Disability in the Far East: Japan’s Social Transformation in Perceptions of People with Disabilities

The phenomenon of disability is socially constructed; therefore, it is not free from norms, rules, shared understandings or value systems—in short, culture. This paper examines the universal presence of disability in the Japanese context, which is affected by a myriad of ever-changing influences, including political, cultural, and social forces

An adjustment process and communication dilemma of people with disabilities in Japan.

Throughout their lives, people make various kinds of adjustments. Most people are capable of making adjustments in order to survive challenging experiences. This fact is especially true for newly disabled individuals whose lives have been turned upside down. An adjustment to a severe disability is accompanied by significant psychological (lowered self-esteem), physical (restricted mobility), and social (changed social identity, "disabled") changes, and such sudden changes also require short-term (physical) and long-term (psychological and social) adjustments. In other words, the investigation of adjustment to a disability gives social scientists a unique opportunity to study various facets of human adjustment strategies and processes. This research focuses on how people with disabilities in Japan have changed their worlds after acquiring a disability. The researcher used ethnography and an interview method to follow the participants' disability transformations for three years. Several themes emerged, such as information pooling places for the disabled, interacting with others with disability and adjustment to the disability, negotiation with the non-disabled, an early going-out as a prologue to the disability adjustment, changed perceptions toward the wheelchair, and changed communication with others, just name few. Moreover, based on these themes, this researcher generated three binary oppositions. They are integration-separation, defying disability-accepting disability, and independence-dependence. In the end, it was concluded that communication was the main vehicle for the disability adjustment. The researcher summed up that communication with others facilitated the participants' disability transformations, and in return, they adjusted their communication as they adjusted to their disability

Patient experience (PX) among individuals with disabilities in Japan: a mixed-methods study

[Background] People with disabilities (PWDs) tend to be disadvantaged in terms of receiving preventive medicine and medical checkups. About 7.6% of the Japanese population is estimated to have a disability. Although patient experience (PX) is an effective measure of patient-centeredness, little is known about the PX of PWDs. The present study aimed to compare the PX of PWDs with those of the non-disabled both quantitatively and qualitatively. [Methods] The present study involved a questionnaire survey and a free-response question on the survey form. The quantitative part of the study involved a comparison of JPCAT scores between PWDs and non-disabled participants. JPCAT is composed of five primary care principles: First contact, Longitudinality, Coordination, Comprehensiveness (service provided and service available), and Community orientation. Descriptive statistics were used to assess age, sex, years of education, self-rated health status, and type of disability (for PWDs). Multivariable analysis was performed using a linear regression model to detect differences between PWDs and non-disabled participants in total and domain-specific JPCAT scores. The model included the following confounding variables: age, sex, years of education, and self-rated health status. The qualitative part of the study involved a thematic analysis of answers to the free-response question. [Results] Data from 338 participants (169 PWDs and 169 non-disabled participants) were analyzed (response rate of 36% for PWDs). After adjusting for age, sex, years of education, and self-rated health status, PWD scores were significantly lower than those of non-disabled participants for the Longitudinality, Community Orientation, and Comprehensiveness (services available) domains of the JPCAT. Qualitative analysis yielded six themes, each of which was further divided to have Disability-Specific and General themes. [Conclusions] JPCAT scores in PWDs were significantly lower than those of non-disabled participants for the Longitudinality, Community Orientation, and Comprehensiveness (services available) domains. Qualitative analysis revealed that PWDs shared several themes with non-disabled participants, but also to face unique challenges due to disabilities, such as the lack of a health care provider familiar with disabilities and the insurance transition at age 65, a unique feature of the Japanese health care system. [Trial registration] The study was a non-interventional, observational research trial, and thus registration was not required

Experiences and attitudes of residents regarding a community-based genome cohort study in Japan: A population-based, cross-sectional study

Background: Because of the rapid development in genomics, more research findings have emerged. However, the association between society and research results remains controversial. This article examines the experiences and attitudes of residents regarding a community-based genomic cohort study. Methods: This study was conducted as a part of the health survey of the City Health Promotion section. At the conclusion of the first stage of the project, a self-administered questionnaire was mailed to a random sample of 2, 500 residents in 2012. Results: The response rate was 59 % (n = 1477/2500). The findings show that 70 % of males and 50 % of females knew nothing about the project. Females and elderly people were more likely to have knowledge of the study, indicating that self-rated understanding of the terminology is statistically associated with the level of awareness regarding the project. In addition, those who were aware of the project were also aware of the benefits of research utilizing genetic information, whereas unaware respondents, particularly males, believed that unexpected negative effects may occur. Those with higher self-rated understanding of the terminology and higher awareness of benefit of the research utilizing genetic information had more positive attitudes toward undergoing drug susceptibility genetic testing, indicating that the awareness of project in females and concerns toward genetic research are not statistically associated with the willingness to undergo. Conclusions: This study suggests that a community-based genome cohort project helps raise awareness of benefit of genetic research and that knowledge, however, does not directly affect the willingness to participate in related activities, such as drug susceptibility genetic testing. Therefore, additional research that focuses on the circular relationship between risk and action must be conducted in the future

"When I am in Japan, I feel as though I'm not disabled": A cross-cultural adjustment study of trainees with disabilities from Asia-Pacific regions

This study aims to examine the cross-cultural adjustment processes of trainees with disabilities from Asia-Pacific regions, with the aim to explore factors that influence cross-cultural adjustments and uncover experiences by individuals with disabilities. We interviewed a total of 13 trainees, some of whom were interviewed multiple times. Several factors (e.g., affluence of the Japanese lifestyle, maintaining contact with home via the Internet, and/or previous knowledge of the host culture) greatly affected their transitions to Japan. Notably, participant adjustments were made on several different levels, including physical, social, and attitudinal

Perceptions of government guidance and citizen responses during the COVID-19 pandemic: A cross-country analysis

The public perception of government approaches to pandemic management has played an important role in citizen responses to the COVID-19 pandemic. Although the state and associated health institutions should feasibly be sources of epistemic authority, the pandemic has undermined their legitimacy as anti-science rhetoric proliferated and ‘fake news’ spread rapidly. In this paper, we present a comparative analysis of interviews with citizens across four different countries and explore how a lack of consistency and clarity in public health guidance from government and other trusted institutions led to a polarisation in public perceptions and mixed understandings of the pandemic. Using interview data collected across Brazil, Japan, Spain and the United Kingdom, we explored whether there were differences in the extent to which both state governments and scientific institutions were perceived as epistemic authorities through managing the pandemic. Participants grappled with a distrust of government guidelines, finding alternative sources of information to manage perceived infection risk, and make decisions around self-medication. Our analysis suggests several components were key to maintaining trust – and therefore epistemic authority – during the pandemic: reliability of the information delivered by different government bodies, including clarity of messaging; reliability of the government bodies themselves, including whether officials conducted themselves appropriately; and honesty about claims to expertise, including communicating when the scientific evidence was unclear or inconclusive. Our data suggests that honest communication about the limits of their knowledge would assist governments in engendering trust among citizens, and theoretically, compliance with public health guidelines