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

Rural Māori experiences of accessing heart health care: a Kaupapa Māori qualitative analysis. 农村Māori获得心脏保健的经验：一项考帕帕Māori定性分析。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24111

Taria Tane, Vanessa Selak, Kyle Eggleton, Matire Harwood

{"title":"Rural Māori experiences of accessing heart health care: a Kaupapa Māori qualitative analysis.","authors":"Taria Tane, Vanessa Selak, Kyle Eggleton, Matire Harwood","doi":"10.1071/HC24111","DOIUrl":"10.1071/HC24111","url":null,"abstract":"Introduction Rural Māori experience inequities in heart health outcomes compared to rural non-Māori and urban Māori. Access to health care is a significant contributor to these inequities. There is a wealth of literature that explores Māori access to health care; however, the voice of rural Māori within the literature is limited. Under Te Tiriti o Waitangi (The Treaty of Waitangi), Māori have legislative rights to access, engage, and participate in the health care system equitably. Aim This study aimed to investigate the barriers and facilitators of accessing heart health care for rural Māori. Methods The study was informed by Kaupapa Māori Theory, which centres on Māori worldviews and epistemologies. Rural Māori (n =11) with lived experience of (or who had supported their whānau (family) member with) acute coronary syndrome, heart failure or cardiovascular risk assessment were interviewed, and reflective thematic analysis of the data was undertaken. Results Three overarching themes were generated: rural Māori desires and expectations of heart health care; how the system engages with rural Māori; and knowing what is important to rural Māori when it comes to heart health. Discussion Participants experienced many barriers to accessing quality heart health care, some of which were unique to rural settings. Participants sought heart health care that was close to home, culturally responsive, included a representative Māori workforce, involved their whānau, and valued partnership. System-level action is needed to adequately address inequities in health care access and outcomes in rural Māori and to meet obligations under Te Tiriti o Waitangi.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"53-62"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735984","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

Interprofessional communication between general dental practitioners and general medical practitioners: a qualitative study. 全科牙医和全科医生之间的跨专业交流：一项定性研究。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24071

Guangzhao Guan, Amanda Lim, HuiYee Sim, YeYan Khor, Li Mei

{"title":"Interprofessional communication between general dental practitioners and general medical practitioners: a qualitative study.","authors":"Guangzhao Guan, Amanda Lim, HuiYee Sim, YeYan Khor, Li Mei","doi":"10.1071/HC24071","DOIUrl":"10.1071/HC24071","url":null,"abstract":"Introduction Interprofessional communication between health care professionals is crucial to deliver quality health outcomes and enhance patients' quality of life. Aim This study aimed to investigate the perspectives and contents of the interprofessional communication between general dental practitioners (GDPs) and general medical practitioners (GPs), and to explore the barriers and strategies that could bridge the gap between these health care professionals from their perspectives. Methods A qualitative study approach was undertaken, with semi-structured interviews conducted with GDPs and GPs from Dunedin and Auckland, New Zealand. Transcripts were analysed using a thematic approach to identify patterns and main themes. Results Three major themes emerged from the interviews with GDPs (n =10) and GPs (n =6): (1) experiences of communication, (2) the content of communication and (3) barriers and suggestions to improve communication. Most GDP and GP participants reported that there was a lack of communication between these two specialties. Complex medical conditions and polypharmacy were the topics perceived as essential for interprofessional communication between GDPs and GPs. The barriers of communication included time constraints, insufficient knowledge of the dental field among most GPs, inadequate understanding of referral among GDPs, and the absence of a common means of communication. Discussion Both GDPs and GPs reported a lack of efficient interprofessional communication. They suggested implementing interprofessional education, integrating health record systems, scheduling regular face-to-face meetings, and developing effective referral guidelines.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"30-36"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735931","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

Technology-enhanced, culturally-informed primary care results in sustained improvements in biomarkers for Indigenous patients with type 2 diabetes - a pilot study. 一项试点研究表明，技术增强、文化知情的初级保健可以持续改善土著2型糖尿病患者的生物标志物。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24056

Lynne M Chepulis, Rebekah Crosswell, Suzanne Moorhouse, Helen Morton, Michael Oehley, Ryan Paul, Hamish Crocket

{"title":"Technology-enhanced, culturally-informed primary care results in sustained improvements in biomarkers for Indigenous patients with type 2 diabetes - a pilot study.","authors":"Lynne M Chepulis, Rebekah Crosswell, Suzanne Moorhouse, Helen Morton, Michael Oehley, Ryan Paul, Hamish Crocket","doi":"10.1071/HC24056","DOIUrl":"10.1071/HC24056","url":null,"abstract":"Introduction Type 2 diabetes disproportionately affects Indigenous Māori in New Zealand. The reasons for this are multifactorial but include a history of colonialism, barriers to health care access and a lack of culturally appropriate interactions/relationships with health care providers. There is currently a need to develop models of health care delivery that are tailored to the needs of this population. Aim This pilot study evaluates the use of technology, education and culturally-informed wrap-around care (including medication optimisation) to improve type 2 diabetes biomarkers and self-management in a high-needs, majority Indigenous population. Methods Twenty-three participants with HbA1c >80mmol/L received 2-4weeks of continuous glucose monitor (CGM) wear at baseline and at 3months alongside culturally-informed type 2 diabetes education and clinical care. Clinical biomarkers and psychometric measures were recorded at 0, 3, 6 and 12months and 0 and 3months respectively. Medication changes were recorded throughout the study. Results Mean (± s.d.) HbA1c significantly decreased from 93.4±15.7mmol/mol at baseline to 76.5±14.8mmol/mol at 3months, with reductions maintained at 6 and 12months by approximately three-quarters of participants (all P Discussion CGM informed, culturally-appropriate care has the potential to lead to sustained improvements in glycaemia in high-risk, Indigenous populations managed in primary care.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"83-87"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735988","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

Use of a smartphone-based, non-mydriatic fundus camera for patients with red flag ophthalmic presentations in a rural general practice. 在农村全科诊所中使用基于智能手机的无散瞳眼底相机治疗有危险症状的眼科患者。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24040

Scott Davidson, Waldir Rodrigues de Souza, Kyle Eggleton

{"title":"Use of a smartphone-based, non-mydriatic fundus camera for patients with red flag ophthalmic presentations in a rural general practice.","authors":"Scott Davidson, Waldir Rodrigues de Souza, Kyle Eggleton","doi":"10.1071/HC24040","DOIUrl":"10.1071/HC24040","url":null,"abstract":"Introduction Fundus examination by direct ophthalmoscopy is widely used in general practice; however, it offers limited field of view, requires close approximation to the patient, has a steep learning curve and is a difficult skill to master and maintain. Non-mydriatic fundus photography (NMFP) offers an alternative with a wider field of view, ability for image analysis and transmission, and is able to be conducted by allied healthcare staff. Aim This study aimed to compare the use of direct ophthalmoscopy with smart-phone NMFP in a large rural general practice. It also aimed to analyse the number of adequate views and positive findings achieved with each instrument and the impact of NMFP on ophthalmology referral decisions. Methods Patients aged ≥16 years presenting to Dargaville Medical Centre (Dargaville, New Zealand) with visual disturbance, headache, hypertensive urgency (systolic blood pressure (BP) >200 mmHg or diastolic BP >120 mmHg), transient ischemic attack (TIA) or stroke were enrolled prospectively into an observational study of visualisation, diagnosis and management impact for a 1-year period (n = 152, 304 eyes). Direct ophthalmoscopy findings and management plans were documented by the attending general practitioner (GP), and then again following assessment of the NMFP. Results NMFP significantly improved visualisation of the fundal structures with an increase in adequate views achieved of both the optic disc and the retina. Inter-rater agreement between the referring GP and ophthalmologist was good. Discussion The use of NMFP in general practice might result in greater accuracy in diagnosing retina and optic disc disease. Routine transmission of NMFP images to specialist eye clinics as part of the referral might improve management and result in health system efficiencies.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"4-9"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736010","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

Exploration of family/whānau and general practitioner perspectives of paediatric grommet services: a mixed methods study. 探索家庭/whānau和全科医生对儿科美容服务的看法：一项混合方法研究。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24083

Michelle A Pokorny, Elizabeth A-L Holt, Hannah Fuller, Peter R Thorne

{"title":"Exploration of family/whānau and general practitioner perspectives of paediatric grommet services: a mixed methods study.","authors":"Michelle A Pokorny, Elizabeth A-L Holt, Hannah Fuller, Peter R Thorne","doi":"10.1071/HC24083","DOIUrl":"10.1071/HC24083","url":null,"abstract":"Introduction Traditionally, grommet post-surgical follow-up care has been undertaken by otorhinolaryngologists (ORLs), but in a large public outpatient ORL service in Auckland, New Zealand (Counties Manukau), this responsibility has been partially devolved to general practitioners (GPs). Aim The purpose of this study is to explore the perspectives and experiences of families/whānau and GPs regarding grommet services for children. Methods A mixed methods approach was used with family/whānau comprising semi-structured interviews and a GP survey. Recruitment of families/whānau reflected the local demographic and all participants were primary carers of a child who had received grommet surgery between 2020 and 2021. All GPs were practising in clinics within the ORL service catchment area. Results Twenty-eight family/whānau interviews were conducted, and 22 GPs responded to the survey. Five main themes were identified: (1) awareness of child development; (2) challenges accessing health care; (3) responses to health information; (4) importance of aftercare; and (5) preference for service provision. Most (16) GP respondents reported they should not be responsible for post-surgical follow-up after grommet insertion. Lack of capacity and funding were identified as key barriers to GP-led follow-up. Discussion Families/whānau highly valued follow-up services and hearing evaluations after grommet insertion, and had a strong preference for clinicians with perceived expertise in ear and hearing care (ORLs and audiologists). They reported multiple barriers to receiving the desired care. Māori and Pacific families/whānau experienced additional delays for referrals into specialist services. GPs showed low support for primary care-led grommet follow-up care, with most not providing routine grommet checks after surgery.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"45-52"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735926","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

Corrigendum to: Evaluating the impact of the Piki te Ora extended primary care team on clinical outcomes in type 2 diabetes patients: a retrospective study. 更正：评估 Piki te Ora 扩展初级保健团队对 2 型糖尿病患者临床疗效的影响：一项回顾性研究。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24108_CO

Sara Mustafa, Claire Cannon, Rawiri Keenan, Martin Mikaere, Tammy Dehar, Suzanne Moorhouse, Janine Thompson, Lynne Chepulis

引用次数: 0

Equitable access to primary health care: better availability of GP appointments is only one piece of the jigsaw. 公平获得初级保健服务：更好地提供全科医生预约服务只是拼图中的一块。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC25047

Tim Stokes, Felicity Goodyear-Smith

引用次数: 0

Envisaging better care for patients with complex multimorbidity in Aotearoa New Zealand. 设想更好的护理患者复杂的多病在新西兰奥特罗阿。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24082

Anna Askerud

{"title":"Envisaging better care for patients with complex multimorbidity in Aotearoa New Zealand.","authors":"Anna Askerud","doi":"10.1071/HC24082","DOIUrl":"10.1071/HC24082","url":null,"abstract":"Introduction Client-Led Integrated Care (CLIC) was implemented in general practices between 2018 and 2022 in the Southern region of New Zealand. It was envisaged to be an equitable, holistic and patient-centred inter-disciplinary framework of care for those with multiple long-term conditions; usually called multimorbidity. Aim This process evaluation aimed to determine whether CLIC supported self-management ability and assessed its alignment with current priorities for multimorbidity management. Method Mixed methods were used across four purposively selected general practices. At each practice interviews were undertaken together with participant observation over 3years. This was followed by analysis of annual self-report surveys. Results CLIC worked well for those patients who were engaged, but the implementation provided minimal consideration of the resources required for everyone to receive culturally competent integrated care. Staff reported structural difficulties and wondered if the right patients were targeted. Discussion CLIC did not address the needs of all participants, nor did it target those with the most ability to benefit. In all practices, despite increasing rates of multimorbidity and social complexity during a pandemic, the organisation of general practice and how it connected with the health system remained unchanged. Transitioning to a general practice system for complex multimorbidity will require changes in funding, strong leadership and clear communication. It requires all areas of the health system to provide an integrated health and social care system that is culturally competent and engages those most vulnerable in our community.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"37-44"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735903","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

Evaluating the impact of the Piki te Ora extended primary care team on clinical outcomes in type 2 diabetes patients: a retrospective study. 评估 Piki te Ora 基层医疗扩展团队对 2 型糖尿病患者临床疗效的影响：一项回顾性研究。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24108

Sara Mustafa, Claire Cannon, Rawiri Keenan, Martin Mikaere, Tammy Dehar, Suzanne Moorhouse, Janine Thompson, Lynne Chepulis

{"title":"Evaluating the impact of the Piki te Ora extended primary care team on clinical outcomes in type 2 diabetes patients: a retrospective study.","authors":"Sara Mustafa, Claire Cannon, Rawiri Keenan, Martin Mikaere, Tammy Dehar, Suzanne Moorhouse, Janine Thompson, Lynne Chepulis","doi":"10.1071/HC24108","DOIUrl":"10.1071/HC24108","url":null,"abstract":"Introduction Type 2 diabetes (T2D) is a significant health issue in New Zealand with a disproportionate effect for Māori. To address inequities and optimise care, Te Korowai Hauora o Hauraki, an Iwi Māori health provider, established the 'Piki te Ora service' to support its five rural clinics by providing culturally safe, multidisciplinary support for patients with T2D. Aim This study aimed to undertake a service review, describing and evaluating the available clinical data, of the Piki te Ora service. Methods Patients enrolled in the Piki te Ora service between January 2021 and March 2024 were invited to have their data (sociodemographic, HbA1c, cholesterol and blood pressure) included in the review. Frequency and mode of health care/patient contact were also explored. Results A total of 112 patients were contacted and 64 (mean age 58years, 62.5% Māori) consented to data review. Over 6months, patients in the Piki te Ora service were contacted an average of 9.5 times, with phone calls being the predominant mode of contact. Median HbA1c levels significantly decreased by 16.0mmol/mol at 6months post enrolment in the Piki te Ora service (P =0.011) but no significant changes were observed in cholesterol or blood pressure. Discussion The Piki te Ora service appears to provide effective support for T2D management, particularly glycaemic control, however more clinical data is needed to evaluate its effectiveness. Its flexible and accessible approach, including free consultations, may enhance care accessibility, especially for economically deprived patients.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"88-92"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735919","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

Tertiary institution's duty of care for the health and well-being of Pacific students during COVID-19 pandemic: a cross sectional survey. 在COVID-19大流行期间，高等教育机构对太平洋地区学生健康和福祉的关注义务：一项横断面调查。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24039

Faafetai Sopoaga, Shyamala Nada-Raja, Malia Lameta

{"title":"Tertiary institution's duty of care for the health and well-being of Pacific students during COVID-19 pandemic: a cross sectional survey.","authors":"Faafetai Sopoaga, Shyamala Nada-Raja, Malia Lameta","doi":"10.1071/HC24039","DOIUrl":"10.1071/HC24039","url":null,"abstract":"Introduction There is increasing concern about the wellbeing of tertiary students, and this is likely to be further exacerbated by the COVID-19 pandemic. There is minimal information about what support is being provided. In New Zealand, there is even less information available on Pacific students in the tertiary environment. Aim This study explored the role of one tertiary institution in the provision of support for Pacific tertiary students during the COVID-19 pandemic. Methods Pacific students' perceptions of all the support they received from the University of Otago during the COVID-19 pandemic were obtained from a cross-sectional survey between April to June 2022. All Pacific students attending the University in 2022 were eligible to participate. An online survey was emailed to all students. Results There were 1277 Pacific students enrolled at the University in 2022. Of all eligible Pacific students, 358 (28%) completed the survey. Three quarters of students had to isolate since the start of the academic year, either because they had COVID-19, or they were a close contact of someone with the disease. Of all participants, 356 (99%) received a health pack. At least two-thirds (67.6%) had accessed other support from the University. A third (32.4%) accessed support through the Otago University Students' Association and some from the community and local Pacific health provider. The support was highly valued by students who utilised these services. Discussion Institutions can provide effective leadership in the coordination of support for their students through working together with student-led, government and non-governmental organisations in the community.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"17-22"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736006","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