Practice developmentthrough collaborative research:

A global perspective

Abstract

My interest in collaborative researches was triggered by my involvement in international cooperation in developing countries in nursing. 1) Disaster nursing education including practical training to students and nurses in collaboration with a university in Nicaragua. Nicaraguan co-researchers provided training to the staff of a host-hospital of practical training. 2) Studies on differences in nursing with some developing countries in collaboration with universities. Their findings have been incorporated into lectures as issues for consideration in international cooperation in nursing. 3) A study on nursing practice in Indonesia was conducted by a graduate student of mine at Gunma University and a lecturer at Padjadjaran University. 4) Aon-going study on distance education with universities in three countries. Keys to success: 1) Good communication, 2) Trust relationship and equal relationship, 3) Similar interest, aspiration and motivation, and common goal, 4) Equal basic research skills, and 5) Agreement on research expenses

Key words: Nursing, practice, collaborative research, international

1. Introduction

In Japan, collaborative researches are often conducted between universities, universities and research institutes, or universities and enterprises. In a collaborative research between a university and enterprise, a formal contract is signed prior to its start. On the other hand, in aresearch between universities or a university and research institute, it is frequently started based on the trust relationship between individual researchers. A number of international collaborative researches are conducted in the fields of biotechnology and information technology with the USA and European countries.

Regarding the field of nursing, however, the number of collaborative researches is still quite limited. In Japan comparative studies primarily constituted the mainstream of its past conventional collaborativeinternationalresearches in nursing. In such studies, the instrument developed in the USA is translated into Japanese, which is then applied to the studies in Japan, and their results are compared with those of the US studies. Many Japanese researchers in nursing have preferred theUSA and European countries. In particular the greatest number went to the USA, and the researchers who have come back from their studies there introduce its nursing theories, knowledge and techniques, which createsmore opportunities forcollaborative researches and exchanges with the USA. Thus, collaborative researches have often been conducted by using the networks of such returnee researchers.

However, my experiences are rather unique among such Japanese researchers, and I conduct my collaborative researches incountries other than the USA. The reason for this relates to my activities abroadin international cooperation in nursing for developing countriesfor the last 20 years. This paper focuses on my collaborative researches conducted in the countries where I have been involved in international cooperation activity, and their results.

2. My researches in developing countries 1) Collaborative research regarding disaster nursing

Japan implemented the first project in nursing education in Indonesia for five years from 1978 through JICA,the ODA execution organization;that was thenfollowed by similar projects ineleven countries.As a project, JICA also dispatched some experts each in nursing education to many countries. I was dispatched to Honduras, Sri Lanka, Nicaragua, and Uzbekistan as one of such experts. In Nicaragua I was dispatched to the National Autonomous Universityof Nicaragua Managua (UNAN-Managua) as an advisor to the dean for a period of four months. This gave me the opportunity to conduct an international collaborative research later. One year prior to my dispatch, Hurricane Mitch, one of the most powerful hurricanesof the 20th century, struck the Central Americaregion and claimed a number of victims. When I was dispatched, its aftermath could still be observed. In one town, for instance, the water level of a lake nearby remained high, thus still leaving roads and houses

under water. UNAN-Managua planned a panel discussionon disaster nursing in a training seminarfor university graduates and requested me to join the discussion as a panelist. I talked about the way in which the Japan Nursing Association systematically dispatched its member nurses in the aftermath of the Great Hanshin Earthquake and my nine-day experience in nursing activity as one of them. I also discussed the process of how Japan developed and incorporated the study of disaster nursing into subsequent nursing education programs. Obviously my talk had a substantial impact: disaster nursing was included in the nursing education curriculum of the new academic year which began three months later. However, I finished the term of my dispatch and came back to Japan before I could give advice as to the content of disaster nursing education. This issue lingered on in my mind. Three years later, I obtained the states scientific research funds for the subjectChanges in awareness for and behavior indisasters through disaster nursing education in developing countries. I began a collaborative research with three Japanese researchers and nursing staff at UNAN-Managua. The Nicaraguan co-researchers were the professors with whom I had worked during the duration of my dispatch as a nursing education expert. In this collaborative research, the researchers of both countries provided disaster nursing education to students and nurses (including practical training within the region) and compared their reaction before and after, whereby we were able to explorean education program thatwas mostsuited to Nicaragua. We reported the findings of this disaster nursing education research in Nicaragua at the 22nd(Mori et al. 2001) and 23rd ICN Quadrennial Congress(Mori et al. 2005). Through this collaborative research, the Nicaraguan side explored disaster nursing education which would be most effective in Nicaragua and revised its subsequent disaster nursing education program. During the research period, at one of the hospitals that hosted practical training, we conducted a simulation of a disaster for their staff members. The research adopted the approach of action research known as a methodthat instigates changes. Indeed, it changed the content of actual education just as we had expected. On the other hand, the Japan side was able to gain hints on disaster education particularly from the perspective of regional disasters.

2)Studies on differences in nursing with some developing countries JICA has dispatched approximately 2,500 nurses as volunteers to developing countries

around the world over the last 47 years. Nonetheless, in all likelihood it is not alwaysthe case that they conduct nursing activitywhich is highly effectivein a given country. Now Iassume the position of technical advisor and give advice to the volunteers dispatched by JICA. In order to explore the ways in which they will be able to provide high-quality, international nursing cooperation, I started a collaborative research together with co-researchers who have undergone experiences as volunteers dispatched by JICA with the research funds obtained for the abovementioned subject. We analyzed the periodic reports sent by volunteer nurses, had interviews with them, and conducted a field study to observe nursing practice (Miyakshi et al. 2008), (Takada et al. 2009, 2010), (tsujimura et al. 2009).In

the field study, we could have cooperation from the researchers with whom we have developed relationships through international cooperation and exchanges between universities. The findings of the research are discussed below (Mori et al., 2010):

Some cases are attributable to differences in the roles of nurses between Japan and the country they were assigned to.

The most typical one is feculence treatment; In Japan, nurses are responsible for part of the feculence treatment process, but in those countries, it is considered that it is not nurses but other kinds of people to perform such work, according to the countrys social system like caste.

While bed bath with hot water is preferred in Japan, other methods are used because of difference in climate.

Like differences of transfer methods with a stretcher, some differences are rooted in the culture. In some countries, a dead patient is only transferred with his/her feet being laid ahead on the stretcher.

Due to inadequacy of items, substitute means seem to be used. Some practices appear to be inappropriate against the world standards. It is not known that

they may be due to lack of new knowledge, or due to whether or not there are some reasons even though they are apparently inappropriate practices.

We plan a further research with the focus on some nursing techniques by inviting co-researchers from additional countries.

Our researchs findings at this point of timeare incorporatedinto the lectures given prior to the dispatch of volunteer nurses as important issues to be kept in mind in international cooperation in nursing.

2) A study titled Details and quantity of services provided by nurses working in a hospital in Indonesia(Tosaki Y, 2012) This study was conducted by a graduate student under my supervision in collaboration

with Ms. Hana Rizmadewi Atustina of Padjadjaran University in Indonesia in September 2011 and written as a masters degree thesis paper. The paper has revealed the features of nursing in Indonesia in comparison with that of Japan in terms of the content and quantity of nurses duties by using the time study method. Its findings will, no doubt, contribute to improving the training program for the Indonesian nurses whom Japan began to accept several years ago. The study will be reported inacademic meetings and journals.

3) On-going study: Study on distance education A study has been in progress for about one year at one university each in Sri Lanka,

Mongolia and Nicaragua. I have developed relationships primarily through technical

cooperation with all of these three universities. I believe that its findings will provide some hints on nursing education inuniversity and physical therapy education in the future.

3. Requirements forcollaborative researches Good communication

One of the reasons why a collaborative research does notproceedsmoothly in some cases is that there is no common language in which researcherscan fully communicatewith each other. A collaborative research cannot be smoothly conducted unless one researcher has a good command of the others language or both researchers share a common language that can be used as a tool to understand each other. Trust relationship and equal relationship

In absence of a trusting relationship, any joint undertaking is bound for prompt failure. Likewise, a research project in which one member only is charged with the task of data collection would not be of mutual benefit. Joint undertakings must be based on equalityamong partners if the relationship is to realize its maximum potential. Similar interest, aspiration and motivation, and common goal

When both researchers share a similar interest, aspiration and motivation and a common goal, it is possible to design a well-balanced research, based on which data collection and evaluation will proceed smoothly. Equal basic research skills

In order to conduct a collaborativeresearch, essential is that the researchers share the basic knowledge and understanding related to the research. If one side is insufficient in this matter, the other must conduct it while giving detailed guidance, which imposes a heavy burden on the latter. Agreement on research expenses

The issue of money may cause a major problem. Depending upon the situation of one side, the other may have to pay a greater portion. It is essential to fully discuss the matter prior to the start of a research. In an international collaborative research, researchers must often travel, thereby pushing up its research funds. Hence, in order to conduct a collaborative research stably, it is necessary to secure a larger amount of research funds than other normal researches. The fact that research funds have been successfully acquiredenhancesthe motivation to carry through the research as well.

Acknowledgement The researches above have been conducted by the author and many co-researchers in

various countries where the author worked as a JICA expert on nursing education.The authorwould like to express deepest gratitude to them and JICA. Special thanks should be given to co-researchers of on-going study: distance education.

Some of the researches above were supported by Grant-Aids for Scientific

research(No.15592222, No.19592429 and No.23390486).

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