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INTRODUCTION: There is growing interest in increasing uptake of hepatitis C (HCV) treatment. HCV is strongly associated with injecting drug use and is a stigmatised illness. People with HCV may be reluctant to engage with health care services. A community-based, nurse-led integrated care clinic was established in Christchurch, New Zealand with the intention of bridging the health care gap for those unwilling or unable to access mainstream health care. This paper explores the experiences and perceptions of health professionals regarding the implementation of this clinic, with particular attention paid to the interprofessional relationships relevant to the clinic. METHODS: Qualitative, in-depth interviews were conducted with 24 stakeholders, including four staff of the clinic and other service providers with varying relationships to the clinic. FINDINGS: Participants generally endorsed the clinic model and described its operation as easy to access, non-judgmental and non-threatening, and, therefore, able to attract and engage 'hard-to-reach' clients. The clinic model was also thought to support more effective use of health resources. Some participants expressed concerns regarding the potential 'poaching' of patients from other services (particularly general practice) and indicated a preference for HCV treatment services to be restricted to hospital settings. CONCLUSION: The findings of this study suggest the need to address concerns of general practitioners regarding patient poaching. Key information to disseminate is the clinic's success in engaging with complex clients and contribution to more efficacious use of health service resources. These activities may require the advocacy of a key local opinion leader acting as 'knowledge broker'. [ABSTRACT FROM AUTHOR]

Music therapy school consultation, according to Rickson (2010), is a process in which a music therapist aims to empower team members to use music in an on-going way with students who have special education needs. However, while consultation is primarily an indirect activity, direct interaction between therapist and student continues to be important for modelling strategies and techniques, and highlighting students' strengths. This paper describes student responses to the direct interaction that took place between the music therapist and students as part of a music therapy school consultation in a mainstream city school in New Zealand. The music therapist, who is also the first author, worked with four students and their respective teams over the period of one week. Each team included a teachers' aide, parent and classroom teacher. Follow-up interviews undertaken by an independent researcher, who is the second author, suggest the adults involved were unsure of what to expect of the consultation, and some had reservations about how the students might respond. However, in all cases students engaged relatively easily with the music therapist and, according to team members, each demonstrated higher than usual levels of participation during music therapy activities. Team members therefore developed an increased awareness of the potential benefits of music therapist and student interaction, as well as musical ideas that they might use in their on-going daily interactions with students to help further educational outcomes. In this paper, four contrasting case vignettes describe the complexity of student needs and goals, and demonstrate how the music therapist, in her direct interactions with students, was able to draw on a variety of therapeutic strategies and techniques to illicit the positive responses of the students. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The prevalence of long-term health conditions (LTCs) continues to increase and it is normal for people to have several. Lifestyle is a core feature of the self-management support given to people with LTCs, yet it seems to fail to meet their needs. From a larger study exploring the experiences of this group, this paper reports on the role of food and mealtimes, and the effect of the nutritional advice on the lives of people with several LTCs. METHODS: The experiences of 16 people with several advanced LTCs were explored using multiple qualitative case studies. Over an 18-month period, contact with participants included monthly conversations, two longer, semi-structured interviews and one interview with their primary care clinicians. The data were analysed inductively using thematic analysis. RESULTS: There was profound social, psychological and cultural significance of food to the participants. These aspects of food were then described using the Whare Tapa Wha model of health. The approach to food and nutrition participants experienced in health care was closely associated with conventional weight management. They found this advice largely irrelevant and therefore ineffective. DISCUSSION: The pressure people with several LTCs experience during clinical encounters has perverse effects on wellbeing and reinforces an overall sense of failure. This research challenges the assumption that all people have the will, agency and income to follow the advice they receive about nutrition and exercise. Considering people's needs using the Whare Tapa Wha model of health offers clinicians a framework to re-conceptualise the core features of self-management support and provide realistic, compassionate care that will optimise the quality of life for people with multiple LTCs. [ABSTRACT FROM AUTHOR]

A crucial development resulting from consumer involvement in mental health services has been engagement as active participants in mental health research, often conducted in collaboration with mental health researchers representing the health disciplines (referred to in this paper as 'other' researchers). Despite progress in mental health consumer research, unequal power relations continue to pose a major barrier. Although power issues are discussed in the literature, there is little research from the perspective of other mental health researchers who have collaborated with consumers on research projects. This qualitative study explored other mental health researchers' perspectives on the role of power in collaborative research with consumers. Semi-structured interviews were completed with 11 other mental health researchers. Thematic analysis of the transcript version of interview recordings was conducted. The findings were grounded in 'the table' as a literal and metaphorical site of power relations. The umbrella theme was prominence and presence (of consumers) at the table, followed by subthemes on barriers (tokenism, undermined potential) and surmounting them through reworking power (critical mass and openness to power dynamics). Overall it was found that while there continue to be significant power-related barriers to further building of robust collaborative research with consumers in mental health, there are several avenues that should be considered, much more assertively, to disrupt and transcend them. [ABSTRACT FROM AUTHOR]

Background: This paper draws on a 2015 study in New Zealand that examined perceptions of registered nurses (RNs) and general practitioners (GPs) regarding the role of Nurse Practitioners (NPs) in long-term aged care facilities (LTACF). Aim: To explore the attitudes of RNs and GPs regarding the role of NPs in LTACFs. Design: A descriptive, mixed methods design with a survey and invitation to interview was used. RNs and GPs who provided hospital-level care were invited to participate. Findings: The findings showed RNs and GPs are open to considering the NP role in aged care. However, there remains a lack of understanding of what NPs do. Conclusions: This study suggests a shift in attitude towards accepting the NP role by RNs and GP working in LTACFs. [ABSTRACT FROM AUTHOR]

Purpose The risk associated with heavy episodic drinking in young people has caused concern among public health professionals. The purpose of this paper is to investigate the gender differences in the perception of risk in alcohol consumption behaviour for better targeting of messages.Design/methodology/approach This qualitative descriptive study examines the narratives of 28 young people’s experience of a “night out” framed as the Alcohol Consumption Journey to examine the ways young men and women experience context-specific risks for alcohol use.Findings The young people perceived participation in the Alcohol Consumption Journey involved risk to their personal safety. Both young men and young women described their alcohol consumption as controlled and perceived the risks as external inevitabilities linked to the public drinking establishments. However, they displayed noticeable gender-based differences in the perception and management of risk in diverse contexts of the Alcohol Consumption Journey. Young women drink in close friendship groups and have a collective view of risk and constructed group strategies to minimise it. Comparatively, the young men’s drinking group is more changeable and adopted a more individualistic approach to managing risk. Both groups exhibited prosocial tendencies to protect themselves and their friends when socialising together.Originality/value The concept of “edgework” is effective in providing an explanatory framework for understanding young people’s ritualised Alcohol Consumption Journey and to illustrate the context-specific risks associated with alcohol use. [ABSTRACT FROM AUTHOR]

Advance care planning (ACP) has been framed as best practice for quality palliative care, yet a growing body of literature affirms the need for an early iterative ACP process to begin when people are young and healthy. A significant gap appears to exist in the literature regarding the utility of death conversations outside the end-of-life context. Could ‘death conversations’ early in life be an effective tool by which doctor and patient can co-construct a more healthful way of life, and realistic relationship with death? And what variables must be taken into account for these conversations to proceed successfully? This paper provides a narrative exploration of the value of death conversations in the clinical context in New Zealand. Five exemplars are discussed, drawn from a sample of 21 semi-structured interviews with young older adults (54–65 years old) not receiving palliative care or diagnosed with a terminal illness. Together, these narratives indicate that further community consultation is required to determine culturally appropriate ways to initiate productive conversations around aging, death and dying and how to build patient/practitioner/family relationships which allow these conversations to happen safely. There is a need to acknowledge the important factor of culture related to age, generation, sex, faith and ethnicity when engaging in conversations about aging, death and dying. By doing so, health professionals will be best equipped to assist their patients to live well into death. [ABSTRACT FROM PUBLISHER]

This paper presents findings from a study exploring the nurses' experience of caring for adults with intellectual disability and mental health issues in inpatient settings. Semi structured interviews were undertaken with 13 nurses from various regions of New Zealand. Methods suggested by an Appreciative Inquiry methodology were used to explore the nurses' positive experiences of their role. Interviews were transcribed and analysed using open coding and Leximancer (an online data mining tool) analysis to identify dominant themes in the discourse. Analysis revealed themes around 'Contextualising behaviour', 'Communication', 'Confidence to care' and 'Time'. Participants reflected upon their experiences offering personal interpretations in identifying the aspects of nursing that mattered and that worked. What is shown is that nurses were able to describe a range of creative and adaptive ways of nursing in responding to numerous complex factors they faced in their roles. This suggests a strong foundation on which to advance nursing care in this field. [ABSTRACT FROM AUTHOR]

Objectives Smoking during pregnancy is harmful for the woman and the unborn child, and the harms raise risks for the child going forward. Indigenous women often have higher rates of smoking prevalence than non-indigenous. Exercise has been proposed as a strategy to help pregnant smokers to quit. Māori (New Zealand Indigenous) women have high rates of physical activity suggesting that an exercise programme to aid quitting could be an attractive initiative. This study explored attitudes towards an exercise programme to aid smoking cessation for Māori pregnant women. Methods Focus groups with Māori pregnant women, and key stakeholder interviews were conducted. Results Overall, participants were supportive of the idea of a physical activity programme for pregnant Māori smokers to aid smoking cessation. The principal, over-arching finding, consistent across all participants, was the critical need for a Kaupapa Māori approach (designed and run by Māori, for Māori people) for successful programme delivery, whereby Māori cultural values are respected and infused throughout all aspects of the programme. A number of practical and environmental barriers to attendance were raised including: cost, the timing of the programme, accessibility, transport, and childcare considerations. Conclusions A feasibility study is needed to design an intervention following the suggestions presented in this paper with effort given to minimising the negative impact of barriers to attendance. [ABSTRACT FROM AUTHOR]

Young people in statutory care and protection interact with social workers, who hold potential to provide a supportive adult role in their lives. Many however, run away at an early age and end up on the street trading sex for money or other favours. There is potential to improve outcomes for young people in care if the relationship between young people and their social workers is better addressed. This paper uses data from a qualitative study of 14 young people who traded sex and who had experienced interactions with social workers. A thematic analysis identified three themes: the rigidity of social work practice; contesting the family situation; and resisting the at-risk label. We argue that to have any impact on outcomes for young people in care, social workers need to prioritise relationship-building above the need to conform to organizational protocols and guidelines. Such guidelines assist the social worker in assessing whether family situations pose high risk for a young person, but the 'at-risk' label is contested by young people, which results in a lack of trust and a barrier to relationship building. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about the barriers and facilitators to pregnancy, birth and motherhood for disabled women within the New Zealand context. Our study explored this deficit with the aim of improving health care interventions and support for disabled mothers. Methods: This paper reports on the third phase of a mixed-methods study. The first two phases used semi-structured individual and focus group interviews with disabled women, and health professionals, involved in maternity and postnatal care and has been reported elsewhere. Phase 3 utilised a modified Delphi technique with both groups of participants to seek consensus on the prioritisation of recommendations from the study. This article focuses on the disabled women's recommendations. Results: In all, 20 disabled women took part in the Delphi phase of the study (28% of the cohort from Phase 1). In total, 11 key recommendations were identified by the disabled women, with the top seven discussed in detail here. Conclusions: Health professionals and health systems could, and arguably should, utilise a matrix of these recommendations to facilitate a review of service responsiveness to disabled women. [ABSTRACT FROM AUTHOR]

Introduction. From a coronavirus disease (COVID-19) pandemic perspective, Aotearoa New Zealand (NZ) rural residents formed an at-risk population, and disparities between rural and urban COVID-19 vaccination coverage have been found. Aim. To gain insight into factors contributing to the urban-rural COVID-19 vaccination disparity by exploring NZ rural health providers' experiences of the vaccine rollout and pandemic response in rural Māori and Pasifika communities. Methods. Rural health providers at four sites participated in individual or focus group semi-structured interviews exploring their views of the COVID-19 vaccine rollout. Thematic analysis was undertaken using a framework-guided rapid analysis method. Results. Twenty interviews with 42 participants were conducted. Five themes were identified: Pre COVID-19 rural situation, fragile yet resilient; Centrally imposed structures, policies and solutions - urban-centric and Pakehā focused; Multiple logistical challenges - poor/no consideration of rural context in planning stages resulting in wasted resource and time; Taking ownership - rural providers found geographically tailored, culturally anchored and locally driven solutions; Future directions - sustained investment in rural health services, including funding long-term integrated (rather than 'by activity') health services, would ensure success in future vaccine rollouts and other health initiatives for rural communities. Discussion. In providing rural health provider perspectives from rural areas serving Māori and Pasifika communities during the NZ COVID-19 vaccine rollout, the importance of the rural context is highlighted. Findings provide a platform on which to build further research regarding models of rural health care to ensure services are designed for rural NZ contexts and capable of meeting the needs of diverse rural communities. [ABSTRACT FROM AUTHOR]

Introduction. Community-based primary care physiotherapy has developed through private practice, fee-for-service model in Aotearoa New Zealand where independent businesses operate in competition. Aim. We aimed to explore how the private practice model of physiotherapy impacts patient care, physiotherapists, and professional behaviour. Methods. Six physiotherapists managing musculoskeletal conditions in a primary care private practice in Aotearoa New Zealand were recruited using maximum variation purposive sampling. In-depth individual face-toface semi-structured interviews were audio-recorded, transcribed verbatim, and analysed using Interpretive Description. Inductive data analysis synthesised and contextualised data, creating a thematic framework that developed across interviews. Results. All physiotherapy participants discussed concerns about culture and professionalism in private practice physiotherapy despite not being asked about these. Three themes were identified. 'Competitive business model and lack of collaboration' - participants thought that competition between practices resulted in a lack of trust, collegiality, and collaboration, and pressure on clinicians to maintain income. '(Un)professional behaviour' - participants thought that physiotherapists were defensive and averse to scrutiny, resulting in reluctance to admit when they needed help, or to undertake peer review or seek second opinions. 'Lack of support and mentoring' - the professional culture in private practice was perceived to reduce support and mentoring, with negative impacts that affected physiotherapists at all stages of career. Conclusion. This exploratory qualitative study suggests that competition dominates communication and collaboration in private practice physiotherapy and may have wider implications for professionalism and the quality of patient care. Competitive business models and an aversion to scrutiny may reduce collegial interaction and professional behaviour. [ABSTRACT FROM AUTHOR]

Aims: Investigated the experiences of Māori (the Indigenous peoples of Aotearoa, New Zealand) patients and whānau (extended family network) engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. Design: A qualitative Māori-centred research design using a Thought Space Wānanga (learning through in-depth group discussion, deliberation and consideration) approach. Methods: Two wānanga were conducted between May 2022 and June 2022, with 13 Māori patients who had been acutely hospitalized within the past 12 months and their whānau members. The first wānanga utilized storytelling and journey mapping to collect data. The second wānanga refined the initial themes. Wānanga were audiorecorded and then inductively coded and developed into themes. Results: Thirteen patients and whānau attended the first wānanga, while 10 patients and whānau participated in the second wānanga). Four themes were developed: (1) Whakawhanaungatanga (establishing connections and relationships), (2) Whakamana (uplifting the status and esteem of Māori), (3) Whakawhitiwhiti kōrero (the importance of communicating, discussing and deliberating) and (4) Kotahitanga (working together with purpose) all provide insights into the importance of effectively engaging and connecting with Māori patients and whānau when acutely hospitalized. Conclusions: The experiences and priorities of Māori patients and whānau affirm the international literature, suggesting that Indigenous relational concepts are critical to building relationships, connections and trust. Despite existing healthcare models for working with Indigenous peoples, their poor application contributes to sub-optimal healthcare experiences at all points of their healthcare journey. A relational mode of practice focused on engagement and forming connections better meets the needs of Indigenous peoples engaging with inpatient health services. Implications for the profession and/or patient care: Despite the existence of Indigenous models of care, Indigenous peoples consistently report a lack of engagement and connection when accessing inpatient health services. Without establishing relationships, applying models of care is challenging. Impact (Addressing): • What problem did the study address? Internationally, healthcare systems are consistently ill-equipped to deliver culturally safe care for Indigenous and marginalized peoples, evident in ongoing health inequities. Like other reports of Indigenous experiences of health services, Māori express dissatisfaction with care delivery in an acute inpatient setting. This study investigated Māori patients and whānau experiences engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. • What were the main findings? Māori patients and whānau recounted negative experiences with healthcare professionals lacking effective relationships and trust. Satisfaction occurred when engagement with health care professionals resembled Indigenous cultural rituals of encounter that considered their holistic, collective and dynamic worldviews. Previous models of relational care, while helpful, are not Indigenous and so do not address their needs, such as engagement as a mode of practice (how) to achieve this. • Where and on whom will the research have an impact? This research impacts Indigenous peoples' health outcomes, particularly Māori, and nurses and clinicians working and interacting within acute inpatient and other hospital settings. Indigenous research methods support co-constructing knowledge for translation into practical outcomes through transformational practices, policies and theory development. Reporting method: We used the Consolidated Criteria for Strengthening the Reporting of Health Research Involving Indigenous Peoples (CONSIDER) statement (see File S2—CONSIDER Checklist) and the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (see File S3—COREQ Checklist). [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]

ABSTRACT:This paper estimates the incidence (all ages) of spinal cord neurological impairment (SCI; traumatic and non traumatic) in New Zealand and describes pre-SCI characteristics and early post-SCI outcomes for participants (16-64 years) in this longitudinal study. Demographic and clinical data on all people admitted to New Zealand's two spinal units (mid-2007 to mid-2009 )were included for the estimate of incidence. Participants in this longitudinal study were asked at first interview about pre-SCI socio-demographic, health and behavioural characteristics, and about post-SCI symptoms, general health status (EQ-5D) and disability (WHODAS 12-item). Age-adjusted incidence rates (95% CI) for European,Maori, Pacific and 'Other' ethnicities were 29 (24-34), 46 (30-64), 70 (40-100) and 16 (9-22) per million, respectively. Interviews with 118 (73%) participants (16-64 years), occurred 6.5 months post-SCI. Most reported bother with symptoms, and problems with health status and disability. Compared with Europeans, the incidence of SCI is high among Maori and particularly high among Pacific people. Six months after SCI, proximate to discharge from the spinal units, considerable symptomatic, general health and disability burden was borne by people with SCI. [ABSTRACT FROM AUTHOR]

Purpose – Disabled people who are the end-users (EU) of health services have a poor record of inclusion, yet a major stake in the quality of scientific research that informs the development of health knowledge and interventions. In traditional rehabilitation research it has been the researcher who sets the agenda, including determining the research question, study design and methods, and who controls dissemination of findings. This paper aims to describe the development of an EU research consultation committee and to describe the evaluation protocol used to assess the effectiveness of the committee. Design/methodology/approach – The paper describes the context and development of an EU research consultation committee (the committee) to promote collaboration between researchers and lay-EUs within a research organization in New Zealand. It also describes the qualitative evaluation protocol to be used to assess the effectiveness of the committee over the first 12 months of operation in order to refine its process and procedures. Findings – The paper discusses the issues and challenges involved in achieving collaboration between researchers and EUs in the rehabilitation research space and describes this consultation model as a positive example of making inclusion a reality. Challenges include building research capacity within the EU community and development of real models of collaboration and partnership in rehabilitation research. Originality/value – It is argued that the integrity and relevance of clinical research is enhanced by the involvement of EUs in all aspects of the research process. [ABSTRACT FROM AUTHOR]

cook c. (2012) Email interviewing: generating data with a vulnerable population. Journal of Advanced Nursing 68(6), 1330-1339. Abstract Aims. This paper describes online recruitment and the email interviewing data collection method with women diagnosed with a viral sexually transmitted infection. The paper highlights the advantages of the method to researchers and participants when conducting research where face-to-face participation may difficult. Background. Online recruitment and in-depth email interviewing have been used by only a small number of nurses internationally. The method enables inclusion of people who might otherwise be excluded from research, for reasons such as geographical distance, incompatible time frames, clinicians''gate-keeping' and participants' desire for anonymity for physical or emotional reasons. Methods. In-depth email interviews were conducted with 26 women in New Zealand, United States of America, Canada and England who had a diagnosis of either human papilloma virus or genital herpes simplex virus. Data were collected during 2007-2008 and analysed using a poststructuralist, feminist thematic analysis. Results. Participant retention was high. Women emphasized satisfaction with the process. Asynchronous interviews allowed for additional reflexivity in the researcher's responses and rich data generation. Conclusion. This method has the potential to enable nurses to include vulnerable and relatively inaccessible participants in 'sensitive' research. In-depth email interviews may generate rich data through a process participants deem to be of personal value. [ABSTRACT FROM AUTHOR]

Hoare KJ, Mills J, Francis K. International Journal of Nursing Practice 2012; 18: 240-245 Dancing with data: An example of acquiring theoretical sensitivity in a grounded theory study Glaser suggested that the conceptual route from data collection to a grounded theory is a set of double back steps. The route forward inevitably results in the analyst stepping back. Additionally sidestepping through, leading participants down lines of inquiry and following data threads with other participants, is also characteristic of acquiring theoretical sensitivity, a key concept in grounded theory. Other ways of acquiring theoretical sensitivity comprise: reading the literature, open coding, category building, reflecting in memos followed by doubling back on data collection once further lines of inquiry are opened up. This paper describes how we 'danced with data' in pursuit of heightened theoretical sensitivity in a grounded theory study of information use by nurses working in general practice in New Zealand. Providing an example of how analytical tools are employed to theoretically sample emerging concepts. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to analyse attitudes, understanding of gambling and gambling related harm among Asians in New Zealand using secondary data from the New Zealand 2006/07 Gaming and Betting Attitudes Survey (GBAS). Design/methodology/approach -- This survey interviewed 1,973 nationwide randomly selected youths and adults ($18 years) using structured questionnaire. Chinese (N = 113) and Indian (N = 122) data were analysed separately to compare between them and with NZ Europeans (N = 792). Descriptive analysis was carried out and was subsequently tested for significant correlations by weighted (p < 0.01) and un-weighted (p < 0.05) variables. Findings -- A higher proportion of Chinese males (66.8 percent) represented in the survey compared to Indian (43.0 percent) and NZ European (48.9 percent) where Chinese consisted of more youthful age structure. Chinese respondents were more likely to be in the lowest income bracket (NZ$10,000) compared to others. Among the ten gambling activities "casino table gambling" and "casino electronic machines" (slot-style machine) were most popular among the Chinese where Indians preferred "gambling/casino evening". A significant proportion of Chinese were unwilling to refer family or friends to gambling help services despite believing that gambling does more harm than good. Pre-committed gambling sum was the most common harm minimising strategy suggested by participants. They believed education and consultation could deter youths from harmful gambling. Research limitations/implications -- This survey highlighted gambling behaviours and thoughts of the ethnic minority population in New Zealand. Study outcomes would be valuable in formulating ethnic specific preventative programme and may have policy implication. Originality/value -- There has been limited research on gambling behaviour of ethnic minorities in New Zealand. This paper fills some of the gaps. [ABSTRACT FROM AUTHOR]

Research suggests that Occupational Health and Safety (OHS) practitioners have difficulty influencing the decisionmaking process because they are placed on the sidelines in the organisation. This paper analyses the strategies that OHS practitioners use to fulfill their job role and the impact they have on the working environment and OHS management systems. Semi-structured interviews were conducted with ten New Zealand OHS practitioners from mainly large private and public organisations about their job role, OHS tasks, strategies and their impact. The interviews were tape recorded, transcribed, entered into a qualitative data management programme and analysed thematically in relation to their strategies, barriers and their impact on the OHS management system and working environment. The analysis revealed that these OHS practitioners used multiple strategies - chosen in relation to the situation, the stakeholders and their own resources. They saw themselves as change agents or facilitators. They preferred to use a knowledge strategy, supported by an audit strategy. Their last resort was a regulation strategy. All of the practitioners had a positive impact on stakeholders' knowledge, attitude and behavior and on OHS management systems. Some practitioners improved the working environment but few were involved in introduction of new technology. [ABSTRACT FROM AUTHOR]

This paper reports on an exercise conducted within a state-owned body (Crown Research Institute) in New Zealand aimed at building greater understanding of the key factors in successful research programmes. Success was defined in this study as a high level of uptake of the emerging science, with commensurate benefits to both industry and the community. The methodology had three parts. A review of the knowledge and technology transfer literature; a series of 15 semi-structured interviews with science leaders; and a facilitated workshop. The purpose of the review was to generate a robust framework upon which to centre the interview dialogues, and two models were selected. The results varied, reflecting the diversity of research services provided by the organization, but the findings were predominantly new and valuable. The importance of the long term relationship with the end users was the strongest recurring theme. The methodology may have wider application in both research and consulting settings; for the benefits derived from the interactive process with staff, as well as for the specific findings. [ABSTRACT FROM AUTHOR]

In this paper, we explore the challenges posed to, and reactions of, human resource (HR) managers by the concept of environmental sustainability. From interviews with 14 New Zealand HR managers, we explore three related aspects of morality identified by Fineman: private, conventional, and enacted. Findings indicate that while the HR managers note a private position of environmental concern, they take a passive approach to environmental sustainability within their organizations. We note that this passive position is not without potentially adverse effects in relation to the role of HR as a strategic partner and for the advancement of environmental sustainability within organizations. [ABSTRACT FROM AUTHOR]

Family circumstances in infancy are persistent and powerful determinants of children's physical and mental health, influencing inequalities that trace from childhood through to adulthood. While the social factors that perpetuate patterns of inequality are more complex than can be addressed through single interventions, child and family health (CFH) services represent crucial sites where trajectories of inequality can be disrupted. In particular, approaches that foster opportunities for practitioner-parent engagement that challenge traditional hierarchical health care practice, such as the Family Partnership Model (FPM), are recommended as ways of addressing disadvantage. Little is known about how practitioners implement models of working in partnership with families and, consequently, there is a gap in understanding how best to develop and sustain these new CFH practices. This paper reports a research project that investigated the experiences of 25 health professionals working within a FPM framework with vulnerable families. Through discussion of four key themes - redefining expertise, changing practices, establishing new relationships with parents and the complexities of partnership practice - the paper offers first-hand accounts of reframing practices that recognise the needs, skills and expertise of parents and thus contribute to empowerment of families. [ABSTRACT FROM AUTHOR]

In contemporary times, evidence-based medicine is used as the basis for clinical decision-making. For a great number of diseases, surveillance guidelines, which are informed by evidence-based medicine, have been drawn up with much input from specialists in their relevant fields. However, these guidelines are implemented in general practice where different rationalities are brought to bear on clinical decision-making. This qualitative study interviewed both specialists and General Practitioners in New Zealand about their use of surveillance guidelines for colorectal cancer. Tension between both groups of medical professionals was apparent with regard to referral practices, with specialists advocating a rational approach to risk. However, the socio-cultural context within which General Practitioners' clinical decision-making takes place demands a more reflexive process. This paper argues the need to explore power within medical practice as the devolution of power to one group, specialists, who are constructed as the knowledge 'elite', sidelines other groups, in this case General Practitioners, who have to deal with the more qualitative aspects of health service delivery. [ABSTRACT FROM AUTHOR]

Purpose - Clients often report reluctance in attending publicly funded mental health services, particularly when those services are provided at segregated and stand-alone locations well known to the wider community. One way to address this stigma-driven reluctance to attend appointments is to deliver mental health services in combination with employment services, education and training, income support, housing, disability support, legal services, and other health services, as an essential suite of community services. This paper aims to research this possibility.Design/methodology/approach - The paper outlines the early planning and implementation phases of the Huntly Community Link project.Findings - The paper finds that ongoing joint governance and management, clear on-site leadership, and an evaluation strategy are needed to ensure joint service delivery goals are attained.Practical implications - Several important practical issues emerge. For instance, differences in organisational culture take time to change towards greater support for the new joint service delivery goals.Social implications - Early indicators suggest that the Huntly Community highly values the joint delivery of these essential services from a suitable purpose designed building.Originality/value - This is an innovative New Zealand program that promises to reduce attendance stigma by nesting the delivery of publicly-funded mental health services among a broad mix of other essential community services. [ABSTRACT FROM AUTHOR]

There is growing interest in the idea of elected members on health service governing boards as a means to induce public participation in planning and decision making, yet studies of elected boards are limited. Whether elected boards are an effective mechanism for public participation remains unclear. This article discusses the experiences of New Zealand where, since 2001, there have been three sets of elections for District Health Boards. Information on candidates and election results is presented along with data gathered via post-election voter surveys. The article also considers the broader regulatory context within which the elected boards must operate. The New Zealand experience illustrates that elected health boards may not be an effective mechanism for public participation. Voter turnout has declined since the inaugural elections of 2001, and non-voters form the majority. Reasons for not voting include failure to receive voting papers, a lack of interest, or no knowledge of elections. The elections have also failed to produce minority representation, while the capacity for elected members to represent their communities is subject to constraints. On the upside, elections have enabled public involvement in various dimensions of participation, including oversight and processes of governance. New Zealand's mixed performance suggests that elected boards may need to be complemented with other participatory channels, if increased public participation is the goal. [ABSTRACT FROM AUTHOR]

INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic lockdown in New Zealand in March 2020, there was a rapid shift to virtual consultations in primary care. This change was supported by system adjustments to enable electronic transmission of prescriptions without a handwritten signature if they met certain security criteria. International research suggests potential for unintended consequences with such changes, so it is important to understand the effect on professional practice in New Zealand general practice and community pharmacy. AIM: The purpose of this study was to undertake a preliminary exploration of the experiences of New Zealand general practitioners and community pharmacists when prescriptions are transmitted electronically directly from prescriber to pharmacy. METHODS: Semi-structured interviews with a purposive sample of four pharmacists and four general practitioners gathered qualitative data about their experiences of the shift to electronic transmission of prescriptions. Participants' perceptions of effect on professional workflow, interprofessional interactions between general practitioners and pharmacists, and interactions with patients were explored. Interviews were audio-recorded, and the data analysed thematically using an inductive approach. RESULTS: Four themes were identified: workflow transformation; mixed impact on interactions with patients; juggling timing and expectations; and new avenues for interprofessional communication (with some cul-de-sacs). DISCUSSION: Both general practitioners and pharmacists experienced transformational changes to workflow. This was positive for general practitioners due to saved time and increased work flexibility. Pharmacists noted potential benefits but also some challenges. To fully reap teamwork benefits, more work is needed on managing the timing issues and patient expectations, and to refine the new modes of communication between health-care practitioners. [ABSTRACT FROM AUTHOR]

Pubic hair removal, now common among women in Anglo/western cultures, has been theorised as a disciplinary practice. As many other feminine bodily practices, it is characterised by removal or alteration of aspects of women's material body (i.e., pubic hair) considered unattractive but otherwise “natural.” Emerging against this theorisation is a discourse of personal agency and choice, wherein women assert autonomy and self-mastery of their own bodies and body practices. In this paper, we use a thematic analysis to examine the interview talk about pubic hair from 11 sexually and ethnically diverse young women in New Zealand. One overarching theme – pubic hair is undesirable; its removal is desirable – encapsulates four themes we discuss in depth, which illustrate the personal, interpersonal and sociocultural influences intersecting the practice: (a) pubic hair removal is a personal choice; (b) media promote pubic hair removal; (c) friends and family influence pubic hair removal; and (d) the (imagined) intimate influences pubic hair removal. Despite minor variations among queer women, a perceived norm of genital hairlessness was compelling among the participants. Despite the articulated freedom to practise pubic hair removal, any freedom from participating in this practice appeared limited, rendering the suggestion that it is just a “choice” problematic. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper was to determine the value and impact of the Leadership Development – Coaching and Mentoring Programme at Counties Manukau Health and understand how the skills gained are applied.Design/methodology/approach Mixed-methods approach including surveys of programme participants and senior staff and semi-structured interviews with programme participants.Findings The survey response rate was 24.4 per cent for programme participants and 30 per cent for senior staff. Eight programme participants participated in semi-structured interviews. Of the 70 programme participants, 69 utilised their learning from the programme; 45 of 70 changed their approach to managing staff; and 40 of 68 programme participants reported that meeting with peers for triad group coaching was the most challenging aspect of the programme. Key themes identified through interviews included: working with others; not owning others’ problems; professional support and development; coaching and mentoring; future participants.Practical implications The majority of participants changed their leadership behaviours as a result of the programme, which has resulted in improved communication, a more supportive culture and distributed leadership. These changes contribute to better patient care.Originality value There is a paucity of evidence in the literature about the impact of coaching and mentoring programme on leadership development and how the skills gained in such programmes are applied in practice in a healthcare context. This evaluation helps to address that gap. [ABSTRACT FROM AUTHOR]

Family members continue to be used as interpreters in medical consultations despite the well-known risks. This paper examines participant perceptions of this practice in three New Zealand clinics chosen for their frequent use of interpreters and their skill in using them. It is based on a detailed study of 17 video-recorded interpreted consultations and 48 post-consultation interviews with participants (5 doctors, 16 patients and 12 interpreters, including 6 family members). All participants expressed satisfaction with the communication. Analysis of the interviews explored what participants liked or valued about family member interpreters (FMIs). Key themes were the FMIs' personal relationship and knowledge, patient comfort, trust, cultural norms, time efficiency and continued help outside the consultation. General practitioners (GPs) expressed awareness of potential risks and how to manage them, in contrast to patients and FMIs. Although the use of professional interpreters needs to be strongly promoted, a well-informed decision to use a family member is appropriate in some situations. GPs need to be well trained in how to assess and manage the risks. Rather than striving for 'best practice' (i.e. universal use of professional interpreters), it is better to aim for 'good practice' where a considered judgement is made about each situation on an individual basis. [ABSTRACT FROM AUTHOR]

This paper summarizes, elaborates upon, and contrasts the findings of two research projects that explored how general practitioners and nurses coped with the dual challenge of personal and work demands following the earthquakes in Canterbury, New Zealand, in 2010 and 2011. Qualitative data from two separate studies - the first with general practitioners and the second with nurses - are compared to identify the challenges faced during and following the earthquakes. Semi-structured interviews took place with eight general practitioners two years after the start of the earthquake sequence and 11 nurses a year later to enable exploration of the longer-term aspects of the recovery process. The interview transcripts were analyzed and coded using a constructivist grounded theory approach. The analysis identified that the earthquakes had a significant impact on nurses and general practitioners both in terms of their professional and personal lives. The nurses and general practitioners commented on the emotional impact and their support needs, as well as some of the longer-term recovery issues. [ABSTRACT FROM AUTHOR]

Despite international efforts, stigma is still a significant issue for people living with HIV/AIDS (PLWHA). This paper explores the stigma encountered in health interactions, focusing on strategies PLWHA use to manage and reduce it. It is hoped that our findings will improve future interactions by contributing towards a more understanding practitioner–patient relationship. The data have been drawn from a small qualitative study conducted in Christchurch, New Zealand. Fourteen participants took part in semi-structured face-to-face interviews in 2013 and 11 of these participants were then interviewed again in 2014. Codes and themes were developed through inductive thematic analysis of the interview transcripts. Our findings identified that whilst the majority of participants had positive experiences, nearly all had faced stigma during their health interactions. Most of these encounters were due to healthcare workers holding exaggerated fears of transmission or not maintaining confidentiality and privacy. The main way that participants managed this stigma was through seeking control in their interactions. This overarching strategy could be further divided into three key themes: selective disclosure of their HIV status, self-advocacy and developing their HIV knowledge. We discuss these findings in the context of the current literature, comparing our results to strategies that have been previously identified in social settings. [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]

Purpose A case study is reported of a relationship-based early intervention (EI) service for children with complex needs in New Zealand. The purpose of this paper is to explore parent and professional views and perceptions about the key characteristics of a relationship-based EI service.Design/methodology/approach This qualitative study involved interviews and observations with 39 participants (10 children, 11 parents and 18 professionals).Findings Parents appreciated the knowledgeable, well-trained professionals who invested time in getting to know (and love) children and families and family practices, worked together in harmony and valued the contribution that parents made to their child’s progress and achievement. Professionals described the key characteristics of the service in terms of the range of therapies offered by the service, the focus on a strengths-based and family-focussed approach, play-based assessments, acceptance and value of family practices (including responsiveness to Maori and bi-culturalism), appropriate and respectful places to meet and greet families and work with children, and recruitment and retention of humble professionals who identified with the ethos of the model. Observable social processes and structures within the delivery of the model include respectful professional interactions and relationships with children and families, integrated professional working, effective and timely communication between professionals and families, pedagogy of listening, waiting and personalisation, engaged families and actively participating children.Originality/value This case study emphasises the significance of professional love and relational pedagogy to EI services and the value of this to improving parent-child relationships and children’s long-term outcomes. [ABSTRACT FROM AUTHOR]

Living with human immunodeficiency virus (HIV) in the industrialised world has for over a decade been conceptualised as living with a chronic illness. People living with HIV now are amongst the first to live and age with the virus. Drawing on a qualitative longitudinal study in a low-incidence area in a low-incidence country, this paper investigates the nuanced ways that people negotiate this condition. While it has been argued that HIV is a condition like any other chronic disease, our thematic analysis reveals some similarities and particularities around living with the condition. In comparing themselves to others with the condition, high levels of diversity of experience were identified that extended well beyond length of time from diagnosis. In comparing their illness with other illnesses, the location, for example, of their specialist service within a clinic for those with acute sexually transmitted diseases was identified as problematic. The work involved in maintaining a coherent sense of self in the face of existing and shifting challenges as a result of their infection was a second strong theme. The final theme involved flux and flex work in the ways people sought to gain and maintain control over various aspects of their lives. All of these experiences are mediated by place; that is the experience is not the same as that of those who live where there is a much higher incidence of infection. The work involved in negotiating this condition in low-incidence environments deserves more attention, but aspects of these findings are significant in higher incidence contexts as well; in particular, passivity in face of infection as one ages and the potential for medication refusal as a means of maintaining control over life and death. [ABSTRACT FROM PUBLISHER]

Purpose The purpose of this paper is to explore the indicators of quality in care for people working and living in aged residential care (ARC) settings.Design/methodology/approach This research was conducted using an ethnographic design in two distinct ARC facilities in a New Zealand city, a large facility with residential, dementia and hospital level care, and a small family owned facility providing residential care only. In total, 50 hours of observational data were collected, and semi-structured interviews were conducted with 21 people, including managers, careworkers, nurses, family members and residents. These data were thematically analysed using the constant comparative method.Findings The main indicators of quality for staff, family and residents included: a home-like, friendly and safe environment; good medical and personal care; respect for the residents; and good staff. Participants also acknowledged the need for adjustments by residents to living in aged care; and the challenges of caring for increasingly frail residents.Originality/value Findings support the growing recognition of a need for resident-centred approaches to ARC that are reflected in government policy and regulatory apparatus. Managers in ARC facilities must balance adherence with health and safety standards, and providing an environment where their residents can enjoy a meaningful life that has purpose and value. [ABSTRACT FROM AUTHOR]

The incidence of diabetes in people with an intellectual disability, although unknown, is indicated to be higher than the general population. Given the challenges individuals with intellectual disability may face, this population is often dependent upon key workers to manage their health and well-being. One aim of a wider study on the self-management of diabetes by people with intellectual disability was to explore how key workers supported their self-management. That aim was the focus of this paper. Between 2009 and 2010, 17 staff from five residential intellectual disability services and two supported independent living services within New Zealand, consented to a semi-structured interview. Transcripts of the interviews were analysed using Thomas' General Inductive Approach. Three overarching themes emerged; having knowledge and understanding, being lifestyle police and ensuring future well-being. While knowledge, skills and perspectives varied, all participants were committed to ensuring that the lifestyle of the person concerned was compatible with the management of their diabetes. A range of perspectives existed between the expectations they had of themselves, colleagues and the individual with diabetes. There was an identified need for initial and ongoing education of permanent and casual staff and the people themselves with diabetes in collaboration with health and disability services to build confidence and promote self-management practices. In so doing, the impacts of this long-term condition may be reduced and the health outcomes improved for people with intellectual disability. [ABSTRACT FROM AUTHOR]

Systematic study of data sharing by citizen scientists will make a significant contribution to science because of the growing importance of aggregated data in data-intensive science. This article expands on the data sharing component of a paper presented at the 2013 ASIST conference. A three-phase project is reported. Conducted between 2011 and 2013 within an environmental voluntary group, the Australian Plants Society Victoria ( APSV), the interviews of the first phase are the major data source. Because the project revealed the importance of data sharing with professional scientists, their views are included in the literature review where four themes are explored: lack of shared disciplinary culture, trust, responsibility and controlled access to data, and describing data to enable reuse. The findings, presented under these themes, revealed that, within APSV, sharing among members is mostly generous and uninhibited. Beyond APSV, when online repositories were involved, barriers came very strongly into play. Trust was weaker and barriers also included issues of data quality, data description, and ownership and control. The conclusion is that further investigation of these barriers, including the attitudes of professional scientists to using data contributed by citizen scientists, would indicate how more extensive and useful data sharing could be achieved. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Youth health outcomes are poor in New Zealand and have a life-long impact on individuals, wha-nau (family) and society. Little is known about how young people view their experiences of general practice care despite it being the most common place to access health care. AIM: This study sought to explore young peoples' experiences of care in a selected, youth-friendly general practice. METHODS: In-depth individual interviews with six young people. RESULTS: Four themes were identified from young peoples' narratives in relation to their experiences of general practice care: going to the doctor is not easy for a young person; the attributes of staff make all the difference; specific youth-friendly consultation practices help young people; and a youth-friendly physical environment can help young people access services and feel safe. DISCUSSION: Even though the study general practice had explicitly instituted youth-friendly initiatives, including offering no-charge consultations and specialist staffmembers, young people still described considerable barriers to attendance. Many barriers are practice-based and could bemodified by staff training, provision of further youth care staff roles and consideration of environmental changes. Other barriers such as waiving prescription costs need government funding. [ABSTRACT FROM AUTHOR]

Introduction. Regular diabetic foot checks, at least annually, are important for early identification of risk factors and prevention of ulceration and amputation. To ensure this, most general practices in Aotearoa New Zealand (NZ) offer free annual diabetes reviews (ADRs) which include a comprehensive foot evaluation. However, attendance rates at these ADRs are low. Aim. To explore patients' perspectives on the barriers to attending ADRs and foot checks. Methods. Semi-structured interviews with people with type 2 diabetes who were overdue their ADR (n = 13; 7 women, 6 Māori) from two urban practices were conducted. Interviews were audio recorded and transcribed verbatim and then analysed using an inductive thematic analysis approach. Results. We identified three key themes demonstrating barriers to attendance: healthcareassociated factors (suboptimal clinician-patient relationship, not having a consistent general practitioner (GP)); patient-related factors (co-morbid health conditions, issues surrounding identity, and logistical issues); and systemic factors (COVID-19 pandemic, travel distance to the practice, unawareness of available foot care services). Participants' feedback focused on patient-centred approaches for improvements to service delivery, for example using online educational materials, and utilising culturally appropriate models of health including Te Whare Tapa Whā and Whānau Ora approach. Discussion. We identified several barriers to attendance, some of which are potentially modifiable. Addressing modifiable barriers and incorporating suggestions made by participants may improve access to the ADR and reduce non-attendance. Further participatory action research could explore these insights in ways that facilitate tino rangatiratanga (self-determination) and palpable action. [ABSTRACT FROM AUTHOR]

Introduction. In Aotearoa New Zealand (NZ), type 2 diabetes (T2D) is predominantly managed in primary care. Despite established guidelines, patients are often suboptimally managed, with inequitable health outcomes. To date, few NZ studies have evaluated the primary care management of T2D at the time of diagnosis. Aim. This study aims to explore the provision of education and delivery of care to patients at the time of diagnosis, which is a crucial time in the disease trajectory. Methods. Participants were recruited from a Māori health provider in the Waikato District, and diagnosed with T2D after January 2020. Patients were texted a link to opt into a survey (larger study) and then registered interest by providing contact details for an interview (current study). Semi-structured interviews were conducted and were audio recorded, transcribed, and thematically analysed. Results. In total, 11 participants aged 19-65 years completed the interviews (female n = 9 and male n = 20); the comprised Māori (n = 5), NZ European (n = 5) and Asian (n = 1) participants. Three overarching themes were identified, including: (1) ineffective provision of resources and education methods; (2) poor communication from healthcare practitioners; and (3) health system barriers. Discussion. Evidently, there are difficulties in primary care diabetes mellitus diagnosis and management. Improvements could include locally relevant resources tailored to patients' experiences and cultural identities. Utilising whānau support and a non-clinical workforce, such as health navigators/kaiāwhina, will drastically address current workforce issues and assist patient self-management. This will allow improved diagnosis experiences and better health outcomes for patients and whānau. [ABSTRACT FROM AUTHOR]

Introduction. The value of family health history as a means to understanding health risk has been long known. Its value in a precision medicine context is also now becoming apparent. General practitioners (GPs) are considered to play a key role in the collection, and investigation, of family health history, but it remains widely reported as being both poorly and infrequently undertaken. Little is known about this practice in Aotearoa New Zealand (NZ). Aim. This study aimed to explore current practices in relation to the ascertainment of family health history, with a view towards precision medicine. Methods. Semi-structured interviews were conducted with 10 GPs recruited from one urban area of NZ. The interviews were subjected to a thematic analysis. Results. Family health history information was used to varying degrees in four areas - risk ascertainment, patient engagement with a diagnosis, social context and building relationships. Patient cultural considerations were rarely mentioned. Reliability of information provided by patients, resource constraints, context driven consults and electronic health record limitations are potential indicators of current limits of family health history. Discussion. Our findings present a baseline of current practice and echo larger studies from overseas. As precision medicine is not yet routine, a unique opportunity exists for consideration to be given to establishing specific roles within the NZ health system to enable equitable practice of, and subsequent health gains from, the use of family/whānau health history information as part of precision medicine. [ABSTRACT FROM AUTHOR]

Purpose: Many psychiatrists and trainees in Aotearoa New Zealand used telepsychiatry during COVID-19 lockdowns, despite minimal experience and training in the area. Research on a culturally safe telepsychiatry framework is lacking in Aotearoa. This study aims to provide a better understanding of telepsychiatry in the Aotearoa context and identify potential gaps with the current practice, with a focus on exploring telepsychiatry use with Maori, Pacific peoples and Asians. Design/methodology/approach: This qualitative study was guided by the principles of the Kaupapa Maori methodology and the "Give Way Rule" from Pan-Pacific studies, to ensure culturally appropriate analysis and outcomes. Semi-structured interviews were conducted with a sample of psychiatrists and trainees recruited from Aotearoa members of the Royal Australian and New Zealand College of Psychiatrists. The qualitative data were then analysed using general inductive thematic analysis to identify the major themes. Findings: In total, 18 participants were interviewed. Three key themes were identified: cultural safety such as preparation for a telepsychiatry session, cultural practices and equity issues; clinical practice such as continuity of care, patient selection and limitations; and process of running a telepsychiatry service. Originality/value: The analysis of the main themes gives both practical ideas for providing a culturally safe telepsychiatry appointment, as well as a wider base for developing a telepsychiatry service that works particularly for Maori, Pacific and Asians mental health users. Issues around resources and expertise in the field are lacking and further frameworks to support infrastructure and training are needed. [ABSTRACT FROM AUTHOR]

Examining the concepts underpinning the reasoning processes of social worker's decision‐making provides important insights into how social work practice is undertaken. This paper examines one of the major discourses used by social workers in decision reasoning in a non‐governmental organization child protection context in Aotearoa/New Zealand: family maintenance. This study found that family maintenance as a concept was strongly privileged by social workers. This resulted in attempts to preserve families and created a hierarchy of preferred decision outcomes. A preference for family maintenance was supported by legal, moral, psychological and Māori cultural concepts. This pattern of constructs underpinned the ‘weighing up of harms’ when considering removal, and generally reflected a child welfare orientation. In addition to this, it was found that ‘family’ was broadly defined, and could include people who had a relationship with the children, or Māori definitions of extended family, in addition to legal ones. [ABSTRACT FROM AUTHOR]

Little is known about how mental health services consider the parenting role and the well‐being of children when assessing parents with acute mental illness. This paper investigated how crisis mental health services addressed child well‐being in the Wellington region, New Zealand. This mixed‐method case study included: (i) an audit of the electronic clinical records of all adults presenting to the crisis assessment team; (ii) interviews with 22 key informants; and (iii) a documentary review. We found that data about children were not systematically collected. Less than half of (49 of the 104) the records of patients who were parents included information on their child's well‐being; only six (6%) contained a specified plan for action. The focus for services was the adult patient. Key informants were unclear about their role. They identified inadequate training and institutional support, inflexible funding models and limited availability or inappropriateness of referral services as problems. They saw a need for children to become more visible, for collaborative working to improve the use of existing services and for new funding models, resources and roles. Existing national policy documents contained little guidance and no practice guidelines were in use. These were lost opportunities to improve support for the parenting role and promote child well‐being. [ABSTRACT FROM AUTHOR]

Purpose – Food practices, including associated routines, rituals, and habits, are an unexplored area in school health promotion. The purpose of this paper is to fill this gap through exploring how food rituals act as vehicles for young people to establish, maintain, and strengthen social relationships. Design/methodology/approach – Through an ethnographic inquiry, including observations and interviews with teachers and 16-18 years old students in New Zealand, everyday practices were explored in-depth across one school year. Findings – The findings include three food rituals as significant for young people in managing their social relationships, including the lunch walk, ritualised sharing, and gifting food. The findings highlight the importance of everyday food rituals for young people’s social relationships. For instance, gifting cake mediated care to friends, showed trust in the relationship, and allowed to reciprocate; the lunch walk encouraged social interaction and was a means by which young people could integrate into a new group; and ritualised sharing food involved negotiating friendship boundaries. Research limitations/implications – The study is exploratory with findings reported from one school. Further research exploring how young people use food rituals in their everyday lives for managing social relationships is needed. Originality/value – A focus on social relationships in settings such as schools could broaden the scope of nutrition promotion to promote health in physical, mental, and social dimensions. Implications for school health promotion are discussed. [ABSTRACT FROM AUTHOR]

Introduction: The Department of General Practice and Primary Health Care at the University of Auckland is considering developing a Master of Primary Health Care (MPHC) programme. Masters level study entails considerable investment of both university and student time and money. Aim: To explore the views of potential students and possible employers of future graduates to discover whether there is a market for such a programme and to inform the development of the programme. Methods: Semi-structured interviews were conducted with 30 primary health care stakeholders. Interviews were digitally recorded, transcribed and analysed using a general inductive approach to identify themes. Findings: Primary care practitioners might embark on MPHC studies to develop health management and leadership skills, to develop and/or enhance clinical skills, to enhance teaching and research skills, or for reasons of personal interest. Barriers to MPHC study were identified as cost and a lack of funding, time constraints and clinical workload. Study participants favoured inter-professional learning and a flexible delivery format. Pre-existing courses may already satisfy the post-graduate educational needs of primary care practitioners. Masters level study may be superfluous to the needs of the primary care workforce. Conclusions: Any successful MPHC programme would need to provide value for PHC practitioner students and be unique. The postgraduate educational needs of New Zealand primary care practitioners may be already catered for. The international market for a MPHC programme is yet to be explored. [ABSTRACT FROM AUTHOR]

Aim The objective of this paper was to explore how present-day filial piety is understood among Koreans in geographically different settings. Methods Data were collected from qualitative interviews with 61 Korean participants in Australia, New Zealand and Korea and then thematically analysed and evaluated. Results The findings from this study show that filial piety for Koreans consists of family care and support, along with respect for parents. The norm of filial piety is regarded as an important aspect of intergenerational family relationships in current Korean culture, while its practice is perceived as increasingly eroded within a context of major socio-cultural and economic changes, including migration. Conclusion The results show that the tension between the social and economic aspects of filial piety often creates a 'bystander' attitude toward parents and provides fertile ground for the seeds of family conflict. [ABSTRACT FROM AUTHOR]