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In this paper, whānau Māori highlight how a Kaupapa Māori-centred intervention (the Harti Hauora Tamariki tool, hereafter Harti tool) has improved interactions with health services. The Harti tool is undergoing a randomised control trial (RCT) at Waikato Hospital in New Zealand. As part of the RCT, the authors engaged in a series of qualitative interviews with whānau members of tamariki Māori (children aged 0–5 years) admitted to Waikato Hospital's paediatric ward. Whānau who met at least one criteria for New Zealand's domains of deprivation were included. Using a Kaupapa Māori approach to the study, participants shared their views on barriers and facilitators to accessing health resources and primary care services. The interviews conducted highlight how the Harti tool, when administered in a culturally appropriate and respectful manner that prioritised relationship-building, enabled better connection to healthcare services. Prevalent in our analysis were connections to wider determinants of health and ways to reduce existing health inequities. To conclude the paper, how the Harti tool has enhanced feelings of being in control of health, with the potential to reduce the likelihood of a hospital readmission, is highlighted. [ABSTRACT FROM AUTHOR]

This exploratory study examined general practitioners' (GPs) perspectives on delivering end-of-life care in the New Zealand residential aged care context. A general inductive approach to the data collected from semi-structured interviews with 17 GPs from 15 different New Zealand general practices was taken. Findings examine: (1) GPs' life experience; (2) the GP relationship with the facilities and provision of end-of-life care; (3) the GP interaction with families of dying residents; and (4) GP relationship with hospice. The nature of the GP relationship with the facility influenced GP involvement in end-of-life care in aged care facilities, with GPs not always able to direct a facility's end-of-life care decisions for specific residents. GP participation in end-of-life care was constrained by GP time availability and the costs to the facilities for that time. GPs reported seldom using hospice services for residents, but did use the reputation (cachet) associated with hospice practices to provide an authoritative buffer for their end-of-life clinical decisions when talking with families and residents. GP training in end-of-life care, especially for those with dementia, was reported as ad hoc and done through informal mentoring between GPs. This paper is on a topic of increasing policy importance. With the aging of the population, the pressure on our aged care facilities will become intense. This paper highlights how GPs, the main source of clinical supervision in residential aged care, do their job and what the issues are that facilitate and impede their participation. [ABSTRACT FROM AUTHOR]

Former quota refugees are known to have higher health and social care needs than the general population in resettlement countries. However, migrants with a refugee-like background (refugee-like migrants) in New Zealand are not currently offered systematic government-sponsored induction or health services. This study explored the experiences of New Zealand health and social care providers in general practice. Staff at two Wellington region general practices with known populations of refugee-like migrants and former quota refugees were approached to participate in an exploratory qualitative study. Semistructured audio-recorded interviews and focus groups were undertaken. Deductive and inductive analyses were used to identify key themes. Twelve interviews were undertaken with professionals with backgrounds in clinical pharmacy, cross-cultural work, general practice medicine, primary care nursing, reception and social work. Key themes from the interviews were communication challenges, organisational structure and teamwork, considerations to best meet core health and support needs, and the value of contextual knowledge. Healthcare workers perceived many similarities between working with refugee-like migrants and working with former quota refugees. Even though communication challenges were addressed, there were still barriers affecting the delivery of core health and support services. Primary care practices should focus on organisational structure to provide high-quality, contextually informed, interprofessional team-based health and social care. Migrants, especially family members of former refugees, may have similar health and social experiences to former refugees. Health and social care professionals should take these experiences into account when planning and providing care. Little is known about how professionals specifically interact with such migrants, so we examined the experiences of primary care professionals, finding key themes for successful care. This expands on research into the health of former refugees, emphasising the importance of also considering the health needs of migrating family. [ABSTRACT FROM AUTHOR]