Rebecca Llewellyn

The Cancer Stories Project: narratives of encounters with cancer in Aotearoa, New Zealand.

The Cancer Stories Study aimed to identify the factors that empower people who have experienced cancer. More specifically the project sought to explore the coping and support mechanisms people adopted to help understand and manage their cancer experience.

‘Why worry about something you can’t control?’ Negotiated risk, longevity and health behaviours:

While we know about lay attitudes towards death and dying, we understand little about the ways people estimate their overall personal risk of life-limiting disease and/or death. This study contributes to the limited literature on lay longevity reckonings, with a particular focus on how these reckonings may influence health behaviours. Semi-structured interviews were held with 21 young older adults (54–65 years), addressing the core questions of ‘What do you think you will die from, and how long do you expect to live?’ Participants indicated their longevity estimation was guided by three key frameworks: family history, environment and lifestyle factors and lived experience. The reckoning process was also moderated by assumptions about loci of control and self-efficacy and the information available to participants. A tripartite model of death risk assessment is proposed, extending the idea of ‘negotiated risk’ beyond the scope of family history where it has received most attention. We argue that by drawing on the three risk-assessment frameworks, determining patients’ predisposition for external/internal attributions of control and perceptions of self-efficacy, clinicians will be better equipped to understand – and thus guide – patients’ reckonings of longevity and health behaviours that are influenced by it.

Living into death: a case for an iterative, fortified and cross-sector approach to advance care planning

ABSTRACT Advance care planning (ACP) has been framed as best practice for quality palliative care, yet a growing body of literature affirms the need for an early iterative ACP process to begin when people are young and healthy. A significant gap appears to exist in the literature regarding the utility of death conversations outside the end-of-life context. Could ‘death conversations’ early in life be an effective tool by which doctor and patient can co-construct a more healthful way of life, and realistic relationship with death? And what variables must be taken into account for these conversations to proceed successfully? This paper provides a narrative exploration of the value of death conversations in the clinical context in New Zealand. Five exemplars are discussed, drawn from a sample of 21 semi-structured interviews with young older adults (54–65 years old) not receiving palliative care or diagnosed with a terminal illness. Together, these narratives indicate that further community consultation is required to determine culturally appropriate ways to initiate productive conversations around aging, death and dying and how to build patient/practitioner/family relationships which allow these conversations to happen safely. There is a need to acknowledge the important factor of culture related to age, generation, sex, faith and ethnicity when engaging in conversations about aging, death and dying. By doing so, health professionals will be best equipped to assist their patients to live well into death.

Books on Prescription - community-based health initiative to increase access to mental health treatment: an evaluation.

Objective: To evaluate the implementation of a regional Books on Prescription (BoP) programme.

Still Living, Loving, and Laughing: Spiritual Life in the Dementia Unit

Semi-structured interviews, conducted with dementia unit residents, family, and staff members provided a three-way perspective on the spirituality of residents. The issues covered included: what gives meaning to life, how difficulties are coped with and hope maintained. Themes identified were: “the importance of relationships,” “the retention of identity,” and “the progression of dementia.” These themes are interdependent with relationships being important both in giving meaning in themselves and in assisting with the maintenance of identity, especially as cognitive function deteriorated. An identifiable and relating person remains despite dementia. Provided appropriate assistance, the person with advanced dementia is able to value and engage in spiritual practices that provide ongoing meaning at times of great uncertainty and difficulty.

Breastfeeding friendly pharmacies: a setting with potential

Pharmacists are often the most accessible medication expert for breastfeeding women, and need reliable resources to provide information about medications and safety with breastfeeding.1 It is known that they are often asked for breastfeeding related advice, and “with their highly visible roles in the community, frequent interactions with soon-to-be and new parents, and knowledge of medication safety, pharmacists can be a key component in breastfeeding promotion and support.”2

Little change in tobacco imagery on New Zealand television: 10 years on.

Objectives: To examine changes in the frequency and contexts of tobacco imagery on New Zealand television since 2004.