Journal of primary health care最新文献

{"title":"Impact of a clinical diabetes specialist mentoring programme on type 2 diabetes management among nurses in primary care: a qualitative study.","authors":"Sara Mustafa, Hamish Crocket, Timothy Kenealy, Rinki Murphy, Jo Scott-Jones, Leanne Te Karu, Ryan Paul, Lynne Chepulis","doi":"10.1071/HC25025","DOIUrl":"10.1071/HC25025","url":null,"abstract":"<p><strong>Introduction: </strong>Management of type 2 diabetes (T2D) occurs predominantly in primary health care in Aotearoa New Zealand. Optimising the delivery of clinical diabetes management by upskilling healthcare professionals can reduce the strain on the healthcare system and improve patient care.</p><p><strong>Aim: </strong>This study aimed to qualitatively evaluate the importance of an education programme delivered by a non-physician diabetes specialist on nurses' knowledge and confidence of T2D management in primary care.</p><p><strong>Methods: </strong>Semi-structured interviews with nurses enrolled in the programme for at least 6 months and their nurse leads across two clinics in the Waikato region were conducted to assess their confidence and knowledge in T2D management, as well as the acceptability of the programme. Transcripts were analysed using quantitative content analysis.</p><p><strong>Results: </strong>Four nurses and two nurse leads were interviewed, lasting between 15 and 60 min. Nurses reported improved knowledge of diabetes medications and interpreting clinical measures. Nurses also felt more confident in their communication skills with patients, advocating for their patients, and improved patient engagement. Further education was needed on administering diabetes medication, knowledge of medical devices such as continuous glucose monitoring, and understanding the pathophysiology of diabetes.</p><p><strong>Discussion: </strong>Self-efficacy and self-reported skills of nurses in T2D management improved following the diabetes mentoring programme. Further research is needed to assess quantitative clinical measures and whether the programme is effective in improving patient health outcomes.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"71-74"},"PeriodicalIF":1.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355271","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}

{"title":"Launching a new interprofessional education programme in a rural setting: a qualitative study of the first two years.","authors":"Eileen McKinlay, Melanie Brown, Louise Beckingsale, Fiona Doolan-Noble, Amanda Garnett, Susan Pullon","doi":"10.1071/HC24109","DOIUrl":"10.1071/HC24109","url":null,"abstract":"<p><strong>Introduction: </strong>Delivery of interprofessional education (IPE) in rural settings can support pre-registration health sciences students to achieve interprofessional collaborative practice (teamwork) competencies. It can also grow the rural workforce with previous students recommending the programme to their peers and some choosing to work in a rural workplace as graduates. Launching and implementing a rural IPE programme in a new location is challenging, even when comparable IPE models exist in other settings.</p><p><strong>Aim: </strong>We aimed to evaluate the implementation of a new rural IPE programme in Greymouth, New Zealand.</p><p><strong>Methods: </strong>Qualitative evaluation data were collected through several rounds of interviews during the first 2 years of the programme. The interviews included students, stakeholders (Education Operations Group - the tertiary education providers who sent students, clinical placement providers, community stakeholders), and local programme staff. Focus group and interview data were explored using thematic analysis.</p><p><strong>Results: </strong>Three themes were identified, each with subthemes: (1) allow sufficient lead-in time, (2) ensure there is time to bed down, and (3) undertake location-specific quality improvement. These themes pointed to aspects that were important when implementing a new IPE programme, particularly to enable development of a local flavour.</p><p><strong>Discussion: </strong>Rural IPE programmes are complex, expensive to establish, and difficult to sustain, but such programmes may be key to increasing the rural workforce. It is critical to have local staff who can work effectively with all the stakeholder groups, all of whom are important to continuing the programme.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"11-20"},"PeriodicalIF":1.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355272","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}

{"title":"Implementation considerations for a school-based digital health intervention: school staff perspectives.","authors":"Katie M Babbott, Emily Grover, Anna L Boggiss, Hiran Thabrew, Anna Serlachius","doi":"10.1071/HC25132","DOIUrl":"https://doi.org/10.1071/HC25132","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents in Aotearoa New Zealand (NZ) face rising mental health challenges amidst strained school support systems. Digital mental health interventions (DMHIs) offer scalable and cost-effective support, yet little is known about their real-world implementation in school settings, particularly for culturally diverse populations.</p><p><strong>Methods: </strong>This study explored qualitative considerations of implementing Whitu for Schools (WFS), a digital wellbeing app, within secondary schools in NZ. A qualitative design using semi-structured interviews was conducted with 12 high school staff across 12 schools from the North Island, guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework.</p><p><strong>Results: </strong>Participants described escalating student mental health concerns and limited access to timely support. WFS was welcomed as a timely, low-barrier intervention with engaging and culturally affirming content. However, challenges emerged around digital access, policy constraints (eg phone bans), staff digital literacy, and concerns about sustaining engagement. Effective implementation was seen as contingent on flexible, embedded delivery within school routines, tailored training, and ongoing student feedback. Equity was a recurring theme, with concerns that digital divides may reinforce existing disparities.</p><p><strong>Discussion: </strong>WFS holds promise as a school-based digital wellbeing intervention, but successful implementation requires contextual responsiveness, strong staff and leadership buy-in, and equity-driven infrastructure. Findings highlight the importance of co-design, relational engagement, and sustained adaptation to ensure that digital tools meet the dynamic and diverse needs of rangatahi in NZ.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365880","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}

{"title":"Barriers and facilitators to adverse drug reaction reporting among New Zealand community pharmacists: a qualitative investigation.","authors":"Eliza Jani, Mudassir Anwar","doi":"10.1071/HC25183","DOIUrl":"https://doi.org/10.1071/HC25183","url":null,"abstract":"<p><p>Introduction Adverse drug reactions (ADRs) represent a significant public health burden, accounting for 3-6% of hospital admissions internationally and costing New Zealand taxpayers $280 million between 2015/16 and 2017/18. Community pharmacists are uniquely positioned to identify and report ADRs, yet their contribution to ADR reporting in New Zealand remains understudied. Aim This study aimed to investigate factors influencing ADR reporting by New Zealand community pharmacists, including current practices, barriers, facilitators, and potential improvements. Methods A descriptive qualitative study using semi-structured interviews was conducted with 12 registered community pharmacists across New Zealand. Participants were recruited through purposive and snowball sampling. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis. Results The study resulted in three main themes: workplace environment, education/training, and patient information access. All themes were underpinned by insufficient time and resources, resulting in ADR reporting not being viewed as integral to pharmacy practice. Key barriers included a lack of workplace reporting culture, inadequate education/training, and incomplete patient information access. The COVID-19 pandemic paradoxically served as the primary facilitator by increasing system visibility. Most participants had previously submitted ADR reports, with online submission being preferred. Discussion: Despite understanding the importance of ADR reporting, New Zealand community pharmacists face systemic barriers preventing optimal reporting practices. Addressing these requires comprehensive solutions, including integration of reporting tools into dispensing software, enhanced education/training programs, improved patient information access, and adequate professional recognition and compensation. These findings provide a foundation for targeted interventions to improve pharmacovigilance in community pharmacy settings.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105708","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}

{"title":"Changing the Osteoarthritis Narrative in Aotearoa New Zealand.","authors":"Daniel O'Brien, Elizabeth Holt, Dell Mcleod, Prue Molyneux, Rebecca Meiring, Kore Tombs","doi":"10.1071/HC25188","DOIUrl":"https://doi.org/10.1071/HC25188","url":null,"abstract":"<p><p>Osteoarthritis (OA) affects one in ten adults in Aotearoa New Zealand, yet care remains fragmented and under-prioritised. The 2025 Aotearoa Osteoarthritis Summit explored re-framing OA through a lifespan, equity-focused lens. Summit attendees contribution to a collaborative workshop at the event highlighted misconceptions, harmful \"wear and tear\" narratives, and inconsistent information. Attendees called for empowering, strengths-based messaging, culturally responsive care, and early, lifelong joint-health strategies. Recommendations included myth-busting, accessible education, community support, and integrated non-surgical management. Equity for Māori, Pasifika, rural, and low-income communities was emphasised. Changing the OA narrative requires collaboration, consistent messaging, and scalable frameworks to improve outcomes nationwide.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086093","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}

{"title":"'Point-of-Care-Testing is definitely the way to go': primary healthcare professionals in rural Aotearoa New Zealand talk about point-of-care testing for cervical cancer prevention.","authors":"Ngaire Kereru Sparkes, Anna Adcock, Tania Slater, Evelyn Jane MacDonald, Francesca Storey, Jo-Ann Stanton, Matthew Bennett, Charles Seymour Lambert, Melanie Gibson, Isitokia Paasi, Varsha Parag, Stacie Geller, Merilyn Hibma, Peter Sykes, David Hawkes, Marion Saville, Beverley Lawton","doi":"10.1071/HC25164","DOIUrl":"https://doi.org/10.1071/HC25164","url":null,"abstract":"<p><strong>Introduction: </strong>Rural whānau (families) in Aotearoa New Zealand face persistent barriers to timely healthcare, contributing to inequities - particularly for Māori. Point-of-care testing offers a potential solution by bringing diagnostic services closer to communities. To investigate this potential, the study 'He Tapu te Whare Tangata: A Model for Empowering Rural Solutions for Cervical Cancer Prevention' used human papillomavirus-based screening to examine how point-of-care testing could strengthen cervical screening pathways for rural women. The study combined a cluster-randomised crossover trial with qualitative research to compare two screening pathways, one of which utilised molecular point-of-care testing with direct access to specialist colposcopy appointments.</p><p><strong>Aim: </strong>This paper explores the acceptability and feasibility of point-of-care testing for human papillomavirus in rural primary care from the perspective of healthcare professionals.</p><p><strong>Methods: </strong>This paper draws on 11 interviews with rural primary healthcare professionals who spoke to the implementation and delivery of point-of-care testing. Guided by a Kaupapa Māori approach, semi-structured interviews were conducted between 2021 and 2023. Reflexive thematic analysis guided data interpretation.</p><p><strong>Results: </strong>Interviewees considered point-of-care testing valuable for enabling faster results, timelier care, and more co-ordinated pathways. Community control was perceived to enhance rural service resilience - particularly during extreme weather when access to central laboratories was disrupted. Successful implementation was considered dependent on sufficient resourcing, workforce training, and sustained support.</p><p><strong>Conclusion: </strong>Point-of-care testing for cervical screening was acceptable and, with adequate support, feasible in rural general practice. Point-of-care testing offers an equity-enhancing model for improving access and outcomes for rural Māori communities.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018994","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}

{"title":"A national foot screening indicator: an opportunity to address diabetes-related foot disease and improve equity in Aotearoa New Zealand.","authors":"Michele Garrett, Rinki Murphy, Timothy Kenealy","doi":"10.1071/HC25038","DOIUrl":"10.1071/HC25038","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"382-384"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355244","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}

{"title":"Closing the equity gap in access to early lung cancer diagnosis in Aotearoa: key informant perspectives and recommendations for action.","authors":"Virginia Signal, Moira Smith, Laird Cameron, Shaun Costello, Paul Dawkins, Jonathan Koea, Ross Lawrenson, Catherine Smith, Jason Gurney","doi":"10.1071/HC24187","DOIUrl":"10.1071/HC24187","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer survival is worse for Māori in Aotearoa New Zealand (NZ) than non-Māori. Our previous work identified that Māori are more likely to have their lung cancer diagnosed following an emergency presentation and face additional barriers in accessing secondary diagnostic services.</p><p><strong>Aim: </strong>To inform improvements in lung cancer services, we aimed to collect key informant views on the extent to which these disparities were modifiable and how they might be modified by the healthcare system.</p><p><strong>Methods: </strong>We interviewed 18 key informants from across the cancer sector, including clinicians, academics, policy experts, community workers and advocates. Analysis of collected views was conducted utilising a previously published conceptual framework to help organise and describe key issues and recommended actions.</p><p><strong>Results: </strong>Key themes emerging from the interviews included the value of lung cancer screening; the importance of health promotion; the need for an overhaul to primary care to improve access to clinical symptom recognition and early detection; the importance of improving geographic access to diagnostic/secondary services; the need to ensure the expansion of and improvements in a culturally-safe and competent workforce; the value and importance of good data to enable quality improvement; and the crucial importance of high-quality leadership and political buy-in.</p><p><strong>Discussion: </strong>Our interviews revealed some of the potential drivers of barriers to early detection experienced by Māori and the recommendations for action to address these barriers. The majority of these recommendations require system-level resourcing and change.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"355-362"},"PeriodicalIF":1.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355226","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}

{"title":"Understanding the determinants of health for Māori living with chronic disease in Aotearoa New Zealand.","authors":"Lynley Uerata, Nina Scott, Jade Tamatea, Amy Jones, Polly Atatoa Carr, Lynne Chepulis, Ryan Paul, Haylee Simon, Ross Lawrenson","doi":"10.1071/HC25064","DOIUrl":"10.1071/HC25064","url":null,"abstract":"<p><strong>Introduction: </strong>Aotearoa New Zealand has wide disparities in health outcomes between indigenous and non-indigenous groups, which are strongly associated with inequitable access to determinants of health by ethnicity. Experiences of health determinants culminate in higher rates of diabetes, asthma, kidney disease and other chronic diseases and worse outcomes for Māori.</p><p><strong>Aim: </strong>This paper explores the relationships between health determinants and chronic disease from the perspectives of Māori patients and healthcare providers.</p><p><strong>Methods: </strong>Using a Kaupapa Māori methodology and qualitative methods, six semi-structured focus groups with 21 Māori living with chronic disease and semi-structured consultations with 130 healthcare providers across the Waikato region were undertaken between 2021 and 2023.</p><p><strong>Results: </strong>Participants identified five key health determinants shaping the everyday experience and management of chronic disease, including employment, welfare support, income, access to information and racism. Access to economic resources had significant impacts. Those in situations of economic insecurity experienced significant complications to everyday disease management and had fewer resources to mediate their effects. Chronic disease also reduced access to economic resources through increased health costs, reduced earning power and the impacts of dealing with the welfare and health systems. Comparatively, stable access to economic resources, such as health insurance, enabled disease management.</p><p><strong>Discussion: </strong>Everyday experiences of health determinants are shaped considerably by economic circumstances. Claiming welfare support continues to be difficult for eligible participants, and welfare payment inadequate. The health system needs to re-design healthcare delivery so people with poor access to economic resources are actively supported to access health determinants.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"347-354"},"PeriodicalIF":1.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355168","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}

{"title":"Pacific people in Aotearoa New Zealand and the treatment of long-term conditions: a narrative literature review about Pacific people's understandings of health and wellbeing.","authors":"Lisa Kitione, Debbie Ryan, Ausaga Faasalele Tanuvasa, Ben Gray","doi":"10.1071/HC24151","DOIUrl":"10.1071/HC24151","url":null,"abstract":"<p><strong>Introduction: </strong>Long-term conditions data for Pacific people show unchanged outcomes over several decades. Research suggests that models of care that recognise diverse understandings of health and wellbeing have benefits for people with long-term conditions and their families and help address longstanding health disparities.</p><p><strong>Aim: </strong>To explore Pacific people's understandings of health and wellbeing and, within this context, to examine concepts related to long-term conditions models of care.</p><p><strong>Methods: </strong>A narrative review was conducted using broad search terms in key clinical and social science databases and manual searches of Pacific-focused publications to ensure extensive coverage of topics of interest. The methods were well suited to exploring experiential, conceptual themes often underrepresented in systematic reviews.</p><p><strong>Results: </strong>Eighteen studies produced over a more than 25-year period (1997-2024) were included. The studies describe values and beliefs that form holistic conceptualisations of Pacific health, centred around family and grounded in a collective sense of wellbeing. They provide insights about how these understandings intersect with socioeconomic and environmental factors to shape context-specific experiences of care for Pacific peoples.</p><p><strong>Discussion: </strong>The reviewed studies highlight the 'lived with' effects of long-term conditions that Pacific people and their families experience. They illustrate how the goals of long-term condition models of care, however desirable, may not seem beneficial or feasible for Pacific families if they neglect other dimensions of wellbeing, or fail to consider constraining contextual factors. Literature that challenges conventional concepts in long-term conditions models of care potentially support appropriate approaches for Pacific people and their families.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"372-378"},"PeriodicalIF":1.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355300","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}