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The authors talk about the role of psychiatrists in Australia and New Zealand in dealing with voluntary assisted dying (VAD). They discuss the role of psychiatrists in VAD legislation in Australia and New Zealand, psychological effects of VAD on health practitioners, and VAD research opportunities in New Zealand.

This qualitative study explores the meanings of frailty held by Chinese New Zealanders and Chinese health care professionals with the aim of identifying commonalities as well as potential differences. Two guided focus groups with Mandarin and Cantonese speaking older adults (n = 10), one individual interview with a English speaking older Chinese, and one focus group with Chinese New Zealand health care professionals (n = 7) were held to obtain views on frailty in older adults, followed by transcribing and a thematic qualitative analysis. Three main themes emerged: (1) Frailty is marked by ill-health, multiple chronic and unstable medical comorbidities, and is a linked with polypharmacy; (2) Frailty can involve physical weakness, decline in physical function such as reduced mobility or poor balance, and declining cognitive function; and (3) Frailty is associated with psychological and social health including depression, reduced motivation, social isolation, and loss of confidence. The perspectives of frailty that emerged are congruent with a multi-dimensional concept of frailty that has been described in both Chinese and non-Chinese medical research literature. [ABSTRACT FROM AUTHOR]

Objective: The number of Asian New Zealanders with dementia is growing. The objective of this study was to explore with a group of Asian health care professionals about public attitudes towards dementia in Asian communities in New Zealand, the stigma of dementia, and how best to develop culturally appropriate services for Asian people and families living with dementia.Methods: A focus group was conducted with a group of bilingual Asian health care professionals. A topic guide was developed based on the discussion at a prior meeting with the Cross Cultural Interest Group. The data were independently analysed by three researchers using the thematic qualitative methodology.Results: Eleven overseas-born Asian health care professionals (Chinese: n = 9, 82%) participated in the focus group. Four main themes emerged from the data: (a) cultural interpretations of dementia; (b) stigma; (c) filial piety; and (d) inequity in the availability of resources.Conclusion: Our findings suggest that much work is needed to destigmatise dementia in New Zealand Asian communities, through psychoeducation, public awareness, and the availability of readily accessible services that can meet their cultural and language needs. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to report the findings from a routine collection of Health of the Nation Outcome Scales for older persons (HoNOS65 + ) in a memory clinic and to explore its clinical utility with clinicians working in old age psychiatric services. Methods: We conducted a retrospective analysis of HoNOS65+ ratings collected during a 12-month period in a newly established memory clinic. Results of this part of the study were presented to 34 clinicians. Results: The mean total HoNOS65+ score was 6.8 and 7.0 for the initial and follow-up episodes respectively. Between 60 and 65% of the clinicians indicated that they 'disagree', 'strongly disagree' or were 'unsure' whether HoNOS65+ (i) can contribute to clinical decision making; (ii) is useful in monitoring progress; (iii) is useful in supporting consumers to assess their progress; and (iv) is assisting in assessing, planning and evaluating service delivery. Conclusions: Service users had timely diagnostic assessment and interventions at the memory clinic. The lack of change on the HoNOS65+ suggests the positive effect of the clinic was not captured by this outcome measure. Although HoNOS65+ is routinely collected, its clinical utility as perceived by clinicians is relatively limited. [ABSTRACT FROM AUTHOR]

A Correction to this paper has been published: https://doi.org/10.1007/s10823-021-09429-9 [ABSTRACT FROM AUTHOR]

Objectives: Patient suicide is one of the most stressful events for psychiatrists and psychiatry trainees. However, there is often a lack of consistent guidance and support available to clinicians, including post-vention. The aim of this paper is to describe the development of a resource that could support psychiatry trainees following patient suicide.Methods: Following a literature review, we adapted two US patient suicide post-vention guidelines to reflect local processes and support systems available by consulting a number of key stakeholders in the training programme and district health boards.Results: The first part of the post-vention guidelines included procedural processes such as the serious incident review process and reporting to coroner's office. The second part included a checklist for trainee, supervisor, local training facilitator and director of training according to the following time frame: first 24 hours, first 1-2 weeks and following months.Conclusions: Post-vention guidelines and teaching about patient suicide and its effects could improve the training experience of psychiatry trainees and facilitate the development of resilience as they progress through training. [ABSTRACT FROM AUTHOR]

Background: The number of people living with dementia (PLWD) in Aotearoa New Zealand (NZ) was estimated at 96,713 in 2020 and it is anticipated that this number will increase to 167,483 by 2050, including an estimated 12,039 Māori (indigenous people of NZ) with dementia. Experiencing urinary incontinence (UI) or faecal incontinence (FI) is common for PLWD, particularly at the later stages of the disease. However, there is no robust estimate for either prevalence or incidence of UI or FI for PLWD in NZ. Although caregivers rate independent toilet use as the most important activity of daily living to be preserved, continence care for PLWD in the community is currently not systematised and there is no structured care pathway. The evidence to guide continence practice is limited, and more needs to be known about caregiving and promoting continence and managing incontinence for PLWD in the community. This project will seek to understand the extent of the challenge and current practices of health professionals, PLWD, caregivers and family; identify promising strategies; co-develop culturally appropriate guidelines and support materials to improve outcomes; and identify appropriate quality indicators so that good continence care can be measured in future interventions. Methods and analysis: A four-phase mixed methods study will be delivered over three years: three phases will run concurrently, followed by a fourth transformative sequential phase. Phase 1 will identify the prevalence and incidence of incontinence for PLWD in the community using a cohort study from standardised home care interRAI assessments. Phase 2 will explore continence management for PLWD in the community through a review of clinical policies and guidance from publicly funded continence services, and qualitative focus group interviews with health professionals. Phase 3 will explore experiences, strategies, impact and consequences of promoting continence and managing incontinence for PLWD in the community through secondary data analysis of an existing carers' study, and collecting new cross-sectional and longitudinal qualitative data from Māori and non-Māori PLWD and their caregivers. In Phase 4, two adapted 3-stage Delphi processes will be used to co-produce clinical guidelines and a core outcome set, while a series of workshops will be used to co-produce caregiver resources. [ABSTRACT FROM AUTHOR]

Background: Assessing decision-making capacity to health care is within the scope of practice for all doctors, yet the experience of GPs in this area is unknown.Objective: To explore the experiences, perspectives, approaches and challenges for GPs in New Zealand when conducting decision-making capacity assessments.Methods: Qualitative study design comprising individual in-depth semi-structured interviews conducted with a convenience sample of GPs. Interview transcripts were transcribed verbatim and analysed using a thematic analysis approach.Results: Twelve participants were recruited. The following themes emerged: (i) GPs' roles and responsibilities in decision-making capacity assessments; (ii) GPs lack formal training, knowledge, and confidence in decision-making capacity assessments; (iii) the legal interface of decision-making capacity assessments; (iv) GPs' relationships with specialists and the resulting impact on their confidence in decision-making capacity assessments; and (v) opportunities to improve GPs' knowledge and confidence in decision-making capacity assessments.Conclusions: GPs take responsibility for decision-making capacity assessments; however, assessments can be complex. There is a need to develop specific curriculum and training resources for GPs to improve their clinical skills and legal knowledge in decision-making capacity assessments. [ABSTRACT FROM AUTHOR]