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The provision of academic language and learning (ALL) support to undergraduate and postgraduate students has been a staple across higher education institutions in Australia and New Zealand for some time. However, research has established that there are multiple challenges inherent to working across institutional spaces in the ways that ALL staff do. This has included ambiguity about the parameters of their roles and how they connect with staff and students as support professionals. Furthermore, how advisors respond to student wellbeing as part of the support they offer, and how their own wellbeing is accounted for at work, are not well understood. We draw on data from two recent surveys to explore how ALL advisors in Australia and New Zealand understand and respond to student wellbeing within their practice, how ALL work has been affected by COVID-19, advisors' needs for support, and the views of managers in relation to these matters. The participants highlighted tensions related to student wellbeing, staff wellbeing, and academic support, which have either been brought about or intensified by the pandemic. As we move towards living with the pandemic, these tensions will need to be addressed by higher education institutions. [ABSTRACT FROM AUTHOR]

Egg donation in New Zealand is identity-release, with donor-conceived individuals having the right to access donors' identifying information at the age of 18. It also allows donors and previously unknown recipients to meet prior to donation. Further, donation is altruistic, although reimbursement of costs is possible. In our previous paper we explored the motivations of 21 egg donors in this context and reported that they are motivated to donate as an act of personal gift-giving to recipients who may become known to them through donation, and that they do not want to be compensated for this financially. In this paper, drawing on in-depth interviews, we report on donors' experiences of the donation process and subsequent to donation. Donors understood their donations to be a significant act, both for the recipients and their families, but also for themselves, particularly given the multiple sacrifices which they willingly made. Donors wished for their gift and their role to be valued and acknowledged through being appreciated, informed, involved and supported by recipients and clinics before, during and after their donations. These findings have implications for clinical practice and care, offering insight into how best to support donors prior and subsequent to donation. [ABSTRACT FROM AUTHOR]

The experiences of donor-conceived adults have received relatively little research attention despite the increasing trend of gamete conception. In this qualitative study, ten donor-conceived adults: eight women and two men, were interviewed to explore their experience of being donor-conceived. The participants did not automatically have the right to access identifying information of their donors upon turning eighteen as they were born prior to the introduction of the 2004 Human Assisted Reproductive Technology (HART) Act in New Zealand. The overarching theme identified was a need for parents, donors, and the fertility industry to prioritise their longer-term wellbeing. To this effect, participants wanted recognition of the importance of their donor conception history for their identity, and called for early disclosure to be reinforced through open, ongoing conversations with their parents. They highlighted the need for support to process the implications of donor conception, and to search for and link with their donors. Study findings underscore the value of legislation and practices which enable disclosure in the context of ongoing openness and provide access to support for donor-conceived individuals. [ABSTRACT FROM AUTHOR]

Background: The Global Specialist Digital Health Workforce Census is the largest workforce survey of the specialist roles that support the development, use, management, and governance of health data, health information, health knowledge, and health technology., Objective: This paper aims to present an analysis of the roles and functions reported by respondents in the 2023 census., Methods: The 2023 census was deployed using Qualtrics and was open from July 1 to August 13, 2023. A broad definition was provided to guide respondents about who is in the specialist digital health workforce. Anyone who self-identifies as being part of this workforce could undertake the survey. The data was analyzed using descriptive statistical analysis and thematic analysis of the functions respondents reported in their roles., Results: A total of 1103 respondents completed the census, with data reported about their demographic information and their roles. The majority of respondents lived in Australia (n=870, 78.9%) or New Zealand (n=130, 11.8%), with most (n=620, 56.3%) aged 35-54 years and identifying as female (n=720, 65.3%). The top four occupational specialties were health informatics (n=179, 20.2%), health information management (n=175, 19.8%), health information technology (n=128, 14.4%), and health librarianship (n=104, 11.7%). Nearly all (n=797, 90%) participants identified as a manager or professional. Less than half (430/1019, 42.2%) had a formal qualification in a specialist digital health area, and only one-quarter (244/938, 26%) held a credential in a digital health area. While two-thirds (502/763, 65.7%) reported undertaking professional development in the last year, most were self-directed activities, such as seeking information or consuming online content. Work undertaken by specialist digital health workers could be classified as either leadership, functional, occupational, or technological., Conclusions: Future specialist digital health workforce capability frameworks should include the aspects of leadership, function, occupation, and technology. This largely unqualified workforce is undertaking little formal professional development to upskill them to continue to support the safe delivery and management of health and care through the use of digital data and technology., (© Kerryn Butler-Henderson, Kathleen Gray, Salma Arabi. Originally published in JMIR Medical Education (https://mededu.jmir.org).)

The Supervisor Support Consensus Statement has been developed after consultation with supervisors of surgical training for the Royal Australasian College of Surgeons (RACS) programmes in Australia and Aotearoa New Zealand and other key stakeholders. Six key areas have been recognized with specific recommendations crafted to improve the support and recognition of Supervisors: 1. Clarity of role, 2. Education and Training, 3. Local support, 4. RACS support, 5. Recognition and valuing of the Supervisor role, 6. Risk Management. The purpose of this consensus statement is to clearly articulate supervisor opinions on the support they require to undertake this important role. It has been produced by an independent writing group of experienced surgical supervisors and educators, with support from RACS education department. The consensus statement is a response to a needs assessment of supervisors of surgical training. The statements in this consensus document have been generated from comments and feedback from supervisors that have been refined through process of extensive consultation using a Delphi methodology. We advise specialty training Committees consider these statements and mandate them as part of their accreditation of terms. The role of the supervisor of training requires greater recognition, and incorporation in the Enterprise Bargaining Agreement (EBA) in Australia and the ASMS Te Whatu Ora SECA in Aotearoa New Zealand would ensure the provisions in this document are enacted. The six areas identified have transferability to other specialities and countries and are valuable when considering how to support supervisors involved in training our next generation of specialist doctors., (© 2024 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.)

Recent research has highlighted that a high prevalence of young adults who have various forms of neurodivergence come into contact with the criminal justice system. Currently, many courts are not designed to respond to neurological differences often seen in young people who engage with them. The aim of this study was to identify ways to make locality courts more accessible, engaging, and ultimately more responsive to neurodivergence. A panel of neurodivergence specialists reviewed the general district courtroom environment of a new specialised young adult list court in Aotearoa New Zealand to identify potential barriers to accessibility and to highlight areas for improvement. The methodology involved naturalistic observation of a typical morning in the courtroom. We identified a series of recommendations with the potential to improve the court experience and increase access to justice for neurodivergent young adults. This study identified specific need for neurodiversity education and screening within the court environment. [ABSTRACT FROM AUTHOR]

The diagnostic experiences of autistic adults in New Zealand have not been investigated and little is known globally about autistic adults' satisfaction with the autism diagnostic process. This study describes the diagnostic experiences of 70 autistic adults living in New Zealand and explores how these experiences are related to satisfaction during three stages of the diagnostic process. The results show that autistic adults were reasonably satisfied with the early query and diagnostic assessment stages, but were dissatisfied with the post-diagnostic support stage, with significant unmet needs. Dissatisfaction during the post-diagnostic support stage was also related to satisfaction during previous stages and poor coordination of supports. Suggestions are made on how to improve the autism diagnostic pathway for autistic adults in New Zealand. [ABSTRACT FROM AUTHOR]

With high numbers of Chinese international tertiary students worldwide, it is important that institutions understand how best to establish environments that support positive mental health in this student group. This study used a mixed methods approach via an online survey to explore levels of psychological distress, help-seeking preferences, and engagement with counselling among Chinese international students at a New Zealand university. Findings support existing literature showing that Chinese international tertiary students experience high levels of distress and under-utilise counselling and other campus services, while the relationship between students and family is an important consideration to assist in mitigating psychological distress. Culturally appropriate interventions are needed to improve the wellbeing, and aid the integration, of Chinese students to their host country and educational environment. [ABSTRACT FROM AUTHOR]

Introduction: Research indicates radiation therapy students are at risk of burnout. Peer Group Supervision (PGS) is a tool used to help reduce stress, increase reflective practice and help manage professional issues. This pilot study aimed to investigate the third‐year New Zealand radiation therapy students' perceptions of participating in PGS. Methods: In 2019, all 27 third‐year radiation therapy students were introduced to PGS. At the end of the year, the students were invited to fill in a 14‐item Clinical Supervision Evaluation Questionnaire (CSEQ), answer an open‐ended question and provide demographic data. The CSEQ asks participants to indicate the extent to which they agree with 14 statements related to Purpose, Process and Impact of PGS. The open‐ended question asked if there were anything else they would like to say about participating in PGS as a student. The study utilised both qualitative and quantitative methods. Results: Of the 27 students invited, 22 responded to the questionnaire. Analysis of the CSEQ revealed that eight of the 22 students (36.4%) had a positive impression of PGS, 13 (59.1%) were neither positive nor negative, and one (4.6%) had a negative perception of PGS. The thematic data showed that the students perceived PGS to assist with stress management. They valued having scheduled time out to reflect on practice and appreciated the safety and trust established in the groups. Conclusion: Overall, the radiation therapy students responded positively to PGS. The students felt safe talking about clinical issues in their groups, and they perceive PGS to positively affect their stress management, resulting in new clinical insights and increased self‐awareness. Further research is required to examine the long‐term effects of PGS on patient care and if PGS can help reduce burnout for student radiation therapists. [ABSTRACT FROM AUTHOR]

Indigenous peoples are more likely than non-Indigenous peoples to experience family violence (FV), with wide-reaching impacts on individuals, families, and communities. Despite this, service providers indicate that Indigenous peoples are less likely to seek support than non-Indigenous peoples. Little is known about the reasons for this, particularly from the perspective of Indigenous people themselves. In this scoping review, we explore the views Indigenous peoples have on help seeking for FV. Online databases, Google Scholar, and reference lists were searched for relevant studies. Inclusion and exclusion criteria were applied so that only original studies where the Indigenous voice was specifically sought were chosen. Fifteen studies met our inclusion criteria including qualitative and mixed-methods research. Studies were conducted in the Americas, New Zealand, Australia, and India. Overall, findings suggest that Indigenous peoples are reluctant to engage in help-seeking behaviors for FV. Data were inductively organized into three main themes reflecting this reluctance: tendency to avoid help seeking (acknowledging the barriers of shame, tight-knit communities, and inappropriate service responses causing mistrust and fear), turning to informal support networks, and help is sought when crisis point is reached. We conclude that to overcome barriers for Indigenous peoples seeking help for FV, improving service providers response to FV through training and more research about what works is required; these activities need to be informed by both male and female Indigenous voices. [ABSTRACT FROM AUTHOR]

Introduction: Research indicates that radiation therapists (RTs) are at risk of burnout and that there is a lack of evidence on effective coping strategies for managing work‐related stressors within this workforce. Peer group supervision (PGS) is a useful tool in assisting staff to manage stress in the clinical setting, improve reflective practice and provide support. The aim of this research was to investigate New Zealand (NZ) RTs' perceptions of participating in PGS. Methods: In‐service training on PGS was offered to all RT centres in NZ, and five of the nine centres agreed to partake in PGS. Participants anonymously completed the same online questionnaire, six months apart. The questionnaire consisted of the Clinical Supervision Evaluation Questionnaire (CSEQ), an open‐ended question and demographics. The CSEQ asks participants to indicate their agreement with 14 statements related to Purpose, Process and Impact of PGS. Results: Overall, 71 and 48 participants completed the first and second surveys, respectively. In contrast to previous studies, this study found that confidence in practice, team support and group safety were valued by participants. This was supported by the qualitative data that revealed four themes: supportive groups, time out to reflect, organisational barriers and group process issues. RTs with one to five years' experience were more likely to structure their meetings, understand the purpose of the meetings and had clearer expectations of the group process. Conclusions: PGS may address burnout for RTs with one to five years' experience. This group of RTs feel patient‐related matters can be discussed openly during PGS, and PGS appears to be helping to improve their practice and reduce stress. More experienced RTs appear to be using the groups as a 'professional support group', rather than 'peer supervision', as a strategy for managing organisational stressors associated with burnout. [ABSTRACT FROM AUTHOR]

Capacity-building practices actively promote the skills and abilities of parents to provide development-enhancing learning opportunities for their child. Speech-language pathologists (SLPs) use parent-implemented interventions to enhance parent-child interactions, often using a training and coaching approach. In this article, we present feedback from three New Zealand parents of young children on the autism spectrum regarding their experience of a training and coaching intervention offered by an SLR Parent feedback stems from a broader research project that explored the impact of an intervention targeting parents' Implementation of i,Ileracliuii promoting strategies and embedded naturalistic interaction practices. This article describes the significance of coaching parents to use more systematic and precise practices in their interactions with their child and how this approach could be applied in the context of speech-language services. [ABSTRACT FROM AUTHOR]

Universal services focus on prevention and providing the support to parents that will help them meet the challenges of parenthood and deal with problems before they become entrenched. Many countries now have good universal services available for new families, and significant advances have been made in recent years to recognize the importance of the early years in the optimal development of the child. This article is based on a qualitative study of transition to parenthood. The study explored the experience of 25 first-time mothers in socioeconomically diverse circumstances in New Zealand. Eleven partners of these women also participated. Mothers were interviewed three times, first in late pregnancy, then 3 and 12 months after giving birth. Partners were interviewed once, mid-way through the baby's first year. The article focuses on how participants experienced service support. It illustrates some of the diverse needs of new parents, and explains ways in which prevention services might become more responsive to parents' expressed needs. The authors offer a case for stronger interplay between universal services and informal systems of support, and the development of a new generation of universal services that act as enablers of natural support hubs for new families within their own communities. [ABSTRACT FROM AUTHOR]

The purpose of the article is to explore the nature of support given to staff undergoing stressful organizational change and to determine the forms, antecedents, targets, and consequences of this support. Interviews in a wider study of changes in a New Zealand public health care authority produced the surprising finding that although 31 participants were asked about receiving support, 17 volunteered information on giving support to others. Various forms of support were given to different targets for various reasons and produced positive and negative outcomes for those providing support. Given that studies focusing on offering support during organizational change are extremely rare, our article, and the model it contains, makes a contribution to the literature on change, well-being, and support. The implications for practice are that organizations need to be aware of change's potentially stressful impacts and make an extra effort to provide support without draining the resources of its employees. [ABSTRACT FROM AUTHOR]

Knowledge about the impacts of traumatic brain injury (TBI) and aspects that influence recovery and adaptation are key to understanding how best to provide appropriate services. Whilst injury experiences have been documented, factors that help or hinder recovery and adaptation over time and across injury severities remain unclear. We present overarching findings addressing these matters in a large longitudinal qualitative study of recovery and adaptation following TBI. People experiencing TBI (n = 52) and their significant others (n = 37) were interviewed at 6-, 12- and 24-months post-injury. Data were thematically analysed cross-sectionally and longitudinally. Two overarching themes were captured in the analysis: making room for recovery and cultivating important resources. Themes comprise circumstances and processes that changed and developed over time in different ways for different participants. Key complexities within the overarching themes included the notion of "acceptance" and the role it played in allowing for recovery and adaptation; and the concept of "self" as a resource aiding recovery, but one that is perpetually at risk due to the intersection between the functional and social effects of the injury. Developing concepts of TBI recovery and living with TBI were central processes across diverse participants, but necessarily individualised in how they could be enacted. [ABSTRACT FROM AUTHOR]

Knowledge about the impacts of traumatic brain injury (TBI) and aspects that influence recovery and adaptation are key to understanding how best to provide appropriate services. Whilst injury experiences have been documented, factors that help or hinder recovery and adaptation over time and across injury severities remain unclear. We present overarching findings addressing these matters in a large longitudinal qualitative study of recovery and adaptation following TBI. People experiencing TBI (n = 52) and their significant others (n = 37) were interviewed at 6-, 12- and 24-months post-injury. Data were thematically analysed cross-sectionally and longitudinally. Two overarching themes were captured in the analysis: making room for recovery and cultivating important resources. Themes comprise circumstances and processes that changed and developed over time in different ways for different participants. Key complexities within the overarching themes included the notion of "acceptance" and the role it played in allowing for recovery and adaptation; and the concept of "self" as a resource aiding recovery, but one that is perpetually at risk due to the intersection between the functional and social effects of the injury. Developing concepts of TBI recovery and living with TBI were central processes across diverse participants, but necessarily individualised in how they could be enacted. [ABSTRACT FROM AUTHOR]

Increasing numbers of women in New Zealand are choosing to become single parents via donor insemination and may be referred to as Choice Mothers. However, the issues these women face have yet to receive much research attention and thus little is known about them and their lives. This research explored the experience of being a Choice Mother in New Zealand using semi-structured interviews. Data was analysed thematically, and identified that despite variations within their individual situations, there were similar aspects to their experiences. These included: their determination to become a parent, grief at not having achieved the "traditional family unit", challenges of partner absence, difficulties in explanations of their family unit, managing complex family structures, and their pride at having taken action to achieve their family, albeit unconventionally. [ABSTRACT FROM AUTHOR]

Aim: Total gastrectomy and Ivor Lewis oesophagectomy procedures are the mainstay of upper gastrointestinal cancer management. Maintenance of adequate nutritional intake is essential for positive patient outcomes. Although numerous nutritional support options exist, clear evidence‐based guidelines on the optimal means and duration of nutritional support are lacking. The aim of this study is to establish preliminary data on the current perioperative nutritional practices of upper gastrointestinal surgeons performing these procedures across Australia and New Zealand. It is hoped this will help provide the platform for future research towards establishing evidence‐based guidelines in upper gastrointestinal surgery. Methods: A questionnaire exploring the nutritional practices and considerations of surgeons was developed and emailed to the members of the Australia & New Zealand Gastric & Oesophageal Surgery Association. Results: A total of 27.4% of Australia & New Zealand Gastric & Oesophageal Surgery Association members completed the questionnaire. Surgeons reported inserting a jejunostomy feeding tube intraoperatively in Ivor Lewis oesophagectomy procedures 80–100% of the time, compared to only 20–39% of the time in total gastrectomy procedures. For both procedures, surgeons often refer their patients to a dietitian preoperatively, and always postoperatively. Preoperative immune‐enhancing nutrition is rarely administered. Patient age and BMI are deemed to be of low importance when determining the means of nutritional support. Conclusions: This study has demonstrated the current nutritional practices employed in Australia and New Zealand for patients undergoing major upper gastrointestinal surgery. Questions remain regarding the noted differences between procedures as well as the optimal means and duration of perioperative nutritional support. [ABSTRACT FROM AUTHOR]

Background: Giving up driving is a pivotal life event and universal challenge for people living with dementia and their families, and a complex area of clinical practice for health professionals who monitor driving cessation. The best outcomes are for individuals to plan for and eventually cease driving, however with insufficient support programs in place, many avoid the issue until it is reaches a crisis point. This program of research investigates a comprehensive support- and education-based intervention targeted at people living with dementia and their care partners who are managing driving cessation. The primary aim of this research is to determine the effectiveness of the program through a cluster randomized controlled trial.Methods/design: The intervention (CarFreeMe) is an intensive program delivered by a trained health professional that addresses practical and emotional needs relevant to driving cessation. The seven module program is person-centred, covering awareness raising, adjustment, and practical support that is individualized according to geographic location and the particular goals and preferences of participants. A cluster randomized controlled trial will evaluate the effectiveness of the program. Evaluation will take place pre-intervention, immediately following, and three months post-intervention. Clusters are randomized to either intervention or usual treatment. Participants within clusters will be recruited via primary and secondary care clinics, community agencies, service providers, local media, social media, support groups, and word of mouth. The primary outcome measure for persons with dementia and their care partners is lifespace, collected via (i) smartphone GPS technology and (ii) self-reported number of episodes away from home (during the past week). Secondary outcomes include safe alternative transport status, wellbeing, depression, anxiety, and self-efficacy, which will be collected from dyads. Caregiving strain will be collected from care partner/family member only. A process evaluation of the intervention will also be undertaken.Discussion: There is an urgent need for therapeutic approaches to supporting people living with dementia and their families to negotiate the complex decision making involved in deciding to change their approach to driving. The driving cessation intervention may fill an important gap in service delivery to people living with dementia who are adjusting to life without driving.Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12618000388213 , 15 March 2018. [ABSTRACT FROM AUTHOR]

Drawing on data from a longitudinal study of young people's transitions to adulthood, this article explores the experiences of young people who face high levels of adversity. These young people had experienced challenging circumstances from an early age (exposure to harm and to impoverished social and material conditions). This article draws on the qualitative phase of the study. Young people and a trusted other, nominated by the young person, participated in three annual qualitative interviews. The article explores experiences in two domains: education and employment. It concludes with a discussion of the implications for practice with young people who face adversity. [ABSTRACT FROM AUTHOR]

Background:There is growing international support for a public health approach to palliative care; however, the status of the movement in the New Zealand context is unknown. Aim:To explore the understandings, uptake, and nature of a public health approach to palliative care by hospices in New Zealand. Methods:A mixed method study, using a convergent parallel design, was conducted. In phase one, quantitative data were collected using an online survey of hospice leaders, and in phase two, qualitative data were generated from semi-structured telephone interviews with a sub-sample of phase one participants. Data from the survey were analysed using appropriate statistical techniques. Transcripts of the telephone interviews were analysed using thematic analysis. The findings from each phase were then triangulated to check for congruency. Sample:Fifteen leaders (12 chief executive officers and three senior managers) at New Zealand hospices participated in the online survey, representing a response rate of 54%. Ten of these participants took part in a semi-structured telephone interview. Results:Analysis of the quantitative results confirmed that a public health approach to palliative care was a current priority at 60% of New Zealand hospices. However, both phases of the study demonstrated that community engagement, one of the chief out-workings of a public health approach to palliative care, was incompletely understood and practised. Furthermore, the qualitative results showed that, while this approach is supported, there are significant barriers to implementation, including paternalism, resource constraints, adequate evaluation, and incomplete understanding of key concepts, such as social networking and community engagement. Conclusion:This study is the first to explore the extent to which a public health approach to palliative care is supported by hospices in New Zealand. The unique new findings show that there is need for the model to be recognized in policy. Related to practice, if the model is to be implemented to maximum benefit, further conceptual clarity of the key tenets is needed. In addition, addressing the barriers to implementation identified by this study will need to be prioritized by hospice leadership. [ABSTRACT FROM AUTHOR]

This article draws on the findings from the qualitative phase of a New Zealand longitudinal study concerning vulnerable young people’s transitions to adulthood. The young people, aged between 12 and 17 at the time of the first interview had sustained exposure to harm (abuse, violence, addictions, disengagement from school and mental health issues) and were clients of statutory and non-governmental services including: child welfare services, juvenile justice services, remedial education services and mental health services. Qualitative interviews explored young people’s experiences of services, their key transitions, their coping capacities, and the strategies they used to locate support and resources to mitigate the effects of harmful events and environments. There were three stages to the qualitative phase of the study; this article draws on the interviews from stage one and two. It explores the idea of resistance which emerged as a key theme in the data analysis. Three thematic clusters are presented: the nature of young people’s resistance; practitioner responses to resistance; and harnessing resistance in interventions. The article concludes with a discussion of how social workers and other practitioners can understand resistance and build more responsive and meaningful relationships with vulnerable youth. [ABSTRACT FROM PUBLISHER]

This article draws on the findings from the qualitative phase of a New Zealand longitudinal study concerning vulnerable young people’s transitions to adulthood, the challenges they faced, their experiences with services and the factors that helped lead to positive outcomes. It reports on the experiences of foster parents and their perspectives on what contributed to meaningful support for these young people. The youth (aged 12 to 17 years at the time of their first interview) had experienced sustained exposure to harm, including abuse, violence, addictions, disengagement from school and mental health issues. They used multiple services (child welfare, juvenile justice, mental health and education support services). The study involved the administration of a survey (n = 593) and qualitative interviews over three years with a sub-sample of young people (n = 107). In the qualitative phase, they were asked to nominate a person whom they trusted to also be interviewed. Twenty-one chose a foster parent. Three thematic clusters emerged from the analysis of the foster parents’ interviews: the challenges in providing care to vulnerable youth; the provision of practical and emotional support; and foster parents becoming an enduring presence in their lives – holding hopes and dreams. The article concludes with a discussion that draws on ecological-transactional approaches and explores the key elements that enable foster parents to become an enduring presence for vulnerable young people. [ABSTRACT FROM AUTHOR]

This paper reports on the qualitative phase of a New Zealand study of young people who had been exposed to "risky" environments from a young age. These young people had experienced traumatic events such as abuse, violence, addictions, mental health issues, and many had been excluded from school. The young people (aged between 13 and 17) were users of multiple services (statutory and nongovernmental services including: child welfare, juvenile justice, remedial education, and mental health services). Qualitative interviews (n = 109) explored young people's experiences in their families, communities, education, and their perspectives on support provided by services and their own support networks. Three thematic clusters emerged as central motifs in young people's experiences and are the focus of this article: navigating "risky" environments; services and support; and, working to find different pathways. [ABSTRACT FROM AUTHOR]

Objective:The aim of this study was to explore the psychological support needs of patients with head and neck cancer (HNC) and their caregivers. The appropriate timing, length, format and content of sessions were also investigated. Design:Eighty-three patients with HNC and 73 of their caregivers completed questionnaires at diagnosis. Follow-up questionnaires were mailed to patients six months later. Main outcome measures:Free text-comments to open-ended questions in the questionnaires were analysed using an inductive thematic approach with coding and theme development directed by the content of responses. This was used to determine psychological support needs both at diagnosis and at six month follow-up. Results:Patients described ‘just being there’, empathy, maintaining normality and practical support as helpful from family/friends. They desired information, honesty, positivity and empathy from clinical staff. Formal psychological support was desired by approximately 40% of patients and caregivers, particularly early after diagnosis and during treatment. Most participants desired face to face sessions, providing individualised information and coping strategies. Conclusion:The results of this study suggest that psychological interventions for patients with HNC and their caregivers should be delivered early after diagnosis in face to face sessions, presenting honest and factual information about the disease and coping strategies. [ABSTRACT FROM PUBLISHER]

The shortage of nurses is known. We explored nurses' reasons for leaving the profession based on responses from an e-newsletter of the Nurses and Midwives e-cohort Study. Qualitative content analysis of data from email responses ( n = 66) showed 'Lack of support' as a social work value describing their manager's lack of support, unsupportive relationships within their work group, and a health-care system putting business principles before care resulting in job dissatisfaction and nurse turnover. These findings are examples of a 'complex'/'wicked' problem and as such will resist simple solutions to the presenting issues. The dialogic process such as Open Space Technology and Talking Circles should be considered as potentially suitable to the needs of nurses. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative evaluation of the postgraduate courses offered by distance in one university department. The types and amount of support provided to students was evaluated and compared with Simpson's (2008a) Proactive Motivational Support model (PaMS). While students were largely satisfied with the support they received during their studies, their perceptions of the levels and effectiveness of that support varied. They also perceived a variation in the levels of support between individual courses. A number of areas where support could be improved were identified, including those that met the characteristics of the PaMS model. [ABSTRACT FROM AUTHOR]

Abstract: Exploration of the influence of neighbourhood social context on supportive relationships and social cohesion is on the rise. Positive social contexts may be less stressful for residents, resulting in mental wellbeing and calmness; whereas negative contexts may increase stress and deleterious mental health. To examine this, we measured the relationship between an Index of Neighbourhood Social Fragmentation and overall mental well-being in New Zealand. Then we examined the influence of fragmentation on two components of mental health: depression and calmness. Increased fragmentation was significantly associated with lower mental health scores for the entire population and for females, with similar but insignificant trends for males. Increased fragmentation was associated with increased depression in both sexes, but not calmness. Depression rather than calmness may contribute to the observed association between fragmentation and overall mental health. Groups vulnerable to stressful social contexts may be prone to depression in fragmented neighbourhoods. Further examination of the specific aspects of living in fragmented neighbourhoods which increase depressive feelings is warranted. [Copyright &y& Elsevier]

Aims and objectives To explore the ageing experiences of gay men in New Zealand over the age of 65 years. Background An increased acceptance by many people in Western societies towards men who are same-sex attracted is likely to result in a corresponding increase in the number of visible older gay men being the recipients of nursing care. Previous research has shown that nursing has some way to go towards providing a service that is culturally safe and appropriate. Design A critical gerontological approach was employed to explore the ageing experiences of gay men in New Zealand over the age of 65 years. This methodology ensured the voices of older gay men were foregrounded in the research. Methods Semi-structured digitally recorded individual interviews with 12 gay men aged between 65-81 years who lived in the community were undertaken. Data were analysed using thematic analysis to identify the repeated patterns across the men's talk. Results Three main themes relating to the ageing experiences of these men were identified: 'homophobia', 'being with someone' and 'future care'. Conclusions Resilience was a significant factor in how well older gay men aged even in an environment where homophobia and heterosexism were common. Having a strong social support network was an important factor that contributed to supporting the ageing process. These gay men were wary about having to go into residential care, preferring to age in their own homes. Relevance to clinical practice Nurses and other healthcare professionals need to ensure healthcare services meet the needs of older gay men. Any interaction with older gay men should occur in a way that is open and respectful. The usage of best practice guidelines will assist organisations to deliver culturally safe and appropriate care to this group. [ABSTRACT FROM AUTHOR]

This article discusses the family dynamics of South Sudanese parents who arrived in New Zealand as quota refugees. It investigates how they experience parenting in relation to language barriers, gender roles, and cultural differences in raising children. The article reports on in-depth interviews with four solo mothers and two married fathers during which participants commonly expressed tensions between finding a workable relationship between traditional parenting and current expectations in New Zealand. This study identifies some potential pathways for working with refugee families who are raising children in resettlement contexts and highlights several key considerations concerning settlement support and gender. [ABSTRACT FROM PUBLISHER]

Using 105 medical doctors across three DHBs, we tested intentions to turnover from the medical profession, and found approximately 50% had varying degrees of intentions towards leaving the medical profession. A mediation path model was determined to best fit the data. Results of the structural equation modelling showed that the antecedents followed a path relationship: interpersonal fairness was negatively related to DHB systems and positively related to perceived organisational support (POS). DHB systems were positively related to workplace issues which in turn was negatively related to POS. POS was positively related to outcomes, although this was fully mediated by job satisfaction. As such, POS was positively related to job satisfaction, which in turn was negatively related to emotional exhaustion, cynicism, stress, and profession turnover. Overall, the model accounted for large amounts of variance for all outcomes although a more modest amount for profession turnover. Additional analyses showed no demographic variables were related to turnover intentions from the medical profession. Overall, the findings show that support from the DHB and satisfaction with their jobs are the key determinants of retaining medical doctors. Further work is needed to extend this research across a broader range of medical doctors. [ABSTRACT FROM AUTHOR]

The challenges of providing sensitive and structured care for children in foster care go well beyond normative experiences of parenting. The present paper describes a mixed-methods study of foster carers' perceived need for support and training, referenced to estimates of their burden of care. Semi-structured interviews were conducted with 17 foster carers in the Canterbury region of New Zealand. Carers' perceived need for support and training were identified through qualitative analysis of interviews using domain analysis method. Carers' burden of care was estimated from the Parenting Stress Index and from a measure of carers' encounters with children's emotional, behavioural and relationship difficulties that was designed for the present study (the Caregiver Behavioural Encounters Index). Foster carers reported substantive, unmet needs for support and training. Foster carers also reported high parenting stress and encounters with a wide range of children's mental health difficulties, including both uncommon and severe difficulties, which together represent an exceptional burden of care. Carers' highest priority need was for training and support on managing and responding to children's mental health difficulties, while their greatest existing support came from Caregiver Liaison Social Workers and other carers. The findings suggest a number of critical implications for practice. [ABSTRACT FROM AUTHOR]

Little is known about the role the spouse plays in an entrepreneur’s motivations for entrepreneurship. A gender comparative qualitative study is presented, based on interviews with 68 entrepreneurs (45 men and 23 women) in New Zealand. A continuum of spousal support is described—those whose spouses are co-founders, supportive spouses, and unsupportive/ambivalent spouses. Findings show that women and men tend to have different expectations of their spouse when contemplating starting a business. A woman looks to her husband for business advice, for support, and encouragement and considers the effects that starting a business may have on her spouse. A man tends to assume support is forthcoming, and some men start businesses without explicit spousal support. Contributions to theories of family business are made. [ABSTRACT FROM AUTHOR]

Surgical performance is increasingly under public scrutiny and non-technical behavioural issues are more frequently the focus of complaints. Currently, there is a lack of a suitable framework or template to assist surgeons in the assessment of their own performance or that of their colleagues. A Royal Australasian College of Surgeons (RACS) Working Party considered the methods currently available to define and assess surgical performance. The scope included assessment tools, resources available, and support for surgeons. The Non-Technical Skills for Surgeons (NOTSS) programme developed by the Royal College of Surgeons, Edinburgh and the School of Psychology, University of Aberdeen was of particular interest. This programme was reviewed, adapted and expanded. The nine RACS competencies were used as the foundation for developing a set of three behavioural patterns within each competency domain. Each behavioural pattern was then described by a set of eight behavioural markers – describing four good and four poor behaviours. A variety of resources were identified to assist surgeons, including College and other similar courses and guidelines, publications covering professionalism-and health issues and support through various agencies. It was recognized that the College has a role to support its Fellows and to ensure any review of performance is conducted impartially, competently and confidentially. The resulting guide was approved by College Council in June 2008 and later distributed to Fellows and hospitals throughout Australia and New Zealand. It is intended to be used for self-reflection and self-assessment, although it could equally be used as a template for the review of an individual surgeon’s performance by a clinical director of surgery or other agency. Considerable progress has been made in the assessment of performance of practising surgeons. This guide has been published to address performance issues across all RACS competencies. It also outlines a variety of assessment methods and strategies to support surgeons. [ABSTRACT FROM AUTHOR]

It is well documented that doctors experience a high level of stress in their profession, and that this can lead to physical, psychological, and emotional harm, in particular, burnout. Overseas (especially in the UK and USA), research investigating the levels of stress, burnout, and associated psychiatric morbidity in health professionals, across many specialities, has been carried out with a view to prevention of these adverse outcomes. To assess the level of burnout in a sample of New Zealand physicians, the associated work and personal characteristics, and the need for development of a support peer supervision or support system. Questionnaires that measured a number of work and personal characteristics, including the Maslach Burnout Inventory, the General Health Questionnaire, and additional questions regarding mistakes, and need for support, were sent to 83 physicians in the Waikato and Bay of Plenty areas. Analysis involved descriptive statistics, with t-tests for comparison with other studies, Pearson Product-Moment correlations between variables and analysis of variance where appropriate. Of the 50 respondents, 28% experienced high levels of two or three aspects of burnout (emotional exhaustion, depersonalization, low personal accomplishment). Emotional exhaustion correlated with a greater need for support. Most respondents favoured a one-to-one support system. This study highlights the presence of significant workplace difficulties for physicians and the need to develop a preventative support system for the protection of physicians and the patients in their care. (Intern Med J 2005; 35: 272–278) [ABSTRACT FROM AUTHOR]

Despite the idyllic potential, many parts of New Zealand’s rural health services have continued to struggle for want of a workforce whose retention is not threatened by demanding rosters, heavy workloads and overwhelming bureaucracy. There may now be a basis for cautious optimism that a plan to integrate recommendations and trialled initiatives from the past decade may attract sufficient government funding to see a renaissance for rural primary health care. This paper outlines the elements contributing to what may be a last hope before crisis takes over. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore how people self-manage their long-term conditions and the support enabling them to do so., Background: People with long-term conditions are required to engage in daily self-management with the support of health practitioners, family and friends., Design: A qualitative interview study., Methods: Thirty-two New Zealand European and Pacific people with long-term conditions were interviewed about how they manage their condition/s at home with support from family, neighbours, agencies and general practice doctors and nurses. Interviews were recorded, transcribed, checked and analysed for thematic content. The COREQ checklist was used., Results: Three themes emerging from the data were as follows: 'acceptance' of conditions, limitations, support and advice; 'making it work' regarding life with long-term conditions; and the need for health practitioners to 'work alongside me'., Conclusions: People with long-term conditions struggle with acceptance of a diagnosis and symptoms, and acceptance of help which conflicts with their need to maintain independence and personal control. They self-manage every day, learning to plan, choose what and what not to do and negotiate with others to get tasks done and maintain quality of life. They manage better with support from understanding health practitioners, especially advanced nurses, with whom they have established a positive, sustained relationship., Relevance to Clinical Practice: Active support for people to self-manage has been shown to assist people to achieve their goals and improve overall health and well-being. Nurses are well positioned to provide self-management support for people with long-term conditions but require allocated time and system changes to enable this. Practitioners need to acknowledge that it is difficult for people to accept diagnoses and symptoms and provide individualised support for this process. The desire to remain independent may limit acceptance of help, making it harder for people to maintain life quality. A change in length and content of consultations is required in order for practitioners to really get to know people and provide the self-management support they need to meet their goals., (© 2020 John Wiley & Sons Ltd.)

Knowledge about the impacts of traumatic brain injury (TBI) and aspects that influence recovery and adaptation are key to understanding how best to provide appropriate services. Whilst injury experiences have been documented, factors that help or hinder recovery and adaptation over time and across injury severities remain unclear. We present overarching findings addressing these matters in a large longitudinal qualitative study of recovery and adaptation following TBI. People experiencing TBI ( n  = 52) and their significant others ( n  = 37) were interviewed at 6-, 12- and 24-months post-injury. Data were thematically analysed cross-sectionally and longitudinally. Two overarching themes were captured in the analysis: making room for recovery and cultivating important resources . Themes comprise circumstances and processes that changed and developed over time in different ways for different participants. Key complexities within the overarching themes included the notion of "acceptance" and the role it played in allowing for recovery and adaptation; and the concept of "self" as a resource aiding recovery, but one that is perpetually at risk due to the intersection between the functional and social effects of the injury. Developing concepts of TBI recovery and living with TBI were central processes across diverse participants, but necessarily individualised in how they could be enacted.

Background: Despite numerous recommendations by governments, researchers, and education policymakers the recruitment, retention and success of undergraduate indigenous students in higher education is not commensurate of the wider student population. There is minimal evidence of valuing indigenous worldviews and perspectives in curricula, and effectiveness of educational strategies to strengthen indigenous student success rates in completing undergraduate studies., Objectives: To conduct an integrative systematic review of educational strategies to promote academic success and resilience in undergraduate indigenous students., Methods: Major databases of Scopus, ProQuest, Informit and Web of Science were searched. Inclusion criteria were peer reviewed research articles from scholarly journals that referenced indigenous, aboriginal, First Nation or Māori students in undergraduate programs in higher education. The search was limited to English language and studies conducted from 1995 to 2014., Results: The search yielded 156 research papers which reduced to 16 papers that met the inclusion criteria. The included papers were critiqued from a standpoint theory approach that reflects feminism, cultural respect, and humanism. Much of the literature describes issues, and provides qualitative analyses of experiences, but empirical evaluations of interventions are rare., Conclusions: There was a gap in current research evaluating strategies to improve indigenous student success and resilience. Key strategies for indigenous student success are multi-faceted, layered support, underpinned by the principles of respect, relationships, and responsibility. Implications for nursing and midwifery education, research and health care practice are outlined., (Copyright © 2015 Elsevier Ltd. All rights reserved.)