title: Cross-cultural comparison of long-term psychiatric patients hospitalized in Tokyo, Japan and Honolulu, Hawaii.
abstract: 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.
authors.affiliation: School of Nursing, University of Hawaii, Honolulu 96822, USA. anders@hawaii.edu
authors.forename: R L
authors.initials: RL
authors.lastname: Anders
authors.forename: M
authors.initials: M
authors.lastname: Kawano
authors.forename: C
authors.initials: C
authors.lastname: Mori
authors.forename: H
authors.initials: H
authors.lastname: Kokusho
authors.forename: J
authors.initials: J
authors.lastname: Tomai
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003134:Commitment of Persons with Psychiatric Disorders; D003431:Cross-Cultural Comparison; D005260:Female; D005555:Forensic Psychiatry / Q000379:methods*; D006254:Hawaii; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric; D006801:Humans; D008134:Long-Term Care; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy*; D008875:Middle Aged; D009733:Nursing Diagnosis / Q000706:statistics & numerical data; D011568:Psychiatric Nursing / Q000379:methods*; D011795:Surveys and Questionnaires; D014041:Tokyo
chemical_list: D014150:Antipsychotic Agents