NEW ZEALAND MEDICAL JOURNAL最新文献_第3页

Māori experiences and perspectives of hospital treatment in the context of acute care. 毛利人在急诊治疗中对医院治疗的体验和看法。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-23 DOI: 10.26635/6965.6397

Misty Edmonds, Stephanie Shankar, Te Inuwai Elia, Carlos Fc Campos, Mataroria Lyndon, Jennifer M Weller

{"title":"Māori experiences and perspectives of hospital treatment in the context of acute care.","authors":"Misty Edmonds, Stephanie Shankar, Te Inuwai Elia, Carlos Fc Campos, Mataroria Lyndon, Jennifer M Weller","doi":"10.26635/6965.6397","DOIUrl":"10.26635/6965.6397","url":null,"abstract":"Aim: Through exploring Māori experiences when presenting acutely to hospital, we aimed to identify specific aspects of culturally safe care that we could incorporate into healthcare professionals' training and hospital processes.Methods: Using Kaupapa Māori approaches, we undertook semi-structured interviews and thematic analysis to collect and analyse data from diverse groups of Māori participants.Results: We interviewed 17 participants, with 16 follow-up interviews. We found a lack of trust, and perceptions of unequal treatment for Māori. Our participants highlighted the following key needs: the importance of whanaungatanga in building trusting relationships with patients and whānau; creating safe spaces for patients and whānau; improved staff cultural safety; exploring individual patient and whānau needs, avoiding assumptions about cultural requirements or stereotypical characteristics; upholding the mana of all patients with respectful interactions; and empowering Māori as partners in their care.Conclusion: By sharing their personal experiences, participants have highlighted specific aspects of their interactions with hospital staff and the healthcare system that could and should be improved. These insights can guide our efforts to enhance cultural safety for Māori patients and whānau through targeted staff training and structural changes.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037359","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

Acute and persistent post-operative pain following mastectomy: a descriptive study in a tertiary hospital cohort. 乳房切除术后的急性和持续性术后疼痛：一项在三级医院队列中进行的描述性研究。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-23 DOI: 10.26635/6965.6524

Jenna Donaldson, Sami Swadi, Chris Frampton, Christian Brett

{"title":"Acute and persistent post-operative pain following mastectomy: a descriptive study in a tertiary hospital cohort.","authors":"Jenna Donaldson, Sami Swadi, Chris Frampton, Christian Brett","doi":"10.26635/6965.6524","DOIUrl":"https://doi.org/10.26635/6965.6524","url":null,"abstract":"Aims: Post mastectomy pain syndrome (PMPS) can have significant negative effects on patients' quality of life after mastectomy. The estimated prevalence of PMPS varies widely and there is little data from a New Zealand population. This limits clinicians' ability to meaningfully describe and discuss pain-related complications of mastectomy peri-operatively.Method: We designed a single-centre, retrospective study to describe acute post-operative analgesic requirements after mastectomy, to describe the prevalence of PMPS at least 1 year after surgery, and to identify associated risk factors for this complication.Results: One hundred and thirty mastectomy patients met inclusion criteria and 59 were willing and able to participate in 12-month follow-up. Acute post-operative pain was generally well managed with modest doses of oral analgesics. Sixty-six percent (n=39) of women reported some form of persistent pain symptoms post-mastectomy; this was associated with younger age, axillary surgery and chemotherapy. Only 5% of patients (n=3) met consensus criteria for PMPS, which limited identification of risk factors for this more severe complication.Conclusion: Despite PMPS occurring infrequently, post-operative pain of a less severe nature after mastectomy occurs commonly. Clinicians should remain vigilant to possible risk factors for this post-operative complication and counsel patients appropriately.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037353","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

Ad hominem; Author information or conflict of interest. 谩骂；作者信息或利益冲突。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-23 DOI: 10.26635/6965.l1601

Ben Lawrence, Simon Gordon, Elizaveta Rakhmanova, William Park, Johnathan Reynecke, Frank Frizelle

引用次数: 0

Do parents of children with cancer use religious coping in New Zealand? 在新西兰，患癌儿童的父母是否使用宗教应对方法？

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-23 DOI: 10.26635/6965.6466

Hüseyin Çaksen

引用次数: 0

Safety and feasibility of same-day discharge for per-oral endoscopic myotomy. 经口内窥镜肌切开术当天出院的安全性和可行性。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-23 DOI: 10.26635/6965.6583

Jun Young Kim, Michael Chieng, Rees Cameron, Frank Weilert

{"title":"Safety and feasibility of same-day discharge for per-oral endoscopic myotomy.","authors":"Jun Young Kim, Michael Chieng, Rees Cameron, Frank Weilert","doi":"10.26635/6965.6583","DOIUrl":"https://doi.org/10.26635/6965.6583","url":null,"abstract":"Aims: Per-oral endoscopic myotomy (POEM) is a recognised treatment for achalasia, with the accepted approach involving admission for imaging and dietary progression. However, recent publications suggest same-day discharge (SDD) may be possible, which could be time and cost-saving. We sought to investigate the safety of SDD following POEM.Methods: Fifty consecutive POEMs at two referral centres in New Zealand were performed between 2020-2023. All patients were planned for early dietary introduction and were eligible for SDD if symptoms were managed. Analgesia was available in recovery and supplied at discharge. Imaging and endoscopy were performed only if there were clinical concerns. Rates of discharge clearance, discharge, complications and re-admission were analysed.Results: All 50 POEMs were technically successful. A total of 41/50 (82%) received clearance for SDD. Additionally, 35/50 (70%) achieved discharge and 6/50 (12%) were observed overnight for social reasons, including lack of transport to the referring domicile. Of the patients not cleared for SDD, 7/9 (78%) were discharged within 24 hours, and the others after 48 and 72 hours. Procedural complications were recorded in three patients (6%), with one requiring endoscopic assessment and clipping. There were two re-admissions (4%), both lt;24-hour hospital stays, and managed medically.Conclusions: The majority of patients achieved same-day discharge clearance (82%) and 96% required less than 24 hours hospital stay. Complication and re-admission rates were low overall. We have demonstrated that POEM can be an SDD procedure facilitated by early dietary introduction and liberal analgesia, without the need for routine imaging or endoscopy.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037361","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

Promoting digital inclusion for enhanced resident wellbeing: an examination of aged residential care facility websites. 促进数字共融，提升居民福祉：对养老机构网站的研究。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-23 DOI: 10.26635/6965.6511

Wendy Wrapson, Chiara Gasteiger

{"title":"Promoting digital inclusion for enhanced resident wellbeing: an examination of aged residential care facility websites.","authors":"Wendy Wrapson, Chiara Gasteiger","doi":"10.26635/6965.6511","DOIUrl":"https://doi.org/10.26635/6965.6511","url":null,"abstract":"Aim: Digital inclusion has a positive impact on health and wellbeing through fostering connectivity and access to information. In Aotearoa New Zealand, 4% of older adults live in aged residential care (ARC) facilities and are vulnerable to social isolation. This study explored whether ARC facilities provide opportunities to socially connect online and whether the COVID-19 pandemic affected the provision of these opportunities.Method: Information on technology and internet provision from 558 ARC facilities was extracted from facilities' own or related websites in 2019 and 2021. ARC facilities were categorised according to whether they provided digital devices, internet access and internet-based leisure activities, or made no reference to technology.Results: In 2019, 392 (70%) of 558 ARC facilities publicised availability of internet-based technologies for residents; however, only 46 (8%) mentioned providing access to computer devices. In 2021 (during the pandemic), there was a small increase to 421 (76%) and 54 (10%) of facilities respectively. Facilities mentioning internet-based leisure activities were 63 (11%) in 2019 and 55 (10%) in 2021. Those not referring to technology had reduced from 166 (30%) in 2019 to 137 (24%) in 2021.Conclusion: Few ARC facilities enabled residents to fully access the digital world, even after periods of isolation due to COVID-19. Aged care providers could be more proactive by providing internet access and digital learning opportunities.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037360","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

Twenty-year review of the bariatric programme at Te Whatu Ora Waitematā. Te Whatu Ora Waitematā减肥计划二十年回顾。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-23 DOI: 10.26635/6965.6472

Megan Grinlinton, Mavis Orizu, Michael Booth

{"title":"Twenty-year review of the bariatric programme at Te Whatu Ora Waitematā.","authors":"Megan Grinlinton, Mavis Orizu, Michael Booth","doi":"10.26635/6965.6472","DOIUrl":"https://doi.org/10.26635/6965.6472","url":null,"abstract":"Aims: Obesity is a significant health issue. Te Whatu Ora Waitematā serves a population of 650,000 patients across the North Shore, Waitākere and Rodney areas. The Waitematā bariatric service at North Shore Hospital was introduced in October 2001. The aim of this study was to review the development and impact of the service over the last 20 years, and identify whether equivalent bariatric services could viably be introduced into other hospitals in Aotearoa New Zealand.Methods: A retrospective audit was conducted of the 20-year results of the Waitematā bariatric surgical service to identify the impact of technology, teaching and research on service provision.Results: Since its inception, the Waitematā bariatric service has launched minimally invasive surgery, multiple operative options and an enhanced recovery after surgery (ERAS) protocol. Approximately 100 cases are performed per year. Of these, 3.4% of patients require admission to the intensive care unit/high dependency unit (ICU/HDU), with an average length of stay (LOS) of 0.66 days. The 1-year mortality rate is 0.39%. Eleven surgical fellows have undergone post-fellowship training with the service, which is a recognised training unit for the post-fellowship AANZGOSA/ANZMOSS programme.Conclusions: Bariatric surgery can be performed safely and has good long-term outcomes. The Waitematā bariatric service is dedicated to providing excellent care within the resource constraints of a public healthcare system. The high number of procedures, low requirement for ICU/HDU and low mortality rate suggest that bariatric surgery could be safely performed within a public setting in secondary and regional hospitals across the country.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037364","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

Asian health in Aotearoa New Zealand: highlights and actionable insights. 新西兰奥特亚罗亚的亚裔健康：亮点和可行见解。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-23 DOI: 10.26635/6965.6705

Sherly Parackal, Eleanor Holroyd

引用次数: 0

Diabetes treatment satisfaction among a multi-ethnic Aotearoa New Zealand population with uncontrolled type 2 diabetes mellitus. 新西兰奥特亚罗瓦多民族未受控制的 2 型糖尿病患者对糖尿病治疗的满意度。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-02 DOI: 10.26635/6965.6341

Ry Yves Tweedie-Cullen, Yannan Jiang, Rebecca Brandon, Audrey Tay, Ryan Yeu, Kate Smallman, Glenn Doherty, Ofa Dewes, Rebekah Doran, Penny Clark, Norma Nehren, Jennie Harré Hindmarsh, Frances King, Tony R Merriman, Brandon Orr-Walker, Ryan Paul, Rinki Murphy, Allan Moffitt

{"title":"Diabetes treatment satisfaction among a multi-ethnic Aotearoa New Zealand population with uncontrolled type 2 diabetes mellitus.","authors":"Ry Yves Tweedie-Cullen, Yannan Jiang, Rebecca Brandon, Audrey Tay, Ryan Yeu, Kate Smallman, Glenn Doherty, Ofa Dewes, Rebekah Doran, Penny Clark, Norma Nehren, Jennie Harré Hindmarsh, Frances King, Tony R Merriman, Brandon Orr-Walker, Ryan Paul, Rinki Murphy, Allan Moffitt","doi":"10.26635/6965.6341","DOIUrl":"https://doi.org/10.26635/6965.6341","url":null,"abstract":"Aims: To assess whether diabetes treatment satisfaction differs by ethnicity among participants with insufficient glycaemic control of type 2 diabetes mellitus in a clinical trial involving additional oral diabetes medications. Patient satisfaction is used as an indicator of healthcare quality. However, data on patients' diabetes treatment satisfaction in the context of insufficient glycaemic control is limited.Methods: Individuals with type 2 diabetes and an HbA1c of 58-110mmol/mol (7.5-12.5%) were recruited across Aotearoa New Zealand to participate in an 8-month randomised crossover study of vildagliptin and pioglitazone as add-on therapy to metformin and/or sulfonylurea. Participants completed the Diabetes Treatment Satisfaction Questionnaire (DTSQ) at baseline pre-randomisation. Treatment satisfaction scores were compared between ethnic groups and other characteristics using the analysis of variance and linear regression. Perceived hyper- and hypoglycaemia were summarised separately.Results: Between February 2019 and March 2020, 346 participants (41% women, 32% Pacific peoples, 23% Māori, 26% European) completed the DTSQ. Mean (SD) age was 57.5 (10.9) years, diabetes duration was 9 (6.3) years and HbA1c was 75 (12)mmol/mol (9.0[3.2]%). At study entry, 40% were receiving monotherapy for diabetes. Treatment satisfaction was rated highly, with a score of 29(6) (interquartile range 25-33). Pacific peoples and older people reported greater treatment satisfaction than other groups (p<0.001).Conclusions: Diabetes treatment satisfaction was high, particularly among Pacific peoples, despite suboptimal glycaemic control and insufficient glucose-lowering therapy.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876330","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

Adherence to national Lynch syndrome testing guidelines for colorectal cancer in an Aotearoa New Zealand hospital-based population. 新西兰奥特亚罗瓦医院人群中遵守国家林奇综合征结直肠癌检测指南的情况。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-02 DOI: 10.26635/6965.6551

Nejo Joseph, Matthew McGuinness, Cavaghn H Prosser, Georgina Trifinovich, William Xu, Christopher Harmston

{"title":"Adherence to national Lynch syndrome testing guidelines for colorectal cancer in an Aotearoa New Zealand hospital-based population.","authors":"Nejo Joseph, Matthew McGuinness, Cavaghn H Prosser, Georgina Trifinovich, William Xu, Christopher Harmston","doi":"10.26635/6965.6551","DOIUrl":"10.26635/6965.6551","url":null,"abstract":"Aim: Lynch syndrome (LS) is estimated to affect 1-3.9% of patients with colorectal cancer (CRC). Testing for LS is important in determining management and establishing surveillance for \"Lynch families\". Previous studies have identified poor rates of testing for LS in CRC patients. This study aimed to describe adherence to guidelines for testing of newly diagnosed CRC for LS.Methods: A single institution cohort study of patients over 18 years with colorectal adenocarcinoma from 2018-2022 in Te Tai Tokerau, Aotearoa New Zealand was conducted. Rates of baseline immunohistochemistry (IHC) testing for mismatch repair (MMR) deficiency, further testing for MLH1-deficient cases and rates of germline mutational analysis were audited to determine adherence to national guidelines. The rate of LS in newly diagnosed CRC was estimated.Results: Six hundred and sixty patients were eligible for universal testing for LS, of which 84% (n=553) completed initial IHC testing. MMR deficiency was reported in 20% (n=114) cases. Eighty-nine percent (n=101) was attributable to MLH1 deficiency, of which 99% (n=100) were appropriately tested for BRAF-V600E mutation. Sixty-four percent (4/11) patients indicated for hypermethylation testing were appropriately tested. Seventeen patients had an indication for germline mutational analysis, of which only 29% (n=5) were tested. The estimated incidence of LS in newly diagnosed CRC was 0.7-3.8%.Conclusion: Compliance with initial IHC testing was good. However, there is a need to improve rates of confirmation genetic testing. The incidence of confirmed LS in this study is 0.7%, however this may be as high as 3.9%.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876295","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