Understanding end-user perspectives to enhance perceived value uptake of harm-minimization tools: considering gambler’s views of a pre-commitment system

Harm-minimization strategies reduce the experience of gambling-related harms for individuals and those close to them. Most policies and particularly discussions of tool design and implementation fail to involve end users and consider their concerns and needs. This study aimed to investigate the best way to introduce a harm-minimization tool for electronic gaming machines (EGMs) that will maximize the perceived value and subsequent uptake by the intended audience of gamblers. Focus groups were conducted with 31 Australian regular EGM gamblers experiencing a range of gambling problems. Participants were asked their perspectives of a pre-commitment system (features including accessing activity statements, setting limits, viewing dynamic messages, taking breaks), including concerns, and how to enhance perceived value and usefulness. Positive attitudes about the system were expressed; however, many gamblers saw the tool as relevant only for problem gamblers. Participants indicated that value could be enhanced by making the system flexible and customizable, but still easy to use. Design and implementation strategies such as incorporating flexibility in features, ease of use, appropriate terminology, and educational efforts may address gamblers’ concerns, particularly regarding privacy and potential stigma. This would enhance user perception of harm-minimization tools as relevant and may subsequently enhance effectiveness.     

Complex home care: challenges arising from the blurring of boundaries between family and professional care

Over the last 50 years, increasingly complex care (such as tracheostomy management, dialysis or enteral feeding) has shifted from hospital to home, with a concomitant rise in patient self-management and care given by family members. Recognition of the importance of the contribution of family care to the health system is also growing. This article reports the findings of a New Zealand study which explored the experiences of family carers who manage technical health procedures at home. It then draws attention to some broader issues raised by shifting complex care from professional management in hospital settings to family care at home, namely the ways in which complex home care blurs the boundaries between professional and family care (creating the ambiguous position of the expert carer) and questions of safety and responsibility in family care. We also discuss the implications for policy around family caregiving in New Zealand. Given the potential physical and mental health impacts of caring, it is time for renewed consideration of what family carers should be expected or allowed to manage and how the health system can support them in their important role.     

Grandchildren's perspectives on grandparents in rural New Zealand

Within studies of ageing, rurality and family relations, the prevalent “point of view” is based on the perspectives of adults, particularly older people themselves. However, taking seriously the reciprocal nature of kinship relations also challenges researchers to find ways to explore younger people's views and experiences of intergenerational ties. The study on which this paper is based addressed this challenge, by considering the dynamics of ageing in rural families through the lens of young people's experience. In the South Island of New Zealand, Area Schools serve families in rural regions specifically defined in terms of a catchment area based on distance from any other state school. This research study selected five (from 16) of these schools, and invited the classes of Year 7 and 8 students to take part in a classroom activity, led by the researcher with support from the class teacher. The activity involved a total of 98 young people (aged 11–13) in written completion of a survey which outlined their relationships and contacts with the people they know as grandparents, along with basic demographics of their own age, gender, family and household situation, and length of attendance at the school. From this survey, information was derived about 380 grandparents (of whom 73 were no longer alive), the nature and frequency of their contacts, and the types of activities they shared with these grandchildren. Around 40 percent of the students have daily or weekly contact with a grandparent, one third “regularly do things together”, and one fifth say they have “a special relationship” with a grandparent. By controlling the age group of the grandchild, and focussing on rural families, this study adds insights and detail to a growing body of research interest in understanding the roles and contributions made by grandparents to New Zealand families, in particular those in rural communities.     

Keeley's journey: From service user to service provider

Background: This paper presents the vocational journey of a young British woman, Keeley, who changed her career aspirations to become a mental health worker following an episode of significant mental health difficulties. Keeley's story illustrates the application of the locally developed WORKS framework in conceptualising and supporting Keeley's vocational recovery. Approach: A narrative approach highlights the partnerships that developed between Keeley, the Occupational Therapist, Sally, and the User Support and Employment Service. Findings: The WORKS framework supported Keeley and Sally to collaboratively develop a successful employment pathway. Strategies, including attention to Keeley's view of her capabilities and aspirations, volunteer placements, support of peers, employer engagement and planning for sustainable employment, assisted Keeley to establish her chosen career. Keeley's journey highlights the leadership role that mental health services can assume by providing paid work for people with experience of mental health difficulties.     

Are Psychology University Student Gamblers Representative of Non-university Students and General Gamblers? A Comparative Analysis

Students recruited from psychology undergraduate university populations are commonly used in psychology research, including gambling studies. However, the extent to which the use of this subpopulation produces findings that can be extrapolated to other groups is questionable. The present study was designed to compare results from university-recruited psychology student gamblers to those obtained from a sample of gamblers recruited from the general population that also included students. An online survey measuring gambling behavior and Internet gambling, attitudes and knowledge about gambling and problem gambling severity was posted on websites accessed by gamblers. Participants were recruited from two sources, a psychology undergraduate university population (n = 461) and online websites (n = 4,801). Results showed university-recruited students differed significantly from both adults and students recruited from the general population in respect to demographic variables and gambling behavior. Psychology undergraduate students were younger, more likely to be female, and had lower incomes. When relevant demographic variables were controlled, psychology undergraduate students were found to gamble less frequently, at different times, and to be at lower-risk for gambling-related problems, but had more irrational beliefs and more negative attitudes towards gambling than gamblers recruited from the general population. Results suggest that caution should be used in extrapolating findings from research using university-recruited psychology student gamblers to wide community populations due to differences related to gambling thoughts, attitudes and behaviors.     

The sustainability of Egan’s Skilled Helper Model in students’ social work practice

This paper investigates the nature of students’ learning of the Egan Skilled Helper model in enabling them to develop collaborative communication skills which place service-users at the centre of decision making. The paper is a follow-up to an earlier paper which found that the Egan model was helpful to students as a communication and problem management tool and that they had transferred their learning into practice. The current study involves seven students from the first study and examines whether their knowledge and skills from learning the model in year one have been sustained two years later during their third year practice placement. A key finding is that participants were continuing to use most stages of the model (with the exception of challenging skills) with service-users in a variety of settings. Further findings are that the model is still useful in situations where goals are set by social workers rather than by service-users; and that it is the utilisation of role-play when learning the model which most embeds skills. The implications of these findings for skills training are discussed together with suggestions for further focus.