title: Issues in healthcare services in Malaysia as experienced by Japanese retirees.
abstract: Worldwide, international retirement migration is growing in its popularity and Japanese retirees choose Malaysia as their most preferred destination. This study examines the pertinent issues related to healthcare services as experienced by Japanese retirees in this country.
  
  
  
  From January to March 2015, we conducted focus group discussions with 30 Japanese retirees who live in Kuala Lumpur and Ipoh. Guided by the social-ecological model, we discovered seven pertinent themes: 'language barriers','healthcare decisions', 'medical check-ups','healthcare insurance', 'nursing and palliative care', 'trust and distrust of healthcare services', and 'word-of-mouth information'.
  
  
  
  We identified seven pertinent issues related to healthcare services among Japanese retirees in Malaysia, of which four are especially important. These issues are explained as integrated themes within the social-ecological model. Language barriers prohibit them from having difficulty accessing to healthcare in Malaysia, but lack of will to improve their language skills exist among them. For that reason, they rely heavily on word-of-mouth information when seeking for healthcare. As a consequence, some develop feelings of trust and distrust of healthcare services. In addition, we have identified the needs for provide nursing and palliative care among Japanese retirees in Malaysia.
  
  
  
  Based on the magnitude of the discussion, we concluded that there are four crucial healthcare issues among Japanese retirees; 'language barriers', 'trust and distrust of healthcare services', 'word-of-mouth information' and 'nursing and palliative care'. We propose that further dialogue by healthcare stakeholders should be carried out to improve further the healthcare service provisions for Japanese retirees in Malaysia.
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. kohnoayako@gmail.com.|Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan. kohnoayako@gmail.com.
authors.forename: Ayako
authors.initials: A
authors.lastname: Kohno
authors.affiliation: Faculty of Business and Accountancy, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Ghazali
authors.initials: G
authors.lastname: Musa
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Nik Daliana
authors.initials: ND
authors.lastname: Nik Farid
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Norlaili
authors.initials: N
authors.lastname: Abdul Aziz
authors.affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.|Julius Centre, University of Malaya (JCUM), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Maznah
authors.initials: M
authors.lastname: Dahlui
mesh_terms: D000368:Aged; D001294:Attitude to Health; D003144:Communication Barriers; D003695:Delivery of Health Care / Q000592:standards; D054242:Emigrants and Immigrants / Q000523:psychology*; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility / Q000592:standards; D006299:Health Services for the Aged / Q000592:standards*; D006801:Humans; D007564:Japan / Q000208:ethnology; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D012179:Retirement / Q000523:psychology* / Q000706:statistics & numerical data; D035502:Trust
keywords: Focus group discussion; Healthcare; Japanese retirees; Malaysia my second home; Qualitative study