Practice developmentthrough collaborative research:

A global perspective
<Running titleDevelopment through collaboration

Yoshie Mori, RN, NM,PHN,PhD

Graduate School, Gunma University
3-39-22, Showa-machi, Maebashi, Gunma, 371-8514 Japan
myoshie@gunma-u.ac.jp
TEL/FAX 81-27-220-8924

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
international nursing cooperation, I started
co-researchers who have undergone experiences
research funds obtained for the abovementioned

they will be able to provide high-quality,

a collaborative research together with
as volunteers dispatched by JICA with the
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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