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Taken out of context: academic rural health in Aotearoa New Zealand. 断章取义:新西兰奥特亚罗瓦的农村学术卫生。
IF 1.1 Q4 PRIMARY HEALTH CARE Pub Date : 2024-09-01 DOI: 10.1071/HC24133
Garry Nixon
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引用次数: 0
Preferred format and strategies for seeking and trusting online health information: a survey of cardiology outpatient attendees across three New Zealand hospitals. 寻求和信任在线健康信息的首选格式和策略:对新西兰三家医院心脏科门诊病人的调查。
IF 1.1 Q4 PRIMARY HEALTH CARE Pub Date : 2024-09-01 DOI: 10.1071/HC23143
Susan Wells, Faith Mahony, Arier Lee, Andrew McLachlan, Jennie Dean, Jane Clarke, Siobhan Lehnhard, Robyn Whittaker, Matire Harwood, Jacqueline Cumming, Janine Bycroft

Introduction The volume and quality of online health information requires consumers to be discerning. Aim This study aimed to explore consumer Internet use for health information, preferred format and what factors helped them to trust the source. Methods A cross-sectional study was conducted in 2016-2017 with adults attending three cardiology outpatient clinic sites using a short paper-based survey. The survey included questions regarding online health information use and perceived trustworthiness with opportunities for free text responses. Survey data were summarised with key questions adjusted by age group, gender and ethnicity using logistic regression. Results Of the 708 respondents (51% women, 66% aged 45-74 years, 16% Māori, 12% Pacific), 73% had sought health information online (64% in the previous 12 months), commonly for medication side effects, their health condition and self-help. Most (65%) were successful, although Pacific respondents reported a lower likelihood of search success compared to Europeans. Younger age groups were more concerned about information quality. Fact sheets (80%) were the most popular format and for all ethnic groups, followed by short videos (31%) and discussion groups (23%). Trusting online information required many strategies with 72% wanting health professionals to recommend websites. Discussion Online health information seeking is a norm for consumers, with simple fact sheets being the preferred format to build knowledge and skills. With the rising tide of misinformation, health portal providers need to offer accurate and easy-to-read fact sheets in their suite of formats and health professionals need to support consumers guiding them to trusted websites.

引言 网上健康信息的数量和质量要求消费者具有辨别力。目的 本研究旨在探讨消费者使用互联网获取健康信息的情况、偏好的形式以及帮助他们信任信息来源的因素。方法 在 2016-2017 年期间,对在三个心脏病学门诊地点就诊的成年人进行了一项横断面研究,采用的是一项简短的纸质调查。调查内容包括有关在线健康信息使用和感知可信度的问题,并提供了自由文本回答的机会。采用逻辑回归法对调查数据进行汇总,并根据年龄组、性别和种族对关键问题进行调整。结果 在708名受访者中(51%为女性,66%年龄在45-74岁之间,16%为毛利人,12%为太平洋裔),73%的人曾在网上寻求健康信息(64%是在过去12个月内),通常是为了了解药物副作用、自身健康状况和自助。大多数人(65%)搜索成功,但太平洋裔受访者的搜索成功率低于欧洲裔受访者。年轻群体更关注信息质量。概况介绍(80%)是所有种族群体最常用的形式,其次是视频短片(31%)和讨论组(23%)。信任在线信息需要很多策略,72%的人希望医疗专业人员推荐网站。讨论 网上寻求健康信息对消费者来说是一种常态,简单的概况介绍是他们积累知识和技能的首选形式。随着错误信息的不断增加,健康门户网站提供商需要以各种形式提供准确易读的概况介绍,而健康专业人员则需要为消费者提供支持,引导他们访问值得信赖的网站。
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引用次数: 0
Reframing rural health inequities: a norm-critical approach. 重塑农村健康不公平现象:规范批判方法。
IF 1.1 Q4 PRIMARY HEALTH CARE Pub Date : 2024-09-01 DOI: 10.1071/HC24130
Kyle Eggleton
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引用次数: 0
Can SSRI's help women suffering with PMS? SSRI 能帮助经前综合征妇女吗?
IF 1.1 Q4 PRIMARY HEALTH CARE Pub Date : 2024-09-01 DOI: 10.1071/HC24135
Vanessa Jordan
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引用次数: 0
Comfort with having sexual orientation recorded on official databases among a community and online sample of gay and bisexual men in Aotearoa New Zealand. 新西兰奥特亚罗瓦男同性恋和双性恋社区及网络样本对官方数据库记录性取向的满意度。
IF 1.1 Q4 PRIMARY HEALTH CARE Pub Date : 2024-09-01 DOI: 10.1071/HC23107
A H Ludlam, H Petousis-Harris, B Arroll, P J W Saxton

Introduction Sexual orientation minorities have worse health outcomes than the heterosexual majority. In 2023, Aotearoa New Zealand (NZ) added sexual and gender identity items to the Census, offering actionable data for improving sexual identity and gender identity (SOGI) community health. However, this also raises questions about individuals' willingness to provide such information to Government and their comfort with data privacy and governance. Methods Using data from gay, bisexual, and other men who have sex with men (GBM) participants of the Gay Auckland Periodic Sex Survey and Gay Men's Online Sex Survey 2014 cross-sectional surveys, the study question examined comfort having their sexual orientation recorded in official databases. A logistic regression model was used to identify independent predictors of comfort, including sociodemographic and behavioural variables. Results Of 3173 participants who completed the question, 63.1% were comfortable with recording sexual orientation. Adjusted odds ratios showed less comfort among those identifying with an 'Other' ethnicity (AOR: 0.64, 95% CI: 0.43-0.96), identifying as bisexual (AOR: 0.45, 95% CI: 0.35-0.56), and those who did not believe their GP to be aware of their sexuality (AOR: 0.32, 95% CI: 0.26-0.40). No sexual behaviours were independently associated with comfort. Discussion The majority of GBM participants reported comfort with having their sexual orientation recorded on official databases, but some are not, and this is patterned by sociodemographic variables. Officials should improve the safety and perceived relevance of sexual orientation data collection efforts to increase their representativeness and utility for sexual minority populations.

导言:与大多数异性恋者相比,性取向少数群体的健康状况更差。2023 年,新西兰政府在人口普查中增加了性取向和性别认同项目,为改善性取向和性别认同(SOGI)群体的健康状况提供了可操作的数据。然而,这也引发了关于个人是否愿意向政府提供此类信息以及他们对数据隐私和管理是否满意的问题。研究方法:利用奥克兰同性恋定期性调查(Gay Auckland Periodic Sex Survey)和 2014 年男同性恋在线性调查(Gay Men's Online Sex Survey)的男同性恋、双性恋和其他男男性行为者(GBM)参与者的数据,研究问题是他们是否愿意将自己的性取向记录在官方数据库中。研究采用逻辑回归模型来确定舒适度的独立预测因素,包括社会人口学变量和行为变量。结果 在 3173 名填写了问题的参与者中,63.1% 的人对记录性取向感到满意。调整后的几率比表明,那些认为自己是 "其他 "种族的人(AOR:0.64,95% CI:0.43-0.96)、认为自己是双性恋的人(AOR:0.45,95% CI:0.35-0.56)以及认为自己的全科医生不了解自己的性取向的人(AOR:0.32,95% CI:0.26-0.40)对记录性取向感到不自在。没有任何性行为与舒适度独立相关。讨论 大多数 GBM 参与者表示对在官方数据库中记录他们的性取向感到满意,但也有一些人不满意,这与社会人口变量有关。官方应提高性取向数据收集工作的安全性和相关性,以增加其对性取向少数群体的代表性和实用性。
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引用次数: 0
Māori and Pacific young people's perspectives on testing for sexually transmitted infections via an online service: a qualitative study. 毛利和太平洋裔青少年对通过在线服务进行性传播感染检测的看法:一项定性研究。
IF 1.1 Q4 PRIMARY HEALTH CARE Pub Date : 2024-09-01 DOI: 10.1071/HC23136
Sally B Rose, Tracey Gardiner, Abigail Dunlop, Marama Cole, Susan M Garrett, Eileen M McKinlay

Introduction International research suggests free online postal self-sampling for sexually transmitted infection (STI) testing is an acceptable alternative to clinic-based testing. A user-pays online STI testing service exists in Aotearoa New Zealand, but acceptability among priority populations is unknown. Aim To explore Māori and Pacific young people's perspectives on online postal self-sampling for STI testing (as prospective service users). Methods Four wānanga (knowledge-sharing forum) were held between November 2022 and May 2023 with Māori and Pacific participants aged 15-24 years who were recruited via youth-focused community organisations. Three facilitators guided discussions about STI testing and use of an online service. Inductive thematic analysis was used to analyse data generated from audio-recorded discussions, group work notes and facilitator field notes. Results None of the 38 participants were aware of online STI testing and all considered it cost-prohibitive. Perceptions of online testing were mixed, and discussion about concerns outweighed perceived benefits. Three themes were identified: (i) potential to support autonomy (perceived benefits and positive features of self-sample collection kits); (ii) barriers and process-related concerns; and (iii) tailoring online STI testing to young people's needs (facilitating engagement with online testing). Discussion For online STI testing to be an accessible alternative to clinic-based testing for priority populations, cost, low awareness and other barriers in the testing pathway need to be addressed. Clinician follow-up on positive results and free treatment would be critical to ensure the cycle of best practice care is completed. Regardless of where testing is accessed, investment is needed to support young people's knowledge of when, why and how to access a sexual health check.

导言:国际研究表明,免费在线邮寄性传播感染(STI)检测自我采样是一种可接受的替代诊所检测的方法。在新西兰奥特亚罗瓦,有一种用户付费的在线性传播感染检测服务,但重点人群的接受程度尚不清楚。目的 探讨毛利人和太平洋裔年轻人(作为未来的服务使用者)对在线邮寄自我取样进行性传播感染检测的看法。方法 在2022年11月至2023年5月期间举办了四次wānanga(知识分享论坛),参加者均为15-24岁的毛利族和太平洋裔青年,他们是通过以青年为重点的社区组织招募的。三位主持人主持了有关性传播感染检测和在线服务使用的讨论。归纳式主题分析法用于分析从讨论录音、小组工作笔记和主持人现场记录中获得的数据。结果 38 名参与者都不知道在线性传播感染检测,而且都认为费用过高。对在线检测的看法不一,对其担忧的讨论多于对其好处的看法。确定了三个主题(i) 支持自主性的潜力(自我样本采集工具包的好处和积极特征);(ii) 障碍和与过程相关的问题;以及 (iii) 根据年轻人的需要定制在线 STI 检测(促进参与在线检测)。讨论:要使在线性传播感染检测成为重点人群在诊所进行检测的替代方案,就必须解决检测过程中的成本、认知度低和其他障碍问题。临床医生对阳性结果的跟踪和免费治疗对于确保完成最佳实践护理周期至关重要。无论在哪里进行检测,都需要进行投资,以帮助年轻人了解何时、为何以及如何进行性健康检查。
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引用次数: 0
Milk thistle. 奶蓟草
IF 1.1 Q4 PRIMARY HEALTH CARE Pub Date : 2024-09-01 DOI: 10.1071/HC24131
Rayna Sharma, E Lyn Lee, Jo Barnes
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引用次数: 0
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 Q4 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

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.

导言:对于许多变性人和非二元性(TNB)人群来说,性别肯定激素疗法(GAHT)是医疗保健的一个重要方面,但人们对新西兰奥特亚罗瓦地区(NZ)变性人和非二元性人群的长期治疗效果知之甚少。接受变性治疗的途径正在从二级医疗转向初级医疗,因此,现在正是开始对接受变性治疗者的长期健康和福利结果进行本地研究的大好时机。目的 本文旨在报告四次会议的主要结论,这些会议为设计前瞻性队列研究提供了信息,该研究将跟踪新西兰初级和二级医疗机构中开始接受 GAHT 治疗的患者的治疗过程。方法 我们与一个由六名 TNB 年轻人组成的社区咨询小组合作,并向 14 名参与 TNB 患者 GAHT 治疗的医疗服务提供者(全科医生、二级护理医生和心理健康服务提供者)征求意见。采用半结构式访谈表来指导讨论。根据访谈表中确定的主题,采用模板分析法对数据进行初步编码,并在讨论中添加新的主题。结果 参与者就基线调查和后续调查的招募和数据收集重点交流了看法。其中包括了解开始荷尔蒙疗法的历程(信息寻求、决策)、开始接受 GAHT 的服务途径、信息提供的适当性、收到第一张处方、GAHT 的目标和体验,以及非二元人群的独特需求。讨论 TNB咨询小组和医疗保健专业人员的意见为制定一项调查提供了参考,该调查将用于了解在新西兰开始接受GAHT治疗的人的经历和结果。这项计划中的前瞻性队列研究的结果有可能改善希望接受GAHT治疗的TNB患者的就医情况。
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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 Q4 PRIMARY HEALTH CARE Pub Date : 2024-09-01 DOI: 10.1071/HC24058
Stephen Ram, Karen Carlisle, Sarah Larkins, Katharina Blattner

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.

导言 农村医院为新西兰大部分农村人口提供二级医疗服务。社区对医院的健康和社会贡献的看法却鲜为人知。这项描述性定性研究旨在探讨毛利人和太平洋裔人口较多的社会经济地位较低的农村地区的社区对其农村医院作用的看法。研究方法 对农村社区成员进行了半结构化个人访谈和焦点小组访谈,了解他们对乡镇医院作用的看法。并进行了迭代主题分析。结果 共有 22 人接受了访谈。主题分析产生了四个主题:(i) 乡镇医院作为安全网--提供急诊服务并缓解初级医疗服务有限的问题;(ii) 提供个性化、具有文化意识的医疗服务;(iii) 促进家庭/瓦瑙人的支持;(iv) 利用有限的资源做到最好。后者包括对资源限制的务实态度,但希望医院继续开放。讨论 农村医院通过增加获得紧急医疗服务的机会和减轻获得初级医疗服务的困难,为社区安全做出了贡献。农村医院服务提供者对当地情况的了解使其能够提供个性化的、以家庭为中心的、符合当地文化的医疗服务。尽管服务集中化,但乡村医院仍受到社区的欢迎。农村医疗规划者应考虑如何最大限度地扩大当地提供的服务范围,以减少旅行和转院对医疗服务的影响。
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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 Q4 PRIMARY HEALTH CARE Pub Date : 2024-09-01 DOI: 10.1071/HC24027
Madeleine Reid, Tania Moerenhout

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.

导言:自 COVID-19 大流行以来,电话和视频咨询的使用大幅增加。传统临床实践中的医疗服务提供者将这些虚拟咨询作为面对面咨询的替代方式,但通过商业实体直接向消费者提供的服务也在同步增加。远程医疗(以及更广泛的数字医疗领域)面临的主要挑战之一是如何对此类服务进行有意义的伦理评估。目的 本文提出了一个新颖的框架,用于对新西兰奥特亚罗瓦地区直接面向消费者的虚拟全科医生咨询服务进行实用的伦理分析。方法 首先,对学术和政策文件进行了范围界定,确定了虚拟咨询带来的核心伦理挑战。其次,进行定性分析,将主要伦理主题和次主题转化为评估虚拟全科医生服务的实际问题。结果 共选择了 49 份相关文件进行审查。与远程医疗相关的六个主要伦理主题是:隐私、安全和保密;公平;自主权和知情同意;医疗质量和标准;患者赋权;以及医疗的连续性。根据这些主题及其次主题,制定了由 25 个问题组成的实用伦理核对表。讨论 该核对表提供了一种将伦理纳入技术评估的简便方法,可供包括患者、医疗服务提供者和开发者在内的所有利益相关者使用。应用该框架有助于提高虚拟咨询服务的质量,并特别关注伦理问题。
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引用次数: 0
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Journal of primary health care
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