scholarly journals Lead maternity care midwives' perspectives on the effect of severe perineal trauma on their relationship with women

2021 ◽  
Author(s):  
◽  
Audrene Samuel
Keyword(s):  
New Zealand ◽  
Maternity Care ◽  
Genital Tract ◽  
Postnatal Period ◽  
Perineal Trauma ◽  
Structured Interviews ◽  
Geographical Regions ◽  
Severe Perineal Trauma ◽  
Ongoing Relationship ◽  
The Impact

<p>Although childbirth is a time of happiness and joy for couples, happiness can be flawed by pain and discomfort associated with perineal trauma sustained during childbirth. It is estimated that 85% of vaginal births are accompanied by trauma to the perineum. A higher risk of trauma is sustained at the first birth compared with subsequent vaginal births. In New Zealand, midwives work in partnership with the woman. The Lead Maternity Care (LMC) midwife has an ongoing relationship with the woman in her care that starts when the pregnant woman books with the midwife and ends at six weeks postpartum. The relationship between the woman and the LMC midwife involves trust, shared control, responsibility and a shared meaning through mutual understanding. Midwives fear they will be held responsible by women who sustain severe perineal trauma during their birth for the outcome. There is a lack of research into how New Zealand midwives’ relationships are affected when women in their care sustain severe perineal trauma. This research sought to explore the experiences of LMC midwives who have cared for women who sustained severe perineal trauma during childbirth. The objective of this study was to understand the effects of severe perineal trauma on the midwife/ woman relationship. The aim was to explore LMC midwives` perception of how they were affected when women in their care sustained severe genital tract trauma during birth. Qualitative descriptive methodology was used. Face-to-face semi-structured interviews were conducted with LMC midwives from three geographical regions in lower North Island of New Zealand. The participants were eight midwives who had personal experience of caring for a woman who sustained severe genital tract trauma during childbirth. The findings revealed three themes: building a relationship with women, participants’ perceptions of the effects of severe perineal trauma on women, and the impact of severe perineal trauma on the midwife. The findings demonstrate that LMC midwives build relationships with women during the antenatal period. This relationship ensures an excellent partnership, established on the foundation of trust and respect, developed with the women. Midwives are affected on a personal and professional level when woman sustains trauma during childbirth, and the midwife adopts ways of coping. In the aftermath of severe perineal trauma, the woman may suffer health problems. This can impact her relationship with her LMC midwife during the postnatal period.</p>

scholarly journals Lead maternity care midwives' perspectives on the effect of severe perineal trauma on their relationship with women

2021 ◽  
Author(s):  
◽  
Audrene Samuel
Keyword(s):  
New Zealand ◽  
Maternity Care ◽  
Genital Tract ◽  
Postnatal Period ◽  
Perineal Trauma ◽  
Structured Interviews ◽  
Geographical Regions ◽  
Severe Perineal Trauma ◽  
Ongoing Relationship ◽  
The Impact

<p>Although childbirth is a time of happiness and joy for couples, happiness can be flawed by pain and discomfort associated with perineal trauma sustained during childbirth. It is estimated that 85% of vaginal births are accompanied by trauma to the perineum. A higher risk of trauma is sustained at the first birth compared with subsequent vaginal births. In New Zealand, midwives work in partnership with the woman. The Lead Maternity Care (LMC) midwife has an ongoing relationship with the woman in her care that starts when the pregnant woman books with the midwife and ends at six weeks postpartum. The relationship between the woman and the LMC midwife involves trust, shared control, responsibility and a shared meaning through mutual understanding. Midwives fear they will be held responsible by women who sustain severe perineal trauma during their birth for the outcome. There is a lack of research into how New Zealand midwives’ relationships are affected when women in their care sustain severe perineal trauma. This research sought to explore the experiences of LMC midwives who have cared for women who sustained severe perineal trauma during childbirth. The objective of this study was to understand the effects of severe perineal trauma on the midwife/ woman relationship. The aim was to explore LMC midwives` perception of how they were affected when women in their care sustained severe genital tract trauma during birth. Qualitative descriptive methodology was used. Face-to-face semi-structured interviews were conducted with LMC midwives from three geographical regions in lower North Island of New Zealand. The participants were eight midwives who had personal experience of caring for a woman who sustained severe genital tract trauma during childbirth. The findings revealed three themes: building a relationship with women, participants’ perceptions of the effects of severe perineal trauma on women, and the impact of severe perineal trauma on the midwife. The findings demonstrate that LMC midwives build relationships with women during the antenatal period. This relationship ensures an excellent partnership, established on the foundation of trust and respect, developed with the women. Midwives are affected on a personal and professional level when woman sustains trauma during childbirth, and the midwife adopts ways of coping. In the aftermath of severe perineal trauma, the woman may suffer health problems. This can impact her relationship with her LMC midwife during the postnatal period.</p>

scholarly journals General Practitioners providing obstetric care in New Zealand. What differentiates GPs who continue to deliver babies?

2017 ◽  
Vol 9 (1) ◽  
pp. 9 ◽  
Author(s):  
Zara Mason ◽  
Chrys Jaye ◽  
Dawn Miller
Keyword(s):  
New Zealand ◽  
Maternity Care ◽  
Obstetric Care ◽  
Shared Care ◽  
Structured Interviews ◽  
Birth Process ◽  
Professional Isolation ◽  
Local Solutions ◽  
Legislative Changes ◽  
Maternity Practice

ABSTRACT AIM To identify factors that have enabled some New Zealand general practitioner obstetricians (GPOs) to continue providing maternity care and factors implicated in decisions to withdraw from maternity care. METHOD Semi-structured interviews and one focus group (n = 3) were conducted with 23 current and former GPOs. Interviews were transcribed and analysed thematically. RESULTS Current and former GPOs practiced maternity care because they enjoyed being involved in the birth process and delivery suite environment. Their maternity practice was framed by a philosophy of lifelong continuity of care for patients. Legislative changes in New Zealand and barriers to shared care that resulted in many GPOs withdrawing from maternity care left remaining GPOs feeling professionally isolated; another reason for ceasing maternity care. Funding was perceived to be inadequate and on-call demands were both major disincentives to providing maternity and intrapartum care. Current GPOs often have strong supportive local relationships with other maternity providers when compared with those no longer practicing. Local shared care arrangements enhance professional support and reduce professional isolation. CONCLUSION GPOs still practicing in New Zealand do so because they find maternity care highly rewarding despite their perceptions that the current maternity care model is incompatible with general practice. They have often developed local solutions that support their practice, particularly around shared care arrangements.

scholarly journals Maternal socio-economic disadvantage in Aotearoa New Zealand and the impact on midwifery care

2020 ◽  
Vol 56 ◽  
pp. 26-34
Author(s):  
Lesley Dixon ◽  
Eva Neely ◽  
Alison Eddy ◽  
Briony Raven ◽  
Carol Bartle
Keyword(s):  
New Zealand ◽  
Maternity Care ◽  
Survey Methodology ◽  
Social Issues ◽  
Economic Disadvantage ◽  
Midwifery Care ◽  
Pregnancy And Childbirth ◽  
Aotearoa New Zealand ◽  
Women's Lives ◽  
The Impact

Background: Maternal socio-economic disadvantage affects the short- and long-term health of women and their babies, with pregnancy being a particularly vulnerable time. Aim: The aim of this study was to identify the key factors that relate to poverty for women during pregnancy and childbirth (as identified by midwives), the effects on women during maternity care and the subsequent impact on the midwives providing that care. Method: Survey methodology was used to identify Aotearoa New Zealand midwives’ experiences of working with women living with socio-economic disadvantage. Findings: A total of 436 midwives (16.3%) who were members of the New Zealand College of Midwives responded to the survey, with 55% working in the community as Lead Maternity Care midwives, or caseloading midwives, and the remainder mostly working in maternity facilities. The survey results found that 70% of the cohort of midwives had worked with women living with whānau (family) /friends; 69% with women who had moved house during pregnancy due to the unaffordability of housing; 66% with women who lived in overcrowded homes; and 56.6% with women who lived in emergency housing, in garages (31.6%), in cars (16.5%) or on the streets (11%). The cohort of midwives identified that women’s non-attendance of appointments was due to lack of transport and lack of money for phones, resulting in a limited ability to communicate. In these circumstances these midwives reported going to women’s homes to provide midwifery care to optimise the chances of making contact. The midwives reported needing to spend more time than usual referring and liaising with other services and agencies, to ensure that the woman and her baby/ family had the necessities of life and health. This cohort of midwives identified that women’s insufficient income meant that midwives needed to find ways to support them to access prescriptions and transport for hospital appointments. The midwives also indicated there was a range of social issues, such as family violence, drugs, alcohol, and care and protection concerns, that directly affected their work. Conclusion: Recognising the impact of socio-economic disadvantage on maternal health and wellbeing is important to improving both maternal and child health. This cohort of midwives identified that they are frequently working with women living with disadvantage; they see the reality of women’s lives and the difficulties and issues they may face in relation to accessing physical and social support during childbirth.

scholarly journals How do traditional Māori values affect the sustainability of Māori tourism businesses?

2021 ◽  
Author(s):  
◽  
Adam Ransfield
Keyword(s):  
New Zealand ◽  
Research Question ◽  
Social Science Research ◽  
Science Research ◽  
Tourism Industry ◽  
Structured Interviews ◽  
Business Sustainability ◽  
Tourism Product ◽  
Kaupapa Māori ◽  
The Impact

<p>The Māori economic asset base has seen significant growth over the past 100 years. Research estimates the Māori economy to be valued at 50 billion (NZ Foreign Affairs & Trade, 2018). While this figure represents the Māori economy, Māori tourism makes a significant economic contribution to this asset base. When considering the different aspects of the New Zealand tourism product, a key aspect that sets New Zealand tourism apart from other destinations is the unique Māori culture. This cultural aspect is a key motivating factor for international tourists intending on visiting New Zealand.  Māori tourism businesses offer a range of tourism products and services that are embedded in, and informed by Māori values. When incorporated in business, many of these traditional Māori values align closely to the three pillars of business sustainability. Literature on Māori tourism, Māori values and business sustainability provide some insight into this phenomenon. However, little is known about how these three components interrelate. Ultimately very little is known about how traditional Māori values impact the business sustainability of Māori tourism businesses. The aim of this thesis is to investigate whether Māori tourism businesses incorporate traditional Māori values into their business and if so, how does the application of these values affect the sustainability of Māori tourism businesses.  Developed from an interpretive social science research paradigm aligned with Kaupapa Māori research, this thesis assesses the impacts of the incorporation of Māori values on the business sustainability of Māori tourism businesses. Semi-structured interviews were selected as an appropriate method of data collection. 12 respondents from eight Māori tourism businesses were interviewed and their responses along with an analysis of the wider literature enabled the researcher to answer the overarching research question – how are traditional Māori values affecting the business sustainability of Māori tourism businesses?   Key research findings include the following: the importance of hiring Māori, developing cultural capacity of staff and stakeholders, preventing cultural misappropriation, providing opportunities for local communities, the relationship of Māori with the land, the importance of sustainable relationships, the impact of climate change on Kaitiakitanga, and the importance of making a profit – but not at the detriment of culture and the environment. The findings identified that to have the ability to implement sustainable practices requires financial sustainability.  This thesis makes a contribution to the literature on Māori values, Māori tourism and business sustainability by providing a greater understanding of which Māori values are applied by Māori tourism businesses and how these values impact business sustainability. In particular, this thesis has done something that previous literature has not, that is, it has attributed the specific effects of individual Māori values against the pillars of business sustainability. This gives the indication of which values have the greatest impact on business sustainability. Finally, in accordance with Kaupapa Māori research, this thesis has provided a practical contribution to the Māori tourism industry. This contribution is in the form of recommendations made to enhance the business sustainability of Māori tourism businesses.</p>

The impact of national context on future care planning for Korean parents in Korea and in New Zealand caring for their children living with disabilities: A cross-national study

2020 ◽  
pp. 002087282094962
Author(s):  
Clara Choi ◽  
Mike O’Brien
Keyword(s):  
New Zealand ◽  
Planning Process ◽  
National Study ◽  
Care Planning ◽  
Care Provision ◽  
Structured Interviews ◽  
Korean Parents ◽  
Future Care ◽  
Cross National Study ◽  
The Impact

An increasing concern of families caring for children living with disabilities is related to planning for their future care. This qualitative study explores how the country contexts shape the plans for future care provision of Korean parents in New Zealand and Korea. Data were collected using semi-structured interviews with parents ( n = 18) and professionals ( n = 18). The study revealed that there are differences and similarities regarding the social reality of future care planning among Koreans in different national contexts. Recommendations are made In support of future care planning process taking its place as a conventional phase of care provision for people living with disabilities.

The art of delegation: integration of the veterinary nursing assistant into New Zealand veterinary practice

2021 ◽  
Vol 12 (10) ◽  
pp. 484-491
Author(s):  
Angela C Young
Keyword(s):  
New Zealand ◽  
Patient Outcomes ◽  
Nursing Assistants ◽  
Business Success ◽  
Nursing Assistant ◽  
Job Descriptions ◽  
Structured Interviews ◽  
Workload Management ◽  
Veterinary Practice ◽  
The Impact

Background: In 2016 veterinary nursing assistants (VNAs) were introduced as an additional tier to New Zealand veterinary practice. Aim: This study explores the utilisation of VNAs in New Zealand veterinary practices to ascertain the impact of an additional staffing layer to patient outcomes, workload management and staff wellness. Method: Through focus groups and semi-structured interviews with 30 participants, three themes emerged allowing evaluation of the Allied Veterinary Professionals Regulatory Council (AVPRC) Scope of Practice (SP) (AVPRC, 2020) and development of delegation guidelines (DG). Results: Analysis identified weak processes in delegation. The practice-based perspectives of VNA staff utilisation supports the AVPRC SP. Conclusion: Effective communication of the SP and DG for veterinary practice utilisation could contribute to reducing workload pressure. Additionally, individual practice staff discussions regarding own and colleague job expectations, along with review of contractual job descriptions, could further evolution of multi-tiered practices leading to improved patient outcomes, team wellness and business success.

scholarly journals Clients Coming Out – Men speak out about purchasing sex in New Zealand’s decriminalised environment

2021 ◽  
Author(s):  
◽  
Shannon Mower
Keyword(s):  
New Zealand ◽  
Coming Out ◽  
Sex Workers ◽  
Well Being ◽  
Human Interaction ◽  
Sex Industry ◽  
Contextual Knowledge ◽  
Structured Interviews ◽  
Worker Rights ◽  
The Impact

<p>This thesis explores the client experience of purchasing sex in New Zealand in the context of decriminalisation. This research was conducted at a time when speculation over the impact of decriminalisation on the conduct of clients was at an all-time high. Despite vast speculation by critics, little to no research exists on client populations in New Zealand. This thesis addresses this knowledge gap and offers an initial insight into the experiences of clients in this context. The research that forms the basis of this thesis involved qualitative semi-structured interviews with 12 men and women who purchase sex in New Zealand, along with three key informants with broader contextual knowledge of clients. The clients interviewed constituted a diverse group, and in many ways, they challenged common stereotypes. For example, while all participants were motivated by sexual desire, half the sample placed more significance on their desire for human interaction. Hegemonic masculinity was also discussed as motivating their engagements with the sex industry. The interviews also revealed the impacts of purchasing sex on participants, which related more to their interactions with sex workers than the physical act of having sex. Lastly, the research explored participants’ interactions with sex workers under decriminalisation, finding that they emphasised clear communication, respect of sex worker’s boundaries, and a desire to purchase sex ethically. There are three key conclusions of this thesis. Firstly, that client stereotypes are inapplicable to the entire client population as the participants challenged many and provided support for the ‘every man perspective’. Second, that support exists for non-sexual client motivations, and following the impacts participants discussed, sex workers and their services can be considered therapeutic and supporting the well-being of participants. Lastly, that legal context does make a difference on the conduct within sex industries and under decriminalisation. The participants’ conduct was driven by an awareness for sex worker rights and working conditions, thus producing an informed, harm-reductionist approach to purchasing sex.</p>

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