Search

In New Zealand, people receiving care from specialist mental health and addiction services experience poorer health outcomes compared to the general population. Māori (Indigenous) specialist mental health and addiction service users experience disproportionate inequities. This study aims to: (1) Describe and understand mental health staff perspectives on the quality of care delivered to specialist mental health and addiction service users in their service – including specifically for Māori; and (2) Identify areas staff report as opportunities for quality improvement. In 2020, Southern District Health Board (now Te Whatu Ora – Southern) mental health staff were invited to participate in a cross‐sectional study assessing their perceptions of a range of service aspects. This paper presents quantitative and qualitative analyses about quality of care. Among the 319 staff who completed the questionnaire; 272 provided quality‐of‐care responses. Among these, 78% reported the quality of care delivered to service users as 'good' or 'excellent'; only 60% reported this for Māori service users. Participants identified individual, service and broader system level factors influencing the quality of care delivered to service users, including factors specific for Māori. This study has identified, for what appears to be the first time, empirical and concerning differences in staff ratings of the quality of care delivered to Māori and SMHAS users overall. Findings highlight the need for institutional and managerial prioritization of hauora Māori, and incorporating tikanga Māori and Te Tiriti into practice. [ABSTRACT FROM AUTHOR]

This study assessed the physical activities of Mental Health Nurses (MHN) in New Zealand against the 2018 World Health Organization recommended minimum levels of moderate‐to‐vigorous physical activity. The research design was exploratory and descriptive as there were no previous studies about physical activity levels of MHNs in New Zealand. Quantitative and qualitative data were collected using the International Physical Activity Questionnaire (IPAQ, Long Version) which included options for free‐text responses. Data were analysed using descriptive and inferential statistics. A total of 266 participants returned the survey, a response rate of 4%, and a limitation of the study. More than 50% of MHNs reported <150 min of moderate‐to‐vigorous exercise per week for each of the four physical activity domains. When individual physical activity domains were combined, only 10% spent <150 min on moderate‐to‐vigorous physical activity. Work‐related physical activities were higher for those working in the inpatient area than in community settings. Transport‐related physical activities were higher for those working in community settings. Participants registered from 6 to 20 years had more time sitting than other groups. Nurses aged 55 years and above showed the highest total physical activity levels. Moreover, healthcare organizations and nurse leaders need to promote physical activity and provide wellness intervention for their staff. Nurses who are physically active may be more effective in supporting their patients to increase their physical activity. [ABSTRACT FROM AUTHOR]

Background: Research has indicated that clinical staff in long‐term care often lack self‐confidence in palliative care delivery, particularly at the end of life. Goals: (a) To examine the contribution of age, palliative care education, palliative care work‐related experience and psychological empowerment to palliative care delivery confidence and (b) to explore the social reality shaping those factors for long‐term care staff. Design: Explanatory sequential design. Setting: Twenty long‐term care facilities in two district health boards in New Zealand. Participants: Phase 1:139 clinical staff. Phase 2:46 clinical staff who provided care in the last month of a residents' life. Methods: Phase 1: Cross‐sectional survey. Phase 2: Individual semi‐structured interviews. Results: Phase 1: Previous experience (β =.319) and psychological empowerment (β =.311) contribute most to predicting an increase in palliative care delivery confidence. Phase 2: Four factors underlay palliative care delivery confidence, (a) mentorship by hospice nurses or colleagues (b) contextual factors (organisational culture, resources and experience), (c) maturity and (d) formal education. Conclusion: Organisational leadership should use multiple strategies (e.g. power‐sharing, increased opportunities for mentorship) to improve staff palliative care delivery confidence. Implications for Practice: This study adds to the literature in understanding the predictors of palliative care delivery confidence specific to long‐term care staff. The results indicate that educational interventions must be contextually appropriate to achieve sustainable improvements in palliative care confidence and ultimately in resident care at the end of life. [ABSTRACT FROM AUTHOR]

Abstract: Coproduction of research between consumers of mental health services and nonconsumer mental health researchers is increasing. There is some research available describing consumer perspectives of this experience. However, there is a notable lack of research on other (nonconsumer) researcher experiences of and views about consumer involvement in coproduced research. A qualitative exploratory study was undertaken to examine perspectives of mental health researchers about consumer involvement in research. In‐depth individual interviews were undertaken with 11 nonconsumer mental health researchers in Australia and New Zealand. Interview transcripts were analysed to identify major themes. There were three interacting themes: the salience of experiential difference, expanded learning, and enhanced research. The dynamic between different perspectives and learning had the effect of enhancing research across the spectrum of study phases and in ensuring research was of value to different groups. The findings emphasize the important contribution consumer researchers can make to mental health research by bringing their unique perspective and enhancing an environment of mutual learning. Findings also point to the need for foregrounding the numerous benefits of joint research between consumer and other researchers to enhance and improve clinical practice and the development of policy. [ABSTRACT FROM AUTHOR]

Background Childhood obesity is a growing concern internationally and a top priority for the World Health Organization. Preconception overweight, obesity and excess gestational weight gain significantly increase childhood obesity risk. Optimising preconception weight is a key preventative measure toward reducing childhood obesity. In 2014, the New Zealand ( NZ) Ministry of Health released guidance for health practitioners on healthy weight gain in pregnancy in an effort to reduce the burden of childhood obesity. Aim To explore the knowledge and practice of NZ general practitioners ( GPs) regarding preconception and gestational weight management. Materials and methods A nationwide survey was conducted on a randomly selected sample of NZ GPs using a mixed methods approach. Descriptive statistics were used for survey responses and a general inductive approach was applied to the free text data. Results A total of 200 GPs (42.5%) responded. The majority of GPs were aware of the risks of obesity in pregnancy. Over 50% of GPs reported practice that was not consistent with recommended standards of care. Ministry of Health guidance was known to only 12% of participants. Themes emerging from the free text data included: lack of opportunity for, and awareness of, preconception care; recognition of the importance of this area; and need for further learning. Conclusions General practitioners in NZ are not providing optimal preconception care. This research highlights the need for a public health message encouraging preconception counselling and better education of GPs on the topic. This should start with promotion of the Ministry of Health guidance. [ABSTRACT FROM AUTHOR]

Background Attention-deficit/hyperactivity disorder ( ADHD) has a range of aetiological origins which are associated with a number of disruptions in neuropsychological functioning. This study aimed to examine how low birth weight, a proxy measure for a range of environmental complications during gestation, predicted ADHD symptom severity in preschool-aged children indirectly via neuropsychological functioning. Methods A total of 197 preschool-aged children were recruited as part of a larger longitudinal study. Two neuropsychological factors were derived from NEPSY domain scores. One, referred to as 'Primary Neuropsychological Function,' was loaded highly with Sensorimotor and Visuospatial scores. The other, termed 'Higher-Order Function' was loaded highly with Language and Memory domain scores. Executive functioning split evenly across the two. Analyses examined whether these neuropsychological factors allowed for an indirect association between birth weight and ADHD symptom severity. Results As both factors were associated with symptom severity, only the Primary Neuropsychological Factor was associated with birth weight. Furthermore, birth weight was indirectly associated to symptom severity via this factor. Conclusions These data indicate that birth weight is indirectly associated with ADHD severity via disruption of neuropsychological functions that are more primary in function as opposed to functions that play a higher-order role in utilising and integrating the primary functions. [ABSTRACT FROM AUTHOR]

This study determined the effect of exercise on measures of static and dynamic balance used in the assessment of sports-related concussion (SRC). A balanced three-group cross-over randomized design was used with three levels of exercise verified by blood-lactate, heart rate and 'perceived-exertion': no exercise/rest (NE), moderate-intensity exercise (ME), and high-intensity exercise (HE). Participants performed two timed balance tasks: tandem gait (TG) and single-leg stance (SLS); pre- and post-exercise and 15 min after exercise. Linear mixed-models with adjusted means and contrasts compared exercise effects. Ninety asymptomatic participants (45♂:45♀) were recruited. When times were contrasted with NE; HE resulted in a significant decrease in SLS ( P<0.001) and TG ( P<0.001) performance immediately following exercise. Fifteen minutes of recovery improved SLS ( P<0.001) and TG ( P=0.011) from post-exercise performance. ME caused a significant decrease in performance in SLS ( P=0.038) but not TG ( P=0.428). No statistically significant change occurred following ME in any tasks after 15-min recovery (SLS P=0.064; TG P=0.495). Test-retest reliability was considerably higher for the dynamic task compared with the static task. The reliability of static and dynamic balance tasks, and the change in performance following exercise, have implications for the immediate assessment of SRC, as these measures are utilized in concussion assessment instruments. [ABSTRACT FROM AUTHOR]