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Article ; Online: Correction: Measuring sustainability of opioid agonist therapy programs in the context of transition from Global Fund Support.

Stuikyte, Raminta / Varentsov, Ivan / Cook, Catherine / Dvoriak, Sergii

2024 Volume 21, Issue 1, Page(s) 27

Language	English
Publishing date	2024-01-31
Publishing country	England
Document type	Published Erratum
ZDB-ID	2146691-9
ISSN	1477-7517 ; 1477-7517
ISSN (online)	1477-7517
ISSN	1477-7517
DOI	10.1186/s12954-024-00945-8
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Article ; Online: Measuring sustainability of opioid agonist therapy programs in the context of transition from global fund support.

Stuikyte, Raminta / Varentsov, Ivan / Cook, Catherine / Dvoriak, Sergii

Harm reduction journal

2024 Volume 21, Issue 1, Page(s) 7

Abstract: Background: Programmatic and financial sustainability of health responses dependent on donor funding has risen as a major concern. In the HIV field in particular, it generated a number of instruments and assessments on sustainability and processes ... ...

Abstract	Background: Programmatic and financial sustainability of health responses dependent on donor funding has risen as a major concern. In the HIV field in particular, it generated a number of instruments and assessments on sustainability and processes related to donor transition planning. The authors aimed to develop an instrument specific to opioid agonist therapy (OAT) programs as they were addressed only marginally by the HIV-specific assessments. Methods: The development of the OAT sustainability instrument used desk review of existing HIV sustainability concepts and tools, an International Advisory Board, and piloting to validate the instrument. Results: The new OAT sustainability instrument is comprised of the three parts: the conceptual framework, methodological guidelines and a practical implementation tool for assessing the degree of OAT sustainability at the country level. It measures sustainability in the three broad areas for sustainability measuring-Policy & Governance; Finance & Resources; and Services. The selection of indicators and their composites for the three sustainability areas extensively used the United Nations and World Health Organization's guidance on health system building blocks, on care and HIV and viral hepatitis prevention among people using opioids and for opioid dependence, and the definition of access to health framed by the United Nations Convent on Economic, Social and Cultural Rights. The instrument's methodological guidelines require the engagement of a national consultant to conduct desk review, key informant interviews and focus groups for measuring discrete milestones and adding qualitative information for interpretation of the data, progress and opportunities. The guidelines advise engaging a country-specific multi-stakeholder advisory group for planning, validation and follow-up of the assessment. The pilot of the instrument in 3 countries in 2020 validated it and required minor adjustments in the instrument. By mid-2023, the instrument has been successfully applied in 5 countries. Conclusions: The developed instrument enables a comprehensive review of the resilience of OAT programs and their ability to scale up and to inform a roadmap for improved sustainability. While developed in the context of Eastern Europe and Central Asia, it has been reviewed by a global advisory panel and could be easily adapted outside this regional context.
MeSH term(s)	Humans ; Analgesics, Opioid ; Financial Management ; Global Health ; HIV Infections/prevention & control ; Opioid-Related Disorders
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2024-01-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2146691-9
ISSN	1477-7517 ; 1477-7517
ISSN (online)	1477-7517
ISSN	1477-7517
DOI	10.1186/s12954-024-00931-0
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Article ; Online: A Heideggerian analysis of good care in an acute hospital setting: Insights from healthcare workers, patients and families.

Dewar, Jan / Cook, Catherine / Smythe, Elizabeth / Spence, Deborah

Nursing inquiry

2023 Volume 30, Issue 4, Page(s) e12561

Abstract: This study articulates the relational constituents of good care beyond techno-rational competence. Neoliberal healthcare means that notions of care are readily commodified and reduced to quantifiable assessments and checklists. This novel research ... ...

Abstract	This study articulates the relational constituents of good care beyond techno-rational competence. Neoliberal healthcare means that notions of care are readily commodified and reduced to quantifiable assessments and checklists. This novel research investigated accounts of good care provided by nursing, medical, allied and auxiliary staff. The Heideggerian phenomenological study was undertaken in acute medical-surgical wards, investigating the contextual, communicative nature of care. The study involved interviews with 17 participants: 3 previous patients, 3 family members and 11 staff. Data were analysed iteratively, dwelling with stories and writing and rewriting to surface the phenomenality of good care. The data set highlighted the following essential constituents: authentic care: caring encompassing solicitude (fürsorge); impromptu care: caring beyond role category; sustained care: caring beyond specialist parameters; attuned care: caring encompassing family and culture; and insightful care: caring beyond assessment and diagnosis. The findings are clinically significant because they indicate the importance of nurse leaders and educators harnessing the potential capacity of all healthcare workers to participate in good care. Healthcare workers reported that participating in or witnessing good care was uplifting and added meaning to their work, contributing to a sense of shared humanity.
Language	English
Publishing date	2023-05-17
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1483798-5
ISSN	1440-1800 ; 1320-7881
ISSN (online)	1440-1800
ISSN	1320-7881
DOI	10.1111/nin.12561
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Article ; Online: An analysis of time conceptualisations and good care in an acute hospital setting.

Dewar, Jan / Cook, Catherine / Smythe, Elizabeth / Spence, Deborah

Nursing inquiry

2023 Volume 31, Issue 2, Page(s) e12613

Abstract: This study articulates the relationship between conceptualisations of time and the accounts of good care in an acute setting. Neoliberal healthcare services, with their focus on efficiencies, predominantly calculate quality care based on time-on-the- ... ...

Abstract	This study articulates the relationship between conceptualisations of time and the accounts of good care in an acute setting. Neoliberal healthcare services, with their focus on efficiencies, predominantly calculate quality care based on time-on-the-clock workforce management planning systems. However, the ways staff conceptualise and then relate to diverse meanings of time have implications for good care and for staff morale. This phenomenological study was undertaken in acute medical-surgical wards, investigating the contextual, temporal nature of care embedded in human relations. The study interviews involved 17 participants: 11 staff, 3 previous patients and 3 family members. Data were analysed iteratively to surface the phenomenality of temporality and good care. The following constituents of the data set are explored that together illustrate the relationship between the conceptualisations of time and the accounts of good care in an acute setting: patient time as a relational journey; patient time, sovereign time and time ethics and time, teamwork and flow. The findings are clinically significant because they offer a contrasting narrative about the relationship between time and care quality. The experiences of giving and receiving good care are indivisible from how temporality is experienced and the social relations within which care is embedded. Healthcare staff experience temporality differently from patients and families, a point that healthcare participants in this study appeared to comprehend and accommodate. For all parties involved in providing care or being the recipient of care, however, the capacity to be present was valued as a humanising ethic of care. Our study reinforces the importance of not creating presumptive binaries about which temporal structures are more or less humanising-there is a place for a fast-paced tempo, which can be experienced as being in the flow of human relations with one's team and on behalf of patients.
MeSH term(s)	Humans ; Concept Formation ; Qualitative Research ; Family ; Quality of Health Care ; Hospitals
Language	English
Publishing date	2023-11-05
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1483798-5
ISSN	1440-1800 ; 1320-7881
ISSN (online)	1440-1800
ISSN	1320-7881
DOI	10.1111/nin.12613
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Article ; Online: Good death disrupted: Nurses' moral emotions navigating clinical and public health ethics during the first wave of COVID-19 pandemic.

Mowat, Rebecca / Cook, Catherine / Chapman, Marie K / Roskruge, Matt

Journal of clinical nursing

2023 Volume 32, Issue 17-18, Page(s) 6611–6621

Abstract: Aim: To explore the moral emotions that frontline nurses navigated in endeavouring to ensure a 'good death' for hospital patients and care home residents during the first wave of the COVID-19 pandemic.: Background: Under normal circumstances, ... ...

Abstract	Aim: To explore the moral emotions that frontline nurses navigated in endeavouring to ensure a 'good death' for hospital patients and care home residents during the first wave of the COVID-19 pandemic. Background: Under normal circumstances, frontline staff are focused on clinical ethics, which foreground what is best for individuals and families. Public health crises such as a pandemic require staff to adapt rapidly to focus on what benefits communities, at times compromising individual well-being and autonomy. Visitor restrictions when people were dying provided vivid exemplars of this ethical shift and the moral emotions nurses encountered with the requirement to implement this change. Methods: Twenty-nine interviews were conducted with nurses in direct clinical care roles. Data were analysed thematically informed by the theoretical concepts of a good death and moral emotions. Results: The data set highlighted that moral emotions such as sympathy, empathy, distress and guilt were integral to the decisions participants described in striving for a good palliative experience. Four themes were identified in the data analysis: nurses as gatekeepers; ethical tensions and rule bending; nurses as proxy family members; separation and sacrifice. Conclusions: Participants reflected on morally compromising situations and highlighted agency through emotionally satisfying workarounds and collegial deliberations that enabled them to believe that they were party to painful but morally justifiable decisions. Implications for the profession and patient care: Nurses are required to implement national policy changes that may disrupt notions of best practice and therefore be experienced as a moral wrong. In navigating the moral emotions accompanying this shift, nurses benefit from compassionate leadership and ethics education to support team cohesion enabling nurses to prevail. Public contribution: Twenty-nine frontline registered nurses participated in the qualitative interviews that inform this study. Reporting method: The study adhered to the Consolidated Criteria for Reporting Qualitative Research checklist.
MeSH term(s)	Humans ; Pandemics ; Public Health ; COVID-19/epidemiology ; Morals ; Qualitative Research ; Emotions ; Nurses
Language	English
Publishing date	2023-03-27
Publishing country	England
Document type	Journal Article
ZDB-ID	1159483-4
ISSN	1365-2702 ; 0962-1067 ; 1752-9816
ISSN (online)	1365-2702
ISSN	0962-1067 ; 1752-9816
DOI	10.1111/jocn.16702
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Article ; Online: Understanding barriers to immunisation against vaccine-preventable diseases in Pacific people in New Zealand, Aotearoa: an integrative review.

Tafea, Vika / Mowat, Rebecca / Cook, Catherine

Journal of primary health care

2022 Volume 14, Issue 2, Page(s) 156–163

Abstract: Introduction Pacific people have an increased risk of hospitalisation if barriers to immunisation against vaccine-preventable diseases are not reduced. This research sought to determine what is known about the barriers to immunisations in Pacific people ... ...

Abstract	Introduction Pacific people have an increased risk of hospitalisation if barriers to immunisation against vaccine-preventable diseases are not reduced. This research sought to determine what is known about the barriers to immunisations in Pacific people living in New Zealand and identify ways to reduce these barriers and inform health care. Aim To identify the barriers to immunisation for Pasifika and to identify ways to reduce these barriers and inform health care. Methods An integrative review was undertaken with databases searched for articles published between February 2021 and May 2021. The review follows the five-stage process of problem formulation; literature search; evaluation of data; data analysis and interpretation; and presentation of the results through discussion. Results Twelve studies were included. Three themes were identified: Deprivation, Health Literacy (which covered understanding the importance of immunisation programmes, attitudes and beliefs and communication), and access to health care (including communication accessibility to health professionals and physical access). Discussion This review has identified that barriers such as level of deprivation strongly influences immunisation uptake in Pacific people. The significance of government-led initiatives was shown to improve the rates of immunisation of Pacific children. Pacific people's awareness of immunisation programmes and government campaigns are encouraged to incorporate ethnic-specific strategies in addressing barriers, such as bringing vaccinations to where Pacific people frequent, including churches, community hubs, and venues that parents can easily access.
MeSH term(s)	Child ; Humans ; Immunization ; New Zealand ; Parents ; Vaccination ; Vaccine-Preventable Diseases/prevention & control
Language	English
Publishing date	2022-06-30
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	2572943-3
ISSN	1172-6156 ; 1172-6156
ISSN (online)	1172-6156
ISSN	1172-6156
DOI	10.1071/HC21129
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Article ; Online: Palliative Care, Intimacy, and Sexual Expression in the Older Adult Residential Care Context: "Living until You Don't".

Cook, Catherine / Henrickson, Mark / Schouten, Vanessa

International journal of environmental research and public health

2022 Volume 19, Issue 20

Abstract: Commonly, frail older adults move to residential care, a liminal space that is their home, sometimes a place of death, and a workplace. Residential facilities typically espouse person-centred values, which are variably interpreted. A critical approach to ...

Abstract	Commonly, frail older adults move to residential care, a liminal space that is their home, sometimes a place of death, and a workplace. Residential facilities typically espouse person-centred values, which are variably interpreted. A critical approach to person-centred care that focuses on social citizenship begins to address issues endemic in diminishing opportunities for intimacy in the end-of-life residential context: risk-averse policies; limited education; ageism; and environments designed for staff convenience. A person-centred approach to residents' expressions of intimacy and sexuality can be supported throughout end-of-life care. The present study utilised a constructionist methodology to investigate meanings associated with intimacy in the palliative and end-of-life care context. There were 77 participants, including residents, family members and staff, from 35 residential facilities. Analysis identified four key themes: care home ethos and intimacy; everyday touch as intimacy; ephemeral intimacy; and intimacy mediated by the built environment. Residents' expressions of intimacy and sexuality are supported in facilities where clinical leaders provide a role-model for a commitment to social citizenship. Ageism, restrictive policies, care-rationing, functional care, and environmental hindrances contribute to limited intimacy and social death. Clinical leaders have a pivotal role in ensuring person-centred care through policies and practice that support residents' intimate reciprocity.
MeSH term(s)	Humans ; Aged ; Homes for the Aged ; Palliative Care ; Sexual Behavior ; Sexual Partners ; Sexuality
Language	English
Publishing date	2022-10-12
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph192013080
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Article ; Online: Indigenous nurses' practice realities of cultural safety and socioethical nursing.

Hunter, Kiri / Cook, Catherine

Nursing ethics

2020 Volume 27, Issue 6, Page(s) 1472–1483

Abstract: Background: Persistent healthcare emphasis on universal moral philosophy has not advantaged indigenous and marginalised groups. Centralising cultural components of care is vital to provide ethical healthcare services to indigenous people and cultural ... ...

Abstract	Background: Persistent healthcare emphasis on universal moral philosophy has not advantaged indigenous and marginalised groups. Centralising cultural components of care is vital to provide ethical healthcare services to indigenous people and cultural minorities internationally. Woods' theoretical explication of how nurses can integrate cultural safety into a socioethical approach signposts ethical practice that reflects culturally congruent relational care and systemic critique. Aim: To demonstrate the empirical utility of Woods' ethical elements of cultural safety within a socioethical model, through analysis of indigenous nurses' practice realities in Aotearoa New Zealand. Research design: The study used a qualitative indigenous narrative inquiry. Participants and research context: Participants were recruited nationally. Twelve Māori registered nurses and nurse practitioners were interviewed. All participants provided direct care in either primary or secondary health services. Ethical considerations: Research approval was gained from the Human Ethics Committee of the lead author's tertiary institution. Participation was voluntary, and written informed consent was obtained. Findings: Analysis highlighted the following: (1) cultural needs, which for Māori were integral to care, were easily subsumed by clinical care being prioritised; (2) ethical care by non-indigenous nurses requires critical reflection about broader equity issues that impact Māori disengagement from healthcare; (3) retention of indigenous nurses was seen as essential because their advocacy and the cultural 'fit' for Māori contributed to positive healthcare outcomes; and (4) committed leadership ensured culturally safe care was not eroded through workplace efficiencies. Discussion: The data provide rich representation of Woods' model. The data indicate that nurses must engage reflexively with a relational ethic of care and social justice dimensions in order to deliver culturally safe care. Conclusion: Woods' model provides a critical lens for nurses to examine their relational practice and systemic factors that enhance or detract from culturally safe care when caring for members of any indigenous group.
MeSH term(s)	Cultural Competency/psychology ; Ethics, Nursing ; Humans ; Indigenous Peoples ; Interviews as Topic/methods ; Native Hawaiian or Other Pacific Islander/ethnology ; Native Hawaiian or Other Pacific Islander/psychology ; New Zealand/ethnology ; Nurses/psychology ; Nurses/statistics & numerical data ; Qualitative Research
Language	English
Publishing date	2020-07-28
Publishing country	England
Document type	Journal Article
ZDB-ID	1200467-4
ISSN	1477-0989 ; 0969-7330
ISSN (online)	1477-0989
ISSN	0969-7330
DOI	10.1177/0969733020940376
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Article ; Online: The sexual health consultation as a moral occasion.

Cook, Catherine

Nursing inquiry

2014 Volume 21, Issue 1, Page(s) 11–19

Abstract: Sexually transmitted infections (STIs) are socially constructed as more 'dirty' than other gynaecological conditions. This article analyses women's accounts of interactions with clinicians, subsequent to a diagnosis of genital herpes simplex virus or ... ...

Abstract	Sexually transmitted infections (STIs) are socially constructed as more 'dirty' than other gynaecological conditions. This article analyses women's accounts of interactions with clinicians, subsequent to a diagnosis of genital herpes simplex virus or human papilloma virus. Women conceptualised consultations as a 'moral event,' different from other consultations. This moral component is highlighted drawing on Foucault's notion of 'the confessional.' Additionally, Douglas' anthropological construction of 'dirt' is used to consider why these consultations are 'confessional' experiences. Email interviews were conducted with 26 women diagnosed with a viral STI and 12 sexual health clinicians. Data were analysed thematically using a feminist, poststructuralist approach. Findings indicated that discourses of morality shape sexual health consultations. Five themes were identified in relation to the moral 'work' in clinical consultations about a viral STI diagnosis: the particular 'dirtiness' of viral STIs, clinicians as moral agents, the 'non-judgmental' clinician, women juggling truth-telling and risk and clinicians prescribing moral work. Clinicians support and educate women more effectively if they recognise subjective, moral aspects of sexual health consultations rather than assuming that effective clinical teaching is rational, scientific and non-judgmental.
MeSH term(s)	Adult ; Aged ; Attitude of Health Personnel ; Counseling ; Electronic Mail ; Female ; Humans ; Interviews as Topic ; Middle Aged ; Morals ; Nurse-Patient Relations ; Papillomavirus Infections/nursing ; Papillomavirus Infections/psychology ; Qualitative Research ; Sexually Transmitted Diseases, Viral/nursing ; Sexually Transmitted Diseases, Viral/psychology ; Social Stigma ; Women/psychology ; Women's Health
Language	English
Publishing date	2014-03
Publishing country	Australia
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1483798-5
ISSN	1440-1800 ; 1320-7881
ISSN (online)	1440-1800
ISSN	1320-7881
DOI	10.1111/nin.12018
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Article ; Online: Value pluralism about sexual intimacy in residential care.

Schouten, Vanessa / Henrickson, Mark / Cook, Catherine M / MacDonald, Sandra / Atefi, Narges

Nursing ethics

2023 Volume 30, Issue 3, Page(s) 437–448

Abstract: Background: The existing literature on sexuality and intimacy in residential care tends to focus on either the question of rights, or the value of autonomy. Where the literature does reference values other than autonomy, such values are considered in ... ...

Abstract	Background: The existing literature on sexuality and intimacy in residential care tends to focus on either the question of rights, or the value of autonomy. Where the literature does reference values other than autonomy, such values are considered in the context of being a guide to whether or not a resident is autonomous, rather than being important values in their own right. Objective: This paper draws on qualitative data gathered as part of a larger study in order to inform practice on how care workers respond to intimacy issues that arise with residents with dementia and to inform a general ethics of sex and sexuality, demonstrating that an approach which permits value pluralism can be appropriate in certain contexts. Research design: The qualitative data referred to in this paper was gathered from semi-structured interviews undertaken as part of a larger mixed-method research project. The interview text was analysed using Thorne's methodological approach, interpretive description. Participants and research context: The qualitative arm of the project consisted of semi-structured interviews conducted between October 2018 and October 2019 with participants (staff, residents and family members) recruited from 35 residential care homes in Aotearoa New Zealand. Ethical considerations: Participation was informed, voluntary and written consent was gained before interviews. The project was approved by the Massey University Human Ethics Committee (Northern), number NOR 18/25. Findings: Analysis of the scenarios presented in this paper shows that decision-making around sexual intimacy involving people with dementia in a residential care setting is complex and requires recognizing and weighing the different values that may be a in play. Conclusion: A focus on safety and consent to the exclusion of other values which matter morally in this context is a mistake which prevents care workers from providing appropriately person-centred care to residents, as policies which focus on the goal of care allow space for critical examination of issues which are likely to be highly context-sensitive.
MeSH term(s)	Humans ; Dementia/complications ; Sexual Behavior ; Sexual Partners ; Sexuality ; Nursing Homes
Language	English
Publishing date	2023-02-01
Publishing country	England
Document type	Journal Article
ZDB-ID	1200467-4
ISSN	1477-0989 ; 0969-7330
ISSN (online)	1477-0989
ISSN	0969-7330
DOI	10.1177/09697330221136630
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