title: The characteristics and outcomes of patients with colorectal cancer in New Zealand, analysed by Cancer Network.

authors: Blackmore, Tania Louise

subjects: Aged

abstract: AIM: The incidence of colorectal cancer (CRC) in New Zealand is high by international standards. Approximately 1,200 people in New Zealand die from this disease per year. Outcomes in New Zealand following a CRC diagnosis are poor. We aimed to describe the characteristics and outcomes of patients diagnosed with CRC across the four regional cancer networks in New Zealand. METHOD: Patient demographics, tumour characteristics and survival outcomes for all patients diagnosed with CRC between 2006 and 2015 were analysed retrospectively from the National Cancer Registry (NZCR) and National Mortality collection and were linked by National Health Index (NHI) number. RESULTS: A total of 29,221 CRC cases were recorded during the 10-year study period, of which the majority were cancer of the colon (67.9%). In this sample, 42.0% were >75 years, 52.1% were male and 88.1% were New Zealand European. After adjustment for factors such as age, gender, ethnicity year of diagnosis, cancer extent, cancer grade, lymph node and cancer site, cancer-related and all-cause survival were not significantly different by cancer network for those aged <75 but for patients aged >75 years, those living in the Central and Midland Cancer Network had a higher risk of dying of CRC compared to those in the Northern Cancer Network (1.12, 95% CI: 1.03-1.22 and 1.10, 95% CI: 1.02-1.18 respectively). Overall, Māori and Pacific people had worse cancer-specific and all-cause survival than New Zealand European. CONCLUSION: No regional variations were seen within New Zealand for the characteristics and survival outcomes of patients <75 diagnosed with CRC. The risk of dying from CRC increased for those >75, which is supportive of the international literature regarding outcomes for the elderly and CRC. We continue to show disparity in outcomes for Māori and Pacific patients diagnosed with CRC in New Zealand.

text: The characteristics and outcomes of patients with colorectal cancer in New Zealand, analysed by Cancer Network. AIM: The incidence of colorectal cancer (CRC) in New Zealand is high by international standards. Approximately 1,200 people in New Zealand die from this disease per year. Outcomes in New Zealand following a CRC diagnosis are poor. We aimed to describe the characteristics and outcomes of patients diagnosed with CRC across the four regional cancer networks in New Zealand. METHOD: Patient demographics, tumour characteristics and survival outcomes for all patients diagnosed with CRC between 2006 and 2015 were analysed retrospectively from the National Cancer Registry (NZCR) and National Mortality collection and were linked by National Health Index (NHI) number. RESULTS: A total of 29,221 CRC cases were recorded during the 10-year study period, of which the majority were cancer of the colon (67.9%). In this sample, 42.0% were >75 years, 52.1% were male and 88.1% were New Zealand European. After adjustment for factors such as age, gender, ethnicity year of diagnosis, cancer extent, cancer grade, lymph node and cancer site, cancer-related and all-cause survival were not significantly different by cancer network for those aged <75 but for patients aged >75 years, those living in the Central and Midland Cancer Network had a higher risk of dying of CRC compared to those in the Northern Cancer Network (1.12, 95% CI: 1.03-1.22 and 1.10, 95% CI: 1.02-1.18 respectively). Overall, Māori and Pacific people had worse cancer-specific and all-cause survival than New Zealand European. CONCLUSION: No regional variations were seen within New Zealand for the characteristics and survival outcomes of patients <75 diagnosed with CRC. The risk of dying from CRC increased for those >75, which is supportive of the international literature regarding outcomes for the elderly and CRC. We continue to show disparity in outcomes for Māori and Pacific patients diagnosed with CRC in New Zealand.

year: 2020

title: Grounded Theory of (Dis)Empowered Outcomes in Healthcare Interventions

authors: Mandlik, Milind A.

subjects: Consumer Empowerment

abstract: The human body is a complex, finely-tuned, and ever-evolving “open system” which is always trying to regain good health. Being an open system, the human body relies on surrounding ecological systems for its sustenance, survival, and growth, making it susceptible to the consequences of these ecological systems. One of the biggest concerns for human health in the 21st century is the ever-increasing obesity rate and its associated mortality rate. Of equal concern is the resultant loss of productivity and the net impact of this on publicly-funded healthcare expenditures. Years of research and investment in health-promotive programmes have failed to stymie the growing obesity epidemic. Evidently, current intervention strategies are not working and are in desperate need of remodelling. Obese individuals attempt to remedy the status quo, but often fail to achieve healthy changes in their lives. These individuals appear to be disempowered entities who seem to have given up on their quest for a better quality of life.

The purpose of this grounded theory based enquiry was to develop a substantive theory of the phenomenon of consumer empowerment. The study was designed to explore the multi-level, cross-disciplinary complexities associated with the obesity epidemic and to find a workable solution that would assist with curtailing its growth. The key aim of this research was to understand the social processes that either empower or dis-empower individuals during episodes of consumption. In total, 24 individuals participated in this enquiry by sharing their stories of weight gain and their personal experiences with the weight-management programmes they tried to help them improve their quality of life. The data collection and analysis was guided by the philosophical viewpoints of constructivist grounded theory.  

This study revealed two core categories that helped explain the processes that either empowered or disempowered individuals during episodes of consumption: feeling entrapped and co-creating empowerment.  Data analysis revealed that the processes which either empowered or disempowered individuals during various episodes of consumption were mediated through individually-acting and ecologically-acting influences. Analysis results further suggested if empowered outcomes were desired, then they could only be attained through genuine cooperation and participation amongst members of society at all levels: individual, communal, institutional, and political. Over-reliance on either the individual actor or ecological actor to contribute while the other refrains from contributing would not achieve the desired outcome. This is a significant departure from the current conceptualisation of achieving empowered outcomes. This situation can only be resolved by redefining and operationalising empowerment as a co-created endeavour, one that depends on multi-actor participation. 

This enquiry presents the impetus for researchers to conceive broader definitions of empowerment as well as consumer empowerment phenomenon that includes not just individual participation, but also ecological contributions to the process. This research has the potential to inform the broader literature on empowerment theory.

text: Grounded Theory of (Dis)Empowered Outcomes in Healthcare Interventions The human body is a complex, finely-tuned, and ever-evolving “open system” which is always trying to regain good health. Being an open system, the human body relies on surrounding ecological systems for its sustenance, survival, and growth, making it susceptible to the consequences of these ecological systems. One of the biggest concerns for human health in the 21st century is the ever-increasing obesity rate and its associated mortality rate. Of equal concern is the resultant loss of productivity and the net impact of this on publicly-funded healthcare expenditures. Years of research and investment in health-promotive programmes have failed to stymie the growing obesity epidemic. Evidently, current intervention strategies are not working and are in desperate need of remodelling. Obese individuals attempt to remedy the status quo, but often fail to achieve healthy changes in their lives. These individuals appear to be disempowered entities who seem to have given up on their quest for a better quality of life.

The purpose of this grounded theory based enquiry was to develop a substantive theory of the phenomenon of consumer empowerment. The study was designed to explore the multi-level, cross-disciplinary complexities associated with the obesity epidemic and to find a workable solution that would assist with curtailing its growth. The key aim of this research was to understand the social processes that either empower or dis-empower individuals during episodes of consumption. In total, 24 individuals participated in this enquiry by sharing their stories of weight gain and their personal experiences with the weight-management programmes they tried to help them improve their quality of life. The data collection and analysis was guided by the philosophical viewpoints of constructivist grounded theory.  

This study revealed two core categories that helped explain the processes that either empowered or disempowered individuals during episodes of consumption: feeling entrapped and co-creating empowerment.  Data analysis revealed that the processes which either empowered or disempowered individuals during various episodes of consumption were mediated through individually-acting and ecologically-acting influences. Analysis results further suggested if empowered outcomes were desired, then they could only be attained through genuine cooperation and participation amongst members of society at all levels: individual, communal, institutional, and political. Over-reliance on either the individual actor or ecological actor to contribute while the other refrains from contributing would not achieve the desired outcome. This is a significant departure from the current conceptualisation of achieving empowered outcomes. This situation can only be resolved by redefining and operationalising empowerment as a co-created endeavour, one that depends on multi-actor participation. 

This enquiry presents the impetus for researchers to conceive broader definitions of empowerment as well as consumer empowerment phenomenon that includes not just individual participation, but also ecological contributions to the process. This research has the potential to inform the broader literature on empowerment theory.

year: 2017

title: Health equity and wellbeing among older people's caregivers in New Zealand during COVID-19: Protocol for a qualitative study.

authors: Burholt, Vanessa

subjects: Aged

abstract: BACKGROUND: Knowledge of the challenges unpaid caregivers faced providing care to older people during the COVID-19 pandemic is limited. Challenges may be especially pronounced for those experiencing inequitable access to health and social care. This participatory action research study, located in New Zealand, has four main objectives, (i) to understand the challenges and rewards associated with caregiving to older care recipients during the COVID-19 pandemic restrictions; (ii) to map and collate resources developed (or mobilised) by organisations during the pandemic; (iii) to co-produce policy recommendations, identify useful caregiver resources and practices, prioritise unmet needs (challenges); and, (iv) to use project results in knowledge translation, in order to improve caregivers access to resources, and raise the profile and recognition of caregivers contribution to society. METHODS AND ANALYSIS: Māori, Pacific and rural-dwelling caregivers to 30 older care-recipients, and 30 representatives from organisations supporting caregivers in New Zealand will be interviewed. Combining data from the interviews and caregivers letters (from an archive of older people's pandemic experiences), framework analysis will be used to examine the interrelated systems of the human ecological model and the impact on caregiving experiences during the pandemic. Resources that service providers had created or used for caregivers and older people will be collated and categorised. Through co-production with caregivers and community partners we will produce three short films describing caregivers' pandemic experiences; identify a suite of resources for caregivers to use in future events requiring self-isolation, and in everyday life; and generate ideas to address unresolved issues.

text: Health equity and wellbeing among older people's caregivers in New Zealand during COVID-19: Protocol for a qualitative study. BACKGROUND: Knowledge of the challenges unpaid caregivers faced providing care to older people during the COVID-19 pandemic is limited. Challenges may be especially pronounced for those experiencing inequitable access to health and social care. This participatory action research study, located in New Zealand, has four main objectives, (i) to understand the challenges and rewards associated with caregiving to older care recipients during the COVID-19 pandemic restrictions; (ii) to map and collate resources developed (or mobilised) by organisations during the pandemic; (iii) to co-produce policy recommendations, identify useful caregiver resources and practices, prioritise unmet needs (challenges); and, (iv) to use project results in knowledge translation, in order to improve caregivers access to resources, and raise the profile and recognition of caregivers contribution to society. METHODS AND ANALYSIS: Māori, Pacific and rural-dwelling caregivers to 30 older care-recipients, and 30 representatives from organisations supporting caregivers in New Zealand will be interviewed. Combining data from the interviews and caregivers letters (from an archive of older people's pandemic experiences), framework analysis will be used to examine the interrelated systems of the human ecological model and the impact on caregiving experiences during the pandemic. Resources that service providers had created or used for caregivers and older people will be collated and categorised. Through co-production with caregivers and community partners we will produce three short films describing caregivers' pandemic experiences; identify a suite of resources for caregivers to use in future events requiring self-isolation, and in everyday life; and generate ideas to address unresolved issues.

year: 2022