Development of the Inpatient Dignity Scale Through Studies in Japan, Singapore, and the United Kingdom.

PURPOSE: The importance of human dignity in care is well-recognized. Care recipients' experiences with undignified care have been reported in many countries. However, few studies have measured these situations quantitatively, especially as there are no tools applicable to inpatients receiving ordinary daily care. This study aimed to develop a valid and reliable Inpatient Dignity Scale (IPDS) that can measure inpatients' expectations of and satisfaction with dignity in daily care. METHODS: We conducted a three-phase research project: item generation and a preliminary survey with 47 items related to patients' dignity in Japan, a main survey with 36 items with deliberate translation into English in Singapore, and a confirmatory survey with 35 items in England, with 442, 430, and 500 inpatients as participants in questionnaire surveys, respectively. Data from each survey were processed using factor analysis. RESULTS: Authors obtained a scale with a four-factor structure with acceptable reliability: (F1) respect as a human being, (F2) respect for personal feelings and time, (F3) respect for privacy, and (F4) respect for autonomy. CONCLUSION: The Inpatient Dignity Scale can be periodically used by hospital administrators or nurses to preserve inpatients' dignity in daily care by monitoring inpatients' views regarding their expectations of and satisfaction with dignity.

Transformative elements of intercultural education for Japanese nursing students.

There has been little research exploring Japanese nursing students' experiences of having Western instructors in their nursing programs. The purpose of the present study was to describe Japanese nursing students' lived experiences of being taught by foreign faculty. A qualitative design using an interpretive phenomenology approach was used with purposeful sampling. Graduate and undergraduate nursing students (n = 13), who had the experience of being taught by a foreign faculty member for at least one semester, were recruited. Six themes emerged that suggested the participants went through an evolutionary process as they worked to understand and make meaning of these intercultural experiences: struggling with uncertainty, working to understand, discovering differences in teaching styles, opening my eyes to the world, thinking differently now, and wanting to know more. The work students must do to understand foreign teachers influences what they are able to learn, and must be taken into consideration by both faculty and students. To fully realize meaningful teaching outcomes within this intercultural context, it is essential that students have sustained exposure to foreign faculty.

The Japanese value of harmony and nursing ethics.

Harmony is one of the most fundamental Japanese values. It is derived from Confucianism and encompasses a state of mind, an action process and outcomes of the action. This article draws on research data and discusses Japanese nurses' perceptions of harmony as reflected in their everyday practice. The most important virtues for these nurses were reported as politeness and respect for other persons. The outcome from the nurses' harmonious practice, it is claimed, benefited patients and created peaceful, harmonious relationships for all. Because of the unique link between harmony and the location of interaction, the ideal 'workplace harmony' threatened some nurses' professional decision making. These nurses confused harmony with conformity by superficial agreement. The Japanese seniority system could be a major factor contributing to this problem. Ethics education that includes traditional values and concepts in Japanese culture is strongly urged.

Locating non-working nurses in Japan: A feasibility study.

In order to examine feasibility and to describe characteristics of nurses who were not working as nurses, a questionnaire survey was conducted using channels of newspaper distribution. 70 cases responded, with an estimated response rate of 12%. Age distribution was unimodal with a peak in the 30s. This shape and the age distribution for working nurses obtained by our previous survey were mutually complementary. The result shows that such a method of data collection can be representative of the characteristics of nurses who are not working as nurses to some extent, and has some feasibility. At present there is no other way. However, in the near future, a license renewal system should be built, which would allow collection of information from whole nursing license holders.

Japanese patients' descriptions of "the good nurse": personal involvement and professionalism.

According to recent nursing literature, virtue ethics is regaining attention as a way to establish a comprehensive nursing ethical model, which will appropriately reflect actual nursing. This study explored the characteristics of "the good nurse" as an ethical ideal from Japanese patients' perspectives. The findings described the good nurse for Japanese nursing care recipients and delineated their expectations of her or him. For Japanese patients, the good nurse was a person with personal involvement and professional comportment. The study revealed the participants' perspectives of the importance of person-to-person relationships between nurses and patients, and of nurses' professional disposition and competency.