cotton cloth) as an abdominal bandage during pregnancy〕

Birth Preparation Class in Portuguese for Brazilian Mothers
in 2005
In 2004, classes took place two times. In 2005, we separated
each class into two and conducted 4 sessions. In total, 21
Brazilian women and their partners (or grandmothers)
attended classes. In 2005, new topics were introduced,
bathing baby practice and breathing and relaxing practicefor delivery , which were well appreciated by participants.
(Marie Tashiro)

The Nagano Health Checkup Program for Foreign Residents in 2006
In 2006, due to scarcity of human resources, IRC ceased to
execute the program in Kami-ina region. However, we
continued to take charge of data processing and analysis of
the health checkup results. Also, IRC members (Tanaka,
Takashi, Toda, Kodaira & Tashiro) and 6 NCN students continued to participate in the program in different places within
Nagano.
Details regarding attendees of the Nagano Heath Checkup
Program for Foreign Residents are shown in Table 1. The
total number of attendees were 301, coming from 22 different
countries. The majority was Brazilian, and other major groups
were from China and the Philippines. Nagano's foreign
residents' registration statistics reflected similar trends related to countries of origin of immigrants to Nagano. A third
Furtherof the attendees (32.3%) were identified asconsultation required. This percentage has not changed since2003. It implies that foreign residents in Nagano prefecture
still have many barriers in accessing public medical services,and such conditions around them have not improved.
DATE
Country/Place
BRAZILCHlNA
PHILIPPINES
THAl
KOREA
SRlLANKAPERUOTHERSTOTAL
Mrequired*%ofMrequired#ofcountries rep.

(Marie Tashiro)

Health Checkup Program for Foreign Residents in Nagano
Prefecture in 2005
Since 2003, IRC has been involved in the Heath Checkup
Program for Foreign Residents of Nagano in collaboration
with an NGO, Hokushin International Health Information
Center. It is a Nagano prefecture commissioned project
operated in 7 cities. In 2005, IRC members, NCN students anda local NGO staff formed an executive committee and tookcharge of the Health Checkup for Foreign Residents programin Kamiina-region. On December 18, 2005, the program in
Kamiina-region was conducted at Ina Central Hospital in Ina
city.
Seventy-nine foreign residents from 7 countries visited thecheckup. The checkup was operated by 138 volunteers (i.e.
physicians, nurses, interpreters and attendants), including
civilians, NCN faculty and students. One third of the 79
visitors were recommended for further investigationaccording to their medical test results.
The major health problems identified were hyperlipemia,
hypertension, liver dysfunction, diabetes mellitus, and obesity.
It is suspected that foreign residents are at the same risk oflifestyle-related diseases as the Japanese general population.
Appropriate health follow-up measures for foreign residents
should be considered.
(Marie Tashiro)

10/8 10/29 U/5
NAGANO MATSUMOTO UEDA
18
21
24
7
27
1
3
12
17
3
1
1
4
5
1
9
6
56
72
32
20
24
8
35.7
38.7
25
8
10
8

11/5
lIDA
37
1
2
1
2

1
44
22
50
6

11/12 11/12
SAKU SUWA TOTAL
2
48
150
7
5
48
13
1
31
7
29
2
5
1
5
5
6
5
28
38
59
301
7
13
94
18.4
22.0
32.3
10
7
22

Table1: The result of 2006 Nagano Health Checkup for Foreign Residents

In the coming fiscal year, the committee of this programplans to hold a forum to disseminate information of foreign
residents' health status and their issues among municipal
health workers and to invite their further involvement.
(Marie Tashiro)

Birth Preparation Courses in Portuguese for Brazilian
Mothers in 2006
Birth preparation courses were provided in two sessions, andtwo courses were given in 2006. Table 2 shows the numbersof attendees in the courses in 2006. In this year, we put oureffort on improving healthy diet instructions for pregnant
women. We recruited a Nutritionist and implemented a diet
questionnaire survey among class attendees in order to learn
more about their food habits. We plan to make classes moreculturally sensitive to Brazilian women. Introduction of these−4−birth preparation courses to other municipalities is a newchallenge for us in the next fiscal year.
DATE

Pregnant
woman

Partner

Mother of
P.woman

G TotalSession1

JUN11(SUN)

13

8

0

21

Session2

JUL1(SAT)

11

9

0

20

Session1

NOV18(SAT)

9

2

2

13

Session2

DEC9(SAT)

9

6

1

16

42

25

3

70

n

1

Il

Gross total

Session1
Session2
・lntroducing japanese governmental services for mother & child ・DeIivery in japan
・How to stay healthy during pregnancy ・Delivery in Brazil
・Why is weight control important if you want to deliver in ・Information on hospitals in Kami-ina region
・How to control your weight during pregnancy
・One month baby & mother's check-up
・Abnormal signs during pregnancy
・How to contact hospital when you want to admit to it
・Differences in values & customs regarding・Demonstration & practice of breathing
pregnancy between Brazil & japan& reIaxation during labor & delivery
・Healthy diet suggestions during Pregnancy
・Breastfeeding
・How to register your baby at municipal office・Demonstration & practice of baby bathing

Table4: Contents of Birth Preparation Courses in Portuguese for Brazilian
Mothers in 2007

Table2: Attendees in the Birth Preparation Course for Brazilian Mothers

The focus of this project is to provide reassurance for migrantBrazilian pregnant women by introducing Japanese prenatal
medical & political systems and to facilitate their acculturation in prenatal processes in Japan. We emphasized in
respecting Brazilians' cultural perspectives on pregnancy anddelivery, so that the Brazilian participants will not feel
imposed one-sidedly by the Japanese cultural values introduced in the courses. The plan for 2008 is to make this project
replicable to the other areas within the region in order toimprove accessibility for the beneficiaries.

〔An exercise for relaxation & breathing control during labor〕(Marie Tashiro)

Birth Preparation Courses in Portuguese for Brazilian
Mothers in 2007
Over 7,000 foreign residents are living in Kami-ina region in
Nagano where Nagano College of Nursing located. Brazilians
are the main ethnic sub-group among them. In 2007, in cooperation with local public health nurses and midwives,
Tashiro (IRC Deputy Director), Kodaira (NCN school nurse)and Masuo (NCN research assistant) were involved in conducting Birth preparation courses in Portuguese for Brazilian
mothers in Kami-ina region.
The dates of the courses and participants numbers areshown in Table 3.

〔A suggested balanced diet pattern for Brazilian pregnant women for a day〕

Mothers
PregnantofPartners
Total
women
pregnane
(n)
（N）
women
（n）
(n)

Session

DATE

1

July21

Sat

16

5

0

21

2

Aug11

Sat

14

10

0

24

〔Demonstrating the relaxation & breathing control during labor & delivery〕

1(Marie Tashiro)
1

Nov10

Sat

13

7

0

20

2

Dec08

Sat

13

12

2

27

II

3. Exchange Program with University ofCalifornia, San Francisco (UCSF) and Universityof San Francisco (USF)

Table3: Attendees in the Birth Preparation Course for Brazilian Mothers in 2007

The contents of the courses are presented in Table 4 and theattached photos.

The exchange program between UCSF, USF and NCN is now
in its fifth year. The fourth visit was held from March 10th to14th 2008, and participants consisted of three master students, one undergraduate student, and one faculty member.
We visited clinics run by nurse practitioners and attended
some class meetings at both universities.

−5−

Participants
2004
Leader: Emiko KonishiMember: Toshiaki Aiba, Akiko Iwasaki, Yoshie Kuroyanagi,
Maki Kodama, Nami Todoriki, Michiko Yahiro

2005
Leader: Jukai Maeda
Member: Yuriko Owaki, Chikako Yajima, Mitsuhiro
Nakamura, Natsuko Hirota, Satoko Yoshida, Yuko Kuroda〔At Glide Health Clinic：NCN participants with Prof. JoAnne
Saxe (UCSF) and Ms. Karen L. Hill (Nurse practitioner)〕

2006
Leader: Jukai Maeda
Member: Kumiko Asano, Chizu Ota, Misao Kitazawa, Kimiko
Takeda, Misako Ogura, Yuriko Owaki, Mitsuhiro
Nakamura, Satoko Yoshida, Maki Kodama, Megumi
Nakamura

Short as our visit was, every participant of the delegation
gained valuable experience in this training. We not only cameto know the present situation of nursing practice and education in the United States, but also thought it critically and,reflecting ourselves, had a good opportunity to re-think our
problem and advantages.
(Jukai Maeda)

2007
Leader: Maki Tanaka
Member: Ikue Ito, Mariko Kurosaki, Harumi Soude, Misao
Kitazawa, Takamasa Tanaka

Exchange Program with UCSF and USF in 2006

2008
Leader: Maki Tanaka
Member: Yumiko Aoki, Yuko Tasaka, Taiko Hoshi, Yuki
Kikuchi(Maki Tanaka)

Exchange Program with UCSF and USF in 2005
Between 28 February and 4 March, NCN sent a delegation to
UCSF and USF, which was conducted as part of our exchange program between NCN and those universities. Thissecond delegation consisted of 7 participants: 5 MS-students
and 2 faculty members.

〔At USF：NCN participants with Dr. Patricia Lynch (USF)〕

The important differences between the first visit (2004) andthis second one are as follows: 1) The exchange program
between NCN and the University of California, San Francisco,
School of Nursing was officially established; 2) This program
has been accepted as a course-subject in our MS-course
curriculum. Before the actual implementation of this project, I,
being in charge of program arrangements, visited Dr. Pat
Lynch (my counterpart) at USF last September and discussed
a future agreement of the exchange program and our possible
visit in the coming March. Through our frequent exchange ofe-mails, we arranged our detailed schedule of our overseas
training in San Francisco.

University of California San Francisco (UCSF) and Universityof San Francisco (USF) visit for master students, which took
place twice in the past two years, became a formal subject(one credit, elective). The third (the first as a formal course)
visit was held from February 27th until March 3rd this year.
Participants consisted of five first-year students, three secondyear students, and three faculties. In addition to the regular
contents such as class observation, skills lab. observation, andvisiting clinics run by nurse practitioners, four of visitors had
opportunities to do presentations of their master theses at each
university. These presenters could fulfill their year-longdream of sharing their findings with our friends in San
Francisco. Dr. Pat Lynch (USF) and Ms. Cathy Bain (UCSF)
were kind enough to organize everything to realize ourreckless offer. I am gratefully appreciating theirarrangements. As a test case, some of participants visited otherfaculty than nursing; California Institute of Integral Studies(CIIS). Contents of SF visit program are as follows:<27 February, USF>
7:30-7:40 AM Briefing (Pat Lynch)
7:40-10:25 AM
Nursing Therapeutics (complex medical Surgical Nursing)
Principles and Methods of Practice (Skills for medical surgicalnursing)
Family Health (Pediatrics)
Family Health (Maternity)
11:30 AM-2:30 PM Nursing Research
2:30-3:30 PM Nursing Skills Lab. Tour
3:30-6:15 PM Nursing Research<28 February, USF>
Clinical Lab. Tour (UCSF Medical Center Mt. Zion Hospital)
3:30-6:15 PM
Nursing Therapeutics 1 (beginning Medical Surgical Nursing)
Assessment (Health Assessment)<1 March, UCSF>
7:45-8:00 AM Briefing (Cathy Bain)
8-10 AM Research Methods (Statistics)−6−10-11 AM Violence in Families
11-12 (Breakout Sessions)
Elder Abuse, Violence in the Workplace, Domestic Violence
12-1 PM Presentation
1) The DNR decision making process in Japan
12-1 PM Presentations
1) Japanese patients' perception and Expectations of the good nurse
2) The work based encounter group: experiences of nursing
staff working in a hospital in Japan
1-3 PM Adult Primary Care Seminars
1-4 PM Introduction to Health Care Informatics
4-5 PM Presentation
1) Student's experiences of good student-teacher
relationship at a clinical practicum of a Japanese four-year
nursing college and its effect on their attitude towards nursing

Exchange Program with UCSF and USF in 2007
The exchange program between UCSF, USF and NCN is now
in its fourth year. The fourth visit was held from February
26th to March 1st 2007, and participants consisted of threefreshmen, one sophomore, and two faculty members. We had
opportunity to attend classes, skills lab, and to visit clinicalsettings and a clinic run by a nurse practitioners. Also thisyear, a sophomore presented her master thesis at USF. We
received a very warm welcome from both universities. I wish
to sincerely express my gratitude to Dr. Pat Lynch (USF) and
Dr. Cathy Bain (UCSF).

〔At USF : with Prof. Pat Lynch〕

Monday, Feb.26
7:30-7:45 Briefing (Pat Lynch)
7:45-10:30- Nursing Therapeutics 2 (Advanced Medical SurgicalNursing)- Principles and Methods of Practice (Skills classes)
11:35-14:20 Nursing Research
15:30-18:15- Nursing Therapeutics 1 (Beginning Medical SurgicalNursing)- Assessment of Human Response (physical assessment)- Nursing Research〔At UCSF：with Prof. Cathy Bain〕<2 March, UCSF>
Tour of Glide Clinic
12-1 PM Lunch with UCSF students from Japan
1-4 PM Data Management and Analysis
2-3 PM Meeting with Dr. Christine Kennedy
6 PM Meeting with Dr. Anne J. Davis

Tuesday, Feb. 27
7:00-13:00 Clinical settings
9:00-12:00 Simulation lab in Pediatrics and Maternity
17:30-19:30 Lunar New Years Party〔Dinner with Profs. Anne J. Davis and Cathy Bain〕<3 March, CIIS>
12:00-12:10 PM Welcoming remarks by the President
12:10-12:30 PM Professor Don Johnson's mini-lecture: The
history of Nursing in the United States with a focus on thetransformation of nurses as medical servants to their role ashealers, and exploring where Japan is in this process as well.
12:30-1:00 PM Discussion: With focus on Integrative Healthand Healing
1:00-2:00 PM Lunch and continued informal discussion

Wednesday, Feb.28
7:45-8:00 Briefing (Cathy Bain)
8:00-10:00 Research Methods
10:00-11:00 Health Promotion and Protection
13:00-16:00 Introduction to Health Care Informatics
13:00-15:00 Global Health & International Nursing
15:00-17:00 Adult Primary Care Clinical Residency
17:00-19:00 Ethical Issues in Nursing Practice〔At UCSF : with Prof. Cathy Bain〕〔At CIIS：with President Joe Subbiondo〕(Jukai Maeda)

Thursday, Mar.1
9:30-11:00 Valencia Family Health Care Clinic−7−13:00-16:00 Data management and analysis
19:00 Dinner with Japanese students

We will have a visiting scholar at NCN from the Hong Kong
Polytechnic University in the coming June, who will bestaying and doing some research activities in Komagane for a
few months. We do hope it will be a good beginning of ourbeautiful friendship.
For our wonderful stay in Hong Kong we would like toexpress our sincere gratitude to Dr. Anne J. Davis, our adviser,
who bridged the two institutions and Ms. Michiko Yahiro, ourformer colleague at NCN and now a PhD student at the HK
Polytech U. who organized our meeting.
(Hiroyuki Eto)

Toward Synergy: Collaboration with CMU〔Dinner with Japanese students who were studying at UCSF〕(Maki Tanaka)

4. Promotion of Academic Exchange with
Chinese Universities

Exploring New Ties with Hong Kong
Between 6 and 8 March 2007 two officers of the IRC, Jukai
Maeda and Hiroyuki Eto, visited the Hong Kong Polytechnic
University. The main purpose of our visit was to discuss with
our Hong Kong colleagues the possibilities of student and/or
faculty exchange programs and academic collaborations ofvarious research projects. Prof. Samantha Pang, Head of
School of Nursing, and other faculty members and students
welcomed us very warmly, and we were very impressed with
their Chinese hospitality for which we were so grateful.

〔With Dr. Samantha Pang (right) and Dr. E. Angela Chan (left)〕

During our stay, we had a fruitful talk for our future
programs as well as a good chance to see the school ofnursing. We were fascinated not simply with its high-techequipment and innovative learning and teaching strategies,
but also with their respect for tradition. We became certainthat we would be able to learn from their attitude andphilosophy.

〔training machines for pulse pressure diagnosis at integrative health care center〕

From June 14 to 17, 2007, on behalf of IRC, En Takashi andJukai Maeda visited China Medical University (CMU), which islocated in the middle of Shenyang, Liaoning, the northeastern area of China. The main purpose of this visit was toexplore the possibilities of academic and people-to-people
exchange between CMU and NCN. CMU has provided medical
education for the students not only in their mother language
but also in English and Japanese for a long time. The
graduates from foreign language course go abroad to study,
and most of them come back with various knowledge andtechnology to utilize in the mainland, but some graduatesremain and put down permanent roots in the foreign country.
Prof. Takashi is an alumnus of the Japanese course of
CMU and he served as a mediator between CMU and NCN for
this time. At CMU, we took part in the Japanese course for the
medical students. Actually the lecture was given in Japanese,and I could talk with students in Japanese. This was a newexperience for me to witness not Japanese teaching but
professional education in Japanese overseas. After the classvisit, Prof. Takashi talked on Education and Development of
Human Resources in Nursing in Japan , and I spoke on Issues
and Prospects for nursing human resources from Japanese,
Asian, and Global Perspectives .
CMU has also provided several courses for nursing. They
had MSN course, but did not have PhD course for nurses yet.
Nursing students gathered at the auditorium were so interested in, and asked many questions about higher nursing
education in Japan. As a matter of fact, CMU has a plan toestablish a new Japanese course for nursing students. If theplan would realize, there seems to be many things to collaborate in the area of not only research but also basic
education. I hope the relationship between CMU and NCN will
be fostered so that both schools can obtain synergy effect.
(Jukai Maeda)〔Discussion at CMU, (from left) Dr. Cai Yue, Dr. Jukai Maeda, Dr. Zhao
Qun, Dr. En Takashi, Dr. Qiao Min, Dr. Xiaohan Li〕−8−d) MSN: International Nursing Course (30 hours)

Ⅱ . International Collaborative Activities at
NCN from 2004 through 2007

1. Undergraduate and Graduate Education
2004a) BSN: International Nursing Course (30 hours)
This course promotes the bachelor level students' global
understanding as nursing professions in order to provide
culturally sensitive care for those who have different cultural
backgrounds and health needs, living both in Japan andoverseas. Within Japan, the health and health service issues of
migrant people from overseas are discussed. In overseas, themacro level community health issues in developing countries
are introduced, and the effects of poverty on people's healthare discussed.
In 2004, 27 students took this course. Since last year,
students who take this course are given an opportunity to experience cross-cultural nursing as volunteers at the Nagano
Foreign Health Checkups. At the end of the course, students
enthusiastically presented their group work assignments on
the topics such as the health issue of depleted uranium in Iraq,
the effect of poverty on AIDS/HIV in South Africa and the
AIDS epidemic due to blood selling in rural area of China.
(Marie Tashiro)b) BSN Overseas' Nursing Clinical Practicum in Samoa (135hours)
Based on the official exchange agreement between NUS and
NCN concluded in 2001, three students from NCN were sent
to NUS for two weeks in August, 2004. This was done as anursing clinical practicum in International Nursing course
and was the first overseas' student nursing practicum of NCN.
NCN students paired up with NUS nursing students, andprovided nursing care to the same patients together. Nursing
practicum took place in Samoa National Hospital and Savaii
Island where students could lean Samoan nursing both inclinical and community. Going through the stress and conflict
under the cross-cultural setting, students came to under-standthe dynamic cultural influences on people's health andnursing. They also had a valuable opportunity in evaluating
their experiences of Japanese nursing and Japanese nursing
studies compared to those in Samoa. In 2005, NCN will receive
two nursing students from NUS, and they will experience
Japanese nursing clinical practicum in Nagano together with
NCN students.
(Marie Tashiro)c) BSN Students' Graduation Thesis Focused on International and Cross-cultural Nursing- Tomoko Suzaki, What are the Factors Influencing Condom
Use for Preventing HIV/AIDS and STD?: Literature Review
on the Cases from Brazil, Thai, Uganda and Japan.
- Rie Hirabayashi, Looking into Brazilian Child-care Centers: A
Fieldwork Report on Immigrant Brazilian Child-care Centerin Kamiina District, Nagano.
(Marie Tashiro)This is an introductory course for master's level students,
which provides a basic knowledge of international health andcross- cultural nursing. The contents of the course are,therefore, similar to the one in BSN. The main requirement of
the course is that students present one international research
paper relating to cultural nursing with one's criticalcomments. In order to give a presentation, students learn toread English papers thoroughly and understand both cultural
nursing and research methods for academic critiquing. The
Master's students of this course in 2004 also attended theNagano Foreign Health Checkups with as volunteers and had
a valuable experience to communicate with people fromvarious cultural backgrounds as nursing professions.
(Marie Tashiro)

2005a) BSN: International Nursing Course (30 hours)
In 2005, 24 students took this course. The students are
expected to attend the Health Checkup Program for Foreign
Residents of Nagano as volunteers. The students report thatparticipating in this program is an eye-opening experience:
their stereotype images of foreigners have been cast aside.
Another course requirement is to give a group presentation.
This year, student groups demonstrated lively skits of peoples'living situations in developing countries, which enhanced
their understanding of the learning topics in each class.
(Marie Tashiro)b) BSN Overseas Nursing Clinical Practicum (135 hours)
The student exchange program was initiated in 2004. Between NUS and NCN, 2-3 nursing students are exchanged
each year alternatively. For NCN, this student exchange program is integrated into the formal curriculum as an option of
the final clinical practicum course in the senior year.
In August 2005, NCN received two Samoan nursing
students from NUS for two weeks. They paired up with two
NCN students and visited a general hospital, a children hospital, and a nursing home, and learned about the Japanese
medical system and Japanese ways of providing nursing care.
The students discussed their observations from a transcultural nursing viewpoint. They deeply understood the influences of local culture on health and delivery of nursing
care. We plan to send three NCN students to NUS in August
2006 and expect our students will have a similar cultural andprofessional experience through participating in a nursing
clinical practicum with Samoan students.
(Marie Tashiro)c) BSN Students' Graduation Thesis Focused on International and Cross-cultural Nursing- Emi Takahashi, The Status of Health Literacy among
Foreign pregnant women in Kamiina-region in Nagano- Mie Yui, The Health Issues in Dietary Change among
Japanese Brazilians in Kamiina-region in Nagano- Mariko Kojima, Child Rearing Methods of FilipinoWomen in
Kamiina-region Nagano−Focusing on the Feeding Habits of
Early Childhood(Marie Tashiro)−9−d) MSN: International Nursing Course (30 hours)
This is an introductory course for master's level students,
which provides a basic knowledge of international health andcross-cultural nursing. The contents of the course are similar
to the one in the BSN. Some students who took this course in2005 had practiced experience in nursing for foreign patientsin their past work. One student was from China and had also
experienced a clinical nursing practicum in Japan. Because of
the students rich background of cross-cultural experiences intheir clinical practice, we had lively discussions in each class,and the students deepened their knowledge of transcultural
nursing in a practical way. The students who took this course
this year participated in the Health Checkup Program for
Foreign Residents of Nagano as volunteers and learned about
the checkup as an example of health promotion activity for
local foreign residents.
(Marie Tashiro)

nursing care with Samoan nurses in hospitals and communities. On a remote island, the students followed Samoannurses and learned leadership skills required to provide
medical care for people both in hospitals and communities
where there is no doctor. There was also time for students todiscuss their own nursing views with Samoan new nurses.
The students met JICA (Japanese ODA) volunteers andAmerican Peace Coops members working in Samoa and heard
directly from them their reflections about their cross-culturalexperience in working in Samoa.

2006a) BSN: International Nursing Course (30 hours)〔Accompanying Samoan nurses working independently in rural communities〕(Marie Tashiro)c) BSN Students' Graduation Thesis Focused on International and Cross-cultural Nursing〔NCN students provided heath education classes at a Brazilian school〕

In 2006, 34 students took this course. The uniqueness of thiscourse was the provision of a cross-cultural experience to thestudents. In 2006, a Brazilian private school in Ina city (ColioDesafio) cooperated in conducting a mutual learning sessions
for students of both the school and NCN. The NCN students
were divided into 8 small groups, and each group visited theBrazilian school to teach health related classes for theBrazilian children and teachers. The Brazilian children also
visited Nagano College of Nursing for a school tour andenjoyed sports activities with the students in the gymnasium.
For most students, it was their first experience in being
exposed to a different culture. They used this opportunity toapply cross-cultural communication knowledge and techniques learned in the classroom.
(Marie Tashiro)- Shoko Kawazoe, Perceptions of Japanese and Samoan
Students about Nursing.
(Akira Tagaya)- Megumi Takeuchi & Miki Tanaka. A Comparison study
between Samoan and Japanese on Nursing Students'
Knowledge, Perceptions and Attitudes Toward HIV/AIDS.
- Ayuki Yoshioka. Diet, Obesity and Caries among Three-yearold Brazilian Children in Kami-ina Region, Nagano.
(Marie Tashiro)d) MSN: International Nursing Course (30 hours)
Taking seriously the situation of increasing numbers of immigrants in Japan, learning hours of related to cross-cultural
nursing theory was increased in order to nurture Japanesenurses' cultural competencies. The text-book used was
Galanti's Caring for Patients from Different Cultures. Six
mature students who took this course had already provided
nursing care for foreign patients in their clinical work. Due tothe students' rich background of cross-cultural experiences,
lively discussions were held each time.
(Marie Tashiro)b) BSN Overseas Nursing Clinical Practicum (135 hours)e) Nursing 3209: Influencing Policy and Nursing Human
Resource Planning: Local, National and International
Perspectives

Since 2004, there have been 8 students involved in thisprogram, as of 2006. The NCN graduates have formed analumni association known as TEAM SAMOA and support
junior fellows and exchange students from Samoa.
Three NCN students (Kawazoe, Sago, Takeuchi) and afaculty member (Tashiro) visited Samoa and NUS in August
11 to 27, 2006. The NCN students were selected last February
and prepared themselves in English, Samoan and Samoan
cultural studies before the exchange program. The students
had opportunities to observe Samoan nursing and provide

Nursing 3209 was a graduate seminar designed to provide
students with opportunities to examine relationships between
health, health related policy and health human resource
planning. Theories of policy development and human resource planning were explored. Issues affecting the nursing
workforce were examined from local, national and international perspectives with particular focus on the workplaceenvironment, gender, and education. The students used theirown experiences to explore ways in which hospital andgovernmental policies affected their work and outcomes for−10−their patients. Moving from a local to a global perspective, theworldwide shortage of nurses was examined in depth and two
students chose the shortage of nursing teachers as the topic
for their class presentation. The issue of nurse migration was
also explored as it is considered by ICN to be a major issue atthis time. A second group of students chose this topic forfurther study and shared their findings in their class presentation. Throughout the course students were encouraged
to share their own perspectives as they identified their own
roles and the roles of their nursing organizations in influencing
health related public policy and health humanresource planning.
(Grace Stanley)b) BSN: International Nursing Course (Elective: 30 hours)
In 2007, twenty-one students took up this course. Continuing from the previous year, students visited a Brazilian
private school in Ina city (Colgio Desafio) and conductedhealth education classes for the children and teachers incooperation with the Brazilian school teachers. The contentsof their classes were Healthy Diet, Hand washing andPracticing AED (Automated External Defibrillator) & CPR(Cardio Pulmonary Resuscitation). The students also learned
about the difficulties of life in Japan that migrant Brazilianfamilies faced by the lecture of the school principal Sr. Eduard
Iijima.

2007a) BSN: Transcultural Nursing (Compulsory: 30 hours) &Transcultural Nursing Exercise (Compulsory: 45 hours)
The two new courses on teaching Transcultural Nursing
have started from 2007. The foreign resident population ofNagano is more than 40,000 in last seven years, which implies
migrant families tend to settle down permanently in this area.
As our community becomes multicultural, nursing professionals need to be knowledgeable about the culturally uniquevalues and lifestyles of foreign residents in order to provide
culturally sensitive nursing care.
LectureExercise

・Why peopIe migrate・Assessment modeIs ofTranscuItural nursing

・Dynamics of migrant population worldwide

・Leiningers' Sunrise modeI・Distribution of foreign residents in japan

・Listening to a Brazilian resident

・Background of foreign residents

・Listening to & assessing a Chinese resident

・Accessibility to health services for foreign ers

・Listening to & assessing Filipino residents

・Health problems of migrants

・Group fieIdwork：
Visiting Filipino churches, Chinese club,
Japanese learning classes for foreign
residents etc.

・Understanding cultures in nursing PracticeTable: The courses content of Transcultural Nursing

Establishing these courses, we, faculty members hope thatstudents who graduate from NCN will become a bridge
between Japanese healthcare workers and foreign patients in
hospitals. Thus, the courses focus on nurturing students' cultural competency in nursing. The course contents are shownin the Table above. For most of the students, it was their firstexperience to interact personally with local foreign residents
in their group fieldwork〔NCN Junior students listening to the lecture of the school principal Sr.
Eduard Iijima〕(Marie Tashiro)c) BSN Overseas Nursing Clinical Practicum in Samoa (135hours)The 2007 student exchange program between NUS and NCN
continuously took place in a BSN course of International
Nursing Practicum. The 2007 was the year that NCN received
NUS students. In NCN, four student representatives who
would do nursing practicum with Samoan students wereselected in February and trained in English communication
by Prof. Grace Stanley, a Canadian nursing professor at NCN
for five months. The students were all seniors: Aya Ogiwara,
Ayumi Kumagai, Izumi Sawada & Tomoka Fujita.
In August, two Samoan nursing students joined NCN for
two weeks. Their names were Seipua Tutuila & Peteli Solo.
The Samoan students and the NCN students made up twogroups and exercised nursing practicum. Each group was
assigned to one patient, and they together demonstrated
Cultural assessment on the patients from the Samoan students' cultural perspectives.

〔Welcoming Samoan students (Seipua & Peteli) at Narita International
Airport〕〔NCN Sophomore students visited a Japanese learning class for foreign
residents in Komagane〕(Marie Tashiro)

For Samoans, it was very shock to learn that Japanese older
people stayed in a long-term care facility separated from theirfamilies because caring elder people is heavily valued in
Samoa. The Samoan students also studied that bathing(particularly soaking in a bathtub) was an indispensable
practice for old Japanese people. For Japanese students, it was−11−a cultural experience to know what was unique in Japaneseculture from the Samoan students' view points. The closeinteractions between Samoan and Japanese students createdculture clash among them, which was also a valuable crosscultural learning for them.
In 2008, this is the year of NCN students and Tashiro (IRC
Deputy Director) to visit NUS. Four students have been
selected in February 2008 as the NCN student representtatives of the nursing students exchange program in 2008.
The students' names are Hidemi Mochizuki, Izumi Kasai and
Megumi Takahashi. They have started English trainings with
Ms. Janie Ikegami. We look forward to join NUS for nursing
practicum in Samoa in this coming August.

Lynne E. Young, RN, PhD (Canada)
Associate Professor University of Victoria
Lecture on Action Research in Canada: Addressing Student
Nurses Stress, Health & Quality of life (August 25)

Grace Stanley, RN, MSN (Canada)
Laurention University
Lecture on
Crossing Boundaries: An Ethnography ofOccupational Socialization of Post-Diploma Baccalaureate
Nursing Students in Pakistan (November 10)

Anne J. Davis, RN, PhD, FAAN (USA)Professor Emerita, University of California, San Francisco andNCN
Lecture on The Teaching of Nursing Ethics in Japan(November 19)

2005

Carol E. Smith, RN, PhD (USA)Professor, University of Kansas, School of Nursing
Lecture on Technology Caregiving (May 30)〔2008 TEAM Samoa members (Mochizuki, Kasai, and Takahashi) &faculty members (Tashiro & Ikegami)〕(Marie Tashiro)d) BSN Students' Graduation Thesis in International andCross-cultural Nursing- Reiko Konta & Kaori Takahashi. Children's Sexuality from
Migrant Brazilian Mothers' Perspective in Japan.
- Ayako Matsumoto & Hidemi Maruyama. Lifestyle and
Health Status of Migrant Brazilian Children in a Brazilian
School in Nagano.
(Marie Tashiro)e) MSN: International Nursing Course (30 hours)
This course focuses on building up nursing professionals'
clinical cultural competency. Cultural theories in various
healthcare settings were introduced and discussed by reading
the textbook of Galanti's Caring for Patients from Different
Cultures. Seven mature students took up this course including one former JOCV volunteer who worked in Madagascar.
Each student presented the critiques on Trans-cultural
nursing research which written in English. Their selected
research topics were The Adaptation of Mothers of Children
Beliefs and Ritualswith Intellectual Disability in Lebanon,Thein Traditional Birth Attendant Practice in Guatemala,Meaning of Family Caregiving in Japan and the United(Marie Tashiro)
States etc.

〔Prof. Carol E. Smith with her former PhD student, Prof. Chiemi Kochinda〕

Grace Stanley, RN, PhD (Canada)
Professor, Nagano College of Nursing
Lecture on
Nursing Education from an International
Perspective (September 23)〔Prof. Grace Stanley with Prof. Hiroyuki Eto〕

Emilia Mari Wako Sogumo, RN, MS (Brazil)
Occupational health nurse specialist
Lecture on Nursing System in Brazil and Training Programin Japan (November 22)

2. NCN Hosted International Colleagues
Who came, and what they did at Nagano College of Nursing.

2004

Tonny Zuch, RN (Australia)
Director of Nursing, Manager Residential Service, Helping
Hand Aged Care
Lecture on End of Life Care of Aged Care in South ofAustralia: Philosophy and Approach (May 22)−12−〔Emilia Mari Wako Sogumo〕

2006

3. IRC-Related Papers and Presentations

Anne J. Davis, RN, PhD, FAAN (USA)Professor Emerita, University of California, San Francisco and
NCN
Colloquium with younger faculty members and researchers.
(December 6)

2005(Paper)Ozawa A.，Fujioka Y.，Yuki M.，Tashiro M. Samoan Culture
and Nursing：An Observation and Experience of JapaneseNursing Students. Bulletin/Nagano College of Nursing，7,21-30.

2007

Jenny Arndt, RN (Sweden)
Susannah Johansson, RN (Sweden)
Therese Osterberg, RN (Sweden)
Psychiatric Nurse Spesialist
Lecture on Nursing Education at Swedena) Research and Student Exchange Program with National
University of Samoa(Presentation)(April 20)

Yue Cai, MD (China)
Director of The International Exchange Center, China Medical
University
Information exchange about promoting academic exchange
between CMU and NCN (July 5)

Maeda J., Hope E., Aiolupotea M.F., Uchida M., Tagaya A.,
Kuroyanagi Y., Maiava V., Lees T., Faresa M., Enoka M.I.,
Pita-Uo Aiavao F.: A comparative study on the healthrelated lifestyle of Samoan and Japanese children.
Suggestions from characteristics of BMI distributions.
International Council of Nurses (ICN) 23rd Quadrennial
Congress, 2005.5.25, Taipei.

2006(Paper)Moon Fai Chan, PhD (Hong Kong)
Assistant Professor, Hong Kong Polytechnic University,
School of Nursing
Lecture on The Application of Cluster Analysis in Nursing
Research (July 24)

Uchida M., Tanisguchi E., Tagaya A., Maeda J., Kuroyanagi Y.
The lifestyle of Japanese small town students of junior highschool and upper grades of elementary schools. Bulletin/
Nagano College of Nursing，8, 71-84.

(Presentation)
Ozawa A., Yuki M., Fujioka Y., Kubo Y., Shiozawa M., Tashiro
M.: A Samoan-Japanese Nursing Education Exchange
Program: earning Experiences of Japanese Students. The
13th South Pacific Nurses Forum, 2006.9.6, Apia, Samoa.

2007(Presentation)
Mikoshiba Y., Hope E., Aiolupotea M.F., Uchida M., Tagaya A.,
Maeda J., Kuroyanagi Y., Maiava ., Lees T., Faresa M., Enoka
M.I., Pita-Uo Aiavao F.: A comparative study to describe thehealth related lifestyle of Samoan and Japanese children:
Suggestions from characteristics of eating habits. ICN
Conference 2007, 2007.6.1, Yokohama.

〔Dr. Moon Fai Chan (Tony)〕

Seipua Tutuila (Samoa)
Peteli Solo (Samoa)
The National University of Samoa, Faculty of Nursing
Presentation and Discussion on the National University of
Samoa (August 3)b) Health Promotion Project for Foreign Residents' Health

Min Qiao, MD, MHPE (China)(Paper)Dean, School of Nursing, China Medical University

Tashiro M.，Kuroyanagi Y. Health Status and Lifestyle ofForeign Attendants at the Medical Check-up for Foreigners in
Nagano, 2003. Bulletin / Nagano College of Nursing，7, 41-50.

2005

Xiaohan Li, RN (China)
Associate dean, School of Nursing, China medical University
Information exchange and discussion toward academic
collaboration between CMU and NCN (November 22)(Presentation)
Tashiro M., Kuroyanagi Y., Uchisaka Y., Matsumura T.: Health
Status and Lifestyle of Foreign Attendants at the Medical
Check-up for Foreigners in Nagano in 2003 and 2004. The
20th Japan Association for International Health Conference,
2005.11.6. Tokyo.

2006(Presentation)[after discussion with Profs from CMU]

Tashiro M., Kuroyanagi Y., Uchisaka Y., Matsumura T.:
Transition of Health Status of Foreign Attendants at the
Medical Check-up for Foreigners in Nagano from 2003 to
2005. The 21st Japan Association for International HealthConference, 2006.10.13. Nagasaki.

−13−

Ⅲ . Miscellaneous International Activities of
IRC Members from 2004 through 2007
2004

Activities of JMTDR for the Earthquake and Tsunami
Disaster of the Republic of Indonesia
On December 26th 2004, a strong Earthquake with amagnitude of 9.0 on the Richter scale occurred in the
Republic of Indonesia and Tsunami struck the southwest
coast of Sumatra Island. The Government of Japan and theJapan International agency (JICA) dispatched the Japan
Medical Team for Disaster Relief (JMTDR) in order to carryout relief activities for the people affected by the earthquake
and tsunami after the request from the Indonesia government.
The mission of JMTDR is to provide support on the medical
treatment including first aid and primary health care and thesurvey concerning to the public health issues for the people
affected tsunami disaster.
The team consists of twenty-two members including four
medical doctors, seven nurses and a pharmacist were trained
for a disaster management before dispatched. It was the valuable and priceless experience for me to be engaged in therelief activities in the city of Banda Ache as a member of the
JMTDR.
Duration of activities
was from December
30th, 2004 to January
11th, 2005. The city ofBanda Ache wasisolated since the roads
and bridges weredestroyed in the quake
and tsunami wave.
Debris blocking were
scattered everywherein the streets withpossibly victims of thetsunami in those piles.
Power and watersupply were cut off
and the telephone lines
went out.
〔The Contributor on duty in Banda Ache,
by JICA〕
The team started medical services in a field clinic set up in a
football playground near the area stricken by tsunami
disaster. The clinic was filled with sick and injured patients.
The injuries were mainly superficial, but wounds were dirty.
The major internal diseases were upper airway disease suchas common cold, pharyngitis, and diarrhea. There were many
patients who had nightmare, flashback, re-experiencing, evenin children, Post Traumatic Stress Disorder was diagnosed.
During the period of 9 days, Team provided medical
services to approximately 1,500 patients.
Completed hard mission, we returned safely home. I realize
again that Nurse has an important role in those activities. I
hope all the students to be more concerned with the problemsof disaster and take an interest in Cross-Cultural Nursing andcontribute to the world as an international specialist in the
future.

More than a month after the Tsunami devastated, the death
toll continues to rise in Indonesia where more than 220,000
are now confirmed dead or missing. I would like to express mydeepest condolences to relatives of the victims by tsunami
disaster and appreciate for sincere supports provided by thenative people in the city of Banda Ache.
(Takamasa Tanaka)

2005

Lecture by Dr. Carol Smith on

Technology Caregiving

On May 30th 2005, the special lecture entitled Technology
Caregiving was given by Dr. Carol E. Smith, Professor, University of Kansas School of Nursing, U.S.A.
Recently, care for those patients, who require advanced
healthcare technology and advanced healthcare equipments,
has been moved from hospitals to their home. There arevarieties of complex in-home technology care, such as hemodialysis, mechanical ventilators, sleep apnea, electro-cardiograms (EKG) monitors, respiratory monitors, total parental
nutrition (TPN).
Dr. Smith has been conducting research on this topic for 20
years in the United States, the country well known for homehealthcare with advanced technology. She is one of the nationally recognized researchers and her research has been
receiving continuous funding from the NIH (National Institutes of Health) for over 18 years.
In this special lecture, Dr. Smith shared her research and thefindings with many interesting episodes of those patients andtheir families who are dependent on hi-tech homecare. Basedon her Caregiving Effectiveness Model, Dr. Smith discussed
about how the complex in-home technology care affects thepatients and their families in terms of quality of lives (QOL),
infection management and its effects on their economical
status, as well as importance of nursing care on these issues,and telehealth (telenursing) using tele-communication such as
TV phones and internet.

〔Prof. Smith and Prof. Chiemi Kochinda, Smith's former PhD student〕

There were over 80 people attended the lecture, including
faculty and staff, nurses and other healthcare professionals,
nursing students, and many people who are not in healthcare
profession. The audience actively participated in the discussion during the question time following the lecture.
(Chiemi Kochinda)

Presentation at USF and UCSF
Three master students and I presented our master theses at
USF (2 times) and UCSF during the period Feb27-Mar1.This
was the first time that NCN students ever presented their own
research papers during the NCN-USF and UCSF exchange−14−

program.
The presentation was held in a nursing research class(freshers and sophomores) and was received positively by thestudents. The preparation of our work was so hard, because
we were not used to speaking in English. Before the presentation, we did not sleep well because of excitement and ongoing
preparation. We were very nervous, but presented smoothly.
Following the presentations, there were many questions andcomments which we were able to respond clearly. Afterclasses, many students came and gave us suggestions and said
they were pleased with our presentation. We worked hard andgained a great experience.

within the nursing workforce and interprofessional practicemodels. A second theme focused on professional practice inlong term care, mental health, the emergency room, NICU,
and other specialty venues.
Jukai Maeda's presentation Some Statistical Considerationsin Designing a Nursing Human Resource Database in Japan
provided an overview of an exploratory survey of nurses in
Nagano prefecture with results suggesting a need to develop a
more accurate system of measuring the size of the nursing
workforce in Japan. Grace Stanley's presentation An Ethnography of Occupational Socialization of Post-diploma
Baccalaureate Nursing Students in Pakistan described how
a group of students from public sector schools used individualand group strategies to negotiate an intercultural shift when
they moved from a publicly administered nursing school intoa private university setting. Ways of moving professional
issues into the policy arena and how to address the current
and future shortage of nursing personnel from local andglobal perspectives were highlighted during the discussion
periods.

〔A presentation at USF〕

Presenting our research in English to students in a foreigncountry enhanced our confidence and presentation skills. It
also offered an opportunity to disseminate our researchfindings outside of Japan. I would recommend that the NCNUSF and UCSF exchange program continue to provide thesetypes of research presentation opportunities for future
students. My heartfelt thanks to all those who were involvedin this project.

〔A photo with Anita Fisher (right: a former faculty member of NCN, anda co-chair of planning and scientific review committee of the conference)at opening reception in the Hamilton Art Gallery〕(Grace Staley)

JANS 2006〔After giving presentations〕(Maki Kodama)

During December 2nd through 3rd 2006, Japan Academy of
Nursing Science (JANS) The 26th Annual Academic Conference was held at Kobe International Exhibition Hall andKobe International Conference Center. Besides symposium,
paper and poster presentation sessions, exchange meeting
sessions were provided with a variety of themes, including
Human Resource Development in Nursing Through International Cooperation and Exchange.

2006

Practice to Policy Conference in Canada
Two members of the IRC, Jukai Maeda and Grace Stanley,participated in the 5th international Practice to Policy
conference October 25 to 27th, 2006 organized by the
Nursing Health Services Research Unit of McMaster University and the University of Toronto. Keynote speakers
included Mireille Kingma, RN PhD, Nursing consultant, ICN,
and Jean Yan, PhD, Chief Scientist Nursing & Midwifery,WHO. The program included 100 papers and 50 poster
presentations submitted from across Canada, Pakistan,
Australia, Scotland and Japan. A major program theme
focused on health human resource planning including
nursing workforce profiling, work environments, late career,
early retirement issues, job redesign, migration, diversity〔Discussion〕

The International Research Institute in Cross-Cultural
Nursing has been involved in and taking a leading role inmany projects, such as international research forums, theexchange programs with the sister universities abroad,−15−

international research projects, the health checkup programfor foreign residents in Nagano prefecture, and so forth. For
this exchange meeting session, we (Kochinda and Tanaka)
presented Human Resource Development through International Exchange in Local Regions and Abroad focusing on
3 selected topics: volunteer activities in the health checkup
program for foreign residents in Nagano prefecture, theexchange program with National Samoa University (NUS),
and the exchange program with University of California San
Francisco (UCSF) and University of San Francisco (USF).
The other presenters were Oita University of Nursing and
Health Sciences, Ishikawa Prefectural Nursing University,
and Niigata University who presented Nursing Education
Maternal
improvement project in Republic of Uzbekistan,and Child Health Support Project in Republic of Tajikistan,and Project for Development of Cross-Cultural Nursing
Practitioners, respectively. There were many interestingquestions and comments which led to a good discussion period
following the presentations.
(Chiemi Kochinda/Maki Tanaka)

Cold Weather and Warm Hearts in San Francisco
Exceeding my expectations, it was a wonderful experience
for me to participate in the exchange program at USF andUCSF.
I attended several classes and observed clinical practice and I
was deeply impressed by the students. They were highly
motivated to learn and were inspired by teachers at USF and
UCSF. All students were nice and kind and tried tounderstand my poor English when I joined them in there
group work.

in San Francisco, it was a lot of fun to ride the world famous
cable car and see the golden gate bridge from Fisherman's
Wharf.
I truly appreciate to all who helped and warmly greeted us
in San Francisco, and I hope that some day we may fullheartedly welcome the students and teachers of USF andUCSF to the Nagano College of Nursing.
(Takamasa Tanaka)

International Study: Relationships Among Joint Flexibility,
Fall Prevention Self-Efficacy, and Quality of Life inJapanese and Canadian Older Adults
An international study exploring relationships among joint
flexibility, fall prevention self-efficacy (FPSE), and quality oflife (QOL) in Japanese and Canadian older adults has recently
been completed by NCN faculty members. As conditions
affecting the joints are increasingly contributing to the global
burden of disease, it is timely to focus on how nurses canpromote joint health. The participants included 100 womenand men aged 70 to 79 living in the South Ina area of Nagano
Prefecture, Japan, and South Central Ontario, Canada.
Significant relationships were found to exist within both theJapanese and Canadian groups among components of each of
the three variables. These findings suggest that if joint healthand flexibility is promoted within a cultural group there may
be accompanying positive effects in the enhancement of selfconfidence to carry out activities of daily living and morepositive perceptions of quality of life. In comparisons between
the two groups, the Japanese group scored significantly
higher on knee and ankle joint flexibility suggesting that
there are elements within the Japanese lifestyle and culturethat promote the maintenance of joint flexibility better thanthe Canadian lifestyle and culture does. The Canadian group
scored significantly higher on fall prevention self-efficacy andseveral components of QOL suggesting there may be elements
within the Canadian culture and lifestyle that promote these
positive perceptions. The next step is to design research withlarger randomly selected samples that would explicate andprecisely describe the elements that contributed to withingroup relationships and between-group differences.

〔With Dr. Anna Kwong at St. Mary's Medical Center〕

We talked to a Japanese nurse who worked in a hospital andshe told us about some differences in nursing between the
USA and Japan. We met two master course students who
were Japanese and studying hard at UCSF. I believe that welearned many important things in a short period of time in
San Francisco, that we could never have learned in Japan
In spite of cold weather and many days when it rained all day〔Research members〕

The research team will present their findings on May 31,
2007 at the ICN conference in Yokohama and will develop ajournal article at a later date. Results may be used by nurses
and other health care providers who are designing healthpromotion programs related to the maintenance of joint
health and flexibility, FPSE and QOL across the lifespan inJapan, Canada and elsewhere.
(Grace Stanley)〔With Prof. Winter Quarter at UCSF〕

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2007

NCN get-together returns, and will return soon
The second assembly named "NCN get-together" was held on
May 31, 2007 at Italian restaurant during ICN Yokohama. We
had 20 people related to NCN, and sat around the lunch tableexchanging the latest news about ourselves. The next "NCN
get-together" is scheduled to be held in the ICN Congress at
Durban, Republic of South Africa. Further information will beannounced through the next newsletter or e-mail. Save your（Jukui Maeda）
money, and see you there.

〔NCN get-together at ICN Yokohama〕

opportunities to attend the tour to visit skills lab and clinicalsettings at University of Maryland School of Nursing, Johns
Hopkins University School of Nursing and Hospital. Throughthese programs, we had various experiences which gave us
valuable hints to our nursing education and research.
(Satoko Yoshida/Chiemi Kochinda )2004-2007
Between 2004 and 2007 NCN welcomed a delegation ofyoung professionals of public health services from Papua New
Guinea (2004) and Indonesia (2005-2007) supported by JICA.
Their primary concern was curriculum, international andregional activities of Japanese nursing colleges. Members of
IRC organized the necessary arrangements and hosted ourguests.
In the presentation and discussion session, NCN president
Tomoyo Miyama made warm welcoming remarks, whichwere followed by a few presentations regarding the structureof curriculum of NCN, our cross-cultural collaboration, collaborative projects of local government such as health checkups for foreign residents, and working with community.

Honor Society of Nursing, the 39th Biennial Convention
From November 3rd through 7th 2007, Sigma Theta Tau
International 39th Biennial Convention was held at Baltimore
Convention Center, Maryland, USA. This year's theme was
Vision to action: Global Health through Collaboration , andthe program included nearly 650 oral and poster presentations submitted from across America and various countries
including Japan.

〔Delegation from Papua New Guinea in 2004〕

Thereafter, they had a short campus travel and see ourfacilities. During the campus tour, they had a chance to enjoya cup of Japanese tea at a traditional tea ceremony hosted byour students.
(Hiroyuki Eto)

2005-2007〔At Baltimore Convention Center〕

Chiemi Kochinda and Satoko Yoshida, members of IRC,
participated in the convention. We presented our research
Japanese Nurses' Perception of Their Own Caring andUncaring Behaviors: From a Perspective of Motivation to Help
Theory. After the presentation, we had good discussion, someinteresting questions and comments from the participants.

〔At The Johns Hopkins Hospital〕

During the period of this convention, we also had good

Caring in Nursing
My 3-year research project, Caring in Nursing, From a
Perspective of Motivation to Help Theory (PI: Chiemi
Kochinda) has been funded by the NCN. The purpose of thisstudy was to examine the concept of caring and uncaring
among patients and their family, nurses, and nursing students in Japan, and to compare cross-cultural differences withthat of nurses and nursing students in Taiwan.
Unfortunately, the research process in Taiwan has not been inprogress as I expected; however, in the future, I hope tocontinue the collaborative project with nursing researchersand educators in Taiwan.
I originally started the research on Caring as my doctoral
dissertation in U.S.A. so that the original questionnaire wasdeveloped in English. Therefore, to explore this project inJapan and in Taiwan, the questionnaire needed to be translated into the target languages (Japanese and Chinese).
In 2005, I began the translation process of the questionnaire using forward- and back-translation methods. Then, the−17−translation equivalence was established. This process involved
4 translators excluding me. In 2006, data from patients,
patients family, nurses, and nursing students was collected
and began to be analyzed. In the mean time, the translation of
the questionnaire into Chinese has taken place with 3translators. However, due to some difficulties, data collection
process has been put on hold at this moment. In 2007, moredata from nursing students (time 2 data) was collected andanalyzed.
〔Nursing students in skills lab at John Hopkins University〕〔Getting together with Japanese nurse researchers at Midwest Nursing
Research Society Conference in Omaha, NE, USA〕
〔Students document in portable computer chart as a part of skills lab
learning at John Hopkins University〕〔Meeting with nurse researchers from South Africa and the USA at
International Nursing Research Congress in Vienna, Austria〕〔University of Maryland Medical Center〕

During the year 2006 and 2007, my co-investigators and I
were able to disseminate the findings from this project atvarious conferences within Japan, as well as in overseas. Presenting the research findings at conferences brings opportunities not only to explore further discussion with nurse
researchers and educators, but also to interact with nursing
colleagues from all over the world.

In addition, I was reunited with Dr. Carol E. Smith, mydissertation advisor at the University of Kansas, in 2005 here
in Komagane. Dr. Smith visited Komagane after attending
ICN conference in Taipei and following her keynote
presentation at an international conference in Nagoya.
During her visit, Dr. Smith give a special lecture entitledTechnology Caregiving on May 30th 2005, and I was very
fortunate to serve as her interpreter at this event, sponsoredby IRC and Department of adult health nursing.

〔Discussing with nurse researchers from all over the world at Sigma
Theta Tau International 39th Biennial Convention in Baltimore, USA〕

During or after the conference, I often make some schedule
to visit universities and hospitals to see nursing education inother countries. I believe that these experiences further help
to develop collaborative relationships with nurses internationally.

〔Prof. Smith and Prof. Chiemi Kochinda, Smith's former PhD student
Dinner with Smith family at Japanese restaurant〕

IRC also hosted a dinner at Kachou, a Japanese restaurant intown. Dr. Smith and her family enjoyed Japanese foods, someof which were their very first experience, such as Sazae
Tsuboyaki.
(Chiemi Kochinda)

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−19−

Officers and Members of IRC (stand 2007)
Director:
Jukai Maeda, RN, PhD, Associate Professor, NCN

Deputy Directors:
Akira Tagaya, DSc, Professor, NCN
Hiroyuki Eto, PhD, DLitt, Associate Professor, NCN
Marie Tashiro, RN, MSc, PhD cand. Assistant Professor, NCN

Advisors:

Purpose The purpose of the International Research institutein Cross-Cultural Nursing (IRC) at Nagano College of Nursing
is to develop and disseminate knowledge in international andcross cultural nursing and health. It has two foci:
1. International activity which is mainly an Asia-Pacificregional focus.
2. Cross cultural activity which is within Nagano prefecture.
History

Anne J. Davis, RN, PhD, DSc (Hon), FAAN, Professor emer.,
NCN
Emiko Konishi, RN, PhD, Professor emer., NCN
Anita L. Fisher, RN, PhD, Associate Professor, McMaster
University

Members:
Masayo Uchida, RN, PhD, Professor, NCN
En Takashi, MD, PhD, Professor, NCN
Eiko Suzuki, RN, PhD, Professor, NCN
Chiemi Kochinda, RN, PhD, Associate Professor, NCN
Midori Matsuzaki, RN, MSN, Assistant Professor, NCN
Yuko Mikoshiba, RN, BScN, Assistant Professor, NCN
Takamasa Tanaka, RN, MSN, Clinical Faculty, NCN
Maki Tanaka, RN, MSN, Clinical Faculty, NCN
Chikako Toda, RN, BSN, Clinical Faculty, NCN
Satoko Yoshida, RN, MSN, Clinical Faculty, NCN
Koichi Hida, DSc, Research Associate, NCN
Natsuko Kodaira, RN, BSN, NCN

Ex-members (Then Position):
Takehiko Tanaka, MA, (Professor, NCN)
Sachihiro Yamada, MD, PhD, (Professor, NCN)
Grace Stankey, RN, PhD, (Professor, NCN)
Yoshie Kuroyanagi, RN, MSN, (Clinical Faculty, NCN)
Takashi Yamada, BA, (Deputy Executive Director)

About IRC
Background Recently Japanese nursing education has beendeveloping in colleges and universities that include BSN,
Masters, and Doctoral programs. In order to prepare Japanesenurses to participate in international and cross cultural
nursing and health activities, it is necessary for them to obtainknowledge of health problems, health and nursing systems,
cultural differences in world view definitions of health andillness, and access to health care issues for different groups ofpeople. This knowledge base also includes selected major
concepts as communicable diseases (AIDS, SARS and TB) ,women's health, migrants and refugees,
environmental
factors and life styles (smoking) that effect health and illness.
Japan has a history of international aid to developing
countries in the Asian-Pacific region and in other parts of theworld. This aid includes health related projects such as
primary health care that is in nursing domain. In addition,
JICA has sent nurse volunteers to many countries such as
Bangladesh and Vietnam. The more knowledge that thesenurses have about international pubic health nursing, themore they can accomplish in the work they undertake. The
specialty, International Research in Cross-Cultural Nursing(IRC), of Nagano College of Nursing is one place where nurses
can gain such knowledge.
Given Japan's world economic status, Japanese nursing
should be prepared to contribute even more to world nursing
and health.

In late 2001, the faculty of Nagano College ofNursing (NCN) formed a project team to establish a center thatspecializes in international and cross-cultural nursing andhealth. On December 18, 2001, the project team met anddiscussed the name, purpose and aims of the center.
Thereafter the team met several times. On March 19, 2002,
the team named the center as the International ResearchCenter in Cross-Cultural Nursing, IRC, and announced thestatement Background, Philosophy, and Purpose of theCenter, see below. In late 2002, due to the NCN Center
structural change, the IRC changed its name into: The
International Research Institute in Cross-Cultural Nursing(IRC).

Aims In order to attain the goals the IRC members:
1. educate nurses to work overseas and with different culturalgroups in Nagano;2. bring regional and international nursing colleagues to NCN
to enrich the teaching-learning process;3. develop nursing research projects focused on culturalgroups in Nagano;4. develop Asia-Pacific regional collaborative nursing research
projects;
5. develop exchange programs in Asia-Pacific Region;
6. sponsor international seminars and forums;
7. present papers at international and regional conferences;
8. work with organizations such as WHO and ICN;
9. publish in international and regional peer reviewed nursing
journals;
10. develop mechanisms for NCN faculty to provide requested
assistance to countries in the region; and11. obtain funds to carry out the aims listed above

Official Website of IRC
http://www.nagano-nurs.ac.jp/irc/irc.html

Mail to Webmaster (IRC)
jukai@nagano-nurs.ac.jp

International and Cross-Cultural Nursing Newsletter/ No.5
Nagano College of Nursing
March 31, 2008
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長野県看護大学・看護実践国際研究センター
異文化看護国際研究部門
長野県看護大学399-4117長野県駒ヶ根市赤穂1694
Tel.: 0265-81-5100 Fax: 0265-81-1256
URL: http://www.nagano-nurs.ac.jp/
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