scholarly journals Cultural health literacy: the experiences of Māori in palliative care

2018 ◽  
Vol 25 (4) ◽  
pp. 15-23 ◽  
Author(s):  
Jacquie Kidd ◽  
Stella Black ◽  
Rawiri Blundell ◽  
Tamati Peni
Keyword(s):  
Palliative Care ◽  
New Zealand ◽  
Health Literacy ◽  
Health Information ◽  
Health Professionals ◽  
Health Resources ◽  
Structured Interviews ◽  
Aotearoa New Zealand ◽  
Palliative Care Setting ◽  
Maori Health

Abstract: Health literacy is a concept that is frequently applied to the patient’s ability to find and comprehend health information. However, recent literature has included the skill of the health professional and the accessibility of health resources as important factors in the level of health literacy achieved by individuals and populations. In 2014 a qualitative study undertaken in Aotearoa New Zealand, investigated the context of health literacy for Māori in a palliative care setting (Māori are the indigenous people of Aotearoa New Zealand). The study included the experiences of patients, whānau (families), and health professionals. Method: Individual semi-structured interviews were held with 21 patients, whānau and six key informants: a medical specialist, a service leader involved in developing culturally specific responses to patients, two Māori service managers, and two Māori health team leaders. Focus groups were held with a total of 54 health professionals providing palliative care services. Data analysis: A thematic analysis was undertaken using a general inductive approach. The trustworthiness and reliability of the analysis was supported by sharing analysis of the transcripts among the research team. Member checking or respondent validation was used in seeking confirmation of the interim findings at five hui (meetings) with the research communities involved. Findings: This study found that the shock and grief that attends a life-limiting illness made hearing and processing health information very difficult for patients and whānau. Further, ‘hard conversations’ about moving from active treatment to palliative care were often avoided by health professionals, leaving patients and whānau distressed and confused about their choices and prognosis. Finally, poor cultural health literacy on the part of organisations has likely impacted on late access to or avoidance of palliative care for Māori.

scholarly journals New Zealand consumers’ health information needs: results of an interpretive descriptive study

2014 ◽  
Vol 6 (3) ◽  
pp. 203 ◽  
Author(s):  
Michelle Honey ◽  
Dianne Roy ◽  
Janine Bycroft ◽  
Mary-Anne Boyd
Keyword(s):  
New Zealand ◽  
Health Literacy ◽  
Health Information ◽  
Health Professionals ◽  
Information Needs ◽  
Information Provision ◽  
Relevant Information ◽  
Descriptive Study ◽  
Literacy Skills ◽  
Current Time

INTRODUCTION: Health literacy is linked to better health outcomes and underpins effective self-management, yet over one-and-a-half million New Zealanders are known to have poor health literacy skills. An ability to access and understand health information is an important component of health literacy. Little is known, however, about New Zealand consumers’ health information needs. This qualitative study sought to understand the perceptions of consumers related to their needs and use of health information. METHODS: Four focus group interviews provided data for this qualitative descriptive study. Data analysis used a thematic inductive approach. Participants were from the general population, accessed through community-based health organisations. These consumers were predominantly of New Zealand European ethnicity, female, older, and most were actively engaged in managing their health. FINDINGS: Four themes were identified: issues with current information provision; preferences for content; format; and sources of health information. These themes are described in the paper, using illustrative quotes from consumer participants. CONCLUSION: This study indicates that consumers have varied health information needs. Health professionals cannot assume that consumers all have the same health literacy skills. The ideal is to provide personalised, relevant information in a manner the consumer can understand, within the current time constraints in practice. Health professionals can support consumers in their use of different strategies to ensure their health information needs are expressed and met. KEYWORDS: Consumer health information; focus groups; health literacy; qualitative research

Māori Research(er) in Three Poems

2018 ◽  
Vol 2 (1) ◽  
pp. 35
Author(s):  
Jacquie Kidd
Keyword(s):  
Palliative Care ◽  
Health Literacy ◽  
Cultural Identity ◽  
Focus Groups ◽  
Health Professionals ◽  
Bell Hooks ◽  
Face To Face ◽  
The Third ◽  
Ruth Behar ◽  
Seeking Help

These three poems re-present the findings from a research project that took place in 2013 (Kidd et al. 2018, Kidd et al. 2014). The research explored what health literacy meant for Māori patients and whānau when they accessed palliative care. Through face-to-face interviews and focus groups we engaged with 81 people including patients, whānau, bereaved loved ones, support workers and health professionals. The poems are composite, written to bring some of our themes to life. The first poem is titled Aue. This is a Māori lament that aligns to English words such as ‘oh no’, or ‘arrgh’, or ‘awww’. Each stanza of the poem re-presents some of the stories we heard throughout the research. The second poem is called Tikanga. This is a Māori concept that encompasses customs, traditions and protocols. There are tikanga rituals and processes that guide all aspects of life, death, and relationships. This poem was inspired by an elderly man who explained that he would avoid seeking help from a hospice because ‘they leave tikanga at the door at those places’. His choice was to bear his pain bravely, with pride, within his cultural identity. The third poem is called ‘People Like Me’. This is an autoethnographical reflection of what I experienced as a researcher which draws on the work of scholars such as bell hooks (1984), Laurel Richardson (1997) and Ruth Behar (1996). These and many other authors encourage researchers to use frustration and anger to inform our writing; to use our tears to fuel our need to publish our research.

scholarly journals Zero Carbon Building Practices in Aotearoa New Zealand

Energies ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4455
Author(s):  
Thao Thi Phuong Bui ◽  
Suzanne Wilkinson ◽  
Niluka Domingo ◽  
Casimir MacGregor
Keyword(s):  
Climate Change ◽  
New Zealand ◽  
Construction Industry ◽  
Local Governments ◽  
Early Stage ◽  
Policy Implications ◽  
Structured Interviews ◽  
Building Projects ◽  
Aotearoa New Zealand ◽  
Zero Carbon

In the light of climate change, the drive for zero carbon buildings is known as one response to reduce greenhouse gas emissions. Within New Zealand, research on climate change mitigation and environmental impacts of buildings has received renewed attention. However, there has been no detailed investigation of zero carbon building practices. This paper undertakes an exploratory study through the use of semi-structured interviews with government representatives and construction industry experts to examine how the New Zealand construction industry plans and implements zero carbon buildings. The results show that New Zealand’s construction industry is in the early stage of transiting to a net-zero carbon built environment. Key actions to date are focused on devising a way for the industry to develop and deliver zero carbon building projects. Central and local governments play a leading role in driving zero carbon initiatives. Leading construction firms intend to maximise the carbon reduction in building projects by developing a roadmap to achieve the carbon target by 2050 and rethinking the way of designing and constructing buildings. The research results provide an insight into the initial practices and policy implications for the uptake of zero carbon buildings in Aotearoa New Zealand.

scholarly journals Preoperative bariatric surgery programme barriers facing Pacific patients in Auckland, New Zealand as perceived by health sector professionals: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e029525
Author(s):  
Tamasin Taylor ◽  
Wendy Wrapson ◽  
Ofa Dewes ◽  
Nalei Taufa ◽  
Richard J Siegert
Keyword(s):  
Bariatric Surgery ◽  
New Zealand ◽  
Health Literacy ◽  
Health Professionals ◽  
Health Sector ◽  
Publicly Funded ◽  
Attrition Rates ◽  
Pacific Health ◽  
Emotional Safety ◽  
Minority Ethnic

Minority ethnic patient groups typically have the highest bariatric surgery preoperative attrition rates and lowest surgery utilisation worldwide. Eligible patients of Pacific Island ethnicity (Pacific patients) in New Zealand (NZ) follow this wider trend.ObjectivesThe present study explored structural barriers contributing to Pacific patients’ disproportionately high preoperative attrition rates from publicly-funded bariatric surgery in Auckland, NZ.SettingPublicly-funded bariatric surgery programmes based in the wider Auckland area, NZ.DesignSemi-structured interviews with health sector professionals (n=21) were conducted.Data were analysed using an inductive thematic approach.ResultsTwo primary themes were identified: (1) Confidence negotiating the medical system, which included Emotional safety in clinical settings and Relating to non-Pacific health professionals and (2) Appropriate support to achieve preoperative goals, which included Cultural considerations, Practical support and Relating health information. Clinical environments and an under-representation of Pacific staff were considered to be barriers to developing emotional safety, trust and acceptance of the surgery process with patients and their families. Additionally, economic deprivation and lower health literacy impacted preoperative goals.ConclusionsHealth professionals’ accounts indicated that Pacific patients face substantial levels of disconnection in bariatric surgery programmes. Increasing representation of Pacific ethnicity by employing more Pacific health professionals in bariatric teams and finding novel solutions to implement preoperative programme components have the potential to reduce this disconnect. Addressing cultural competency of staff, increasing consultancy times and working in community settings may enable staff to better support Pacific patients and their families. Programme structures could be more accommodating to practical barriers of attending appointments, managing patients’ preoperative health goals and improving patients’ health literacy. Given that Pacific populations, and other patients from minority ethnic backgrounds living globally, also face high rates of obesity and barriers accessing bariatric surgery, our findings are likely to have broader applicability.

scholarly journals The incorporation of Māori environmental values as part of the Ruamāhanga Whaitua Implementation Programme in the Wellington Region, Aotearoa New Zealand

2021 ◽  
Author(s):  
◽  
Bryn Cal Hickson Rowden
Keyword(s):  
Environmental Management ◽  
Decision Making ◽  
New Zealand ◽  
Theory Approach ◽  
Structured Interviews ◽  
Environmental Decision Making ◽  
Aotearoa New Zealand ◽  
Management Processes ◽  
Local Government Level ◽  
Implementation Programme

<p>In recent years, there has been significant efforts to create frameworks in which Māori values are incorporated as part of environmental management processes in Aotearoa New Zealand(Forster, 2014; Harmsworth et al., 2016). This research explores the factors that influence the incorporation of Māori values at the local government level, and what barriers Māori values face to being incorporated in environmental management. This research focused on a case study of the Ruamāhanga Whaitua Committe Implementation Programme process in the Wellington region. Semi-structured interviews were used to collect information on the opinions of members of the Ruamāhanga Whaitua Committee. The interviews were analysed using a critical theory approach. The research found that there was a clear discrepancy between the values and behaviours expressed by some non-Māori members of the Committee. The result of such a discrepancy was that Māori values were not sufficiently part of environmental decision making. Such a discrepancy was a result of the political structures of the Regional Council’s Whaitua Implementation Programme process. The majority of the decision-making power was found to be situated ‘higher’ up in the organisation, outside of the Committee. Overall this research found that there are important opportunities to make sure iwi values are not only included, but form the basis of decisions.</p>

scholarly journals Architecture Without Expectation: Designing a third place for mental wellbeing in the community

2021 ◽  
Author(s):  
◽  
Kezia Fairbrother
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Mental Wellbeing ◽  
Evidence Based ◽  
Third Place ◽  
Therapeutic Landscapes ◽  
Spatial Design ◽  
Aotearoa New Zealand ◽  
The Government ◽  
Maori Health

<p>In 2018, the government published the report of its inquiry into mental health and addiction in Aotearoa New Zealand, which called for a ‘paradigm shift’ in the country’s approach to mental wellbeing. This research portfolio explores the role architecture has to play in this shift, acknowledging the problematic historical associations of architecture and mental health. In doing so, the work aims to establish principles for a new architectural typology of mental health care, outside of conventional institutions. It explores contemporary approaches to wellness, and integrates research from several bodies of theoretical and evidence-based research into a new creative practice within architecture. Specifically, the research draws on theory around nonrepresentational therapeutic landscapes, third place and evidence based design. These inform creative explorations of the therapeutically affective qualities of naturally-sourced materials. The findings of this explorations are transferred to spatial design using a ‘multiplicity’ approach based on nonrepresentational theory and Māori health models, which is then applied to a specific site in Wellington, New Zealand. Finally, architectural applications for this research are proposed in the form of a community-based third place to support mental health and wellbeing.</p>

scholarly journals Rainbow experiences of accessing mental health support in Aotearoa New Zealand: A community-based mixed methods study

2021 ◽  
Author(s):  
◽  
Gloria Fraser
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Community Members ◽  
Community Based ◽  
Aotearoa New Zealand ◽  
Mental Health Settings ◽  
Mental Health Support ◽  
Health Support

<p>While we know that rainbow people in Aotearoa New Zealand (that is, people of diverse sexualities, genders, and sex characteristics) experience high rates of adverse mental health outcomes, we know much less about the extent to which Aotearoa’s rainbow community members are receiving the mental health support they need. To address this gap I used mixed methods and a reflexive community-based approach to extend current understandings of rainbow mental health support experiences, and to explore how the provision of mental health care can be improved for rainbow people in New Zealand.  I first conducted interviews with 34 rainbow community young adults about their experiences of accessing mental health support. My thematic analysis showed that rainbow people across New Zealand faced significant structural barriers to accessing mental health support. Participants understood mental health settings as embedded within a heteronormative and cisnormative societal context, rather than as a safe place outside this context. This, together with a widespread silence from mental health professionals around rainbow identity, meant that participants actively negotiated coming out in mental health settings. Participants shared a variety of perspectives as to whether it should be standard practice for mental health professionals to ask about rainbow identities, but agreed on a number of subtle acts that could communicate a professional or service is rainbow-friendly. Knowledge about sexuality, gender, and sex characteristic diversity, together with clinical skills of empathy, validation, and affirmation, were described as key components for the provision of effective mental health support.  I conducted a second thematic analysis of data from a subset of the initial interviews, in which 13 participants discussed their experiences of accessing gender-affirming healthcare. Participants reported a lack of funding for gender-affirming healthcare in New Zealand, and described its provision a “postcode lottery”; the care available was largely dependent on the region participants were living in. Mental health assessments for accessing gender-affirming care were often described as tests of whether participants were “really” transgender, and participants discussed the need to express their gender in a particular way in order to access the healthcare they needed.  Thematic analyses of interview data informed the development of an online survey about rainbow peoples’ experiences of accessing mental health support and gender-affirming healthcare in New Zealand (n = 1575). Survey results closely reflected interview findings, indicating that rainbow people have mixed experiences in New Zealand’s mental health settings, and that accessing gender-affirming healthcare is a lengthy and convoluted process.   Finally, interview and survey data were used to develop a resource for mental health professionals, to guide their work with rainbow clients. I sought and incorporated feedback from key stakeholders (n = 108) during resource development. I then distributed the resource to mental health professionals around New Zealand, both in print and online.  Overall, my research shows that widespread knowledge gaps compromise the ability of New Zealand’s mental health professionals to provide culturally competent support to rainbow clients. Knowledge from this thesis can be used to increase awareness of rainbow community members’ mental health support needs, and to inform mental health professionals’ training and self-reflection around sexuality, gender, and sex characteristic diversity.</p>

General Practitioners’ Roles in Disaster Health Management: Perspectives of Disaster Managers

2021 ◽  
pp. 1-8
Author(s):  
Penelope L. Burns ◽  
Gerard J. FitzGerald ◽  
Wendy C. Hu ◽  
Peter Aitken ◽  
Kirsty A. Douglas
Keyword(s):  
Health Care ◽  
New Zealand ◽  
General Practitioners ◽  
Health Management ◽  
Health Care Systems ◽  
Health Resources ◽  
Local Health ◽  
Structured Interviews ◽  
Care Needs ◽  
Study Objective

Abstract Introduction: General Practitioners (GPs) are inevitably involved when disaster strikes their communities. Evidence of health care needs in disasters increasingly suggests benefits from greater involvement of GPs, and recent research has clarified key roles. Despite this, GPs continue to be disconnected from disaster health management (DHM) in most countries. Study Objective: The aim of this study was to explore the perspectives of disaster management professionals in two countries, across a range of all-hazard disasters, regarding the roles and contributions of GPs to DHM, and to identify barriers to, and benefits of, more active engagement of GPs in disaster health care systems. Methods: A qualitative research methodology using semi-structured interviews was conducted with a purposive sample of Disaster Managers (DMs) to explore their perspectives arising from experiences and observations of GPs during disasters from 2009 through 2016 in Australia or New Zealand. These involved all-hazard disasters including natural, man-made, and pandemic disasters. Responses were analyzed using thematic analysis. Results: These findings document support from DM participants for greater integration of GPs into DHM with New Zealand DMs reporting GPs as already a valuable integrated contributor. In contrast, Australian DMs reported barriers to inclusion that needed to be addressed before sustained integration could occur. The two most strongly expressed barriers were universally expressed by Australian DMs: (1) limited understanding of the work GPs undertake, restricting DMs’ ability to facilitate GP integration; and (2) DMs’ difficulty engaging with GPs as a single group. Other considerations included GPs’ limited DHM knowledge, limited preparedness, and their heightened vulnerability. Strategies identified to facilitate greater integration of GPs into DHM where it is lacking, such as Australia, included enhanced communication, awareness, and understanding between GPs and DMs. Conclusion: Experience from New Zealand shows systematic, sustained integration of GPs into DHM systems is achievable and valuable. Findings suggest key factors are collaboration between DMs and GPs at local, state, and national levels of DHM in planning and preparedness for the next disaster. A resilient health care system that maximizes capacity of all available local health resources in disasters and sustains them into the recovery should include General Practice.

scholarly journals Mental health professionals’ perceptions on patients control of data sharing

2020 ◽  
Vol 26 (3) ◽  
pp. 2011-2029 ◽  
Author(s):  
Julia Ivanova ◽  
Adela Grando ◽  
Anita Murcko ◽  
Michael Saks ◽  
Mary Jo Whitfield ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Information ◽  
Data Sharing ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Health Data ◽  
Structured Interviews ◽  
Timely Access ◽  
The Impact

Integrated mental and physical care environments require data sharing, but little is known about health professionals’ perceptions of patient-controlled health data sharing. We describe mental health professionals’ views on patient-controlled data sharing using semi-structured interviews and a mixed-method analysis with thematic coding. Health information rights, specifically those of patients and health care professionals, emerged as a key theme. Behavioral health professionals identified patient motivations for non-sharing sensitive mental health records relating to substance use, emergency treatment, and serious mental illness (94%). We explore conflicts between professional need for timely access to health information and patient desire to withhold some data categories. Health professionals’ views on data sharing are integral to the redesign of health data sharing and informed consent. As well, they seek clarity about the impact of patient-controlled sharing on health professionals’ roles and scope of practice.

scholarly journals Digital health literacy of health care profession students

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Dratva ◽  
S Juvalta ◽  
M Gemperle ◽  
D Händler-Schuster ◽  
M Scheermesser ◽  
...  
Keyword(s):  
Health Literacy ◽  
Digital Media ◽  
Health Information ◽  
Health Systems ◽  
Health Professionals ◽  
Digital Health ◽  
Critical Evaluation ◽  
Health Professions ◽  
Information Resources ◽  
Personal Health Information

Abstract Background Digital transformation in health and health systems is a chance and a challenge for health professionals irrespective of their field. To maximize the benefit for patients high digital health literacy is required. A requirement not represented in health professions’ curricula in Switzerland. Little is known on the digital health competencies of students, on their utilization and views of digital media in the context of health, thus a cross-sectional survey was performed at a School of Health Professsions in Switzerland. Methods All BSc. students (N = 1200; nursing, midwifery, occupational health, physiotherapy and health promotion) received an online questionnaire covering utilization of various information resources, views on digital health & media and the German eHealth Literacy Scale (eHEALS, score 0 - 40). Descriptive and group analyses were performed, further adjusted analyses will be run. Results 453 students responded (female N = 368, male N = 26). Participation was 38% and highest in 1st students. Personal health information resources used most were: internet 82%, familiy&friends 70%, health professionals 66%, textbooks 40%. A majority rated digital media as important (66%) or rather important (30%) for their future professional activities. The overall eHeals-score was 28.6 (sd 4.93); critical evaluation and confidence in applying information scored lowest. Preliminary group analyses show significant increase by study year (1st 28.0, 2nd 28.9, 3rd 29.7, p = 0.01), while scores by gender or health profession were non-significantly different. Conclusions Almost all students in health professions use digital media for their own health information needs and consider digital media as highly relevant for their future career. Critical evaluation skills need to be strenghtend. Digital Health Literacy is only slightly higher in 3rd year students. Longitudinal data are needed to differentiate cohort from learning effects. Key messages Digital media are increasingly important in health systems, a view shared by future health professionals. Data indicate only a small increase of digital health literacy across three years of study. Curricula should include digital health competencies to ensure a highly digitally skilled health work force.

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