Health Sciences University of Hokkaido Academic Repository / 北海道医療大学学術リポジトリ

富田, はるか

38729

関口, 真有

38730

河村, 麻果

38731

本谷, 亮

38732

Japanese

Development of the Supervisors’ Difficulties Questionnaire for Line Care (SDQL) and Examination of its Reliability and Validity

北海道医療大学歯学会

38747

北海道医療大学学術リポジトリ
役員
著者 北海道医療大学歯学会
雑誌名 北海道医療大学歯学雑誌
巻 41
号 1
発行年 2022-06-30
URL http://id.nii.ac.jp/1145/00065093/
編集委員会
委　員　長　　石　井　久　淑
越　智　守　生・斎　藤　隆　史
（アイウエオ順）
北海道医療大学歯学雑誌　第41巻　第 1号
令和 4年 6月30日
発行者　越　　智　　守　　生
編　集　北海道医療大学歯学会
〒061‐0293　北海道石狩郡当別町金沢1757番地
　　　　　　北海道医療大学内
　　　　　　電　話　　0133－23－1211（内線2563）
　　　　　　電話/FAX　0133－23－1345（直通）
　　　　　　メールアドレス：iryo-ds＠hoku-iryo-u.ac.jp
印刷　山藤三陽印刷株式会社
　　　札幌市西区宮の沢１条４丁目16番１号
　　　電話　011（661）7163（代）
北海道医療大学歯学会役員
The　Dental　Society　of　Health　Sciences　University　of　Hokkaido
Editorial　Board
Address　of　Editorial　Board
Editor-in-Chief：Hisayoshi　ISHII
Members：Morio　OCHI, Takashi　SAITOU
　　　　　
Hisayoshi　ISHII
Division　of　Physiology, Department　of　Oral　Biology, School　of　Dentistry,
Health　Sciences　University　of　Hokkaido,
Ishikari-Tobetsu, Hokkaido　061-0293, Japan
E-mail：hisayosh＠hoku-iryo-u. ac. jp
Phone/Fax：＋81　133-23-1239
会　　　　　長　　越　智　守　生
専 務 理 事　　伊　藤　修　一
常 任 理 事　　細　矢　明　宏・舞　田　健　夫（庶務担当）
　　　　　　　　　越　野　　　寿・齋　藤　正　人（会計担当）
　　　　　　　　　石　井　久　淑・志　茂　　　剛（編集担当）
　　　　　　　　　永　野　恵　司・永　易　裕　樹（企画担当）
監　　　　　事　　荒　川　俊　哉・入　江　一　元
President：Morio OCHI
Vice　President：Shuichi ITO
Directors：Akihiro HOSOYA, Takeo MAIDA
　　　　　 Hisashi KOSHINO, Masato SAITO
　　　　　 Hisayoshi ISHII, Tsuyoshi SHIMO
　　　　　 Keiji NAGANO, Hiroki NAGAYASU
Auditors：Toshiya ARAKAWA, Kazuharu IRIE
6704514_H2_3_背.indd   1,3 2022/08/19   11:37:04


役員

髙橋, 昌己

38750

渋井, 徹

38751

秋月, 一城

38752

藤田, 景子

38753

中山, 英二

38754

安彦, 善裕

38755

入江, 一元

38756

Morphological analysis of cemento-osseous dysplasia occurred near the apex of the third mandibular molar.

38797

北海道医療大学学術リポジトリ
編集後記
著者 北海道医療大学歯学会
雑誌名 北海道医療大学歯学雑誌
巻 41
号 1
発行年 2022-06-30
URL http://id.nii.ac.jp/1145/00065104/
編 集 後 記
次号（第41巻，第2号）の発行は令和4年12月31日です．
投稿原稿募集の締め切りは令和4年9月30日必着と致します．期日厳守の上，ご投稿をお願いします．本誌投
稿規定は，2022年第41巻，第1号の巻末をご参照ください．
未曾有のコロナウイルスの大規模感染拡大と予防対策は長期戦を呈する模様です．しかしながら，平常生活を取り
戻すための施策も推し進められており，皆様の研究活動におきましても新たなステージへの進展が訪れることを切に
願っております．また，このような状況におきましても，精力的に論文等を投稿していただいた皆様並びに論文の査
読を快く引き受けていただいた先生方に対しまして心から感謝申し上げます．
本号は原著論文1編，症例報告2編並びに最近のトピックス1編の投稿をいただきました．原著論文では，髙橋昌
己先生（解剖学分野）から下顎智歯根尖部に生じたセメント質骨性異形成症のマイクロCT等を用いた詳細な形態学
的検討の結果が示されており，同形成症の発症過程におけるセメント質と血管ネットワークとの密接な関係が示唆さ
れています．症例報告では，今野正裕先生並びに今野 萌先生（函館こんの歯科・矯正歯科）から，片側性唇顎口蓋
裂の既往を有する成人患者に対する非外科的矯正治療と上顎前方牽引装置を使用した成長期の重度開咬を有する骨格
性下顎前突に関する症例が，それぞれ紹介されています．また，最近のトピックスでは，薬理学分野のMST. Tah-
mina AKTER先生からピロカルピンを用いたドライマウス治療における唾液分泌改善機構に関する最新の知見が紹介
されています．いずれも大変興味深い内容ですので，是非ご一読ください．
コロナ禍において感染拡大予防のため，研究発表や教育体制はオンラインやオンデマンド化への変貌を余儀なくさ
れました．しかしながら，紙や鉛筆或いは人々の触れ合いの重要性は何時の時代になっても普遍であり，これらの基
盤はこれからも変わらないものであると信じています．本誌も，大変興味深く読ませていただき，雲外蒼天を信じる
希望と勇気を与えていただきました皆様に深謝いたします．今後も，歯学雑誌のさらなる充実に努めて参りますの
で，引き続きご支援ご協力を賜りますようどうかよろしくお願いいたします．（石井 記）
57
（57）
第４１巻１号　　　４Ｃ１５０　１Ｃ１３３／本文　※３１‐１から組体裁変更　ＯＴＦ／０５７　　　　　編集後記  2022.08.03 08.46.11  Page 57 


編集後記

38798

北海道医療大学学術リポジトリ
奥付
著者 北海道医療大学歯学会
雑誌名 北海道医療大学歯学雑誌
巻 41
号 1
発行年 2022-06-30
URL http://id.nii.ac.jp/1145/00065105/
編集委員会
委　員　長　　石　井　久　淑
越　智　守　生・斎　藤　隆　史
（アイウエオ順）
北海道医療大学歯学雑誌　第41巻　第 1号
令和 4年 6月30日
発行者　越　　智　　守　　生
編　集　北海道医療大学歯学会
〒061‐0293　北海道石狩郡当別町金沢1757番地
　　　　　　北海道医療大学内
　　　　　　電　話　　0133－23－1211（内線2563）
　　　　　　電話/FAX　0133－23－1345（直通）
　　　　　　メールアドレス：iryo-ds＠hoku-iryo-u.ac.jp
印刷　山藤三陽印刷株式会社
　　　札幌市西区宮の沢１条４丁目16番１号
　　　電話　011（661）7163（代）
北海道医療大学歯学会役員
The　Dental　Society　of　Health　Sciences　University　of　Hokkaido
Editorial　Board
Address　of　Editorial　Board
Editor-in-Chief：Hisayoshi　ISHII
Members：Morio　OCHI, Takashi　SAITOU
　　　　　
Hisayoshi　ISHII
Division　of　Physiology, Department　of　Oral　Biology, School　of　Dentistry,
Health　Sciences　University　of　Hokkaido,
Ishikari-Tobetsu, Hokkaido　061-0293, Japan
E-mail：hisayosh＠hoku-iryo-u. ac. jp
Phone/Fax：＋81　133-23-1239
会　　　　　長　　越　智　守　生
専 務 理 事　　伊　藤　修　一
常 任 理 事　　細　矢　明　宏・舞　田　健　夫（庶務担当）
　　　　　　　　　越　野　　　寿・齋　藤　正　人（会計担当）
　　　　　　　　　石　井　久　淑・志　茂　　　剛（編集担当）
　　　　　　　　　永　野　恵　司・永　易　裕　樹（企画担当）
監　　　　　事　　荒　川　俊　哉・入　江　一　元
President：Morio OCHI
Vice　President：Shuichi ITO
Directors：Akihiro HOSOYA, Takeo MAIDA
　　　　　 Hisashi KOSHINO, Masato SAITO
　　　　　 Hisayoshi ISHII, Tsuyoshi SHIMO
　　　　　 Keiji NAGANO, Hiroki NAGAYASU
Auditors：Toshiya ARAKAWA, Kazuharu IRIE
6704514_H2_3_背.indd   1,3 2022/08/19   11:37:04


奥付

北海道医療大学博士（リハビリテーション科学）令和4年度doctoral thesi

山根, 将弘

38804

北海道医療大学学術リポジトリ
肩関節運動における体幹筋の筋活動開始時間解析 
～体幹のpreparatory motionに基づいたフィードフ
ォワード活動～
著者 山根 将弘
学位名 博士（リハビリテーション科学）
学位授与機関 北海道医療大学
学位授与年度 令和4年度
学位授与番号 30110甲第374号
URL http://id.nii.ac.jp/1145/00065109/



Analysis of activity onset of trunk muscles during shoulder movements ~ Feedforward activation based on preparatory trunk motion ~

MST. Tahmina, AKTER

38799

Akihiro, NEZU

38800

Akihiko, TANIMURA

38801

北海道医療大学学術リポジトリ
Recent findings on the therapeutic effects of
pilocarpine on dry mouth
著者 MST. Tahmina AKTER, Akihiro NEZU, Akihiko
TANIMURA
journal or
publication title
The Dental Journal of Health Sciences
University of Hokkaido
volume 41
number 1
page range 27-28
year 2022-06-30
URL http://id.nii.ac.jp/1145/00065106/
［最近のトピックス］
Recent findings on the therapeutic effects of pilocarpine on dry mouth
MST. Tahmina AKTER, Akihiro NEZU, Akihiko TANIMURA
Division of Pharmacology, Department of Oral Biology, School of Dentistry, Health Sciences University of Hokkaido
Pilocarpine, used as a treatment for dry mouth, is a partial
agonist of muscarinic acetylcholine receptors ( mAChRs ) ,
and induces salivation through a rise in the intracellular Ca2+
concentration ([Ca2+]i) by activating mAChRs in salivary aci-
nar cells. In rodents, a 0.1~10 mg (mg/kg, intraperitoneal
administration) dose of pilocarpine induces salivary secre-
tion. Such a dose is similar to a 3~100 µM (0.7~35 µg/mL)
concentration which increases the [Ca2+]i in isolated salivary
gland cells (Fig 1A, Nezu et al., 2015).
Clinically, pilocarpine ( Salagen® tablets ) is prescribed
orally in a dosage of 5 mg/tablet. According to the instruc-
tions provided with Salagen® tablets, this dose of pilocarpine
does not cause salivation after oral administration, but im-
proves salivation after continuous administration of pilo-
carpine for more than 12 weeks. The maximum blood con-
centration ( Cmax ) of a single oral dose of pilocarpine is
around 30 ng/mL. This concentration is estimated to be ap-
proximately 0.1 µM, less than one−thirtieth of the concentra-
tion that increases [Ca2+]i in in vitro experiments. This sug-
gests that mechanisms other than the mAChR−mediated Ca2+
responses may be involved in the improvement of salivation
by Salagen® tablets (Fig. 1A). Recently, Minagi−Ono et al.
(2018) reported what may provide a possible answer to the
mechanism for improving salivation by Salagen® tablets.
At Osaka University Dental Hospital, pilocarpine is used
for patients with Sjögren’s syndrome (SS). The hospital pre-
scribes pilocarpine at about half of the usual dose to reduce
side effects such as nausea, and examined salivary secretions
by the Saxon test and the visual analog scale after the treat-
ment for more than 12 weeks. The results showed signifi-
cant improvements in these evaluations, indicating that con-
tinuous administration of pilocarpine improves the salivary
function in SS patients, even at low doses (Minagi−Ono et
al., 2018).
Next, Minagi−Ono et al. analyzed salivary secretion, cell
morphology, protein, and gene expression after a continuous
oral administration of the low−dose of pilocarpine in wild
type and SS model mice. Two−weeks of pilocarpine (1 mg/
10 mL/kg, orally, Twice daily) administration significantly
increased salivary secretion in these mice. This study also
showed a significant increase in the protein and gene expres-
sion of M3 mAChR in the salivary glands of the pilocarpine−
treated mice (Fig. 1B), suggesting that the increase in the
expression level of M3 mAChR may contribute to the im-
provement of salivary secretion (Minagi−Ono et al., 2018).
Pilocarpine has been thought to improve salivation via the
Ca2+−dependent fluid secretion in the treatment of dry mouth
by Salagen® Tablets. This study provides new insight into
the mechanism by which pilocarpine improves dry mouth :
the up−regulation of the expression of M3 mAChR in sali-
vary gland cells (Fig. 1B). The mechanism for the increase
in the expression of M3 mAChR by pilocarpine remains un-
clear. Elucidation of this mechanism may lead to the devel-
opment of a new treatment for dry mouth.
References
Minagi−Ono H, Ikai K, Araie T, Sakai M & Sakai T.
Benefits of long−term pilocarpine due to increased mus-
carinic acetylcholine receptor 3 in salivary glands. Bio-
chem Biophys Res Commun, 503 (2), 1098−1102, 2018.
Nezu A, Morita T, Tojyo Y, Nagai T & Tanimura A. Par-
tial agonistic effects of pilocarpine on Ca2+ responses and
salivary secretion in the submandibular glands of live ani-
mals. Exp Physiol, 100.6, 640−651, 2015.
27北海道医療大学歯学雑誌 41 令和4年
（27）
第４１巻１号　　　４Ｃ１５０　１Ｃ１３３／本文　※３１‐１から組体裁変更　ＯＴＦ／０２７～０２８　トピックス　Ｔａｈｍｉｎ  2022.08.03 08.46.09  Page 27 
Figure 1 : Mechanism of the therapeutic effect of pilocarpine with dry mouth.
A) Mechanisms of pilocarpine−induced salivary fluid secretion through the activation of mAChR in in vitro experi-
ments. B) Mechanisms of continuous administration of pilocarpine in clinical and in vivo experiments. ACh : acetyl-
choline.
28 北海道医療大学歯学雑誌 41 令和4年
（28）
第４１巻１号　　　４Ｃ１５０　１Ｃ１３３／本文　※３１‐１から組体裁変更　ＯＴＦ／０２７～０２８　トピックス　Ｔａｈｍｉｎ  2022.08.03 08.46.09  Page 28 


English

Recent findings on the therapeutic effects of pilocarpine on dry mouth

Shaun, HOGGARD

38812

北海道医療大学学術リポジトリ
The Theory of Planned Behaviour and Healthcare
Students' Intentions to Communicate With
Foreign Co-workers
著者 Shaun HOGGARD
journal or
publication title
JOURNAL OF NURSING AND SOCIAL SERVICES
number 29
page range 21-25
year 2022-12-20
URL http://id.nii.ac.jp/1145/00065114/
Abstract : The Japanese government's plans to increase the number of foreign healthcare workers in 
Japan will make second-language workplace communications more likely. This research used the theory 
of planned behaviour to model healthcare students' attitudes towards these interactions. The results 
demonstrated that this model was suitable for investigating such behaviour. As more and more non-
Japanese workers start to be employed in the Japanese healthcare system, this study will be of interest to 
those involved in both healthcare education and hospital administration.
Key words: second-language use, theory of planned behaviour, Japanese healthcare system
The Theory of Planned Behaviour and Healthcare Students' 
Intentions to Communicate With Foreign Co-workers
Introduction
 One of the more intractable issues facing Japan is its 
rapidly aging population. Not only is this causing a decline in 
the size of its workforce, it is also increasing demand for 
healthcare related services. Therefore, the healthcare industry 
in Japan is facing pressure from both directions. 
 The government is seeking to alleviate some of the 
manpower shortage issues by encouraging foreign workers to 
come and work in Japan. It is attempting to add up to 60,000 
non-Japanese healthcare providers to the workforce within the 
current five year period. This expansion will be accomplished 
through a combination of easing visa restrictions and 
promoting training programs (Immigration Services Agency 
of Japan, 2022).
 As these non-Japanese workers begin to be 
employed in healthcare institutions around Japan, there will 
no doubt be cultural and linguistic challenges faced by 
everyone involved. These challenges will include those 
encountered by healthcare administrators as they attempt to 
assimilate the new workers into their institutions and 
workspaces. However, the greatest foreseeable area for 
difficulties lies in the interrelationships at the co-worker level. 
This is due to the high number of interactions that are likely to 
occur in the course of day-to-day work-based activities. 
Therefore, this research attempts to investigate the attitudes 
and behavioural intentions of pre-service Japanese healthcare 
workers towards second-language (L2) communications in the 
workplace. 
 This study follows on from a previous one that 
looked at the reasons and impediments that pre-service nurses 
could envision for communicating in an L2, in this case 
English, with non-Japanese co-workers, and their intention to 
engage in such interactions (Hoggard, 2021). In the current 
investigation, a much larger group of pre-service healthcare 
workers, from a variety of disciplines, were surveyed and their 
responses analysed through the framework of the theory of 
planned behaviour.
Literature Review
 The theory of planned behaviour (TPB) is a 
cognitive-based behavioural model that connects attitudes, 
subjective norms, and perceived behaviour control regarding a 
goal-directed behaviour, with the intention to perform the 
behaviour (Ajzen, 2012). This model states that an individual's 
behavioural intention is a product of their attitudes towards 
the behaviour, how they view their social referent's opinions 
＊Center for Education in Liberal Arts and Sciences, Health 
Sciences University of Hokkaido
Shaun HOGGARD＊
＜論文＞
―　　―21
北海道医療大学看護福祉学部紀要　No.29　2022年
03_ホガード.indd   21 2022/11/08   21:51:09
regarding the behaviour, and the degree to which they believe 
they can adequately perform the behaviour (see Figure 1  
below).
Figure 1
Theory of Planned Behaviour Based on Ajzen (1987)
 As can be seen in the figure above, attitudes, 
subjective norms, and perceived behavioural control all 
combine to form behavioural intention, which precedes the 
actual behaviour. Perceived behavioural control can also 
directly affect the performance of the behaviour. This occurs 
when an individual's self-perceived behavioural control 
diverges from their actual behavioural control.
 The TPB has been used to investigate a wide variety 
of behaviours, ranging from public transport use (Heath & 
Gifford, 2002), to food consumption (Vermeir & Verbeke, 
2008). Furthermore, meta-analysis has shown that the model 
can consistently account for 40～49% of the variance in 
intention to perform the behaviours it has investigated 
(McEachan, Conner, Taylor, & Lawton, 2011). 
 However, the TPB has not often been utilised in the 
study of communication or language learning behaviours. One 
noticeable exception being a study of over 600 high school 
English learners in South Korea, which found the TPB to be 
an effective social-psychological model for predicating the 
intention to learn an L2  (Kim & Pae, 2019). 
 Within the field of L2  communication research, 
intention to communicate has often been equated with the 
willingness to communicate construct (e.g. MacIntyre, 
Dörnyei, Clément, & Noels, 1998). Previous studies in the 
Japanese context have found significant correlations between 
willingness to communicate and actual communication 
behaviours (e.g. Yashima, Zenuk-Nishide & Shimizu, 2004). 
 The previous study into a similar cohort of pre-
service healthcare workers uncovered a wide range of reasons 
they could envisage for communicating in English with non-
Japanese co-workers (Hoggard, 2021). These reasons included 
instrumental factors, such as the most commonly cited reason, 
improving their English ability. They also included integrative 
factors, such as making friends with non-Japanese colleagues. 
While the two reasons above were both given as options for 
the participants to select, they could also add their own ideas. 
Among the ones they added were that they could broaden 
their view of the world and be able to provide healthcare to a 
larger group of people if they used English at work.
 Participants in the previous study also had an 
opportunity to select impediments that they could see 
preventing them from communicating in English at work. By 
far and away the impediment most commonly selected from 
the available options was a lack of confidence in their own 
English ability. Among the impediments added by the 
participants were communication anxiety, and also a 
reluctance to engage with foreigners.
Methods
 This research was conducted at a medical university 
in Japan. Four groups of pre-service healthcare workers were 
surveyed: nurses, medical technicians, social workers, and 
psychologists. The medical technician and psychology 
students were first-years, the nursing and social work students 
were second years. Participation in the survey was completely 
voluntary, in total 261 students responded.
 The research instrument was a questionnaire that 
was administered via the use of QR codes and Google Forms 
to minimise the risk of viral transmission during the 
COVID-19 pandemic. The questionnaire contained twelve 
items, three for each of the four constructs measured. For each 
item the participants rated their level of agreement to a 
statement on a six-point Likert scale, ranging from strongly 
disagree to strongly agree. As the scale had six points there 
was no neutral midpoint. 
 The questionnaire items were first written in English 
before being translated into Japanese and checked by an L1  
Japanese speaker. An example of the statements assessing the 
participants' attitudes towards L2  communication with non-
Japanese co-workers is, ‘Using English to communicate with 
my co-workers would be useful’. An example of the 
subjective norm statements is, ‘My friends would be 
impressed if I used English to communicate with my co-
workers’. An example of the perceived behavioural control 
―　　―22
北海道医療大学看護福祉学部紀要　No.29　2022年
03_ホガード.indd   22 2022/11/08   21:51:12
statements is, ‘I can communicate in English without 
becoming nervous’. And finally, an example of the statements 
assessing the participants' intention to communicate in an L2  
with non-Japanese co-workers is, ‘I would talk to my co-
workers in English if I had the chance’.
 The responses obtained from the survey were 
entered into SPSS (Ver 23) and checked for anomalous or 
missing data before being analysed. The results of this 
analysis are presented in the following section.
Results
 The four scales were checked for reliability and 
grouped together to form composite scores for behavioural 
intention, attitudes, subjective norms, and perceived 
behavioural control. These scores were then analysed to test 
the TPB model introduced above. It should, however, be noted 
that actual behaviour was not measured as part of this study.
 A multiple regression was carried out to investigate 
whether attitude, subjective norms, and perceived behavioural 
control could significantly predict the participants' intention to 
engage in L2  communication with non-Japanese co-workers. 
The results of the regression indicated that the model 
explained 63.7% of the variance and that it was a significant 
predictor of behavioural intention, F(3,257) = 150.08, p = 
.000. All of the factors contributed significantly to the model 
(see Table 1  below). 
Table 1
Summary Statistics, Correlations, and Regression 
Results (N = 261)
Variable Mean SD Correlations B
BI 4.55 .87
Attitude 5.00 .78 .754*** .696***
SN 4.42 .91 .466*** .153***
PBC 2.18 .93 .422*** .201***
BI = Behavioural intention, SN = Subjective norm, PBC = 
Perceived behavioural control
* p < .05, ** p < .01, *** p < .001
 The means shown in the table above show a higher 
than neutral (3.5) score for behavioural intention, attitudes, 
and subjective norms. The only factor to be lower than the 
mid-point was perceived behavioural control.
Discussion
 The results from the multiple regression analysis 
presented in the previous section indicate that the TPB model 
is a suitable one for investigating L2  communication intention 
between co-workers in the Japanese healthcare system. A 
score of over 60% for the explained variance is higher than 
expected from meta-analysis of previous studies, which 
suggested scores in the 40~50% range were more common 
(McEachan, Conner, Taylor, & Lawton, 2011). However, it 
has been found that studies utilising self-reported measures do 
tend to report higher levels of explained variance (Armitage & 
Connor, 2001).
 The higher than the neutral mid-point mean score 
for behavioural intention returned in this survey suggest that 
the participants have a positive inclination towards L2  
communication with non-Japanese co-workers. This is 
encouraging when considering how well the new additions to 
the Japanese healthcare workforce are likely to assimilate and 
cooperate together to create a harmonious working 
environment.
 Both attitudes and subjective norms also had higher 
than neutral mean scores. This, again, is promising in that it 
indicates that the participants do not only view L2  use with 
co-workers in a positive light, they also perceive their social 
referents as viewing such behaviour positively. These results 
give further credence to the supposition that Japanese 
healthcare workers will be welcoming towards their non-
Japanese colleagues. 
 In spite of the positive results for attitudes and 
subjective norms, the low mean scores and correlations for the 
perceived behavioural control factor suggest that this is an 
area of concern. As all three factors, attitudes, subjective 
norms, and perceived behavioural control, combine to 
generate behavioural intention, a weak score from just one 
factor can have an impact on intention, and thus actual 
behaviour. In a previous study, low levels of perceived 
behavioural control, in the form of self-efficacy beliefs 
regarding L2  competence, have been linked to reduced verbal 
output of language students using a TPB based model (Zhong, 
2013).
 However, identification of the area requiring 
attention is always a necessary step in producing strategies 
and plans for interventions that can be used to address the 
issue. In this case, it is clear that self-confidence in their 
ability to communicate effectively is acting as a dampener on 
the participants' intention to communicate with their co-
―　　―23
北海道医療大学看護福祉学部紀要　No.29　2022年
03_ホガード.indd   23 2022/11/08   21:51:13
workers in English. Low levels of L2  communication self-
confidence or self-efficacy is an issue that has surfaced in 
previous studies in the Japanese context (e.g. Ball & Edelman, 
2018), so it is not unique to this particular group of learners. It 
was also the most selected impediment chosen in an earlier 
study at the same institution (Hoggard, 2021). Therefore, it 
will not be a simple matter to address. For this type of 
behaviour, communicating with non-Japanese co-workers who 
are themselves not L1  English speakers, interventions aimed 
at fostering an awareness of World Englishes might alleviate 
some of the concerns they may have in regards to making 
mistakes, or not producing L1-level English.
 Finally, although the results of this survey and 
analysis are encouraging, they only investigated the intention 
to communicate in an L2  with non-Japanese co-workers. The 
link between intention and actual behaviour can be affected by 
a variety of factors (Ajzen, 2015). As the participants in this 
study are still pre-service, it is conceivable that their opinions 
and attitudes may shift by the time they enter the workforce. It 
is also possible that there is a gap between self-perceived 
behavioural control and actual control. However, given the 
low scores already recorded for behavioural control, this 
unlikely to be a factor in this instance.
Conclusion
 This study indicated that the theory of planned 
behaviour is a useful model for investigating second-language 
communication intention between Japanese and non-Japanese 
healthcare workers. Multiple regression analysis of the 
questionnaire data showed that over 60% of the variance in 
behavioural intention could be explained by a model 
incorporating attitudes, subjective norms, and perceived 
behavioural control.
 However, although the results also suggested that 
Japanese pre-service healthcare workers would be open to 
such interactions, there are a number of caveats that should be 
considered. First of all, as the participants in this study are still 
students, it is possible their opinions differ from in-service 
workers. Secondly, as they were not included in the current 
study, it is unknown whether the non-Japanese healthcare 
workers would be willing participants in L2  communication 
behaviours. It is possible that they would not be able to 
communicate with their Japanese colleagues in English, even 
if they were willing. It is also likely that they would prefer to 
communicate in Japanese with co-workers, in order to 
improve their ability to communicate with their, mostly 
Japanese, patients.
 Considering the limitations and unanswered 
questions outlined above, it would be useful to do a follow-up 
study including both in-service Japanese and non-Japanese 
healthcare workers. An even more comprehensive picture 
would be created if non-Japanese pre-service healthcare 
students could be surveyed before they came to Japan.
References
Ajzen, I. (1987). Attitudes, traits, and actions: Dispositional 
prediction of behavior in personality and social 
psychology. In L. Berkowitz (Ed.), Advances in 
experimental social psychology  (Vol. 20, pp. 1-63). New 
York, NY: Academic Press.
Ajzen, I. (2012). The theory of planned behavior. In P. A. M. 
Lange, A. W. Kruglanski & E. T. Higgins (Eds.), 
Handbook of theories of social psychology (Vol. 1, pp. 
438-459). London, UK: Sage.
Ajzen, I. (2015). The theory of planned behaviour is alive and 
well, and not ready to retire: A commentary on Sniehotta, 
Presseau, and Araújo-Soares. Health Psychology Review, 
9 , 131-137.
Armitage, C. J., & Conner, M. (2001). Efficacy of the theory 
of planned behaviour: A meta-analytic review. British 
Journal of Social Psychology, 40 , 471-499.
Ball, S., & Edelman, C. (2018). Self-efficacy, motivation, and 
perceived importance of English as an L2  among 
Japanese university students. Language Teacher, 42, 13-
18.
Heath, Y., & Gifford, R. (2002). Extending the theory of 
planned behavior:  Predicting the use of public 
transportation. Journal of Applied Social Psychology, 32, 
2154-2189.
Hoggard, S. (2021). Nursing Students' Intentions, Reasons, 
and Impediments Regarding English Communication 
With Foreign Co-workers. Health Sciences University of 
Hokkaido — Journal of Nursing and Social Services, 28, 
31-34.
Immigration Services Agency of Japan. (2022). Initiatives to 
accept new foreign nationals and for the realization of 
society of harmonious coexistence. https://www.moj.
go.jp/isa/content/930004452.pdf
Kim, K., & Pae, T. I. (2019). Social psychological theories 
and sustainable second language learning: A model 
comparison approach. Sustainability, 11, 1-16.
MacIntyre, P. D., Dörnyei, Z., Clément, R., & Noels, K. A. 
―　　―24
北海道医療大学看護福祉学部紀要　No.29　2022年
03_ホガード.indd   24 2022/11/08   21:51:14
(1998). Conceptualizing willingness to communicate in a 
L2: A situational model of L2  confidence and affiliation. 
The Modern Language Journal, 82, 545-562.
McEachan, R.R.C., Conner, M., Taylor, N., & Lawton, R.J. 
(2011). Prospective prediction of health-related behaviors 
with the Theory of Planned Behavior: A meta-analysis. 
Health Psychology Review, 5 , 97-144. 
Vermeir, I., & Verbeke, W. (2008). Sustainable food 
consumption among young adults in Belgium: Theory of 
planned behaviour and the role of confidence and values. 
Ecological Economics, 64, 542-553.
Yashima, T., Zenuk-Nishide, L., & Shimizu, K. (2004). The 
influence of attitudes and affect on willingness to 
communicate and second language communication. 
Language Learning, 54, 119-152.
Zhong, Q. M. (2013). Understanding Chinese learners' 
willingness to communicate in a New Zealand ESL 
classroom: A multiple case study drawing on the theory 
of planned behavior. System, 41, 740-751.
―　　―25
北海道医療大学看護福祉学部紀要　No.29　2022年
03_ホガード.indd   25 2022/11/08   21:51:15


The Theory of Planned Behaviour and Healthcare Students' Intentions to Communicate With Foreign Co-workers

北海道医療大学看護福祉学部

38817

北海道医療大学学術リポジトリ
内規
著者 北海道医療大学看護福祉学部
雑誌名 北海道医療大学看護福祉学部紀要
号 29
発行年 2022-12-20
URL http://id.nii.ac.jp/1145/00065118/
【紀要の英文名】
1 ．紀要の英文名は下記の通りとする。
　HEALTH SCIENCES UNIVERSITY OF HOKKAIDO
　JOURNAL OF NURSING AND SOCIAL SERVICES
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北海道医療大学看護福祉学部紀要内規
―　　―63
北海道医療大学看護福祉学部紀要　No.29　2022年
99_第29号巻末.indd   63 2022/12/05   21:32:21


内規

38929

北海道医療大学学術リポジトリ
投稿の手引き
著者 北海道医療大学歯学会
雑誌名 北海道医療大学歯学雑誌
巻 41
号 2
発行年 2022-12-31
URL http://id.nii.ac.jp/1145/00065156/
「北海道医療大学歯学雑誌」投稿の手引き（2019年12月1日現在）
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45
（103）
第４１巻２号　　　４Ｃ１５０　１Ｃ１３３／本文　※３１‐１から組体裁変更　ＯＴＦ／０４５～０４７　投稿の手引き  2023.02.20 13.19.23  Page 45 
に従い，文献内容を記載する．
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（Izumi & Ito, 1998）（和泉，伊藤，1998），
3名以上（Izumi et al. , 1970）（和泉ら，
1970），2編以上（Sato et al., 1988; Izumi,
1999）（佐藤ら，1988；和泉，1999）（Izumi,
1999a, b）
※「，」や「；」の様な記号は，日本文の場合は
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suki N. The effects of inhalation anes-
thetics on the parasympathetic reflex
vasodilatation in the lower lip and pal-
ate of the cat. Am J Physiol Regula-
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ganisms.
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tors. Pathologic physiology: mecha-
nisms of disease. Philadelphia: Saun-
ders, 1974, p457−472.
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1987.
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sponse. Proceedings of the First
AMA National Conference on
Child Abuse and Neglect; 1984
Mar 30 − 31; Chicago. Chicago:
American Medical Association;
1985.
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ジの形成と設計について－．新臨床歯科
学講座3，医歯薬出版：1978，157－
165．
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ラミックスの強度と破壊（Mechanical
behavior of ceramics）．共立出版：1982，
34−55．
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46
（104）
第４１巻２号　　　４Ｃ１５０　１Ｃ１３３／本文　※３１‐１から組体裁変更　ＯＴＦ／０４５～０４７　投稿の手引き  2023.02.20 13.19.23  Page 46 
Table1 Mechanical properties of specimen
Specimen
Tensile
strength Mpa
Elongation
％
A 500（20） 10．2（3．3）
B 300（15） 5．4（2．3）
（ ）：SD
表1 試料の力学的性質
試料 引張強さ
Mpa
伸び
％
A 500±20 10．2±3．3
B 300±15 5．4±2．3
平均±標準偏差
4）単位などの表記は同一言語に統一する．単位
（unit），平均（mean），標準偏差（SD）
（例：）
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47
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