Janis Paterson

Participation in Home Therapy Programs for Children with Cerebral Palsy: A Compelling Challenge:

In this grounded theory study, the authors purposed to generate a conceptual model of the experience of parents and therapists involved in home therapy programs for children with cerebral palsy. There were 12 participants: 4 therapists and 8 parents. Through constant comparative method of analysis, a process emerged interpreted as the compelling challenge comprising two time-distinct phases that described the parents’ journey of adjustment and their capacity to participate in activities to improve their child’s abilities. Initially, parents were coming to grips with the diagnosis, and this precluded their full involvement in home activities. However, at a point of breakthrough, they entered a phase of high participation interpreted as striving to maximize. The authors discuss the implications of this process for service providers and therapists.

Intimate partner violence and unplanned pregnancy in the Pacific Islands Families Study

To examine the association between maternal intimate partner violence (IPV) victimization and unplanned pregnancy.

Intimate Partner Violence Within a Cohort of Pacific Mothers Living in New Zealand

Maternal reports of intimate partner violence (IPV) were obtained from a cohort of Pacific mothers living in New Zealand. The Conflict Tactics Scale was completed by 1,095 women who had given birth in the past 12 months, and who were married or living with a partner as married. The 12-month prevalence of “victimization” through verbal aggression was 77%, 21% for “minor” physical violence, and 11% for “severe” physical violence. The 12-month prevalence of “perpetration” of verbal aggression against a partner was 90%, 35% for “minor” physical violence, and 19% for “severe” violence towards their partner. The experience of social inequality and acculturation are associated with IPV, albeit differentially across the experience of victimization and perpetration. Factors significantly associated with victimization are ethnicity, maternal education, social marital status and household income. Factors significantly associated with perpetration are ethnicity, cultural alignment, maternal birthplace and alcohol consumption since the birth of the child.

Maternal mental health and child behaviour problems at 2 years: findings from the Pacific Islands Families Study.

Objective: The present study investigated associations between the timing and persistence of maternal psychological disorder and child behaviour problems in a cohort of Pacific 2-year-old children in New Zealand. Method: Mothers of a cohort of 1398 Pacific infants born in South Auckland, New Zealand were interviewed when their children were 6 weeks, 12 and 24 months of age. Within the context of a wider interview, data regarding maternal mental health were obtained at these times and maternal reports of child behaviour were gathered when the children were 2 years old. Results: Prevalence rates for internalizing problems were significantly higher in children of mothers who had self-reported symptoms of psychological disorder (11.9% in no symptoms, 27.8% in early symptoms of postnatal depression, 21.1% in late symptoms of psychological disorder and 42.9% in persistent or recurrent symptoms). The adjusted odds ratio (OR) of a child having internalizing problems was 1.38 (95% confidence interval (CI): 0.79–2.43) in those of mothers reporting early symptoms of postnatal depression, 1.45 (95%CI: 0.85–2.49) in late symptoms of psychological disorder, and 2.93 (95%CI: 1.54–5.57) in persistent or recurrent symptoms relative to the no symptoms group. For externalizing problems, the effects of maternal psychological disorder were not significant. Conclusions: Maternal persistent or recurrent symptoms of psychological disorder may contribute to the behaviour problems of children as young as 2 years old. However, the timing of disorder, whether it is infant or toddler exposure, does not appear to be as crucial. Improved understanding of the associations between maternal psychological disorder and early child behaviour problems may help maternal and child health professionals design appropriate and effective screening and intervention programs to help Pacific mothers and children.

Prevalence and concordance of interpersonal violence reports from intimate partners: findings from the Pacific Islands Families Study

Background: Intimate partner violence (IPV) is an increasingly significant public health issue. Few studies investigate both partners’ reports of such violence. Aim: To determine the prevalence of IPV perpetration and victimisation and the concordance of both partners’ reports of that violence in a representative sample of Pacific couples using a standardised measure. Methods: A cohort of Pacific infants born during 2000 in Auckland, New Zealand, was followed. At 24-months postpartum, home interviews were conducted separately for mothers and fathers, and experience of IPV within the last 12 months was measured using the Conflict Tactic Scale. Concordance and symmetry between partner’s reports was assessed using the κ statistic and McNemar’s test, respectively. Results: The sample included 915 partnered mothers and 698 partnered fathers of which 674 were couples. Over 85% of individuals perpetrated or were victims of verbal aggression. Perpetration and victimisation of physical IPV was reported by 37% and 28% of mothers and 11% and 8% of fathers, respectively. Fathers systematically under-reported IPV and significant differences emerged in the response distributions from couples with Tongan mothers compared with couples with Samoan or Cook Island Maori mothers. Discussion: IPV is common for many Pacific couples and consistent with that reported in other New Zealand groups. Mothers are as likely as fathers to perpetrate and be victims of this violence. However, patterns of reporting were different between mothers and fathers, and between Pacific ethnic groups, which has implications for the understanding and health promotion targeting of domestic violence.

Risk factors for preterm and small-for-gestational-age babies: a cohort from the Pacific Islands Families Study.

Aim:  To explore risk factors that are associated with preterm birth and full‐term small‐for‐gestational‐age (SGA) birth for a Pacific population.

The effect of illness experience and demographic factors on children's illness representations

Abstract The purpose of this study was to investigate the relative contribution of personal illness experience, age, intelligence, and socioeconomic status on the sophistication of childrens illness conceptualisations of colds and asthma. A structured interview based on six dimensions of illness conceptualisations was conducted with 182 children aged from 7–14 years. Findings revealed that age, verbal intelligence, and socioeconomic status were significant predictors of level of illness conceptualisation. However, even when controlling for these demographic factors, the 35 children who had experienced asthma had more sophisticated conceptualisations of this illness particularly along the dimensions of cause, timeline and control/cure, but not along consequences, and prevention dimensions. These findings suggest that child health promotion should take into account childrens experience with illness as well as cognitive developmental factors. Emphasising issues around the consequences and prevention of ill...

Ageism Among Health Professionals: A Comparison of Clinical Educators and Students in Physical and Occupational Therapy

Negative attitudes towards aging can be a substantial obstacle to the delivery of quality health care to older adults. This study compared the attitudes towards older people and knowledge of aging held by clinical educators and students in physiotherapy and occupational therapy. Participants (n = 175) completed a questionnaire that consisted of the Kogan scale concerning attitudes towards older people, Palmores Facts on Aging Quiz version 1, and questions concerning social interaction with older people and demographic information. The clinical educators of both professional groups had significantly higher attitudinal scores than the student participants in this study. After controlling for the effect of age, clinical educators had a significantly lower negative bias on the Facts on Aging Quiz than the students. Significantly higher positive bias scores on the FAQ1 were reported by the occupational therapy students and clinical educators in comparison to their physiotherapy counterparts. A stronger curriculum emphasis throughout the academic programme together with increased clinical placements in settings providing care for older people may be necessary to better equip students for the workplace.

Traditional Gift Giving Among Pacific Families in New Zealand

The Pacific population in New Zealand is socially disadvantaged and over-represented in adverse social and health statistics. A cohort of 1,376 mothers of Pacific infants were asked about traditional gift commitments and the effect that these commitments had on the financial situation in their household. Sixty-two percent reported that they and/or their partner usually gave to their family or church, with 66.5% of this group giving to family in New Zealand, 58% to family in the Pacific Islands, and 75.9% to their church. Fifty-nine percent of these mothers reported that this gift commitment made their household financial situation more difficult. Factors significantly associated with gift giving are discussed, together with implications of these findings for Pacific families living New Zealand.

Impact of current and past intimate partner violence on maternal mental health and behaviour at 2 years after childbirth: evidence from the Pacific Islands Families Study

Objective: The present study examined the association between maternal intimate partner violence (IPV) at 6 weeks and 24 months postpartum and maternal health problems in a cohort of Pacific families with 2-year-old children in New Zealand. Methods: Data were gathered from the Pacific Islands Families Study. Mothers of a cohort of Pacific infants born in Auckland, New Zealand during 2000 were interviewed when the children were 6 weeks and 24 months of age. There were 828 mothers cohabiting in married or de facto partnerships who completed measures of IPV, mental health, and health-related behaviour such as smoking and high-risk alcohol use at both data points. The main statistical method used was logistic regression analysis. Results: Compared to mothers who did not experience physical violence at either data point, the odds of reporting psychological distress were 2.42 (95% confidence interval (CI) = 1.07–5.44) for those experiencing physical violence at 6 weeks only, 3.47 (95%CI = 1.75–6.86) for those experiencing physical violence at 24 months only, and 3.84 (95%CI = 1.78–8.30) for those experiencing physical violence at both data points after controlling for sociodemographic factors. Mothers experiencing verbal aggression or physical violence at both data points were more likely to report smoking or high-risk alcohol use at 24 months than those who did not, but the associations were no longer significant after controlling for sociodemographic factors. Conclusion: Being a victim of intimate partner physical violence at any time (past, recent and repeated) may contribute to an increase in maternal psychological distress. Health-related behaviours such as smoking and high-risk alcohol use at 24 months postpartum may to some degree be attributable to repeated victimization of physical violence and verbal aggression, but the relationships are not convincing and deserve further research in longitudinal studies.