Journal of primary health care最新文献_第3页

Priorities for data collection through a prospective cohort study on gender-affirming hormone therapy in Aotearoa New Zealand: community and clinical perspectives. 通过对新西兰奥特亚罗瓦地区性别确认激素疗法的前瞻性队列研究收集数据的优先事项：社区和临床观点。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC23170

Rona Carroll, Sally B Rose, Alex Ker, Michaela A Pettie, Susan M Garrett

{"title":"Priorities for data collection through a prospective cohort study on gender-affirming hormone therapy in Aotearoa New Zealand: community and clinical perspectives.","authors":"Rona Carroll, Sally B Rose, Alex Ker, Michaela A Pettie, Susan M Garrett","doi":"10.1071/HC23170","DOIUrl":"https://doi.org/10.1071/HC23170","url":null,"abstract":"Introduction Gender affirming hormone therapy (GAHT) is an important aspect of health care for many transgender and non-binary (TNB) people, but little is known about the long-term outcomes for TNB people in Aotearoa New Zealand (NZ). Pathways to access GAHT are shifting from secondary care towards primary care, so this is an opportune time to commence local research on long-term health and wellbeing outcomes for people initiating GAHT. Aim This paper aims to report on the key findings from four meetings held to inform the design of a prospective cohort study to follow the journey of people initiating GAHT in primary and secondary care settings in NZ. Methods We worked with a community advisory group of six TNB young people and sought input from 14 health care providers involved in the care of TNB people initiating GAHT (GPs, secondary care doctors, and mental health providers). Semi-structured interview schedules were used to guide discussions. Template analysis was used to initially code data based on themes identified from the interview schedule and new themes from discussions were added. Results Participants shared ideas about recruitment and data collection priorities for baseline and follow-up surveys. These included understanding the journey to starting hormone therapy (information-seeking, decision-making), access to services for GAHT initiation, appropriateness of information provision, receipt of the first prescription, goals for and experience of GAHT, and the unique needs of non-binary people. Discussion Input from a TNB advisory group and health care professionals has informed the development of a survey that will be used to understand the experience of, and outcomes for, people starting GAHT in NZ. Findings from this planned prospective cohort study have the potential to improve access to GAHT for TNB people who wish to pursue this option.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 3","pages":"301-307"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rural hospital contributions to community health: community perspectives from a New Zealand rural hospital. 农村医院对社区卫生的贡献：新西兰一家农村医院的社区观点。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC24058

Stephen Ram, Karen Carlisle, Sarah Larkins, Katharina Blattner

{"title":"Rural hospital contributions to community health: community perspectives from a New Zealand rural hospital.","authors":"Stephen Ram, Karen Carlisle, Sarah Larkins, Katharina Blattner","doi":"10.1071/HC24058","DOIUrl":"10.1071/HC24058","url":null,"abstract":"Introduction Rural hospitals provide secondary care for much of the rural New Zealand population. Little is known about community perspectives of the health and social contribution. Aim This descriptive qualitative study aimed to explore community views on the role of their rural hospital in a low socioeconomic rural district with a high Māori and Pacific population. Methods Semi-structured individual and focus group interviews were conducted with rural community members about the perceived role of their rural hospital. Iterative thematic analysis was undertaken. Results In total, 22 participants were interviewed. Thematic analysis yielded four themes: (i) rural hospitals as a safety net - providing access to emergency care and mitigating limited primary care access; (ii) providing personalised, culturally aware care; (iii) facilitating family/whanau support; and (iv) doing the best with limited resources. The latter included pragmatism about resource constraints, but a preference for the hospital to remain open. Discussion Rural hospitals contribute to community safety by enhancing access to emergency care and mitigating difficulties in access to primary care. The local contextual knowledge of rural hospital providers allows personalised, family-centred and culturally-responsive care. Despite service centralisation, rural hospitals are wanted by their communities. Rural health planners should consider how to maximise the breadth of locally-provided services to reduce the impacts of travel and transfer for care.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 3","pages":"278-287"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethical assessment of virtual consultation services: scoping review and development of a practical ethical checklist. 虚拟咨询服务的伦理评估：范围审查和实用伦理清单的制定。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC24027

Madeleine Reid, Tania Moerenhout

{"title":"Ethical assessment of virtual consultation services: scoping review and development of a practical ethical checklist.","authors":"Madeleine Reid, Tania Moerenhout","doi":"10.1071/HC24027","DOIUrl":"10.1071/HC24027","url":null,"abstract":"Introduction The use of telephone and video consultations has vastly increased since the onset of the COVID-19 pandemic. Health care providers in traditional clinical practices have embraced these virtual consultations as an alternative to face-to-face consultations, but there has also been a simultaneous increase in services offered directly to consumers via commercial entities. One of the main challenges in telemedicine (and the broader field of digital health) is how to conduct a meaningful ethical assessment of such services. Aim This article presents a novel framework for practical ethical analysis of direct-to-consumer virtual general practitioner consultation services in Aotearoa New Zealand. Methods First, a scoping review of academic and policy documents identified the core ethical challenges arising from virtual consultations. Second, a qualitative analysis was conducted to translate the main ethical themes and subthemes into practical questions to assess virtual general practice services. Results A total of 49 relevant documents were selected for review. The six key ethical themes related to telemedicine were: privacy, security, and confidentiality; equity; autonomy and informed consent; quality and standards of care; patient empowerment; and continuity of care. A practical ethical checklist consisting of 25 questions was developed from these themes and their subthemes. Discussion The checklist provides an accessible way of incorporating ethics into technology assessment and can be used by all relevant stakeholders, including patients, health care providers, and developers. Application of the framework contributes to improving the quality of virtual consultation services with a specific focus on ethics.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 3","pages":"288-294"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethical assessment of virtual consultation services: application of a practical ethical checklist to direct-to-consumer services in Aotearoa New Zealand. 虚拟咨询服务的伦理评估：新西兰奥特亚罗瓦地区直接面向消费者服务的实用伦理清单应用。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC24030

Madeleine Reid, Tania Moerenhout

{"title":"Ethical assessment of virtual consultation services: application of a practical ethical checklist to direct-to-consumer services in Aotearoa New Zealand.","authors":"Madeleine Reid, Tania Moerenhout","doi":"10.1071/HC24030","DOIUrl":"https://doi.org/10.1071/HC24030","url":null,"abstract":"Introduction Evaluating digital health services from an ethical perspective remains one of the more difficult challenges in telemedicine and health technology assessment. We have previously developed a practical ethical checklist comprising 25 questions covering six ethical themes: privacy, security, and confidentiality; equity; autonomy and informed consent; quality and standards of care; patient empowerment; and continuity of care. The checklist makes ethical analysis more easily accessible to a broader audience, including health care providers, technology developers, and patients. Aim This project applies the previously developed practical ethical checklist to direct-to-consumer virtual primary care consultation services in Aotearoa New Zealand to conduct an ethical assessment. Method We first mapped the available services. The ethical framework was then applied to assess these services based on publicly available information. Results Our findings show that the examined virtual consultation services adequately address ethical considerations, particularly regarding patient data privacy and informed consent. We identified areas for improvement in equity, patient empowerment, and continuity of care. Discussion The application of this framework raises fundamental questions on how continuity of care, equity, and comprehensive care can be protected when virtual care becomes more ubiquitous. The checklist can help virtual consultation services identify areas of improvement and ensure they meet ethical criteria, thus contributing to quality of care. The framework may be adapted to other digital health services and tools, providing ethical guidance to technology developers, clinicians, and patients and their whānau (family).","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 3","pages":"295-300"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Worldviews of hearing health for Pacific peoples in Aotearoa New Zealand: a mixed methods study. 新西兰奥特亚罗瓦太平洋岛屿族裔的听力健康世界观：一项混合方法研究。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC23123

Elizabeth A-L Holt, Latasi Koro, Fiona Langridge, Vili Nosa

{"title":"Worldviews of hearing health for Pacific peoples in Aotearoa New Zealand: a mixed methods study.","authors":"Elizabeth A-L Holt, Latasi Koro, Fiona Langridge, Vili Nosa","doi":"10.1071/HC23123","DOIUrl":"10.1071/HC23123","url":null,"abstract":"Introduction Pacific peoples experience inequity in accessing hearing health care and are disproportionately exposed to the underlying determinants impacting ear and hearing health in Aotearoa New Zealand. Understanding community members' worldviews, including perspectives, beliefs and values, is essential in developing appropriate and responsive hearing healthcare services to meet the needs of Pacific peoples. Aim The purpose of this paper is to understand the worldviews, knowledge and beliefs held by Pacific peoples regarding hearing health in Aotearoa New Zealand. Methods A mixed-methods approach was used. Twelve semi-structured face-to-face interviews were conducted with Pacific community members. Twenty-five participants completed an online questionnaire. A simultaneous, integrated mixed-methods approach was used to analyse the qualitative and quantitative data. Results Five main themes were established, which were: The Meaning of Hearing; Causes of hearing loss; Consequences of hearing loss and Disability; and Improving health care for ear disease and hearing loss. Discussion Pacific peoples value hearing health to communicate and connect with their families and communities. Participants highlighted the importance of hearing health across the life course. Although the study findings revealed there is potentially less stigma and shame around hearing loss in New Zealand, denial and fatalistic attitudes towards hearing loss may delay some people from seeking healthcare services. Participants expressed key ways in which the health system can be more responsive to the hearing health needs of Pacific peoples in Aotearoa New Zealand.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 3","pages":"250-257"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rural health in Aotearoa New Zealand: current state and future challenges. 新西兰奥特亚罗瓦的农村卫生：现状与未来挑战。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC24136

Tim Stokes, Felicity Goodyear-Smith

引用次数: 0

Who uses yoga and why? Who teaches yoga? Insights from a national survey in New Zealand. 谁在使用瑜伽，为什么？谁在教瑜伽？新西兰全国调查的启示。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC23102

Sridhar Maddela, Stephen Buetow, Ruth Teh, Fiona Moir

{"title":"Who uses yoga and why? Who teaches yoga? Insights from a national survey in New Zealand.","authors":"Sridhar Maddela, Stephen Buetow, Ruth Teh, Fiona Moir","doi":"10.1071/HC23102","DOIUrl":"https://doi.org/10.1071/HC23102","url":null,"abstract":"Introduction Globally, yoga has gained popularity as a health-promoting and disease-prevention discipline. The common health conditions prompting yoga use include musculoskeletal disorders, mental health conditions, asthma, fibromyalgia, arthritis, diabetes, and cancers. Although the therapeutic benefits of using yoga are well documented, little is known about the characteristics of yoga instructors (YIs) and yoga users (YUs) in New Zealand (NZ). Aim This paper seeks to profile the characteristics of NZ YIs and YUs and explore reasons for yoga use. Methods Online surveys for YIs and YUs were conducted to collect the sociodemographic characteristics of 84 YIs and 267 YUs. Descriptive statistics were used to determine trends. Results The surveys were conducted between September 2020 and February 2021. The YIs were predominantly female (87.1%) with mean ± s.d. years of practice of 9.8 ± 0.8 (95% CI: 8.2, 11.4). YUs were most commonly female (86%), of NZ European descent (63%), aged 45-64 years (56%), not married (52.5%), and with a university or higher education qualification (61.5%). They use yoga to alleviate chronic health conditions like back pain (18%), menopausal symptoms (14.5%), anxiety (13.5%) and depression (11.5%). Discussion Most YIs in NZ are females facilitating moderate-sized yoga classes. YUs in NZ are disproportionately NZ European, female, middle-aged and tertiary educated. They use yoga to help manage long-term conditions, including mental ill-health and musculoskeletal disorders. The study findings could inform health professionals regarding the utilisation of yoga in NZ. Further research is required to gain insights into yoga use.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 3","pages":"232-242"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A supported primary health pathway for mild traumatic brain injury quality improvement report. 轻度脑外伤辅助初级保健路径质量改进报告。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC23131

A Theadom, J Chua, A Sintmaartensdyk, S Kara, R Barnes, R Macharg, E Leckey, A Mirza

{"title":"A supported primary health pathway for mild traumatic brain injury quality improvement report.","authors":"A Theadom, J Chua, A Sintmaartensdyk, S Kara, R Barnes, R Macharg, E Leckey, A Mirza","doi":"10.1071/HC23131","DOIUrl":"https://doi.org/10.1071/HC23131","url":null,"abstract":"Introduction Best-practice guidelines recommend that patients are followed-up to check if they have recovered following a mild traumatic brain injury (mTBI) and to refer to concussion services, if needed. However, in New Zealand, rates of follow-up are low and access to concussion services can be delayed. Aim We aimed to improve rates of follow-up and access to concussion services for mTBI patients aged ≥8 years by the implementation of a supported health pathway and test its success. Methods The pathway included a decision support tool, funded follow-up appointments, clinician training and a patient education resource. Sociodemographics, injury details and proportions of patients receiving a follow-up by type and time were extracted from the Accident Compensation Corporation (ACC) database between 18 May 22 and 30 June 23 and compared to national ACC data prior to implementation. Results Data were extracted for 220 patients, with a mean age of 31.5 years, 51.4% female and 21.4% Māori and Pacific. There was an increase in the proportion of patients receiving a follow-up from 36% pre-implementation to 56.8% post-implementation. Sixty-three patients (28.6%) accessed a concussion service post-implementation compared to 10% pre-implementation. Time to concussion service reduced from an average of 55 (s.d. = 65.4) to 37 days (29.5). Discussion Risk factor criteria within the decision support tool need to be weighted to improve specificity of referrals. Timing from injury to medical review in primary care needs to be considered. This quality improvement project provides preliminary evidence for implementation of a supported health care pathway for mTBI.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 3","pages":"308-314"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Checklists for assessing ethical aspects of health technologies and services. 评估医疗技术和服务伦理问题的核对表。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC24092

Bjørn Hofmann

引用次数: 0

Aotearoa New Zealand general practice workforce crisis: what are our solutions? 新西兰全科医生队伍危机：我们的解决方案是什么？

IF 1.1

Journal of primary health care Pub Date : 2024-06-01 DOI: 10.1071/HC23178

Albert Andrew

引用次数: 0