Cross-cultural comparison of long-term psychiatric patients hospitalized in Tokyo, Japan and Honolulu, Hawaii

The aim of this study is to cross‐culturally explore the crucial and often conflicting issues of least restrictive placement of long‐term psychiatric patients in Hawaii and Japan, and the need to provide high‐quality care for such patients. Policy implications are discussed. A survey instrument faci...

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Bibliographic Details
Published in:	Nursing & health sciences Vol. 1; no. 1; pp. 35 - 44
Main Authors:	Anders, Robert, Kawano, Masashi, Mori, Chizura, Kokusho, Hiroko, Tomai, Jan
Format:	Journal Article
Language:	English
Published:	Melbourne, Australia Blackwell Science Asia Pty. Ltd 01-03-1999
Subjects:	Adult Antipsychotic Agents - therapeutic use Commitment of Mentally Ill Cross-Cultural Comparison Female Forensic Psychiatry - methods Hawaii Hospitalization - statistics & numerical data hospitalizations Hospitals, Psychiatric Humans Japan Long-Term Care Male Mental Disorders - diagnosis Mental Disorders - ethnology Mental Disorders - therapy Middle Aged Nursing Nursing Diagnosis - statistics & numerical data Psychiatric Nursing - methods psychiatric patients Surveys and Questionnaires Tokyo Hawaii Tokyo
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Summary:	The aim of this study is to cross‐culturally explore the crucial and often conflicting issues of least restrictive placement of long‐term psychiatric patients in Hawaii and Japan, and the need to provide high‐quality care for such patients. Policy implications are discussed. A survey instrument facilitated the comparison of records from psychiatric patients hospitalized over 1 year in Hawaii, as of January 1993, and psychiatric patients hospitalized over 1 year in Japan, as of January 1996. The survey instrument was translated and validated for use in both countries. Interrater reliability averaged 0.96. The 30 subjects in Japan were all men (Japanese), and primarily unmarried. The 83 subjects in Hawaii were mostly men (Hawaiian or other ethnic minority), and unmarried. Subjects in Japan tended to be older, hospitalized longer, and were judged to be more dysfunctional than those in Hawaii. No significant relationship was revealed between nursing diagnoses and Axis I diagnoses in either sample. Although significant clinical differences were found between the two groups, the policy issues are similar: how to place patients in the least restrictive environment and how to provide high quality of care given the limited available resources. Nurses in both countries must become more vocal advocates for policy changes to improve the care of long‐term patients.
Bibliography:	istex:479F7EE5BEAD2DB3BBF7FB345F0A36E9267C69A0 ArticleID:NHS6 ark:/67375/WNG-6MPW88HH-V ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1441-0745 1442-2018
DOI:	10.1046/j.1442-2018.1999.00006.x