title: Knowing when we get there: An investigation into measuring success in new health service interventions for older people in Te Whatu Ora – Waikato region

authors: Guy, Graham

subjects: Success

abstract: Background: Health services are dynamic and undergo significant and ongoing changes.  The delivery of services to older people are no different and in many ways the changes are more dramatic as a consequence of the ageing population.  Monitoring whether health services meet the needs of the individuals that they serve is important as without such knowledge, it is not possible to determine the success of the interventions.  This research explores what does success look like from an older person’s perspective, the health professionals delivering that care, through to operational and executive managers.
Objective:  To explore the concept of success within health services for older people at Te Whatu Ora – Waikato.
Participants: One-to-one interviews were held with stakeholders, from executive and operational management and operational health professionals (n=7); focus groups with needs assessor service coordinators (n=10) and home care support services (n=6); and patient surveys with older participants (n=67).
Methods: Mixed methods research involving interviews and focus groups with stakeholders and surveys with older people receiving services.  Interviews and focus groups were transcribed verbatim and later analysed using a general inductive method of enquiry to generate key themes.  Surveys were analysed with descriptive statistics.
Results: The strategic direction of the health services and anticipated outcomes were well communicated and widely consulted and consequently there appeared to be alignment of views from those health professionals involved.  All believed that they were making a difference and felt personally rewarded by the role that they do and the contributions they make to the community, population in their care and individual patients.  Measures of success focussed on the assessment of quality of life and wellbeing for the older person.  This contrasted with the consumer perspective, who generally reported dissatisfaction with the services they received and on the whole their current quality of life. 
Conclusions: The research showed that health services tended to focus on an acute response and hospital services dominated conversations.  There was little awareness of the need to assess the broader aspects of service delivery.

text: Knowing when we get there: An investigation into measuring success in new health service interventions for older people in Te Whatu Ora – Waikato region Background: Health services are dynamic and undergo significant and ongoing changes.  The delivery of services to older people are no different and in many ways the changes are more dramatic as a consequence of the ageing population.  Monitoring whether health services meet the needs of the individuals that they serve is important as without such knowledge, it is not possible to determine the success of the interventions.  This research explores what does success look like from an older person’s perspective, the health professionals delivering that care, through to operational and executive managers.
Objective:  To explore the concept of success within health services for older people at Te Whatu Ora – Waikato.
Participants: One-to-one interviews were held with stakeholders, from executive and operational management and operational health professionals (n=7); focus groups with needs assessor service coordinators (n=10) and home care support services (n=6); and patient surveys with older participants (n=67).
Methods: Mixed methods research involving interviews and focus groups with stakeholders and surveys with older people receiving services.  Interviews and focus groups were transcribed verbatim and later analysed using a general inductive method of enquiry to generate key themes.  Surveys were analysed with descriptive statistics.
Results: The strategic direction of the health services and anticipated outcomes were well communicated and widely consulted and consequently there appeared to be alignment of views from those health professionals involved.  All believed that they were making a difference and felt personally rewarded by the role that they do and the contributions they make to the community, population in their care and individual patients.  Measures of success focussed on the assessment of quality of life and wellbeing for the older person.  This contrasted with the consumer perspective, who generally reported dissatisfaction with the services they received and on the whole their current quality of life. 
Conclusions: The research showed that health services tended to focus on an acute response and hospital services dominated conversations.  There was little awareness of the need to assess the broader aspects of service delivery.

year: 2023

title: Supporting students with impairments in higher education: social inclusion or cold comfort?

authors: Claiborne, Lise Bird

subjects: inclusive education

abstract: This paper uses a discursive analysis to examine the experience of ‘inclusion’ from several stakeholder groups in one university. The research team included disability support staff at the institution, external disability consultants and academic researchers. A critical focus group investigation centred on four groups: students who were identified as having an impairment (SWIs), academic staff (teachers), administrators and students who did not identify as having an impairment (non‐SWIs). Interviews had facilitators with both research and disability expertise. Groups recounted different experiences of inclusion. SWIs, drawing on a rights discourse, emphasised a lack of resourcing and barriers created by the teaching staff. In contrast, teachers, administrators and (to a lesser extent) non‐SWIs emphasised the importance of social inclusion, reflecting discourses around needs and humanist notions of care and support, which largely seemed to miss the core of SWI concerns about recognition of their technical competence. For all groups, questions around disclosure of disability were of greater concern than tensions between needs and rights or the recent publication of a Code of Practice for the higher education sector. The findings challenged some of the researchers’ own assumptions, with unexpected implications for practice.

text: Supporting students with impairments in higher education: social inclusion or cold comfort? This paper uses a discursive analysis to examine the experience of ‘inclusion’ from several stakeholder groups in one university. The research team included disability support staff at the institution, external disability consultants and academic researchers. A critical focus group investigation centred on four groups: students who were identified as having an impairment (SWIs), academic staff (teachers), administrators and students who did not identify as having an impairment (non‐SWIs). Interviews had facilitators with both research and disability expertise. Groups recounted different experiences of inclusion. SWIs, drawing on a rights discourse, emphasised a lack of resourcing and barriers created by the teaching staff. In contrast, teachers, administrators and (to a lesser extent) non‐SWIs emphasised the importance of social inclusion, reflecting discourses around needs and humanist notions of care and support, which largely seemed to miss the core of SWI concerns about recognition of their technical competence. For all groups, questions around disclosure of disability were of greater concern than tensions between needs and rights or the recent publication of a Code of Practice for the higher education sector. The findings challenged some of the researchers’ own assumptions, with unexpected implications for practice.

year: 2011

title: Demystifying a relationship between voluntary work and Māori

authors: Te Momo, Oliver Helena Fiona

abstract: The purpose of this thesis is to provide evidence that critically reviews the relationship between Māori and voluntary work in social service organisations. Since colonisation very little research has been initiated that investigated the involvement of Māori in voluntary activity yet recent statistics show that Māori are the highest participants in this type of work. This thesis provides an analysis of the relationship of Māori to voluntary work and its evolution in a Colonial State, Liberal State, Welfare State, and Neo-Liberal State in New Zealand. Three perspectives of Māori voluntary work provide the foundation for the analysis of this relationship. The first perspective describes voluntary work from a personal experience as an insider. The second perspective explores literature that records Māori involvement in voluntary activity. The third perspective documents life experiences from Māori voluntary workers in New Zealand communities. The three perspectives provide an empirical foundation for the type of relationship that has developed between Māori and voluntary work; Māori and the State; Māori and their place in New Zealand society. My interest in Te Ao Māori (the Māori world) as a valid and thriving ontological position and my academic interest in critical theory provide the theoretical lens for my analysis. 

Personal experience as a Māori volunteer opened doors to the communities I entered and added strength to the research, the first perspective. Western research in Māori communities often by non-Māori researchers, was conducted to gather knowledge for Western policy makers. Māori knowledge was not recognised as valid and the people were treated as objects. Knowing this, I searched for an approach that valued Māori participants, valued Māori people, and contained cultural aspects that separated the procedure from Western research. A review of literature, the second perspective, introduced a cultural approach to research termed kaupapa Māori research, generated out of and for Te Ao Māori detailed further in Chapter Three.

Participants’ life experiences coupled with literature provide a wealth of knowledge and a testimony to the type of relationship that exists between Māori and voluntary work. Criticism from Māori communities as to the exploitation of Māori volunteers has swelled in recent years so that the environment volunteers work in is no longer attractive to Māori people. Therefore, documenting the life experiences of Māori who participate in voluntary work as the primary source of information was imperative and produced evidence to describe the relationship between Māori and voluntary work in the thesis. A triangular study: case study, community study, and cross-section study (Chapters Six, Seven, and Eight), provide the ‘grass roots voices’ and represent the third perspective. 

My observation of Māori organisations’ involvement in voluntary work generated in me a deep concern in what appeared to be an involvement in activity that improved neither the lives of the volunteers nor the wider problems to which they attributed their aroha. This involvement activity is a product of historical developments whereby the Western ideology of voluntary work became confused with a Māori ideology of collective participation. This confusion has created an environment where Māori voluntary organisations are working unpaid with insufficient resources in oppressive conditions in the attempt to provide social solutions. I argue that the Māori ideology of collective participation has been co-opted in the emerging conflict of neo-liberalism to provide social services in communities which government agencies exploit. In conclusion, the thesis is a journey through the world of voluntary work for Māori in communal organisations.

text: Demystifying a relationship between voluntary work and Māori The purpose of this thesis is to provide evidence that critically reviews the relationship between Māori and voluntary work in social service organisations. Since colonisation very little research has been initiated that investigated the involvement of Māori in voluntary activity yet recent statistics show that Māori are the highest participants in this type of work. This thesis provides an analysis of the relationship of Māori to voluntary work and its evolution in a Colonial State, Liberal State, Welfare State, and Neo-Liberal State in New Zealand. Three perspectives of Māori voluntary work provide the foundation for the analysis of this relationship. The first perspective describes voluntary work from a personal experience as an insider. The second perspective explores literature that records Māori involvement in voluntary activity. The third perspective documents life experiences from Māori voluntary workers in New Zealand communities. The three perspectives provide an empirical foundation for the type of relationship that has developed between Māori and voluntary work; Māori and the State; Māori and their place in New Zealand society. My interest in Te Ao Māori (the Māori world) as a valid and thriving ontological position and my academic interest in critical theory provide the theoretical lens for my analysis. 

Personal experience as a Māori volunteer opened doors to the communities I entered and added strength to the research, the first perspective. Western research in Māori communities often by non-Māori researchers, was conducted to gather knowledge for Western policy makers. Māori knowledge was not recognised as valid and the people were treated as objects. Knowing this, I searched for an approach that valued Māori participants, valued Māori people, and contained cultural aspects that separated the procedure from Western research. A review of literature, the second perspective, introduced a cultural approach to research termed kaupapa Māori research, generated out of and for Te Ao Māori detailed further in Chapter Three.

Participants’ life experiences coupled with literature provide a wealth of knowledge and a testimony to the type of relationship that exists between Māori and voluntary work. Criticism from Māori communities as to the exploitation of Māori volunteers has swelled in recent years so that the environment volunteers work in is no longer attractive to Māori people. Therefore, documenting the life experiences of Māori who participate in voluntary work as the primary source of information was imperative and produced evidence to describe the relationship between Māori and voluntary work in the thesis. A triangular study: case study, community study, and cross-section study (Chapters Six, Seven, and Eight), provide the ‘grass roots voices’ and represent the third perspective. 

My observation of Māori organisations’ involvement in voluntary work generated in me a deep concern in what appeared to be an involvement in activity that improved neither the lives of the volunteers nor the wider problems to which they attributed their aroha. This involvement activity is a product of historical developments whereby the Western ideology of voluntary work became confused with a Māori ideology of collective participation. This confusion has created an environment where Māori voluntary organisations are working unpaid with insufficient resources in oppressive conditions in the attempt to provide social solutions. I argue that the Māori ideology of collective participation has been co-opted in the emerging conflict of neo-liberalism to provide social services in communities which government agencies exploit. In conclusion, the thesis is a journey through the world of voluntary work for Māori in communal organisations.

year: 2003