Annette Huntington

Deviant (M)others: The construction of teenage motherhood in contemporary discourse

Paradoxically, the focus on teen motherhood as an object of concern in the West has coincided with declining rates of teen birth. This suggests that the view of teenage motherhood as problematic is underpinned by changing social and political imperatives regarding the role of women in these countries. This article examines the literature surrounding teenage motherhood from the United States, United Kingdom and New Zealand, and explores the way in which normative perceptions of motherhood have shifted over the past few decades to position teenage mothers as stigmatised and marginalised. Two specific discourses – those of welfare dependency and social exclusion – are highlighted, and their mediation through scientific discourses examined. The increasing trend to evidence-based policy development has masked the ideological basis of much policy in this area and highlights the importance of critical evaluation of the discourses surrounding teenage motherhood. A critical examination of the literature suggests that teenage mothers are vilified, not because the evidence of poor outcomes for teen mothers and their children is particularly compelling, but because these young women resist the typical life trajectory of their middle-class peers which conforms to the current governmental objectives of economic growth through higher education and increased female workforce participation.

Cohort Profile: The Nurses and Midwives e-Cohort Study—A Novel Electronic Longitudinal Study

Nurses and midwives comprise the largest professional group in most national health systems, so shortfalls in numbers can have a substantial impact on health care delivery. A scarcity of human resources in health has been internationally recognized and has led the International Council of Nurses to launch the Global Workforce Project in 2004, and the World Health Organization to announce the Health Workforce Decade 2006–15 in 2006.1,2 Efforts to address workforce needs through coherent workforce planning and policy setting are hampered by the complexity of predicting the supply of and demand for nurses and midwives, and the challenges associated with understanding drivers of workforce retention.3 Available workforce descriptors among regulatory authorities vary considerably; and collections are mostly cross-sectional, frequently incomplete and typically limited to administrative databases. In Australia and New Zealand, workforce issues include the migration of staff between states and countries, and critical personnel shortages in rural and . . . [Full Text of this Article]

The impact of endometriosis on work and social participation

Endometriosis is a debilitating chronic disease that can affect many aspects of everyday life owing to symptoms such as pain and fatigue. This paper reports the findings of a study exploring the impact of symptomatic endometriosis on womens social and working life. The study used a feminist approach. Eighteen women were interviewed and a thematic approach used to analyse the data. The analysis is structured around three themes focusing on issues around disclosure of symptoms in the work place; the impact of symptoms on work, education and social participation; and the strategies used by women in the study to manage endometriosis. A range of health and employment implications are discussed in this paper. In particular, nurses can provide useful support to women by careful assessment and prompt referral for diagnostic procedures and by providing timely and comprehensive information, including information about the lifestyle and nutritional factors recommended by women with endometriosis.

Obesity in pre-school children: issues and challenges for community based child health nurses

Abstract Childhood obesity is becoming a topical issue in both the health literature and the popular media and increasingly child health nurses are observing preschool children who appear to be disproportionately heavy for their height when plotted on standardized growth charts. In this paper literature related to childhood obesity in New Zealand and internationally is explored to identify current issues, and the implications of these issues for nurses in community based child health practice are discussed. Themes that emerged from the literature relate to the measurement of obesity, links between childhood and adult obesity and issues for families. A theme in the literature around maternal perception was of particular interest. Studies that investigated maternal perceptions of childhood obesity found that mothers identified their child as being overweight or obese only when it imposed limitations on physical activity or when the children were teased rather than by referring to individual growth graphs. The implications for nursing in the area of child health practice is discussed as nurses working in this area need an understanding of the complex and often emotive issues surrounding childhood obesity and an awareness of the reality of peoples lives when devising health promotion strategies.

Family violence: Walking the tight rope between maternal alienation and child safety

Abstract Mothers are often alienated from their children when child abuse is suspected or confirmed, whether she is the primary abuser of the child or not. An abusive or violent partner often initiates the process of maternal alienation from children as a control mechanism. When the co-occurrence of maternal and child abuse is not recognised, nurses and health professionals risk further alienating a mother from her child/ren, which can have detrimental effects in both the short and long term. Evidence shows that when mothers are supported and have the necessary resources there is a reduction in the violence and abuse she and her children experience; this occurs even in situations where the mother is the primary abuser of her children. The family-centred care philosophy, which is widely accepted as the best approach to nursing care for children and their families, creates tension for nurses caring for children who are the victims of abuse as this care generally occurs away from the context of the family. This fragmented approach to caring for abused children can inadvertently undermine the mother-child relationship and further contribute to maternal alienation. This paper discusses the complexity of family violence for nurses negotiating the ‘tight rope’ between the prime concern for the safety of children and further contributing to maternal alienation, within a New Zealand context. The premise that restoration of the mother–child relationship is paramount for the long-term wellbeing of both the child/ren and the mother provides the basis for discussing implications for nursing practice.

Engaging With Patient Online Health Information Use: A Survey of Primary Health Care Nurses

Internet health information is used by patients for health care decision making. Research indicates this information is not necessarily disclosed in interactions with health professionals. This study investigated primary health care nurses’ engagement with patient online health information use along with the respondents’ disclosure of online sources to their personal health care provider. A questionnaire was posted to a random sample of 1,000 New Zealand nurses with 630 responses. Half the respondents assessed patients’ online use (n = 324) and had encountered patients who had wrongly interpreted information. Health information quality evaluation activities with patients indicated the need for nursing information literacy skills. A majority of respondents (71%, n = 443) used online sources for personal health information needs; 36.3% (n = 155) of the respondents using online sources did not tell their personal health care provider about information obtained. This study identifies that there are gaps in supporting patient use but more nursing engagement with online sources when compared with earlier studies.

Getting to the Heart of the Story: Using Talanoa to Explore Pacific Mental Health.

Talanoa is an established format for generating discussion about complex topics used throughout the Pacific. Pacific researchers use talanoa to gather data with migrant Pacific Island populations, in countries such as the United States of America, Australia, and Aotearoa/New Zealand (A/NZ). Using talanoa in this way, changes the way that the approach is used as, on the one hand it is out of its original context, and on the other hand, extends its use to gather data with Pacific Islanders. In this article, we discuss the implementation of talanoa in an explorative qualitative research project, and discuss its effectiveness and usefulness for getting to the heart of the story about Tongan interpretations of mental illness and distress.

A missing piece of the workforce puzzle. The experiences of internationally qualified nurses in New Zealand: a literature review.

Aim: To analyse the literature regarding the context and experiences of internationally qualified registered nurses, particularly Filipino and Indian nurses, who have transitioned to New Zealand. Background: Internationally qualified nurses are a significant proportion of the nursing workforce in many developed countries including New Zealand. This is increasingly important as populations age, escalating demand for nurses. Understanding the internationally qualified nurse experience is required as this could influence migration in a competitive labour market. Design: Examination of peer-reviewed research, policy and discussion documents, and technical reports. Method: A systematic literature search sought articles published between 2001 and 2014 using Google Scholar, CINAHL, and Medline. Articles were critically appraised for relevance, transferability, and methodological rigour. Results: Fifty-one articles met inclusion criteria and demonstrate internationally qualified nurses face significant challenges transitioning into New Zealand. Conclusion: The internationally qualified nurse experience of transitioning into a new country is little researched and requires further investigation.

Medical education and informal teaching by nurses and midwives

Objectives The aim of this study was to examine the contribution of nurses and midwives to the education of medical colleagues in the clinical context. Methods The research design was a cross-sectional survey using an online questionnaire. A subsample of 2906 respondents, from a total of 4763 nurses and midwives participating in a web-based study, had taught doctors in the 12 months prior to the survey. The questionnaire generated mainly categorical data analysed with descriptive statistics. Results In the group of respondents who taught doctors (n =2906), most provided informal teaching (92.9%, n=2677). Nearly a quarter (23.9%, n=695) self-rated the amount of time spent teaching as at least moderate in duration. The most common named teaching topics were documentation (74.8%, n=2005) and implementing unit procedures (74.3, n=1987), followed by medication charting (61.9%, n=1657) and choosing correct medications (55.8%, n=1493). Respondents felt their contributions were unrecognised by the doctors and students they taught (43.9%, n=1256). Conclusions Educational contributions while unrecognised could be considered positively by the respondents. However, discussion of teaching responsibilities is necessary to support the development of teaching protocols and supervision responsibilities as respondents reported teaching clinical medical tasks related to medications, consent and other skills within the medical domain. Study limitations include the nature of self-reported responses which cannot be validated and data drawn from a survey concluded in 2009.

A multicase study of prolonged critical illness in the intensive care unit: Families’ experiences

BACKGROUND It is widely acknowledged a critical illness is a stressful life event for not only the patient but also their family members; when an illness becomes prolonged, the impact is profound. It is suggested that as medical technologies advance, the number of days patients stay in an intensive care unit will increase. Therefore, it is important nurses understand how families experience a prolonged critical illness of their family member in an intensive care unit. OBJECTIVE To explore the trajectory of a prolonged critical illness in the intensive care unit from the experiences of family. METHODS A qualitative, longitudinal, multi-case design consisting of six cases from New Zealand intensive care units. Findings presented in this article only relate to the familys experiences, although patients and healthcare professionals formed part of each case. Data collection methods included observation, conversations, interviews and document review. Analysis was undertaken using thematic analysis, vignette development and trajectory mapping. FINDINGS Relentless uncertainty dominated all phases of the trajectory for the family during a family members prolonged critical illness in the intensive care unit. When faced with a critical illness, family shifted rapidly into a world of unknowns. Family worked hard to navigate their way through the many uncertainties that dominated each phase of their family members illness. CONCLUSIONS Nurses need to understand the levels of uncertainty families endure in order to provide care that meets the philosophical underpinnings of family centred care.