Barriers encountered by walk-in international patients in hospital emergency departments in Japan: A qualitative study

INTRODUCTION: The rise in international residents and visitors has increased the number of patients from diverse cultural and linguistic backgrounds in Japanese emergency departments (EDs). However, the challenges encountered by walk-in international patients seeking emergency care remain underexplored, highlighting the need for a better understanding of these barriers and the care provided by ED nurses. This study aimed to investigate the barriers perceived by walk-in international patients visiting EDs in Japan and their perceived experiences of the support provided by ED nurses. METHODS: We adopted a qualitative descriptive approach utilizing purposive sampling and the snowball technique. Semi-structured virtual interviews were conducted with 15 international patients to explore their experiences in Japanese EDs. Data were analyzed using reflexive thematic analysis, and the Standards for Reporting Qualitative Research checklist ensured comprehensive reporting. RESULTS: The analysis revealed four major themes: "conflict of culture," "provider-centered care," "hesitation to engage in culturally sensitive care," and "building connections beyond language barriers." CONCLUSION: This study highlights the challenges of providing emergency care to international patients in Japan, and stresses the need for culturally competent care to improve patient safety and treatment quality.