The document discusses several key aspects of Japanese culture including: 1. Traditional values like memorialism, respect, fear of impurity, and safety/security shape Japanese culture. The major language is Japanese using kanji characters. Common habits include long commutes, overtime work, and not using air conditioning. 2. There is a belief in alternative therapies and anxiety around ages thought to bring illness. A collective thinking views individual success as benefiting the whole. Death rituals focus on memorializing ancestors which is important in Shintoism and Buddhism. 3. Patient autonomy is respected in healthcare decisions but collective thinking can decrease individuality, so nurses encourage open communication. Nutritious diets emphasize variety and balance with

1. Japanese People
Transcultural Nursing
Is all that white powder
good for the skin?

2. Take a closer look:
Children, Food, Lifestyle, and Tragedy

3. Primary values of the group
4 key themes:
■ Memorialism
■ Respect
■ Fear of impurity
■ Safety and security
“konichiwa”

4. Ways of living, language, and habits
■ Life goals are often to live a self-sufficient and
successful life with a respected and honored reputation.
■ Japanese is the major language which uses kanji utilized
and adapted from the silk road
■ Nursing Advice: some common habits are long train
commutes, working overtime, not using air conditioner
(mostly in elderly)

5. Traditional perceptions of health and
illness
■ Belief and consultation in medicinal, alternative, and
religious therapies
■ Anxiety over Yakudoshi-years of life when one is
thought to be especially susceptible to illness or
misfortune
■ Collective thinking-each person’s success benefits the
whole
■ Traditional healing methods include various therapies:
acupuncture, shaman, religious, medicinal, chiropractic, fortune
telling...

6. Rituals associated with birth &
death/dying
■ Importance of ceremonies and
spirits for healing and passing of
the dead
■ Death rituals and importance of
memorializing ancestors ‘senzo’
are the foundational pillars in the
top two religions: Shinto and
Buddhism

7. Use of advance directives, informed
consent, and client autonomy
■ All used very steadily in Japan
■ High importance placed on patient’s being incorporated
in the decision process and deciding for themselves on
the best plan of action
■ Collective thinking decreases client autonomy and it
relies on the medical professionals to encourage
individual questions and ideas

8. Nutrition and Diet
■ Low concentration of fat
■ Various fermented food options: natto, miso,
kombucha, and vinegared foods
■ Small amounts, frequent meals
■ Focus on diverse foods - goal to eat at least 32 different
types of food a day for health
■ White rice is a staple food and has been increasing the
rate of diabetes in the population

9. Religious influences impacting health
and illness■ Collective thinking-
– What’s better for the group?
■ A sin and shame society
– Moral and social order is maintained by social
pressure and fear of ‘losing face’ publicly. this moral
and social control is preserved through the
avoidance of shame, whether that shame is for the
individual, the family or the institution to which the
person belongs.

10. Hearing about and discussing negative
health information
■ Japanese are very willing to discuss health information
and even to hear the negative parts as well.
■ The harder part is that they may not be willing to share
negative information.
– People’s goals are usually to be self-sufficient (not a
burden), so any problem could be thought of as
burdening the other person.
▪ Nursing Advice: Open communication needs to
be continually encouraged to prevent this issue.

11. Perceptions of time, orientation, family
roles, and gender issues
■ Decisional authority has typically been placed on the
man. However, as marriages and families have lessened
women are often involved in the decision making
process as well.
■ Women and men are both well equipped in school and
given equal opportunity within the workplace.
■ Conversation is less blunt and often ‘steps around the
subject’ for politeness.
■ Nursing Advice: Questions need to be asked
appropriately to provide with truthful responses

12. Child rearing practices
■ Childhood is seen as having merit and value
“In fact, Chen points out that in Japanese, the word for cultivating a person is
the same as that for cultivating plants. The development of children is
analogous to the cultivation of a tree that first begins with the seedling. As the
tree grows, the grower’s care is needed in the trimming of its branches and
leaves to enable it to grow in the right direction. However, care must also be
taken to let the plant’s own “inner tendencies” unfold before such shaping is
initiated. Shaping should not be started too early. The parent is essential in
starting the child off in the “correct” direction, by providing the proper
education, as the child is ready.(Chao, 2002)”

13. Summary of relationship to the nursing
profession
■ Exercise is made a priority- obesity and weight-related
disorders are not as prevalent
■ Diet is overall healthier but high in sodium- increase in
seafood and pickled foods
■ Mental health is problematic in the cities mostly-
increased work stress and an individualistic, quiet
society
■ Nursing Advice: Connecting the people to a
community helps improve their mental and physical
health.

14. Implications for nursing practice
■ Dietary practices / role of food in
health & illness
■ Chronic/Acute disease issues
■ Healthcare access
■ Governmental Healthcare (Native
Americans
■ Insurance

15. Legal and ethical standards and professional accountability
related to health care and safety of the culturally diverse
client
1. What ANA Scope of Practice Standards apply to culturally competent
care?
2. What about the new legislation many states including Indiana are
pushing through to mandate culturally competent care?

16. Works Cited
Varley, H. P. (2000). Japanese culture. University of Hawaii Press.
Ogasawara, C., Kume, Y., & Andou, M. (2003, September). Family satisfaction with perception of and barriers to terminal
care in Japan. In Oncology nursing forum (Vol. 30, No. 5, pp. E100-E105). Oncology Nursing Society.
Davies, R. J., & Ikeno, O. (Eds.). (2002). The Japanese mind: understanding contemporary Japanese culture. Tuttle Publishing.
Oyama, H., Watanabe, N., Ono, Y., Sakashita, T., Takenoshita, Y., Taguchi, M., ... & Kumagai, K. (2005). Community based
suicide prevention through group activity for the elderly successfully reduced the high suicide rate for females. Psychiatry
and clinical neurosciences, 59(3), 337-344.
Szanto, K., Kalmar, S., Hendin, H., Rihmer, Z., & Mann, J. J. (2007). A suicide prevention program in a region with a very
high suicide rate. Archives of General Psychiatry, 64(8), 914.
Lands, W. E., Hamazaki, T., Yamazaki, K., Okuyama, H., Sakai, K., Goto, Y., & Hubbard, V. S. (1990). Changing dietary
patterns. The American journal of clinical nutrition, 51(6), 991-993.
Lewis, D.C. (1993). The Unseen Face of Japan. Monarch Publications: England.
Chao, R., & Tseng, V. (2002). Parenting of Asians. Handbook of parenting, 4, 59-93.
Omi, S. (2005). Challenges for Family Physicians in the 21st Century.Japanese Journal of Primary Care, 28(4), 284-294.

17. The Gaijin Toolkit
How NOT to feel and act like a tourist while in Japan.
Make the most of every moment in the land of the
rising sun.