Journal Articles

Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915

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    Reconciling Paid Work and Informal Caregiving Among Older Adults: Implications for Work Interference With Family.
    (Oxford University Press, 2023-10-06) Koreshi SY; Alpass F; Leggett AN
    BACKGROUND AND OBJECTIVES: Many older adults who combine paid work and informal caregiving responsibilities are often in work arrangements that differ from their preference. There is reason to believe that such work status incongruence may lead to work interference with family (WIF). In response, many governments have policies that support flexible work arrangements (FWA) to help individuals manage work and family commitments. This paper examines whether work status preferences contribute to WIF for older adults who combine work and care and whether the use of flexible work arrangements moderates this relationship. RESEARCH DESIGN AND METHODS: The study included 610 informal caregivers (aged 55-70 years) in paid employment who participated in either the 2018 or 2020 waves of the New Zealand Health, Work and Retirement study. Using a simple moderation analysis with demographic controls, the effects of work status preferences and FWAs on WIF were estimated. RESULTS: After controlling for confounds, significant main effects were found for both work status preferences and flexible work arrangements on WIF. The moderation analysis revealed that involuntary part-timers using flexible time-off arrangements reported lower levels of WIF. However, other types of flexible work arrangements did not moderate the relationship between work status preferences and WIF. DISCUSSION AND IMPLICATIONS: These findings suggest that work status preferences can contribute to WIF, but not all types of flexible work arrangements alleviate it. Policy initiatives designed to reduce WIF for those combining work and care should consider accounting for differences in the work status preferences of older workers.
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    Reciprocal relations between cardiovascular disease, employment, financial insecurity, and post cardiac event recovery among Māori men: a case series.
    (BioMed Central Ltd, part of Springer Nature, 2023-11-12) Lisipeki S; Masters-Awatere B; Hodgetts D; Liew TV
    BACKGROUND: Disparities in cardiovascular outcomes between Māori and non-Māori persist despite technological advances in the treatment of cardiovascular disease and improved service provision. Little is known about how social determinants of health, such as income [in]security affect Māori men's access, treatment, and recovery from cardiovascular disease. This paper explores the contexts within which cardiovascular disease is experienced and healthcare becomes embedded. METHODS: This study utilized a case-comparative narrative approach to document and make sense of the patient experiences of four male Māori patients who, in the previous 6 months, had come through cardiac investigation and treatment at Waikato Hospital, a large tertiary cardiac center in New Zealand. Participant accounts were elicited using a culturally patterned narrative approach to case development, informed by Kaupapa Māori Research practices. It involved three repeat 1-3-hour interviews recorded with participants (12 interviews); the first interviews took place 5-16 weeks after surgery/discharge. RESULTS: Each of the four case studies firstly details a serious cardiac event(s) before describing the varying levels of financial worry they experienced. Major financial disruptions to their lives were at the forefront of the concerns of those facing financial insecurity-as opposed to their medical problems. Financial hardship within the context of an unresponsive welfare system impacted the access to care and access to funding contributed to psychological distress for several participants. Economic security and reciprocal relationships between employers and employees facilitated positive treatment experiences and recovery. CONCLUSION: Findings suggest that although multiple factors influence participant experiences and treatment outcomes, financial [in]security, and personal income is a key determinant. The heterogeneity in participant narratives suggests that although general inequities in health may exist for Māori as a population group, these inequities do not appear to be uniform. We postulate diverse mechanisms, by which financial insecurity may adversely affect outcomes from treatment and demonstrate financial security as a significant determinant in allowing patients to respond to and recover from cardiovascular disease more effectively.
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    Understanding the use of Flexible Work Arrangements Among Older New Zealand Caregivers
    (SAGE Publications, 2023-05) Koreshi SY; Alpass F
    Flexibility in the workplace has been suggested to promote prolonged employment among older workers. This study focuses on the question of whether the use of flexible work arrangements (FWAs) differs between caregivers and non-caregivers and how potential differences can be explained. Participants were 296 carers and 1611 non-carers (aged 55–70 years) who completed the 2018 Health, Work and Retirement survey and were in paid employment. Hierarchical regression was used to investigate caregiving as an independent predictor of use of FWAs after controlling for demographic and work-related variables. Results show that caregivers on average used more FWAs than non-caregivers, including flexible work hours, flexible schedules and time off. Differences in FWAs use between caregivers and non-caregivers cannot be explained by differences in socio demographic and work characteristics. The use of FWAs warrants attention in discussions about prolonged employment and reconciliation of care and work among older adults.
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    Employing nurse practitioners in general practice: an exploratory survey of the perspectives of managers
    (CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners, 2021-09) Mustafa M; Adams S; Bareham C; Carryer J
    INTRODUCTION: Establishing the nurse practitioner (NP) workforce in New Zealand is a viable solution to health and workforce challenges in primary health care. General practices have been slow to implement NP services. Managers of general practices are central to the employment and development of NP roles. AIM: To explore the perspectives of managers on employing NPs in general practice. METHODS: An electronic survey was used to collect demographic and numerical data, which were analysed descriptively and analytically using SPSS (version 26). Written answers to open-ended questions were analysed qualitatively. RESULTS: In total, 143 managers participated in the survey (response rate 39.7%); 54 (37.8%) worked in practices employing at least one NP. Of respondents, 88.9% (n = 127) agreed or strongly agreed that NPs could enhance continuity of care (89/143, 62.2%), improved access to services and medications (89/143, 62.2%) and filled a gap that added value to health care (97/143, 67.8%). Practices employing NPs had statistically significant higher levels of agreement about the advantages of NPs than practices not employing NPs. Challenges and enablers to employing NPs were themed under organisational environment, NP scope of practice and role, and NP workforce development. DISCUSSION: This exploratory study revealed that there is little knowledge about the NP workforce in surveyed general practices. Ongoing work is required to improve knowledge for employing general practices, including dissemination of information about NP education and training, scope and models of care, and ability to generate business income.