Japanese People with Vision Disabilities Rate their Experiences with Information Resources Pertaining to Guide Dogs

In many countries, an increasing number of people are choosing to live with an assistance dog to enhance their independence. Guide dogs, hearing dogs, and service dogs for mobility assistance are popular and well-known by the public. Guide dogs, also known as assistance dogs, have been trained for almost 100 years originally to serve veterans who lost their sight in World War I (Fishman, 2003). Presently, guide dogs are trained worldwide and there are about 82 guide dog training schools from 26 countries that are accredited by the International Guide Dog Federation (IGDF) (IGDF, 2011) with the number of accredited schools increasing.

There are 10 guide dog training schools in Japan, and eight of them are accredited members of the IGDF. The number of accredited schools in Japan comprise the third largest from one country, after France (11 schools) and the U.S. (10 schools). However, the ratio of working guide dogs in Japan per million people (7.6) is small compared with several other countries (the U.K.: 79.2; Netherlands: 49.7; the U.S.: 35.5; France: 25.6; Germany: 21.8) (Fukui, 2008).

The small number of guide dogs in Japan is not surprising given the culture, perceptions towards dogs, housing and public spaces, and life-style compared with those in other developed countries (All Japan Guide Dogs Users Association, 2009; Ministry of Land, Infrastructure, Transport and Tourism, 2005; Tomizawa, 1997). In Japan, the Act on Assistance Dogs for the Disabled was published in 2002 allowing people accompanied by their assistance dogs access to public spaces (Ministry of Health, Labour and Welfare, Japan, 2011). However, because the law is not fully understood by the public, and it carries no penalty if disobeyed, some guide dog users have been refused access to public spaces (Matsunaka & Koda, 2008; Miyazaki, 2005). The use of guide dogs in Japan poses unique challenges and particular guide dog training procedures to suit the culture and environment have been implemented. For instance, it is customary to wipe dogs’ feet when entering places where people take off their shoes, such as in Japanese housing, including the rooms covered with “Tatami”, a mat made of rice straw (All Japan Guide Dogs Users Association, 2009). Guide dogs are often trained to do their toileting using toilet sheets or a “One-two belt” which is an attachable belt with a plastic bag that directly catches urine or faeces (Fukui, 2009). These toileting products were created because of the difficulty finding adequate convenient toileting spaces and the need to be considerate towards others. Also, since many people are uncomfortable with shedding dog hair, often guide dogs wear an item called a “Duster coat” or “Manner coat” which covers all the body except the head, toes, and tail (Fukui, 2009). The tandem system created in Japan is another innovation in which two people with vision disabilities use one guide dog, e.g., couples or a parent and child (The National Federation of All Japan Guide Dog Training Institutions, 2001). A benefit of the tandem system is the reduced space required for the housing of only one dog rather than two.

Approximately 18% of people in Japan who have vision disabilities hope to acquire and use a guide dog (Koda et al., 2011; The National Federation of All Japan Guide Dog Training Institutions, 2010; The Nippon Foundation, 1998). As a proportion of the population with vision disabilities, this translates to an estimated 7,800 people who might be interested in acquiring and using a guide dog. However, only about 150 people annually apply to a guide dog school for a guide dog (The Nippon Foundation, 1998). This large discrepancy between the potential population who might use a guide dog (i.e., potential guide dog partners) and those actually applying for one has not been explained. Perhaps some reasons for this discrepancy might include misunderstandings, challenges, and anxiety related to acquiring and using a guide dog. For example, misunderstanding about the eligibility requirements of applying for a guide dog; challenges of housing agreements when living with a dog as well as limited housing space; anxiety about taking care of a guide dog, and the long duration of guide dog training where people are required to leave their employment or home for about one month (The National Federation of All Japan Guide Dog Training Institutions, 2010; The Nippon Foundation, 1998; Whitmarsh, 2005). Whitmarsh (2005) mentioned that demographic factors such as a person’s gender and age influenced their reasons for applying for a guide dog as well as influenced the perceived benefits and drawbacks of guide dog ownership.

In the past, Japanese guide dog organisations focused their efforts on educating the general public about guide dogs, but now concentrate on providing information about guide dogs specifically to people with vision disabilities (The National Federation of All Japan Guide Dog Training Institutions, 2012). For example, seminars, events providing interactive experience with guide dogs, and rehabilitation programs offer information about guide dogs to potential users. The rehabilitation program provided by one guide dog organisation resulted in a large proportion of participants applying for guide dogs (Sugawara, 2008). This suggests that broader dissemination of information provided by guide dog organisations might be useful for people with vision disabilities who would like to acquire a guide dog. It is unknown, however, to what extent the information regarding opportunities to learn about guide dogs reaches people with vision disabilities.

In Japan, guide dog interactive experiences or ‘information programs’ are provided by several guide dog organisations. These programs provide information about and promote guide dogs to people with vision disabilities, with the goal of increasing the number of applicants for guide dogs. This study investigated the awareness and use of the information programs by people with vision disabilities; their age and gender; their perceptions concerning guide dogs after experiencing the programs; and their level of desire to use and live with a guide dog.

People with vision disabilities over 18 years of age who possessed a Physical Disabled Person’s Certificate were recruited through organisations affiliated with the Japan Federation of the Blind to complete a survey. To make it easier for participants to answer the survey in their desired format, three types were prepared namely text with enlarged characters, e-mail, and braille. The researcher contacted the organisations and explained the research and survey. If a particular organisation was interested in disseminating the survey, then the researcher sent information about and procedures for completing the survey. After sending the surveys, the researcher re-contacted the organisations to confirm their inclusion in the study. Fifty-two out of 61 organisations agreed to participate in the study. The surveys were sent to participating organisations that distributed the surveys to their members with vision disabilities. The completed surveys were gathered and returned to the researcher. The surveys that had any unanswered items were not included in the analyses. Four hundred and eighty-four questionnaires with enlarged characters and 434 questionnaires with braille were distributed. The number of completed surveys were 141 (29.1%) and 106 (24.4%), respectively. In addition, 48 surveys were collected through e-mail. In total, there were 295 completed surveys.

The survey questions included: (i) demographic information about participants, such as age, gender, and disability; (ii) knowledge of assistance dogs, information programs where people can have interactive experiences with guide dogs, and hopes for having a guide dog; (iii) sources of information acquisition on general topics, guide dogs, and the information programs offered by guide dog schools, and (iv) satisfaction with the available information about guide dogs. This study complied with the Ethical Code of the Japanese Psychological Association. Prior to participating in the research, all respondents were informed about the research goals, the confidential handling of data used only for this research, the anonymity of participants, and that participation was voluntary.

The survey was analysed using the: Chi-square test, Kruskal-Wallis test, and Mann-Whitney test to investigate the relationships between the acquired information about guide dogs and the participants’ understanding of guide dogs; the amount of acquired information about guide dogs; and the person’s hope to acquire and use a guide dog. The statistical program OMS Statcel2 was used for the analyses (Yanai, 2004).

The participants (n = 295) were: male (n=152), female (n=143); 18-59 years (n=146), over 60 years (n=149). Participant levels of disability were: level 1 (n = 232), level 2 (n = 43), level 3 (n = 10), level 4 (n = 3), level 5 (n =4), level 6 (n = 3); the lower levels indicate more severe vision disability (Okuno, 1998). Thus, most respondents had a maximum level of vision disability based on visual acuity and visual field (Table 1) (Ministry of Health, Labour and Welfare, 2012).

Table 1.

The results are shown for younger (Y: 18-59 years) and older (O: 60+ years) age and gender groups since participants’ perceptions towards guide dogs may be influenced by their age and/or gender (Table 2). Nineteen (6.4%) participants had already used and lived with a guide dog (i.e., guide dog partners). Among these, 14 (Y: 10; O: 4) had participated in information programs. Among non-guide dog partners, forty-five (16.3%) participants hoped to acquire and use a guide dog. Regarding participants’ knowledge of guide dogs, 85.1% answered either “I know very much” or “I know”. A majority of participants (n = 209, 75.7%) knew that guide dog organisations offered information programs that provide interactive experiences with guide dogs, and 95 (34.4%) of these people had joined an information program. Those participants who had not joined an information program expressed “I want to join” (n = 18, 9.9%), “I want to join it if conditions permit” (n = 65, 35.9%) or “I do not want to join” (n = 98, 54.1%). The older age group had less interest in and experience with using and living with a guide dog, and had less interest in participating in information program, compared with the younger group (Table 2). Gender differences were also observed. Younger females expressed a positive attitude toward guide dogs. Younger females reported to have acquired and used a guide dog, hoped to live with a guide dog (Table 2), and hoped to join in an information program more than younger males (Table 3). Female responses differed with age. A greater number of younger women hoped to acquire and use a guide dog than older women (Table 2). Males’ interests in guide dogs exceeded females among the older participants (Table 2). In addition, even though the younger females showed high interest in guide dogs, very few answered that “I acquire abundant information on guide dogs” (Table 3).

Table 2.

Table 3.

Table 4 shows from where participants sourced information about general news, guide dogs, and information programs. The general news refers to any guide dog information and/or events occurring locally, nationally, or internationally. For information about guide dogs the main source for the participants was TV, but for information programs the primary source was the organisation to which they belonged. For older participants, radio was the main information source about guide dogs. Younger participants sourced general information from the TV, PC, and/ or cellphone. Older participants received information from guide dog-related organisations less frequently than younger participants. Regarding gender differences, younger males acquired information about guide dogs from the radio, PC or cellphone, and from people who used and lived with a guide dog (guide dog partners), at a higher rate than younger females. Further, older males acquired information about guide dogs from organisations to which they belonged more than older females. Younger females acquired information on general topics from family members or friends more often than younger males.

Table 4.

Participants were asked whether or not the amount of information related to guide dogs was sufficient. Responses included “I acquire abundant information” (n = 44, 15.9%), “I acquire some information” (n = 144, 52.2%), “I do not acquire enough information” (n = 75, 27.2%), “I do not acquire any information” (n = 13, 4.7%). The participants’ interest in acquiring and using a guide dog and the amount of information on guide dogs they received were not statistically significant. Analyses revealed that a larger number of people who joined the information programs hoped to live with a guide dog more than those who had not joined the programs (p < 0.05, x² = 4.98). Further, people who had participated in information programs had acquired a greater amount of information about guide dogs (p < 0.05, Z = -2.32) than people who had not participated in the information programs and gave the following explanations: “It is hard to take care of a dog,” “I do not want to be taken care of by a dog,” “I have someone who helps me,” “I do not like dogs,” “A dog is the burden in my life,” “I feel sorry for the dogs that receive training,” “I do not want to go out with a dog,” “The place where I live prohibits having dogs,” “other.” For this question, the people who had not participated in the information programs chose “I do not like dogs” (p < 0.05, x² = 3.99), and “The place where I live prohibits having dogs” (p < 0.05, x² = 4.48), significantly more often than those people who had participated.

Participant perceptions toward and knowledge of guide dogs influenced their interests in participating in information programs. Therefore, we examined whether or not: participants hoped to acquire a guide dog or had a misunderstanding about the role of guide dogs; information they received on guide dogs were related to their interest in participating in the information programs, especially among those who had not previously participated in the programs. The results showed that participants’ interests in participating in the information programs were related to their hope to acquire and use a guide dog (p < 0.01, x² = 17.93) and the amount of information received on guide dogs (p < 0.01, Z = 2.64), but were not related to whether or not the person had misunderstandings about guide dogs (p > 0.05, x² = 1.82).

People who acquired information about guide dogs from guide dog partners received a significantly greater amount of information about guide dogs than those who did not (p < 0.01, Z = -3.22). Among the participants not hoping to live with a guide dog, those who had acquired information on guide dogs from guide dog partners chose, “A dog is the burden of my life,” more often than the people who had not acquired information on guide dogs from guide dog partners (p < 0.05, x² = 3.86). Related to this result, there were comments in “others” which included: “…there are lots of constraints related to living with a dog such as not being able to go out in the scorching sun.” Also, comments included that some participants had allergies to dogs, or did not like dogs. It also seemed that dogs eroded the guide dog partners’ human relationships and were sometimes denied access to a restaurant which narrowed their lives. Others commented that “there are [negative] things I learned from my friend who lives with a guide dog.”

A majority of the participants had knowledge of guide dogs, and were familiar with some guide dog organisations that provide interactive experiences with guide dogs (information programs). Participants who hoped to acquire and use a guide dog were in the minority, with younger females showing the highest and older females the lowest interest in living with a guide dog. Also, older participants showed less interest in participating in information programs compared to younger participants. Younger people, particularly younger females, appeared more receptive towards acquiring guide dogs than older people. However, there were no differences in the knowledge of guide dogs or information programs between younger and older groups. These results might indicate that participants were familiar with guide dogs and that information programs were successfully publicised and disseminated to participants. For the dissemination of information about guide dogs and information programs, TV or disability-related organisations to which participants belonged were more effective than guide dog-related organisations. Therefore, people with vision disabilities who do not belong to or use disability-related organisations might have less knowledge of guide dogs and the information programs. Whitmarsh (2005) reported that medical professionals (doctors, social workers, nurses) refer people with vision disabilities to organisations that provide guide dogs. In Japan, the Ministry of Health, Labour and Welfare (2008) reported that 77.8% of people with vision disabilities had received medical treatment regarding their disability within the past year. Therefore, medical professionals in Japan might also be a potential disseminator of information to people with vision disabilities if professionals receive information about the guide dog information programs.

Concerning the amount of information about guide dogs participants acquired, younger females, as well as participants overall, both in the younger and older groups, over 30% answered that they did not receive enough information on guide dogs, regardless of whether or not they were interested in acquiring and using a guide dog. This might indicate that even though participants had knowledge of guide dogs and information programs, they were not fully satisfied with the amount of information about guide dogs.

Participating in the information programs seemed related to individual’s hopes to acquire and use a guide dog and the amount of information received about guide dogs. Participants who hoped to acquire and use a guide dog and received information on guide dogs had a higher interest in joining an information program. Also, participants were interested in joining an information program, regardless of whether or not they had some misunderstandings of guide dogs. It might be that fewer misunderstandings about guide dogs among participants who had previously joined information programs indicate that the programs provided sufficient information about guide dogs. However, it appeared that interacting with guide dogs cannot completely address people’s misunderstandings of guide dogs or their challenges and anxieties about living with a guide dog. It might be useful to revise the content of information programs to effectively address anxiety and apprehension to use and live with a guide dog. While it may not be feasible to address each person’s requirements in the information program given the time limitations, the organisations can arrange an increasingly effective program by focusing on common problems or misunderstandings, providing booklets describing the realities of living with a guide dog, or stories about the way guide dog partners in similar situations solved problems. Fukui (2011) reported that local areas which had support groups for guide dogs, or guide dog partners’ showed higher numbers of guide dogs. The support groups played an active role in their communities which facilitated an understanding about guide dogs, and promoted guide dog use among potential guide dog partners in the communities. Further, the internet, including social media could be used to communicate with potential guide dog partners, as well as to collaborate between support groups and guide dog partners to address any misunderstandings about guide dogs.

About 46% of people who had never joined information programs were interested in joining them in future. Younger participants indicated they wanted to join if conditions permitted. For younger people, their jobs and/or having children might make it difficult for them to find the time to join information programs. Hence, for younger people, more frequent information programs at various times and locations might be necessary.

The results showed that guide dog partners were another useful resource to receive information about guide dogs. The Nippon Foundation (1998) also reported that guide dog partners and ex-partners were useful resources for information about guide dogs, but that the opportunities to hear about guide dogs from the partners in person are limited in Japan. This is mainly the result of the limited number of guide dog partners, especially in the provincial areas. Thus, information programs appear the most reliable method to provide correct and essential information about guide dogs to people with vision disabilities. Interestingly, the people who received information about guide dogs from guide dog partners thought that a dog would be a burden in their life more often than the people who had not received the information about guide dogs from guide dog partners. Matsunaka and Koda’s (2008) study on Japanese guide dog partners (n=30) and non-partners (n=50) reported that guide dog partners experienced more daily stress than the non-guide dog partners, especially when they travelled on a rainy day, used a lavatory, or went on an outing. Reasons for the stress included insufficient public access, and the need to consider others when using a guide dog.

This study revealed that targeted information programs about guide dogs to people with vision disability might be useful to increase guide dog partner numbers. Some limitations of the study included a low response rate, and participants outside of disability organisations were not recruited limiting the generalisability of the findings. Further research is needed to investigate the effectiveness of information programs to a broader population who have a vision disability, including those from more isolated regions.