Experience of internationally qualified nurses providing palliative care in a New Zealand aged residential care facility.

BACKGROUND: New Zealand is reliant upon internationally qualified nurses (IQNs) working within aged residential care (ARC), despite the fact that many of these nurses have limited or no ARC or palliative care experience before arriving in the country. AIMS: To understand the issues faced by IQNs providing palliative care to people in ARC. To understand how the palliative aged residential care (PARC) specialist nurse team can best support IQNs. METHODS: A thematic analysis was undertaken from five focus group interviews with IQNs (n=24) from ARC facilities in the Christchurch and Canterbury regions. FINDINGS: Unfamiliarity with New Zealand 's palliative care and ARC systems, cultural differences and communication barriers caused internal struggles. Transitioning to a New Zealand approach to palliative care highlighted participants' adaptability and resilience. Consistent approaches to training and support by the PARC team and additional cultural training within New Zealand Competence Assessment Programmes (CAP) are required. CONCLUSION: Ongoing education, support and role modelling to develop confidence and reduce internal struggles are required for IQNs providing palliative care in ARC.

Keep on brushing: a longitudinal study of motivational text messaging in young adults aged 18-24 years receiving Work and Income Support.

OBJECTIVES: Using text messaging, underpinned by the Health Belief Model, this study aimed to improve tooth brushing frequencies among unemployed young adults aged 18-24 years. METHODS: Set within Work and Income's Linwood Community Link office (one Christchurch branch of the New Zealand Government's employment and beneficiary services), unemployed young adults aged 18-24 years with access to a mobile phone were recruited using either a purpose-built computer kiosk or Work and Income's Facebook site. Participants completed a baseline survey and then received and responded to a series of motivational text messages over 10 weeks. Self-reported tooth brushing frequency was the primary outcome variable. Important socio-demographic (age, gender, ethnicity, employment status) and method-specific (level of attrition, distribution of successful text messages deliveries, active withdrawal) variables were also collected. Longitudinal analyses of these responses employed generalized estimating equation (GEE) models. RESULTS: Four hundred and three registered for the trial, of whom 171 (42%) were eligible. Self-reported tooth brushing twice or more per day increased from 51% at baseline to 70% at week 3, 74% at week 6, and 73% at week 9 - an increase significant in crude (P<0.001) and adjusted (P<0.001) GEE analyses. No important differences were noted between age, gender, or ethnic groups, although attrition was relatively high with only 26% participating by week 9. However, no evidence of differential attrition was observed. CONCLUSIONS: Invention through motivational text messaging improved the measured oral health self-care behavior in a hard-to-reach group carrying a disproportionately heavy oral health burden. This intervention warrants further investigation.