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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. [ABSTRACT FROM AUTHOR]

This research examined the experience of Amyotrophic Lateral Sclerosis (ALS) patients who depend on an invasive mechanical ventilator in Japan. We investigated their difficulties in expressing their needs, their desires and wishes, and their sources of support and happiness. We examined the relationship between these factors and patient demographics, and hope as an indicator of successful adaptation to the illness experience (assessed by the Herth Hope Index). Interview results guided the formation of an anonymous questionnaire distributed to patients by mail. We interviewed 27 patients and their families and surveyed 157 respondents with a questionnaire. Most patients experienced multiple categories of difficulties, which correlated with reduced hope. More severe physical symptoms correlated with more emotional and social difficulties. Notable findings included a high prevalence of unalleviated pain, fear or experience of ventilator difficulties, and fear of burdening others. Having more sources of psychosocial support and happiness was associated with greater hope. Living at home was associated with fewer social difficulties. No patients claimed additional sources of support without claiming family or professional caregiver support, suggesting their mediation may be crucial in maintaining other social connections. Users of computer communication reported more sources of support and happiness and less frustration from difficulty expressing themselves. The most common reported desires, following a cure for ALS, related to the happiness of the patients' families, and a desire not to burden them. We also found that invasive mechanical ventilation (IMV) had been initiated emergently in 30.1% of patients without patient or family consent. Our results provide an insight into the world of this challenged population, elucidating the difficulties they face, and clarifying the role of support and other factors in maintaining hope. We identify concrete areas to which increased attention should be directed in patient care. Keywords: Amyotrophic lateral sclerosis; Hope; Invasive mechanical ventilator; Expression; Psychosocial support; Difficulties; Japan

Author(s): Yuko Hirano [1]; Klavs B. Hendil [2]; Hideki Yashiroda [1]; Shun-ichiro Iemura [3]; Ryoichi Nagane [3]; Yusaku Hioki [3]; Tohru Natsume [3]; Keiji Tanaka (corresponding author) [1]; Shigeo Murata [...]

This article scrutinizes the situation of Filipino nurses and Japanese hospital staff under the Japan-Philippines Economic Partnership Agreement (JPEPA). As the agreement prioritizes the enhancement of free trade between the two countries in accordance with WTO (World Trade Organization) regulations and the principle of bilateral relations, it compromises the professional practice of Filipino nurses who enter Japan. Based on a construction analysis of JPEPA's provisions on the movement of natural persons (MNP), interwoven with interviews with Filipino nurses and Japanese hospital staff, this article points out that the MNP scheme of JPEPA devises a "double-standard employment," which permits Filipino nurses to work in Japan (recognition of right to employment) but does not permit them to practice their profession (denial of right to practice), until they pass Japan's National Board Examination (NBE) for nurses. As a result, they are prevented from earning a desirable amount. Worse, even if they pass the NBE and are allowed to work in Japan for the long term, the program and other current pertinent laws do not allow them to raise a family in Japan. Without a clear vision of a career path or a future family life, Filipino nurses tend to be discouraged from studying and working enthusiastically to prepare for the NBE. Such predicament is caused by a loophole in an agreement dealing with natural persons in economic terms. It is important that each nurse under JPEPA is treated with due respect as an individual, not as economic goods. [ABSTRACT FROM AUTHOR]

This article surveys the trajectory of the problematic implementation of, and later amendments to, the Japan-Philippines Economic Partnership Agreement (JPEPA)'s Movement of Natural Persons provisions between 2009 and 2016, with reference to the Japan-Indonesia Economic Partnership Agreement (JIEPA) and the Japan-Vietnam Economic Partnership Agreement (JVEPA). It draws on official documents of the Ministry of Foreign Affairs of Japan (MOFA), the Ministry of Health, Labour and Welfare of Japan (MHLW), Japan International Corporation of Welfare Services (JICWELS), and the Philippine Overseas Employment Administration (POEA), among others, as well as a structured survey conducted among the Japanese employers who accepted the first batch of Filipino EPA nurse candidates in 2011, a year after the deployment of Filipino nurses. The study is based on formal and informal interviews since the early 200s with the government officers of the pertaining countries, EPA nurse candidates, and Japanese language education experts. In addition, the paper refers to the recently introduced English proficiency standard for foreign nurse applicants in Australia to reflect on Japanese language requirements in the EPA-MNP scheme. This study identified the learning of the Japanese language - and the difficulties thereof-as a key element of the scheme, and shows that a series of merely short-term amendments have been made to address the issues. The article concludes by suggesting a more systematic management of the EPA-MNP scheme, especially in matters concerning Japanese language training. [ABSTRACT FROM AUTHOR]

Japan has been receiving Filipino nurses under the Economic Partnership Agreement (EPA) since 2009. Under the agreement, they must pass the National Board Examination (NBE)-conducted in the Japanese language-so that they can continue working (as fully fledged nurses) in Japan. It is a challenging requirement for foreign nurses. Indeed, the passing rate in the NBEs turned out to be considerably low (approximately 10 percent). It is essential for both Philippine and Japanese stakeholders to identify the factors contributing thereto. In this light, this article presents the result of the study that observes the distribution of the accuracy rate of Filipino EPA nurses who entered Japan in 2009 in a practice exam of the NBE, which comprised 240 questions. The performance of Japanese examinees in the actual NBE for nurses in 2009 conducted in Japanese was referred to as a benchmark. Among the eleven officially designated categories of nursing, including seven categories from clinical nursing and four categories from the basics of nursing sciences, the average score in each category in clinical nursing ranged from 60.2 percent to 73.2 percent. For the basics of nursing sciences, it was from 55.3 percent to 78.9 percent. Among the Filipino examinees, there was a huge gap in accuracy rate between those who had seen the questions of NBE for nurses of any of the previous years on the one hand, and those who had never seen them on the other. While 57.1 percent of those who had previously seen the exam questions could satisfy the passing rate, only 23.7 percent of those who had never seen them could do that. The study also shows that Filipino nurses in average marked higher points in questions on the knowledge on pharmacology and physiology than their Japanese counterparts, while they marked in average lower points in gerontology nursing than their Japanese peers. From the practice examination result, it is suggested that the obstacles facing the Filipino EPA nurse in passing the National Board Examination concern not only Japanese language proficiency but also differences in examination style, nursing education curriculum, and basic nursing policies in the Philippines and Japan. [ABSTRACT FROM AUTHOR]