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Aim: To identify strategies which support the implementation of interventions to promote compassionate nursing care with a focus on interventions designed to support improved patient outcomes and/or patient experience in acute hospitals. Methods: An integrative review using the PRISMA guidelines and a 5‐stage framework consisting of problem identification, literature search, data evaluation, data analysis and presentation. CINAHL, Embase, Medline, PsychInfo and Web of Science were systematically searched using key search terms. Hand searches were conducted of the reference lists of eligible articles and searching key journals. Results: Six articles met the inclusion criteria with six different interventions described. A thematic analysis of the findings identified three key themes relating to the implementation of interventions which promote compassionate nursing care: (1) the importance of evidence; (2) support for nursing development; and (3) planning for and leading implementation. Conclusion: Compassionate care improves quality of life, the hospital experience and overall recovery. Strong nursing leadership and a supportive team environment are facilitators for delivery of compassionate care in acute settings. Excessive workload, overly rigid reporting and organisational indifference are barriers to delivery of compassionate care. Implications for nursing policy: Health policy is used to inform the systematic implementation and delivery of patient care informed by best evidence. Health setting, environment and culture are important facets of the implementation of a compassionate care framework. Furthermore, nurse engagement, teamwork and nurse leadership are key facilitators for delivery of compassionate care in acute hospital settings. These findings need to be taken into consideration by policy makers and nursing leaders when designing and implementing compassionate care interventions. Implications for nursing policy: Implementing interventions to improve compassionate nursing care can be challenging. This review identified the factors which should be considered by policy makers when implementing these interventions systematically throughout the healthcare system. [ABSTRACT FROM AUTHOR]

During the COVID-19 outbreak a four-level alert system placed social restrictions on New Zealanders to minimise the spread of the virus. Hospices provided community-based care reduced to telecommunications in some regions. Marae (ancestorial gathering places) were closed, and families had to stay in their ‘bubbles.’ This article presents the findings of the Rapua te Mārama study to highlight bereaved Māori families end of life caregiving, death and tangihanga (funeral) experiences during COVID-19 Lockdowns. We highlight how the disruptions impacted Māori death customs and how whānau adapted. Lockdowns impacted the relational processes that underpinned whānau caregiving. Due to the pandemic restrictions there was a lack of palliative care provision within the home. Tangihanga (funeral customs) and Māori death customs were affected; despite this whānau honoured the rangatiratanga (self-determination) of their ill and dying. [ABSTRACT FROM AUTHOR]

In this autoethnographic article, we explore one Māori person's experience of engaging with advance care planning (ACP) while experiencing the distinct relational fracture as expressed into indigenous homelessness. We describe how ACP, envisioned as a relational space, and expressive of Māori holistic care and wellbeing, might be conducive in healing past traumatic experiences and restoring familial relationships and connections. Extending ACP beyond that for which it has been originally conceived for housed populations and by Western health models, may offer a pathway to assist indigenous homeless people with dignity and peace to fulfil tangihanga (traditional death customs and rituals) through re-establishing connections and healing at the end of life. We recommend that ACP in relation to Māori homelessness offers a Māori space, located within a web of Māori health professionals, to respond adequately to the specific demands that might arise from ACP. Essentially, these demands may relate to a) establishing restorative connections with whānau (extended family) and providing appropriate and consistent support whether in the context of the end of life or over time; b) addressing the needs and distress that may arise from expressing trauma events and offering a space to weave those experiences within a collective and transgenerational experience of trauma. [ABSTRACT FROM AUTHOR]

There have been growing concerns that social distancing and stay-at-home mandates have exacerbated loneliness for older people. Empirical evidence about older people's experiences of loneliness and COVID-19 have quantified this phenomena without considering how older people themselves define and understand loneliness. This paper explores how older New Zealanders conceptualized and experienced loneliness under 'lockdown' stay-at-home measures. This multi-methods qualitative study combines data from letters (n = 870) and interviews (n = 44) collected from 914 people aged over 60 and living in Aotearoa, New Zealand during the COVID-19 pandemic. We conducted a reflexive thematic analysis to conceptualise this data. We identify three interconnected ways in which older people conceptualised and experienced loneliness: (1) feeling disconnected relating to lack of emotional closeness to another often resulting from being physically separated from others and not being able to touch; (2) feeling imprisoned relating to separation from preferred identities and activities and was frequently associated with boredom and frustration; and (3) feeling neglected which often related to feeling let down by generalised and idealised forms of support, such as one's neighbourhood and health care system. Older New Zealanders experienced lockdown loneliness in three interconnected ways rather than as a stable and homogenous experience. Māori, Pacific, Asian and New Zealand European older people often discussed loneliness in different ways; attesting to loneliness being a culturally-mediated concept shaped by expectations around desirable social interaction. We conclude the paper with implications for research and policy. [ABSTRACT FROM AUTHOR]

This research explores how the graphic novel Vivian served as the medium for an Arts-Based Knowledge Translation (ABKT) project in the field of palliative care. ABKT seeks to accomplish the goal of disseminating research-based knowledge through the use of the arts. It is regarded as useful for raising awareness about social issues, fostering a deep engagement with audiences and giving new perspectives on topics at hand. The paper describes the process the researchers undertook to create the graphic novel and embed within it empirical evidence about gender and palliative care, thereby extending its reach beyond traditional academic audiences. The paper also explains how Vivian, as an example of a pūrākau (Māori story) serves as a means for foregrounding the values and perspectives of Māori, the indigenous people of Aotearoa New Zealand. Viewed through this lens, Vivian operates as a critique of western societal values at odds with the fundamental Māori principles of care and hospitality (manaakitanga), relationships (whanaungatanga) and prestige or status (mana). [ABSTRACT FROM AUTHOR]

Background: Emergency ambulance personnel respond to a variety of incidents in the community, including medical, trauma and obstetric emergencies. Family and bystanders present on scene may provide first aid, reassurance, background information or even act as proxy decision-makers. For most people, involvement in any event requiring an emergency ambulance response is a stressful and salient experience. The aim of this scoping review is to identify and synthesise all published, peer-reviewed research describing family and bystanders' experiences of emergency ambulance care. Methods: This scoping review included peer-reviewed studies that reported on family or bystander experiences where emergency ambulance services responded. Five databases were searched in May 2022: Medline, CINAHL, Scopus, ProQuest Dissertation & Theses and PsycINFO. After de-duplication and title and abstract screening, 72 articles were reviewed in full by two authors for inclusion. Data analysis was completed using thematic synthesis. Results: Thirty-five articles reporting heterogeneous research designs were included in this review (Qualitative = 21, Quantitative = 2, Mixed methods = 10, Evidence synthesis = 2). Thematic synthesis developed five key themes characterising family member and bystander experiences. In an emergency event, family members and bystanders described chaotic and unreal scenes and emotional extremes of hope and hopelessness. Communication with emergency ambulance personnel played a key role in family member and bystander experience both during and after an emergency event. It is particularly important to family members that they are present during emergencies not just as witnesses but as partners in decision-making. In the event of a death, family and bystanders want access to psychological post-event support. Conclusion: By incorporating patient and family-centred care into practice emergency ambulance personnel can influence the experience of family members and bystanders during emergency ambulance responses. More research is needed to explore the needs of diverse populations, particularly regarding differences in cultural and family paradigms as current research reports the experiences of westernised nuclear family experiences. [ABSTRACT FROM AUTHOR]

Background: Internationally, efforts are being made to promote equity in palliative and end-of-life care for Indigenous peoples. There is a need to better understand the experiences of Indigenous service users and staff. Aim: To explore the views of Māori health practitioners and whānau (family group) caregivers regarding barriers and enablers to culturally safe palliative and end-of-life care. Design: A Kaupapa Māori qualitative study. Setting/participants: Interviews were conducted with 103 participants from four areas of the North Island of Aotearoa New Zealand. Participants comprised bereaved whānau (family) of Māori with a life limiting illness and Māori health practitioners. Results: Māori health practitioners undertake cultural and connecting work to promote culturally safe palliative and end-of-life care for Māori patients and their whānau. This work is time-consuming and emotionally and culturally demanding and, for most, unpaid and unrecognised. Non-Māori staff can support this work by familiarising themselves with te reo Māori (the Māori language) and respecting cultural care customs. However, achieving culturally safe end-of-life care necessitates fundamental structural change and shared decision-making. Conclusions: Our findings indicate that efforts to support equitable palliative care for Indigenous people should recognise, and support, the existing efforts of health practitioners from these communities. Colleagues from non-Indigenous populations can support this work in a range of ways. Cultural safety must be appropriately resourced and embedded within health systems if aspirations of equitable palliative and end-of-life care are to be realised. [ABSTRACT FROM AUTHOR]

This paper examines the exclusion of bi/multiracial Maori women from dominant representations of Maori women's identity and engages with a new articulation of Maori women's difference through a narrative of cultural hybridity. Through a study of key texts on the history of New Zealand and dominant articulations describing Maori nationalists' efforts to invoke equality for Maori during the 1970s and 1980s, I exemplify how an essentialist Maori women's identity was promoted within Maori nationalist appeals to bicultural nationalism. I argue that current articulations of Maori women's identity do not include an analysis of race, gender, and class, nor the way they operate simultaneously to position the bi-multi racial woman discursively in the nation today. Twenty women who position themselves as bi/multiracial were interviewed and their stories show how the raced and gendered body must be reinstated within articulations of Maori women's identity through situating corporeal difference within discussions on their subjectivity and related marginalization. (Contains 5 notes.)

While social connectedness is heralded as a key enabler of positive health and social outcomes for older people, rarely have they themselves had the opportunity to express their views about the concept. Working with a diverse group of Pacific, Māori, Asian and New Zealand European older adults, this paper explores what matters to older people when discussing social connectedness? We draw from individual, in-depth interviews with 44 older adults, and three group interviews comprising 32 older adults. Data were analysed using thematic and narrative analyses. The three themes identified were: getting out of the house, ability to connect and feelings of burden. Fundamental to social connectedness was participants' desire to be recognised as resourceful agents able to foster relationships on the basis of mutual respect. Social connectedness was conceptualised as multi-levelled: relating to interpersonal relationships as much as neighbourhoods and wider society. Alongside these similarities we also discuss important differences. Participants preferred to socialise with people from similar cultural backgrounds where they shared taken-for-granted social customs and knowledges. This is in the context where racism, poverty and inequalities clearly impeded already minoritised participants' sense of social connection. Key structural ways to improve social connectedness should focus on factors that enable cohesion between levels of connection, including stable neighbourhoods serviced with accessible public transport, liveable pensions and inclusivity of cultural diversity. [ABSTRACT FROM AUTHOR]