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Item Awareness, support, and opinions of healthy food and drink policies: a survey of staff and visitors in New Zealand healthcare organisations.(BioMed Central Ltd, 2024-08-12) Gerritsen S; Rosin M; Te Morenga L; Jiang Y; Kidd B; Shen S; Umali E; Mackay S; Ni Mhurchu CBackground In 2016, a voluntary National Healthy Food and Drink Policy (hereafter, “the Policy”) was released to encourage public hospitals in New Zealand to provide food and drink options in line with national dietary guidelines. Five years later, eight (of 20) organisations had adopted it, with several preferring to retain or update their own institutional-level version. This study assessed staff and visitors’ awareness and support for and against the Policy, and collected feedback on perceived food environment changes since implementation of the Policy. Methods Cross-sectional electronic and paper-based survey conducted from June 2021 to August 2022. Descriptive statistics were used to present quantitative findings. Free-text responses were analysed following a general inductive approach. Qualitative and quantitative findings were compared by level of implementation of the Policy, and by ethnicity and financial security of participants. Results Data were collected from 2,526 staff and 261 visitors in 19 healthcare organisations. 80% of staff and 56% of visitors were aware of the Policy. Both staff and visitors generally supported the Policy, irrespective of whether they were aware of it or not, with most agreeing that “Hospitals should be good role models.” Among staff who opposed the Policy, the most common reason for doing so was freedom of choice. The Policy had a greater impact, positive and negative, on Māori and Pacific staff, due to more frequent purchasing onsite. Most staff noticed differences in the food and drinks available since Policy implementation. There was positive feedback about the variety of options available in some hospitals, but overall 40% of free text comments mentioned limited choice. 74% of staff reported that food and drinks were more expensive. Low-income staff/visitors and shift workers were particularly impacted by reduced choice and higher prices for healthy options. Conclusions The Policy led to notable changes in the healthiness of foods and drinks available in NZ hospitals but this was accompanied by a perception of reduced value and choice. While generally well supported, the findings indicate opportunities to improve implementation of food and drink policies (e.g. providing more healthy food choices, better engagement with staff, and keeping prices of healthy options low) and confirm that the Policy could be expanded to other public workplaces.Item Disabled people's experiences accessing healthcare services during the COVID-19 pandemic: a scoping review.(BioMed Central, 2023-04-06) McBride-Henry K; Nazari Orakani S; Good G; Roguski M; Officer TNBACKGROUND: Disruptions to healthcare services during the COVID-19 pandemic are well-recognised problems. However, a dearth of research exists on disabled people's experiences with accessing these services. A scoping review was undertaken to identify and explore research on the experience of disabled people in accessing healthcare services between 2020 and 6 February 2023. METHODS: PubMed, Web of Science, CINAHL, and OVID were employed to search for research that included the voice of disabled people, or their parents or caregivers. Over two distinct phases, a total of 2,201 articles were reviewed according to article titles, keywords, and abstracts. Eighty-one studies were identified that met the inclusion criteria; these were reviewed in full. RESULTS: Eighteen studies specifically described the experiences of accessing healthcare or disability services, and sixty-three raised healthcare challenges as a secondary consideration. Many disabled people struggled to access healthcare services and felt they were invisible; as a result, individuals' mental health was negatively affected. Disabled people with compounding vulnerabilities were at the most risk of experiencing a lack of healthcare access. CONCLUSIONS: There is an urgent need for research and policy that is responsive to disabled people's access to healthcare during the pandemic; currently many health policies are 'disability-blind' and exclude these members of the global community. Furthermore, to assist in creating disability-responsive research, funding needs to prioritise researchers within the disabled community.Item Item Integrative medicine : a contested practice : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Albany, New Zealand(Massey University, 2012) Madden, HelenIn contemporary Western society, the healthcare arena has become increasingly technology-based, rationalised and specialised with alternative forms of medicine being taken up alongside orthodox medicine. This shifting healthcare terrain has brought forth challenges to practitioners' and patients' identity and to the practitioner-patient relationship. Today, the expertise and autonomy underpinning general practitioners' professional identity has been challenged. In parallel, patients have become reconceptualised from subjects in need of medical expertise, to 'informed' and 'active' health consumers. Within this fluid healthcare arena integrative medicine (IM) is emerging, a practice which amalgamates orthodox medicine with forms of alternative medicine. This emerging form of healthcare produces a number of paradoxes. These occur around the paradigm clash between treatment philosophies, issues of professionalism and the standardisation of treatments, power relationships and debates around dominance and subordination, and issues relating to patient autonomy and treatment responsibility. A discursive analysis of IM practitioners' and patients' talk reveals that the practice of IM gives rise to a number of contradictions and challenges for both IM practitioners and patients. Practitioners draw on discourses of holism, liberal humanism, spirituality and empowerment to construct IM as a healthcare model which maintains elements of both allopathic and alternative medicine in place, but also to legitimate practices inherent in IM. Through doing so, they reconstruct their medical professional identity. In conjunction, patients' draw on practitioners' extended knowledge-base and open-mindedness to construct IM practitioners as trustworthy professionals and to legitimate their own engagement in exploratory forms of treatment. This has implications for patients' and practitioners' subjectivity. Patients become individuals who deserve to be understood on a multitude of levels: psychologically, spiritually, emotionally and physically through which they gain recognition. Concurrently, practitioners' become placed in a paradoxical position with respect to their practice. They resolve this by resisting the position of biomedical expert and by incorporating a range of alternative medicine treatments to extend the healthcare they offer to patients. In conclusion, the practice of IM is shown to legitimate patients' engagement in self-reflexivity practices and to reproduce Cartesian dualism. Further, the research reveals how discourses of holism and empowerment, that are held to represent the fundamental difference between allopathic and alternative medicine, are drawn on by practitioners to legitimate a more in depth practice and a deeper level of engagement with patients. Finally, the research questions whether IM constitutes a truly 'integrative' medicine.Item Telehealth practice in eight countries : New Zealand, Australia, the USA, Canada, UK, Malaysia, China and India : a thesis presented in partial fulfillment of the requirements of degree of Master in Information Science at Massey University, Albany campus, Auckland, New Zealand(Massey University, 2012) Altharthi, Mansour SaeedThis research examines the telehealth adoptions and developments in eight selected countries: New Zealand, Australia, the United States, Canada, UK, Malaysia, China and India. An array of methods has been employed into this research, such as PEST, SWOT, and CSF analysis. Each country has been studied individually and then all eight countries have been discussed together through comparisons from various perspectives. Thereafter, the conclusions summarize the key findings and then some recommendations are offered. The studied countries all have certain needs of telehealth; however, these needs vary due to every country’s particular conditions of demographic features, economic development, social and cultural diversity. The development of telehealth in these countries heavily depends on the countries’ healthcare system, countries’ priorities of healthcare needs, decision makers’ vision in telehealth; as well as the development of telecommunication networks and the training level of end users. It is believed that telehealth will help to improve the healthcare service in all of the eight countries. Through the comparison and discussion, the eight countries are found to share some points in common, which can be highlighted as general CSFs: standardization, legislation and regulation, business modelling and program evaluation, financial constraints, and need of more trained professionals into telehealth. While giving some recommendations to each country’s development of telehealth, this thesis also suggested that future development of telehealth may have three priorities: further and continuous improving design and research in technical perspective, re-examination of the current healthcare system thus adjust it to suit telehealth development, and staying with an international perspective. This topic is suggested for further research, with particular interest in extending to some country/region with very small territory and high population density.Item Bayesian networks in healthcare: Distribution by medical condition(2020-07) McLachlan, S; Dube, K; Hitman, GA; Fenton, NE; Kyrimi, E
