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Narcotics Anonymous has flourished globally across 143 countries as a key community response to problematic substance use, despite disruptions, including the COVID‐19 pandemic. This research sought to understand how the Aotearoa New Zealand Narcotics Anonymous (NA) community engaged with NA meetings online during the 2020–2021 COVID‐19 pandemic. During in‐depth, semi‐structured interviews, 11 NA members shared their stories of addiction, abstinence‐based recovery, experiences of NA and managing pandemic restrictions. A narrative analysis identified four tropes particularly relating to how community members managed during the pandemic: responding via technology; maintaining recovery connections; creating opportunities; and consistency. Each trope showcases how NA members were able to connect online and garner support for their abstinence‐based recoveries and, more generally, during unprecedented times. In addition, the NA members in this research narrated the opportunities the pandemic restrictions created for them, such as engaging with the NA programme in new ways and improving their quality of life. Members of NA were able to maintain their psychological, physical, spiritual and community wellbeing during the COVID‐19 pandemic primarily due to existing recovery capital—peer‐based support and the principles of the 12‐steps of NA. The implications are that access to peer‐based communities and salient recovery identities are pivotal during ordinary and extraordinary times. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Stroke can cause lifelong disability and participatory limitations. Stroke survivors thus manage their recovery long term. Health professionals can support self-management, tailoring this support to be culturally appropriate. This study explored the unique culture and ethnicity specific experiences of Indian people living in New Zealand with stroke, focussing on self-management and facilitators and challenges to recovery. Eight individuals with stroke took part in semi-structured interviews. Data were analysed using the General Inductive Approach. Four themes were identified: (1) helping myself, in any way that I can, (2) family and support, (3) social connections, and (4) ethnicity was not a barrier. All participants felt well looked after within the New Zealand healthcare context but highlighted the need for long term support. Self-management strategies participants considered important included changes to their diet, acceptance by oneself and society, returning to work, the role of family, and the use of technology and social media. Health professionals should consider these factors when providing self-management support to individuals of Indian ethnicity. Advice and help around diet, lifestyle, and return to work were important priorities identified by our Indian stroke survivor participants. Our Indian stroke survivor participants requested more long-term specialist support and stroke information. Although the family willingly take increased responsibility for the wellbeing of the individual with stroke, it is not a substitute for professional input which needs to be tailored and offered proactively. [ABSTRACT FROM AUTHOR]

Since the 1990s, New Zealand mental health policy has shifted from a focus on the management of symptoms and risk to the recovery of psychological, social, cultural, and physical well‐being. Despite a vision for recovery‐oriented services being integrated within national and regional policies, there is growing concern that barriers to recovery‐oriented service provision continue to exist. Such barriers include the attitudes, skills, and knowledge of front‐line staff, as well as system issues. This study explored the experience and meaning of recovery‐oriented practice for 10 nurses working in an acute inpatient mental health service. A phenomenological and hermeneutic lens was used to explore the nurses' experience of working in a recovery‐focused manner alongside service users. Stories of practice were collected from participants through open‐ended conversational interviews. Transcribed narratives were analysed to explore taken‐for‐granted aspects of working in acute mental health care and to uncover the meaning of being recovery‐oriented in this setting. Findings revealed that although the experience and meaning of recovery‐focused care varied among nurses, there were common elements in the practice accounts. The accounts highlighted the nurses' role in creating different therapeutic spaces to promote safety, relational commitment, and healing for service users. However, the nurses faced challenges to recovery‐oriented care within the team hierarchical culture and the broader service systems. The nurses were, at times, fearless in advocating for service users and recognized that this was essential for developing recovery‐focused services. The findings have implications for nursing practice, as well as training and service development. [ABSTRACT FROM AUTHOR]

Objective Predicting motor recovery after stroke is a key factor when planning and providing rehabilitation for individual patients. The Predict REcovery Potential (PREP2) prediction tool was developed to help clinicians predict upper limb functional outcome. In parallel to further model validation, the purpose of this study was to explore how PREP2 was implemented in clinical practice within the Auckland District Health Board (ADHB) in New Zealand. Methods In this case study design using semi-structured interviews, 19 interviews were conducted with clinicians involved in stroke care at ADHB. To explore factors influencing implementation, interview content was coded and analyzed using the consolidated framework for implementation research. Strategies identified by the Expert Recommendations for Implementing Change Project were used to describe how implementation was undertaken. Results Implementation of PREP2 was initiated and driven by therapists. Key factors driving implementation were as follows: the support given to staff from the implementation team; the knowledge, beliefs, and self-efficacy of staff; and the perceived benefits of having PREP2 prediction information. Twenty-six Expert Recommendations for Implementing Change strategies were identified relating to 3 areas: implementation team, clinical/academic partnerships, and training. Conclusions The PREP2 prediction tool was successfully implemented in clinical practice at ADHB. Barriers and facilitators to implementation success were identified, and implementation strategies were described. Lessons learned can aid future development and implementation of prediction models in clinical practice. Impact Translating evidence-based interventions into clinical practice can be challenging and slow; however, shortly after its local validation, PREP2 was successfully implemented into clinical practice at the same site in New Zealand. In parallel to further model validation, organizations and practices can glean useful lessons to aid future implementation. [ABSTRACT FROM AUTHOR]

The article focuses on disasters, including earthquakes, wildfires, terrorist attacks, and infectious disease outbreaks, are catastrophic events that expose individuals to stress, disrupt community routines and dynamics, undermine infrastructure and businesses, and result in economic losses for a significant period. Topics include the World Health Organization (WHO, 2020) has declared the COVID-19 outbreak a pandemic in the early months of 2020 and classed it as a major disaster.

Purpose: Our objective was to explore the intersection between mild traumatic brain injury (MTBI) recovery experiences and injury understandings, using both quantitative and qualitative methods. Materials and Methods: The quantitative component was a descriptive case–control study comparing participants (n = 76) who had recovered or not recovered after an MTBI, across demographic and psychological variables. A subset of participants (n = 10) participated in a semi-structured interview to explore experiences of recovery in more detail. We followed threads across the datasets to integrate findings from component methods. Results: The quantitative analyses revealed differences between the two groups in terms of injury recovery understandings and expectations. The qualitative analyses suggested that achieving consistency across information sources was important. By tracing threads back and forth between the component datasets, we identified a super-ordinate meta-theme that captured participants' experiences of wrestling with uncertainty about their recovery and the impacts in terms of heightened anxiety, confusion, and feelings of invalidation. Conclusion: The effectiveness of psychoeducation and reassurance after MTBI may be optimized when content is tailored to the individual. Clinicians are urged to attend both to the subjective interpretations patients make of information gained from formal and informal, internal and external sources, and where information across these sources conflicts and creates uncertainty. Effectiveness of psychoeducation and reassurance after injury may be optimized when content is tailored to the individual rather than being generic. Effectiveness of such interventions may also be optimized by understanding the subjective interpretations individuals make of injury knowledge gleaned from formal and informal, internal and external sources. Conflicting information from such multiple sources may create uncertainty with associated increased distress as an individual negotiates their recovery from injury. Attending to this uncertainty may be a helpful target for treatment. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to seek answer to the following question: Does participating in storytelling changes participants' life experiences in their journey of recovery? The study explores participants' experiences of engaging in a storytelling programme in a community mental health team in a large New Zealand city. The programme aims to provide a safe environment to support and increase participants' engagement with services and the community. Currently, there is limited literature on consumer's experiences of engaging in therapeutic storytelling programmes in the international or New Zealand context. Design/methodology/approach: Following ethical approval, eight adult participants were recruited to the study. Data were collected through semi-structured interviews and analysed using the six-phase process of thematic analysis, developed by Braun and Clarke. Findings: Three main themes emerged from the data. The first theme, breaking barriers, was described by participants as to how they overcame barriers. The second theme, creating positive memories, uncovered the positive experiences that participants gained from the programme. The final theme, becoming a new person, described some of the transformative experiences that emerged through participation in the programme. Originality/value: This is the first qualitative study in the New Zealand context that has explored the value of a storytelling programme from a consumer's perspective. The findings suggest that participating in a storytelling programme can contribute to a participant's journey of recovery; the use of myths, legends and group work is fundamental to those from collective cultures with oral traditions. The ongoing value of storytelling as a therapeutic tool requires further research and the development of a clearer evidence base to inform practice. [ABSTRACT FROM AUTHOR]

Background/Aims: Self-management models have recently been applied to stroke, but the most effective components are yet to be determined. To inform the ongoing refinement of stroke self-management programmes, this study explored challenges at 6 months after stroke. Methods: A total of 53 stroke survivors and 26 significant others were interviewed 6 months after stroke. Results were analysed qualitatively using thematic analysis. Findings: Stroke was experienced as a shocking and frightening event regardless of severity, and participants struggled to manage the consequences of their stroke. The stroke experience occurred within the context of more than one chronic condition and with competing demands of everyday life. Participants struggled to formulate a model of causation for their stroke, yet this appeared a necessary basis for action. Conclusions: The findings suggest that health care targeted at enhancing self-management, including self-management programmes, may benefit from encompassing a specific focus on participants' beliefs as an important foundation for recovery after stroke. [ABSTRACT FROM AUTHOR]

Purpose: Qualitative research examining experiences of recovering from mild traumatic brain injury (MTBI) is limited. Findings from quantitative studies regarding predictors of persisting symptoms are inconsistent with limited attention directed to capturing broad perspectives and priorities of the wider stakeholders. More flexible research approaches may help advance the field. We used a mixed method design to generate patient perspectives of MTBI recovery, integrating these with quantitative investigation to isolate factors that might contribute to divergent MTBI outcomes. Methods: The qualitative component reported here involved semi-structured interviews with selected participants (n = 10) from the quantitative study cohort, sampling both recovered and non-recovered adult MTBI participants. Interviews focused on participants' general description and understandings of their recovery and perceptions of what helped or hindered this. Data were analyzed using general thematic analysis. Results and conclusion: Participants regardless of recovery status identified the importance of having a coherent understanding of their injury and recovery. Factors facilitating coherence included social support, validation, reassurance, accessing credible evidence-based information and having a pathway to wellness. Findings suggested that coherence could be a helpful umbrella construct worthy of examination in future MTBI research. This construct appears broad and able to cope with the complexity of individual experiences after injury. [ABSTRACT FROM AUTHOR]

Purpose:Qualitative research examining experiences of recovering from mild traumatic brain injury (MTBI) is limited. Findings from quantitative studies regarding predictors of persisting symptoms are inconsistent with limited attention directed to capturing broad perspectives and priorities of the wider stakeholders. More flexible research approaches may help advance the field. We used a mixed method design to generate patient perspectives of MTBI recovery, integrating these with quantitative investigation to isolate factors that might contribute to divergent MTBI outcomes. Methods:The qualitative component reported here involved semi-structured interviews with selected participants (n = 10) from the quantitative study cohort, sampling both recovered and non-recovered adult MTBI participants. Interviews focused on participants’ general description and understandings of their recovery and perceptions of what helped or hindered this. Data were analyzed using general thematic analysis. Results and conclusion:Participants regardless of recovery status identified the importance of having a coherent understanding of their injury and recovery. Factors facilitating coherence included social support, validation, reassurance, accessing credible evidence-based information and having a pathway to wellness. Findings suggested that coherence could be a helpful umbrella construct worthy of examination in future MTBI research. This construct appears broad and able to cope with the complexity of individual experiences after injury.Implications for rehabilitationSense of coherence may be a helpful umbrella construct that can facilitate resilience and positive recovery beliefs and expectations after mild traumatic brain injury.Reassurance, validation, and social support appear important and may facilitate injury recovery.Focus on the experiences of people recovering from mild traumatic brain injury may help to refine recovery models and understandings and thus provide more effective intervention targets. [ABSTRACT FROM AUTHOR]

Knowledge about aspects that influence recovery and adaptation in the postacute phase of disabling health events is key to understanding how best to provide appropriate rehabilitation and health services. Qualitative longitudinal research makes it possible to look for patterns, key time points and critical moments that could be vital for interventions and supports. However, strategies that support robust data management and analysis for longitudinal qualitative research in health-care are not well documented in the literature. This article reviews three challenges encountered in a large longitudinal qualitative descriptive study about experiences of recovery and adaptation after traumatic brain injury in New Zealand, and the strategies and technologies used to address them. These were (i) tracking coding and analysis decisions during an extended analysis period; (ii) navigating interpretations over time and in response to new data; and (iii) exploiting data volume and complexity. Concept mapping during coding review, a considered combination of information technologies, employing both cross-sectional and narrative analysis, and an expectation that subanalyses would be required for key topics helped us manage the study in a way that facilitated useful and novel insights. These strategies could be applied in other qualitative longitudinal studies in healthcare inquiry to optimise data analysis and stimulate important insights. [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]

Living kidney donation is an alternative treatment option for end-stage renal failure. Prospective donors are protected from risk by counselling and assessment processes, to ensure they are fully informed about all the stages of donation. Drawing on in-depth interviews with 25 living kidney donors from across New Zealand, this article discusses donors' experience of the pre-donation screening process, donation workup coordination, psychological preparation, and post-operative follow-up care and support. In particular, the article examines donor perceptions of the informed consent process. The findings indicate that donors' experience of the consent process may be at odds with the New Zealand Code of Health and Disability Services Consumers' Rights 1996. Instead of a primary healthcare focus on the threshold elements of informed consent, this study indicates that more effort should be made to adequately inform donors and to clearly spell out each stage of the donation process to better meet donors' needs. [ABSTRACT FROM AUTHOR]

Peer support is a fast growing type of service provision within the mental health sector. This study draws on interviews with peer supporters and peer support managers to explore the ways that risks of violence, suicide and self-harm are managed within peer support settings in Aotearoa New Zealand. Drawing on Nikolas Rose and other theorists, who define risk thinking as an attempt to 'discipline uncertainty', we argue that the philosophy of peer support is in tension with a 'risk consciousness' because it sees crisis as a learning opportunity. We contend that peer supporters are pulled towards the 'risk consciousness', which pervades the mental health sector, and that they address this by managing risk in various ways. Finally, we show that peer supporters challenge this risk consciousness by working with risk through a philosophy of engagement and relationship. As peer support becomes more integrated into the wider health system, the challenge will be to continue the development of risk practices which work within a strong peer support philosophy. [ABSTRACT FROM AUTHOR]

We map a discourse of the trauma of rape that was widely drawn upon by 29 “lay” New Zealand women and men in focus group discussions about the impact of rape. Using a discursiv e approach, we identify the key interlocking elements of this discourse. It centers on the contention that rape is traumatic, and depicts this trauma as unique, sev ere, long lasting, and in need of healing. We discuss the ways in which this ostensibly more enlightened and sensitiv e framework of meaning brings forth its own ways of potentially othering, stigmatizing, v iolating, and obstructing av enues of support and understanding for women who hav e experienced rape. [ABSTRACT FROM PUBLISHER]