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Background: The existing literature on sexuality and intimacy in residential care tends to focus on either the question of rights, or the value of autonomy. Where the literature does reference values other than autonomy, such values are considered in the context of being a guide to whether or not a resident is autonomous, rather than being important values in their own right. Objective: This paper draws on qualitative data gathered as part of a larger study in order to inform practice on how care workers respond to intimacy issues that arise with residents with dementia and to inform a general ethics of sex and sexuality, demonstrating that an approach which permits value pluralism can be appropriate in certain contexts. Research Design: The qualitative data referred to in this paper was gathered from semi-structured interviews undertaken as part of a larger mixed-method research project. The interview text was analysed using Thorne's methodological approach, interpretive description. Participants and research context: The qualitative arm of the project consisted of semi-structured interviews conducted between October 2018 and October 2019 with participants (staff, residents and family members) recruited from 35 residential care homes in Aotearoa New Zealand. Ethical Considerations: Participation was informed, voluntary and written consent was gained before interviews. The project was approved by the Massey University Human Ethics Committee (Northern), number NOR 18/25. Findings: Analysis of the scenarios presented in this paper shows that decision-making around sexual intimacy involving people with dementia in a residential care setting is complex and requires recognizing and weighing the different values that may be a in play. Conclusion: A focus on safety and consent to the exclusion of other values which matter morally in this context is a mistake which prevents care workers from providing appropriately person-centred care to residents, as policies which focus on the goal of care allow space for critical examination of issues which are likely to be highly context-sensitive. [ABSTRACT FROM AUTHOR]

Dementia-related sleep changes can lead to disruptions among families living with dementia which can jeopardise carers' wellbeing and ability to provide support. This research explores and represents the sleep of family caregivers across the trajectory of caring, before, during, and after the key period of their care recipient moving into residential care. The focus of this paper is viewing dementia caregiving as a trajectory, characterised by care needs which change over time. Semi-structured interviews were conducted with 20 carers whose family member with dementia had transitioned into residential care within the prior 2 years. Themes constructed from these interviews indicated that sleep was linked to earlier life course patterns as well as to significant moments of transition in the caregiving journey. As dementia progressed, carers' sleep progressively worsened in relation to the less predictable nature of dementia-symptoms, difficulty maintaining routines, and constant responsibilities creating a state of high alert. Carers attempted to facilitate better sleep and wellbeing for their family member, often sacrificing their own self-care. Around the care transition period, some cares reported not realising how sleep deprived they were; for others the busy momentum continued. After the transition, many carers acknowledged that they were exhausted, although many had not realised this while providing home-based care. Post-transition, many carers reported ongoing sleep disruptions associated with poor sleep habits established whilst caring, insomnia or nightmares and grief. Carers were optimistic that their sleep would improve with time and many were enjoying sleeping according to their own preferences. The sleep experience of family carers is unique and includes tensions between their essential need for sleep and the experience of care as self-sacrifice. Findings have implications for timely support and interventions for families living with dementia. [ABSTRACT FROM AUTHOR]

Background: The increase in multimorbidity or co-occurring chronic illnesses is a leading healthcare concern. Patients with multimorbidity require ongoing care from many different professionals and agencies, and often report a lack of integrated care. Objective: To explore the daily help-seeking behaviours of patients with multimorbidity, including which health professionals they seek help from, how professionals work together, and perceptions and characteristics of effective interprofessional, interagency multimorbidity care. Design: Using a case study observational research design, multiple data sources were assembled for four patients with multimorbidity, identified by two general practitioners in New Zealand. In this paper, two case studies are presented, including the recorded instances of contact and communication between patients and professionals, and between professionals. Professional interactions were categorized as consultation, coordination, or collaboration. Results: The two case studies illustrated two female patients with likely similar educational levels, but with different profiles of multimorbidity, social circumstances, and personal capabilities, involving various professionals and agencies. Engagement between professionals showed varying levels of interaction and a lack of clarity about leadership or care coordination. The majority of interactions were one-to-one consultations and rarely involved coordination and collaboration. Patients were rarely included in communications between professionals. Conclusion: Cases constructed from multiple data sources illustrate the complexity of day-to-day, interprofessional, interagency multimorbidity care. While consultation is the most frequent mode of professional interaction, targeted coordinated and collaborative interactions (including the patient) are highly effective activities. Greater attention should be given to developing and facilitating these interactions and determining who should lead them. [ABSTRACT FROM AUTHOR]

Background: The Aggressive Student Culture Scale (ASCS) is a survey designed to measure the extent to which New Zealand (NZ) students experience aggressive behaviours within the school environment. The aim of this study is to assess the psychometric properties of the ASCS in the multidisciplinary Growing Up in NZ longitudinal study. Methods: We used data from 4938 children from the Growing Up in NZ study to examine the psychometric properties of ASCS for 8-year-old children. Confirmatory factor analysis was conducted, and measurement invariance was tested across sex, ethnicity, and deprivation levels. Results: The ASCS tool comprises a single latent factor: aggressive student behaviour. The ASCS provides an adequate and satisfactory measure for student aggression experiences. Full measurement invariance was supported for child's sex, but only configural invariance was confirmed across ethnicity and area-level deprivation. Males reported higher levels of aggressive experiences than females. Conclusions: The one-factor model structure offers an excellent fit to our data with good internal consistency. Comparisons across sex are valid; however, direct comparisons across ethnicity and deprivation levels should be approached with caution. We recommend replication studies and encourage further research involving participants from different age groups to better understand the factor structure across diverse demographic variables. [ABSTRACT FROM AUTHOR]

This article draws on the findings of the qualitative phase of a New Zealand longitudinal study on vulnerable young people’s transitions to adulthood. The young people were aged between 12 and 17 years at the time of the first interview. The paper focuses on one key finding, how youth enact agency through their relationships with significant others: families, social workers, teachers and care workers. These youth had experienced sustained exposure to harm including abuse, violence, addictions, disengagement from school and mental health issues. The qualitative interviews focused on young people’s experiences with services (child welfare, juvenile justice, mental health and education support services) their key transitions, and the strategies they used to locate support and resources. The thematic analysis of the interviews indicated that a search for agency was a central motif in young people’s experiences. This was reflected in three thematic clusters: making sense of the world, having a voice and acting on the world. [ABSTRACT FROM AUTHOR]

Sexual violence prevention has shifted from centering around a message of ‘no means no’ toward a message of ‘get consent.’ This paper explores how young adults conceptualise consent in relation to how they talked about expressing a willingness to participate in sex. The analysis here argues that understandings of consent are disconnected from how young people understand communication about sex. Consent is viewed as a formal minimum requirement for ‘ok’ sex. At the same time, young people were more sophisticated when discussing how they understand and communicate a willingness to have sex. Implications for sexual violence prevention education and research on sexual consent are discussed. [ABSTRACT FROM PUBLISHER]

In this paper, we document and theorise ‘ownership’ practices in young people’s intimate relationships and discuss the parallels with domestic violence. Ten young New Zealand women engaged in focus group discussions about their heterosexual partner’s ‘ownership’ practices or jealous, possessive and controlling behaviours. Using discourse analysis informed by feminist poststructuralism and critical realism, we identified three proprietary ‘ownership’ practices experienced by these young women: ‘ownership’ entitlement, surveillance and identity ‘ownership’. We discuss the parallels between these practices and those experienced by women subjected to men’s domestic violence, the possibility that such practices may be precursors to the development of domestic violence and the implications for prevention. [ABSTRACT FROM PUBLISHER]

The burden of health inequities borne by Indigenous peoples can be overwhelming, especially when mothers and newborns' lives are at stake and health services seem slow to invest in responsiveness. In Aotearoa (New Zealand), urgent action is required to eliminate persistent systemic inequities for Māori (Indigenous) whānau (family collectives that extend beyond the household). This Kaupapa Māori (by Māori, for Māori) qualitative study aimed to explore the views of health practitioners identified as champions by whānau of preterm Māori infants. Ten health practitioners were interviewed and asked about their involvement with the whānau, their role in explanations and communication, and their thoughts on whānau coping. Interview data were analysed using interpretative phenomenological analysis. Three superordinate themes were identified: working together in partnership, a problem shared is a problem halved, and sacred space. Collaboration between health practitioners and with whānau was important to the champions and central to their goal of enabling whānau autonomy. This was built on a foundation of connectivity, relationships, and a full appreciation that childbirth is a sacred time that is potentially disrupted when an infant is born prematurely. The values- and relationship-based practices of these champions protected and uplifted whānau. They showed that health practitioners have important roles in both the elimination of inequities and the sustaining of Māori self-determination. This championship is an exemplar of what culturally safe care looks like in day-to-day practice with Māori and is a standard that other health practitioners should be held to. [ABSTRACT FROM AUTHOR]

Background: Internationally, efforts are being made to promote equity in palliative and end-of-life care for Indigenous peoples. There is a need to better understand the experiences of Indigenous service users and staff. Aim: To explore the views of Māori health practitioners and whānau (family group) caregivers regarding barriers and enablers to culturally safe palliative and end-of-life care. Design: A Kaupapa Māori qualitative study. Setting/participants: Interviews were conducted with 103 participants from four areas of the North Island of Aotearoa New Zealand. Participants comprised bereaved whānau (family) of Māori with a life limiting illness and Māori health practitioners. Results: Māori health practitioners undertake cultural and connecting work to promote culturally safe palliative and end-of-life care for Māori patients and their whānau. This work is time-consuming and emotionally and culturally demanding and, for most, unpaid and unrecognised. Non-Māori staff can support this work by familiarising themselves with te reo Māori (the Māori language) and respecting cultural care customs. However, achieving culturally safe end-of-life care necessitates fundamental structural change and shared decision-making. Conclusions: Our findings indicate that efforts to support equitable palliative care for Indigenous people should recognise, and support, the existing efforts of health practitioners from these communities. Colleagues from non-Indigenous populations can support this work in a range of ways. Cultural safety must be appropriately resourced and embedded within health systems if aspirations of equitable palliative and end-of-life care are to be realised. [ABSTRACT FROM AUTHOR]

We examine gendered patterns in the use of violence in response to the partner's violence ("fighting back"). Within each gender, we examined if socio-demographic differences in prevalence were present, and if contextual factors influenced the use of violence against a violent partner. Data from a large, population-based sample of New Zealand adults was used to identify ever-partnered respondents who had experienced physical IPV (n = 407 women, and n = 391 men). Weighted percentages and 95% confidence intervals (95%CIs) were calculated for the use of violence against a violent partner, stratified by gender. Multivariable logistic regression was used to assess the association between each contextual risk factors and the use of violence against a violent partner. For both men and women, at the multivariable level, use of violence against a violent partner was associated with contextual factors related to the abuse. However, for almost all of these variables a higher proportion of women than men experienced the risk factor; for example, a higher proportion of women than men reported having experienced severe IPV (57.6% women; 43.7% men), injuries resulting from IPV (44.5% women, 15.0% men), and fear of a partner (22.7% women, 4.9% men). Women were also more likely to report experiencing other types of IPV (particularly sexual IPV) and were more likely to report that their children were present at the time of violence. These factors contributed to the higher proportion of women who reported fighting back at least once (53.4% of women and 22.3% of men). Health, social, and legal services need to conduct appropriate and thorough assessment of nature and context (current and historical) of the violence that individuals have been exposed to as part of service provision. Assessments need to be carried out with a gender-lens in order to provide comprehensive and appropriate responses. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a widespread social problem affecting all populations regardless of gender, race, and socioeconomic status. The aims of this study were to examine (a) patterns of IPV among Pacific women living in New Zealand and (b) the risk and protective factors associated with IPV perpetration and victimization. As part of the longitudinal Pacific Islands Families (PIF) Study, maternal interviews, which included reports about IPV, acculturation, and sociodemographic characteristics, were administered at phases 6 weeks, 2, 6, 11, and 14 years postpartum. Age had a significant effect on perpetration of both minor and severe perpetration of IPV, and on being a victim of minor IPV. However, no significant effect was found for severe victimization. Cultural alignment also had a significant effect on perpetration of IPV with Pacific mothers who were strongly aligned to their traditional Pacific culture being significantly less likely to report minor or severe IPV perpetration compared with Pacific mothers who were closely aligned to western culture. Single mothers reported significantly more minor victimization, and those mothers who were more highly educated and were in a higher income bracket were significantly less likely to report severe physical IPV victimization. These findings can inform the timing and targeting of culturally appropriate violence prevention efforts in adolescence and young adulthood that focus on the development of healthy intimate partner relationships and effective methods of conflict resolution. [ABSTRACT FROM AUTHOR]

Background: the right for patients of all diagnoses to be in receipt of palliative care from an early point in the diagnosis of a life-limiting condition is now enshrined in policy in a number of countries and increased emphasis is placed upon the role of generalist palliative care. However, little is known as to how this policy is enacted on the ground.Aim: to explore understandings of, and perceived roles in relation to, palliative care provision amongst generalist and specialist health care providers in England and New Zealand.Design: qualitative data were collected via individual interviews and focus groups.Setting/participants: participants comprised generalist and specialist palliative care providers working in a variety of settings in England (n = 58) and New Zealand (n = 80).Results: the following issues with significant implications for this new phase of development for palliative care were identified: (1) difficulties with terminology and perceived roles/responsibilities; (2) problems of integrating palliative care into a generalist workload; (3) challenges in generalist/specialist partnership working; and (4) the potential negative consequences of specialization.Conclusions: these data indicate that, within England and New Zealand, the policy rhetoric of universal palliative care provision is not being straightforwardly translated into service delivery and individual clinical practice. Further research is required to explore and evaluate different models of organization and service provision that empower ‘generalists’ to provide palliative care, without resulting in deskilling. Finally, definitional clarity at an academic/policy level is also needed. [ABSTRACT FROM PUBLISHER]

Introduction: Evaluating how therapeutic horse riding improves health for children experiencing disability is made complex by a lack of clarity around mechanisms of treatment effect. This research develops an explanatory theory outlining how health outcomes may be optimised, by exploring what works for which riders, under what conditions and how. Method: Within a realist research framework, we undertook three phases of study using a mix of qualitative and quantitative data collection and analysis approaches. Findings were then integrated into an overall evaluative account. Results: Riders with a range of impairments (n = 32; aged 5 to 17 years), caregivers (n = 29) and therapeutic horse riding providers (n = 16) participated. Three key mechanisms of intervention effect are proposed: (1) therapeutic horse riding facilitates development of a rider's self-concept through opportunities for accessible, meaningful participation; (2) the context in which therapeutic horse riding is provided promotes a focus on riders' capacities and strengths and (3) therapeutic horse riding provides opportunities for a broad range of learning experiences. Conclusion: Therapeutic horse riding provides opportunities for meaningful occupational participation for children experiencing disability. Ensuring that the physical and ideological context in which therapeutic horse riding is provided focuses on a rider's capacities and strengths will enhance self-concept development and participation outcomes. [ABSTRACT FROM AUTHOR]

Just as ageing is part of life, so is death. Death does not end people's desire to connect with deceased family members and, arguably, the connection between the dead and the living plays an important role in people's lives and relationships. This article explores the matter of ancestor worship, as a form of filial piety, and highlights the importance of considering an "expanded" connection between past and current generations, beyond death. Data were collected from two qualitative studies with Korean residents from Australia, New Zealand and Korea, and analysed using an altered mode of thematic analysis in a Korean and English bilingual context. The findings from the studies show that connectedness with ancestors is an important part of the participants' physical and mental worlds. The discussion in this article includes the meaning of ancestral engagement, ancestral veneration, and mutual connections between ascendants and descendants. The term "memorial piety" is used to define what people practise in relation to remembering and commemorating ancestors or other late loved ones – not necessarily worshipping them in contemporary times. This article addresses a need to broaden the scope and quality of social work for both people who have died and their surviving families, and highlights the potential role of social workers in promoting a meaningful relatedness between past and living generations. [ABSTRACT FROM AUTHOR]

Background. Adaptive equipment (AE) is frequently provided during stroke rehabilitation by occupational therapists. Purpose. This study aimed to identify the AE that people typically use after a stroke and the outcomes achieved as a result, and to explore people's experiences obtaining and using AE, to inform both practice and policy in this field. Method. A mixed-methods study, involving a postal questionnaire and interviews, used descriptive statistics and grounded theory to analyze the quantitative and qualitative data, respectively. Findings. Questionnaire data (n = 258) revealed mobility AE was issued most frequently, with increased safety as the primary reported outcome. Interview data (n = 15) indicated relationships with health professionals and the hospital environment shaped early AE selection and use. Once home, making sense of AE and community participation were more influential. Implications. Therapeutic relationships and reflection time are critical to maximize AE use after stroke. Policy and related funding for AE need to prioritize community participation. [ABSTRACT FROM AUTHOR]

Purpose: This article reports on an examination of the psychometric properties of the 28-item Child and Youth Resilience Measure (CYRM-28). Methods: Exploratory factor analysis, confirmatory factor analysis, Cronbach's a, t-tests, correlations, and multivariate analysis of variance were applied to data collected via interviews from 593 at-risk adolescents (12-17 years) to identify the factor structure, internal consistency, test-retest reliability, construct validity, and floor and ceiling effects of the CYRM-28. Results: A four-factor structure was identified comprising two contextual factors, individual and family factors. The CYRM-28 and its factors show good internal reliability, stable test-retest properties, and no floor or ceiling effects. The measure also showed good construct validity. Discussion: The CYRM-28 shows good overall validity on this group of New Zealand youth, and researchers and social workers can have some confidence in its usefulness as a measure that can be used to assess resilience in youth from a range of ethnic backgrounds. [ABSTRACT FROM AUTHOR]

In New Zealand, embryo donation (ED) is “open,” allowing offspring to access genetic information. Donors and recipients meet prior to donation. Drawing on interviews with 15 recipients, 22 donors, and nine counselors, this article discusses how ED may be constructed as a form of gifting. This discourse may evoke expectations that recipients will express gratitude for the gift, including through honoring contact agreements. Donation becomes a relational practice of obligations and counter-obligations. However, the gift discourse may not adequately capture the emotional sacrifice experienced by donors. Donors describe significant attachment to their embryos, ambiguity about relinquishment, and interest in offsprings’ welfare. Furthermore, embryos may be constructed as inalienable bodily gifts resulting in children with whom the donors share immutable social ties. A discourse of ED as mutual exchange, collaboration, and extended family building may be more useful to donors and recipients in managing ED. [ABSTRACT FROM AUTHOR]

Aim: To explore kaumātua attitudes towards physician aid-in dying, to gain a clear understanding of how such attitudes may influence and shape their expectations of medical care at the end of life and to assist health professionals in Aotearoa/New Zealand to address the healthcare needs of older Māori near the end of life. Design: A kaupapa Māori consistent approach was undertaken. A systematic narrative technique was employed for the qualitative data analysis. Data were triangulated through independent data coding by three researchers (two of whom identified as Māori researchers), to ensure a robust and consistent method of analysis as well as adhering to a kaupapa Māori research approach. Setting/participants: Recruitment of participants was through kaumātua of Te Kupenga Hauora Māori (Māori leadership within the Faculty of Medical and Health Sciences), University of Auckland and local Auckland marae. Focus group or individual interviews (as per their preference) were undertaken with 20 Kaumātua from the Auckland region. Results: Five closely interrelated themes were identified from kaumātua narratives regarding physician aid-in dying. These were (1) attitudes and understandings of physician aid-in dying, (2) influence of power, (3) significance of kawa, (4) whānau relationships and the (5) significance of wairua. Conclusion: The study demonstrated that for these kaumātua, medical practices that hasten death such as physician aid-in dying are 'not all just about the dying'. Tikanga and kawa are important processes and concepts to understand during death and dying, and whānau are central to such processes being respected by those involved in the dying process. These factors are so closely intertwined that they cannot be considered in separation of each other. [ABSTRACT FROM AUTHOR]

The article presents information on the economic costs of health service provision for people with palliative care needs. Topics discussed include direct and indirect costs incurred by caregiving, increase of costs in palliative care, and influence of costs of caring on wider family and network. Also being discussed is the inadequate cost and care-support systems.

Childhood is socially constructed, and constructions influence perceptions of appropriate work for young people. This article investigates New Zealand parents’ perspectives on young people’s involvement in paid work. The United Nations Convention on the Rights of the Child, 1989, and the International Labour Organisation C138 Minimum Age Convention, 1973, intended to protect young people, embody constructions of them as vulnerable. We argue that policymakers should consider how these constructions are reflected in legislation and international treaties and take account of research addressing the likely consequences of minimum working age legislation when they decide whether to ratify the Minimum Age Convention, 1973. [ABSTRACT FROM PUBLISHER]

This study reports on discourse analysis of transcripts from focus group discussions held with 28 “ordinary” men about domestic violence. Two broad “mateship” themes emerged: (a) a strong “mateship” discourse that produced public/private boundaries around discussions about intimate heterosexual relationships. Policed by the threat of violence, these boundaries prevented some men from challenging men about their violence. (b) “Loyalty to mates” discourses constituted attention to men’s violence against women as threatening the moral integrity of all men. Finally, some men positioned themselves against men’s domestic violence, distinguishing their masculinity from men who abuse women. Implications for prevention campaigns are discussed. [ABSTRACT FROM PUBLISHER]

The article discusses a study to examine the preferences and concerns of New Zealand patients waiting for kidney transplantation. Topics discussed include the positive attitudes towards living donor kidney transplantation, the importance for patients to understand risks and benefits of various renal replacement therapy options to themselves and the need to integrate a range of initiatives in practice and policy for an effective strategy to increase rates of living donor transplantation.

The article presents a study which explores the reasons some healthy older New Zealanders oppose physician-assisted dying to inform existing debate. It says that the recorded interviews were analysed and transcribed by the authors after some edits had been made by respondents. Results showed that the thinking of some older people about physician-assisted dying was influenced by their past experiences of death and dying.

Background: Few descriptive epidemiologic studies of injury in soccer are of community-level players. Although many sports injury surveillance systems have been described in the scientific literature, only 1 has been implemented in community-level soccer and that was restricted to adolescent players in a single club.Purpose: The objective of this study was to develop a method for undertaking routine surveillance of injury in community-level soccer.Study Design: Cohort study; Level of evidence, 2.Methods: A cohort of 880 community-level players aged 13 years and over was followed over 1 winter competitive season. Each week, each player was contacted by telephone and an interview conducted to collect data on participation in matches and training sessions, injuries, and adherence to injury prevention measures.Results: Seventy-five percent (n = 510) of the cohort was male and the median age was 16 years. Data were collected on 11 268 player-matches totaling 13 483 player-match hours and 11 540 player-training sessions totaling 16 031 player-training hours. A total of 677 match injury events were reported, giving overall incidence rates of 50.2 injury events per 1000 player-match hours and 6.0 injury events per 100 player-matches. The incidence rate for match injury events was significantly higher for females than for males (63.9 vs 46.9). A total of 145 training injury events were reported, giving overall incidence rates of 9.0 injury events per 1000 player-training hours and 1.3 injury events per 100 player-training sessions. The most common injuries were sprains and strains of the lower limb, and tackling was the most common cause of injury.Conclusion: This study has shown that routine injury surveillance, using a cohort design with exposure measurement, can be successfully implemented in community-level soccer. [ABSTRACT FROM AUTHOR]