Clinical Nurses’ and Caregivers’ Experiences with and Perceptions of Japanese Dialect: A Collection of Firsthand Experiences with Oita Dialect


Foreign Languages Division  Gerald T. Shirley


1. Introduction

 In hospitals and institutions that have elderly patients, there are many opportunities for dialects to be heard, and words in dialect include many that contain important information and clues in medical and nursing care. Some nurses do not understand the meaning of dialects spoken by the elderly, and for that reason many have experienced problems in giving care. In this study we have extracted from questionnaire surveys to clinical nurses “difficult dialect”, in order to identify the experiences and perceptions of Oita dialect of caregivers at clinical sites. These results were used to create a Collection of Firsthand Experiences with Oita Dialect.


2. Methods

2.1 Method and Subjects

 The investigation used a self-written questionnaire. From July 12, 2004 to September 15, 2004, the questionnaire was given to a total of 707 subjects.


2.2 Survey Contents

 The following were investigated: 1) subject attributes; 2) subjects’ encountering difficulties with dialect used by patients; 3) the attributes of the dialect users and the meaning of the dialect used; 4) the situation when the encounter occurred; 5) the subjects response to the speaker of the dialect; 6) obstacles to nursing services; 7) things they keep in mind in response to patients who frequently use dialect; 8) subjects’ use of dialect with patients; 9) subjects’ opinion of the use of dialect and standard language with patients.


3. Results

3.1 Collection Number (Rate) and Respondent Attributes

  The questionnaire was distributed to 707 people, and responses were obtained from 352 (49.8%). Respondents were 89.2% female and 10.8% male. 83.9% were from Oita Prefecture and 16.1% were from other prefectures.


3.2 Oita dialect encountered by subjects and their experiences with it

 Among the difficult Oita dialect words the following words had a high encounter rate: “Painful” adj. (14.8%), “Heel” n. (9.6%), “Knee” n. (8.9%), “Shoulder blade” n. (4.4%), “Return” v. (3.7%), “Rest” v. (3.7%). 27.4% of the subjects had experienced dialect they could not understand, and 72.6% had no such experience. Among those not understanding, 24.3% answered that this caused problems to providing nursing care.


3.3 The subjects’ opinions on the usage of dialect and of standard language

 49.1% of the subjects used dialect when communicating with patients, 16.1% did not, and 34.8% answered that they did neither. 39.4% thought it was good to use dialect with patients, 1.0% that it was bad, and 59.6% that it was neither good nor bad. 22.5% answered that it was good to use standard language in the clinical setting, and 20.4% distinguished the use of dialect and standard language on a case-by-case basis.


3.4 The creation of a Collection of Firsthand Experiences with Oita Dialect

 A Collection of Firsthand Experiences with Oita Dialect was created based on the survey results. The size is 12.9 cm wide, 18.3 cm long, and the paper size is B6. Two words on one page are posted, 67 words in total, 35 pages.


4. Discussion

4.1 Response of nurses and others to dialect used by patients and facility users

 Almost 30% of nurses had difficulty in encounters with dialect in clinical sites, and the proportion was higher the younger the age and the longer the clinical experience. It is assumed that this is because (1) younger nursing staff cannot understand well the dialect used by the elderly, and (2) nursing staff with longer clinical experience have a deeper understanding of the local dialect, but also more opportunities to contact various other dialects.

 Among those who encountered difficulty with dialect, about 25% had experienced problems related to nursing and long-term care. Among these some had encountered difficulty with dialect in normal work, and some had experienced difficulty in providing nursing care due to lack of understanding. More than half had experienced the same dialect in other situations at a later time, but 94.2% were able to respond smoothly at that time.


4.2 Problems for nurses in using dialects in clinical practice

 Among the results was the opinion that the use of dialect by nurses was impolite. This indicates the fear of giving a bad impression to patients in terms of the treatment by nurses who are members of a service industry. This is also a problem for the facilities they belong to in regards to their reputation. Some subjects had difficulty understanding dialect used by other nurses. This makes it difficult for nurses to communicate with each other, and may be a factor that hinders proper clinical treatment. One of the results of this research was that a majority of the subjects used dialect on a case-by-case basis in the clinical setting. We believe that losing the trust of patients receiving nursing services is an obstacle to appropriate nursing care, so the use of dialect that could lead to such a situation should be eliminated as much as possible. Therefore, we believe that the training of nursing staff should include clarification of the criteria for the proper use of standard language and dialect by nurses.


4.3 Advantages of using dialect in clinical settings by nurses

 In this study, one of the advantages of using dialect was that it brought affinity, warmth and familiarity to the atmosphere of the clinical site. It is thought that communication in dialect helps to reduce the psychological distance between nurses and patients. In addition, communication via dialect may have a positive influence not only on patients but also on their families. A good and trusting relationship can be built around the patient by the good effect of the use of dialect by the nurse to the patient’s family.


4.4 A Collection of Firsthand Experiences with Oita Dialect

  After the creation of a Collection of Firsthand Experiences with Oita Dialect, the authors distributed it to nurses who cooperated with their research. In the future, it will be necessary to ask the opinions of nursing staff about the Collection and revise it to make it easier to use.


5. Conclusion

 In this research, it was revealed that many nursing professionals had experienced difficulty understanding Oita dialect, and that it led to problems in providing nursing care. Various opinions were found to exist regarding the use of dialect and standard languages for nurses at clinical sites, and a formulation of criteria for proper use of dialect and the standard language was raised as a future task. Based on the results of these surveys, we prepared a 35 – page handbook of A Collection of Firsthand Experiences with Oita Dialect.


 This paper was published in the 15th edition of the Journal of the Kyushu Society for Rural Medicine.