Challenges faced by international patients in Japanese emergency departments have been largely unknown.

This study identifies challenges faced by international patients in Japan’s emergency department.

The research discusses how cultural conflict can impact treatment and patient rights.

The study emphasizes the need for intercultural competencies in emergency nursing.

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.

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.

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.”

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.

Emergency departments

Cultural barriers

Healthcare communication

Minority patients

Cultural safety

Patient-centered care

Japan

© 2026 The Author(s). Published by Elsevier Ltd.