A call for culture-centred care: exploring health workers' perspectives of positive care experiences and culturally responsive care provision to Aboriginal women and their infants in mainstream health in South Australia

Background - Aboriginal women and their infants experience significant disadvantage in health outcomes compared to their non-Aboriginal counterparts. Access to timely, effective, and appropriate maternal and child health care can contribute to reducing these existing health disparities. This research sought to explore factors that contribute to continuity of care for Aboriginal women and their infants living in metropolitan South Australia. This paper reports on the perspectives of health care workers in mainstream health services from the antenatal period to the end of an infants’ second birthday. It explores health workers’ perspectives of what contributes to positive care experiences and satisfaction with care provided to Aboriginal women and their infants in mainstream health. Methods - Eight focus groups were held with 52 health professionals. Participants included Aboriginal Cultural Child and Family Support Consultants (n = 7), Aboriginal Maternal Infant Care Workers (n = 3), Midwives (n = 3) and Child and Family Nurses (n = 39). Data was inductively coded and thematically analysed. Results - Three key themes emerged: the system takes priority, culture is not central in approaches to care, and ‘we’ve got to be allowed to do it in a different way’. Conclusions - This research highlights a lack of continuity of care for Aboriginal families accessing mainstream health services from the antenatal period through to an infants’ first 1000 days of life. This research has implications for communities, and it calls for strategies to enhance continuity, and healthcare services to provide appropriate and culturally safe care. Findings will inform and guide future changes to improve continuity of care for Aboriginal families and infants in the first 1000 days

Netnography: A novel methodology for nursing research

Aim: The aim of this paper is to critically reflect on our team's experience of using netnography to explore vaccine-hesitant parents and pregnant women, a group who have traditionally been difficult to recruit to research studies and a methodology that is underutilized in nursing research. Design: This paper takes the form of a discussion paper that will utilize data obtained from a qualitative netnographic study. Relevant literature was searched including 2015–2023. Method: This paper utilized data obtained from a qualitative study that used netnography as methodology and an online minable data source. Netnography is a relatively new methodology that uses the online environment to explore digital cultures and study networked society. It pays particular attention to cultural insights and conditions that impact the human experience. This methodology is particularly relevant to nursing research which is often humanistic and always conducted to ensure optimal patient outcomes. Results: Using netnography for the first time has resulted in four main insights. These include the adaptability of the process; the creativity involved in designing the site; the ready acceptance of the site by participants and the co-creation knowledge that resulted. Conclusions: Netnography is a creative methodology that was successful in accessing and engaging the vaccine-hesitant community, a group who are often marginalized. Netnography has the advantage of using a platform that is familiar and safe for many people and provides access to an extensive minable data source

Sámi language in Norwegian healthcare: “He speaks good enough Norwegian, I don’t see why he needs an interpreter”

Introduction: The Indigenous people of Norway are legally entitled to use their Sámi language in encounters with healthcare services, yet these encounters are generally conducted in Norwegian language. The right to Sámi language and culture in health is particularly relegated when Sámi healthcare personnel is not present. This neglect of Sámi language and culture in the Norwegian healthcare system impacts on the quality of care Sámi patients receive. Aim: This paper describes and interprets healthcare interactions between nurses and Sámi-speaking patients in Norway. Method: Qualitative semi-structured focus group interviews were conducted with Sámi (n = 13) and Norwegian nurses (n = 10). Participants were included if they had experience working with Sámi-speaking patients and two years clinical practice in the Sámi area of northern Norway. Interpretive and descriptive analyses were conducted. Findings: Obtaining only basic patient information and lack of mapping of native language in admission documents or patient notes makes it challenging to recognise Sámi patients. In encounters with Sámi patients, Norwegian nurses must navigate linguistic challenges with an additional layer of interplay between culture and care. Misunderstandings in this area can undermine patient safety and be directly contrary to health legislation and patient rights. As remedy, Sámi nurses often improve the nurse–patient dialogue by translating and explaining cultural nuances, thus improving understanding of healthcare interactions, and bridging the gap to the Norwegian staff. Conclusion: To integrate Sámi language and culture into nursing care new guidelines to implement knowledge of Sámi patients’ culture and language rights in healthcare education is needed. In addition, the authorities have to facilitate implementation of laws and regulations, research and guidelines in practical health care. At last, the number of Sámi-speaking nurses has to increase

Samarbeid om brukerstyrte tjenester i ettervern: Et samarbeidsprosjekt på rusfeltet mellom ideell sektor, kommuner, spesialisthelsetjenesten og forskere

Bruker og pårørendeorganisasjonen A-larm, Blå Kors klinikk, Loland, Vennesla kommune, Grimstad kommune og forskningsinstituttet Norwegian Research Centre AS (NORCE), gikk sammen om et treårig prosjektsamarbeid for å utvikle og prøve ut et nytt tiltak som kombinerer brukerstyrte seng og likepersonoppfølging til mennesker med utfordring knyttet til rus. Målgruppen var voksne personer i rehabilitering etter endt behandling ved Blå Kors klinikk, Loland. Dette nye tiltaket søkte å utvikle en oppfølgingsmodell som kan forebygge tilbakefall og reinnleggelser ved at målgruppen får mulighet til å benytte seg av brukerstyrte senger på Loland i den sårbare overgangen fra institusjon til egen bolig. Kombinert med avtale om brukerstyrt seng har deltakerne i prosjektet blitt koblet til en likeperson i A-larm, som har fulgt deltakerne som supplement til ordinære tjenester fra kommuner og spesialisthelsetjeneste.Samarbeid om brukerstyrte tjenester i ettervern: Et samarbeidsprosjekt på rusfeltet mellom ideell sektor, kommuner, spesialisthelsetjenesten og forskerepublishedVersio

En som alltid vil lete etter meg (ref. deltaker): Likemannstjenesten i Stavanger, Sola og Sandnes

I denne rapporten presenteres likemannstilbudet «Samarbeid om ettervern i Stavanger, Sola og Sandnes kommune», som ble gjennomført i perioden 2019–2021. Likemannstjeneste er et oppfølgingstiltak etter institusjonsbehandling for rusavhengighet og et ettervernstiltak i rusomsorgen. En viktig målsetting for satsingen har vært å øke og supplere kapasiteten i kommunenes oppfølgingsarbeid på rusfeltet, ved hjelp av større involvering fra frivillig sektor og bruk av erfaringsbasert kunnskap. 36 personer med et betydelig rusproblem fikk oppfølgning av likemenn fra A-larm i prosjektperioden. Tilbakemeldingene fra deltakere som har fått dette tilbudet er samstemte: Likemannstjenesten har hatt stor betydning for dem. Dette ønsker de å formidle de til dem som skal bestemme skjebnen for satsingen videre. Noen faktorer synes å være helt avgjørende for denne opplevelsen hos deltakerne. Stor fleksibilitet er en slik faktor, og at en er tettere på. Erfaringsbasert kompetanse er en annen faktor som må være der, noe som blir ivaretatt gjennom den rollemodellen en likemann representerer. Den tredje faktoren er å bidra til at deltakerne får sosiale rusfrie nettverk, som er viktig for de som har levd i et rusmiljø over lengre tid. Samarbeidsmodellen en har benyttet er videreutviklet og styrket til et nivå som er hensiktsmessig for formålet den skal tjene. Tilbudet har også vært gitt i en tid med koronapandemi, det vil si en tid hvor mange andre tilbud til denne målgruppen har vært stengt ned.publishedVersio

«Du lurer ikke en luring» (ref. likeperson): Likepersontjeneste i Bergen for mennesker med utfordringer knyttet til rus

Rapporten utforsker erfaringer fra ansatte som jobber som likepersoner på bakgrunn av erfaringer de har fra egne rusutfordringer. I undersøkelsen kommer det frem hvordan det å jobbe som likeperson også representerer en åpning og videre vei inn i et ordinært arbeidsliv. Dette medfører også et behov for en generell opplæring om «det å være tilknyttet arbeidslivet», i tillegg til opplæring for å utøve selve jobben som likeperson. Det mest sentrale i opplæring og oppfølging er likevel knyttet til hvordan likepersonene kan benytte sin egen recovery-kompetanse ovenfor deltaker i deltakers egne recovery-prosesser. Funnene fra likepersontjenesten i Bergen tyder også på at likepersonene selv har behov for stor grad av fleksibilitet i tjenesten og deres eget arbeid, at det gis rom for læring underveis, og at likepersonene også får muligheter til å fortsette deres egen recovery-prosesser. Gjenkjennelse er en kjernekomponent som kommer frem i materialet fra likepersonprosjektet i Bergen, og som vi også finner i materiale fra andre komparative studier vi har gjort i Norge. Potensialet som ligger i gjenkjennelser i relasjonen mellom deltaker og likeperson skiller seg fra relasjoner deltaker har til fagpersoner de møter i andre (oppfølgings)tjenester. Dette skaper en form for nærhet mellom deltaker og likeperson, hvor det ellers ofte oppleves en distanse mellom deltaker og fagperson. Likeperson og deltaker møter hverandre på et mer likeverdig grunnlag, siden utgangspunktet for dem begge er egenopplevde erfaringer knyttet til rus, behandling og recovery. Dette skaper en arena som ofte får en større grad av åpenhet, direkte samtaleform og mulighet til å være nettopp direkte, utfordrende og ærlig i relasjonen mellom likeperson og deltaker.publishedVersio

Likepersontjenesten i A-larm – Fra prosjekt til varig tilbud

Prosjektet denne rapporten utgår fra var et treårige prosjektsamarbeid der bruker- og pårørendeorganisasjonen A-larm, Kristiansand kommune (tidligere Søgne kommune) og forskningsinstituttet Norwegian Research Centre (NORCE), gikk sammen for å utvikle en tjeneste til mennesker i den sårbare overgangsfasen mellom rusbehandling og/eller fengsel til et liv i en norsk kommune. Prosjektet fikk innvilget tilskudd våren 2019 under Helsedirektoratets tilskuddsordning Aktivitetstilbud rettet mot personer med psykiske problemer, rusmiddelproblemer eller prostitusjonserfaring, og har i hovedsak pågått i perioden 2019–2021.Likepersontjenesten i A-larm – Fra prosjekt til varig tilbudpublishedVersio

Pushed to the Fringe – The Impact of Vaccine Hesitancy on Children and Families

Vaccine hesitancy has been described as any delay or refusal of vaccines despite their availability and is increasing in Australia and other middle to high-income countries. The aim of this study is to gain a deep understanding of the experiences and influences on vaccine hesitant children and their families. A qualitative interview approach was undertaken with vaccine hesitant parents and pregnant women (n = 12). Semi-structured interviews were conducted by telephone. Inductive thematic analysis was undertaken on data obtained using the guidelines of Braun and Clarke. Three main themes were identified in this study, including Pushed to the fringe; A culture of Distrust; and Coerced choices. The study revealed that vaccine hesitant parents felt isolated and pushed to the fringe of society. They also expressed dissatisfaction with the Australian “No Jab – No Pay” and “No Jab – No Play” legislation. This contributed to feelings of marginalization. Participants also cited a breakdown in the therapeutic relationships, which impacted their child’s health. Additionally, a lack of sufficient information was received to achieve informed consent. These results suggest that there is a need for enhanced education for some health-care professionals, many of whom have reported being confronted by conversations with vaccine hesitant parents

Mental health, wellbeing, and support needs of nursing students – ‘Help! I’m overwhelmed, I need an extension’

Source at https://anmj.org.au/mental-health-wellbeing-and-support-needs-of-nursing-students-help-im-overwhelmed-i-need-an-extension/.High and increasing prevalence rates of mental health problems among young people mean that youth mental health is a key priority for policymakers worldwide

Staff perceptions of support for early menarche in Australian primary schools: a qualitative study

The age of the onset of menstruation, termed menarche, has been declining for decades worldwide. Approximately 12% of Australian girls reach menarche between eight to 11 years of age. Current health and physical education subject guidelines from the Australian Curriculum Assessment and Reporting Authority state that puberty education should be introduced to students between year levels five to six (ages 10–12) when many have already begun puberty. To explore how girls experiencing early menarche are currently supported in Australian primary schools, semi-structured telephone interviews were conducted with 15 primary school staff from separate schools, including teachers, principals, a school services officer, and a school counsellor. Thematic analysis identified three main themes, (1) the prevalence of deficit models of early menarche and children’s capacity to know; (2) gendered gatekeeping of menstruation knowledge; and (3) systemic barriers and inconsistencies in menstruation education. Our analysis complements but extends recent calls for improvements to menstruation education in Australian schools. Affirmative menstrual support practices and facilities are needed in primary schools to normalise and encourage conversations with students about menarche and menstruation irrespective of age, gender, class or culture