Measuring attentiveness toward oral care needs: a comparative study of Indonesian care workers in Japan and Indonesia.

BACKGROUND: Japan has opened its labor market to care workers from Indonesia under the Japan-Indonesia Economic Partnership Agreement (EPA). However, few studies have examined the types of care skills transferred between countries. We therefore analyzed Indonesian care workers employed in Japan and Indonesia to identify discrepancies in their attentiveness toward oral care in older adults. METHODS: A checklist comprising 42 items of universal oral care assessment was developed prior to the study and distributed via the Internet to 418 Indonesian EPA care workers in Japan and via a paper survey to 213 Indonesian care workers in Indonesia. The Mann-Whitney U test was used to compare the distribution of scores for each checklist item for each group. RESULTS: The respondents were 110 Japan-based EPA care workers (response rate: 26.3%) and 213 Indonesia-based care workers (response rate: 99.1%). Japan-based care workers were significantly more likely to perform environmental observations of their older adult patients (p < 0.001) and to check items on the oral care checklist during feeding (p < 0.001) and post-meal (p = 0.001), while Indonesia-based care workers were more likely to check the overall condition of patients before meals (p = 0.021). CONCLUSIONS: Discrepancies in checking oral care between the two groups were attributed to the differences in laws and regulations governing the care environments. Indonesian care workers employed in Japan have the advantage of learning to employ a more systematic approach in caring for older adults, in accordance with Japan's Long-Term Care Act. This approach could contribute toward lowering the risk of aspiration pneumonia in Indonesia. A training program designed for returning migrant workers to transfer newly developed oral care skills will thus be essential for Indonesia to diminish the negative impacts of its aging population.

Factors associated with the recruitment of foreign nurses in Japan: a nationwide study of hospitals.

BACKGROUND: Nurse migration under bilateral agreements is a recent global trend, although lack of consultation with the health industries has led to challenges in the recruitment of foreign nurses by hospitals. To analyze the prevailing perception of hospitals on the Economic Partnership Agreement (EPA), under which Japan opened the doors to foreign nurses, we surveyed hospitals that are yet to employ foreign nurses. METHODS: An anonymous questionnaire was developed and distributed to eligible hospitals; it assessed managers' perception of Japan's policy on the recruitment of foreign nurses and their intentions to hire foreign nurses under the EPA (hereafter called EPA nurses). We randomly selected 1879 hospitals, or 22% of the hospitals in Japan (n = 8540), with more than 20 beds. We used descriptive statistics, a Chi-square test, and logistic regression analysis to identify the predictors and developed a model to predict the likelihood of their intention to recruit EPA nurses in the future. RESULTS: In total, 432 hospitals were eligible for further analysis (response rate: 22.9%). Half (50%) of the hospital managers were considerably interested in Japan's policy on recruiting EPA nurses, although only 20% intended to recruit EPA nurses in the future. Willingness to recruit EPA nurses was associated with the degree of interest in the policy (OR 9.38; 95% CI 4.42-19.90) and managers' perception of EPA nurses (OR 5.32, 95% CI 2.38-11.89). CONCLUSIONS: To attract more hospitals to recruit foreign nurses, it is essential for the Japanese government and the sending countries to review their EPA systems. Utilizing returning nurses to assist language acquisition by the forthcoming EPA nurses could be a provisional solution. For a more fundamental solution, long-term provision, from prior to their migration until their return migration, is needed to encourage brain circulation, as opposed to brain drain, between sending and receiving countries.

Factors Related to Job Continuance of Nurses Who Migrated to Japan: A Cross-Sectional Study.

Japan has accepted nurses from Indonesia, the Philippines, and Vietnam under the Economic Partnership Agreement, but nearly half of them have already left the workforce. This study aimed to clarify the factors related to the job continuance of nurses who migrated to Japan under the Economic Partnership Agreement. Our goal was to explore factors specific to migrant nurses and to contribute to the development of support measures for them. This research was a cross-sectional study in which a web-based questionnaire and interview were conducted at a single point in time. Migrant nurses (n = 40) participated in the web-based questionnaire survey. Of those, nine nurses were also interviewed. Spearman's rank correlation coefficient was used to establish correlations, and qualitative descriptive analysis was used to analyse interviews. The questionnaire survey results revealed the content of work, human relationships in the workplace, the number of night shifts, and satisfaction with the balance between work and private life were significantly and negatively correlated with the Intention to Quit scale total score. All correlation coefficients were less than 0.5, indicating weak correlations. Three categories emerged from the interviews as positive factors related to job continuance: "generous support from the workplace", "beneficial nursing experience in Japan", and "determination to live in Japan". A good working environment, generous support from the supervisor and colleagues, high values of nursing in Japan, and desire to migrate to Japan were the factors that had a positive effect on migrant nurses' job continuance in Japan. Understanding the characteristics of migrant nurses and providing generous support will enable them to continue working in Japan. This study was not registered.