Journal of primary health care最新文献

Introduction Manatū Hauora (Aotearoa New Zealand (NZ) Ministry of Health) recognises that respecting and listening to Pacific peoples' knowledge and skills in caring for their communities' wellbeing is a priority, and that novel approaches to care, particularly for chronic health conditions, are necessary. Allied health professionals have the potential to play important roles in primary care design and delivery. Pacific Trust Otago (PTO) provides a weekly seniors' group gathering that has evolved over the years and incorporates exercise, health information and cultural activities. Aim This study aims to explore what Pacific seniors are learning about their health and wellbeing, and what factors contribute to sustained engagement with this weekly group activity. Methods The research team conducted a qualitative study using the Kakala Research Framework and the pan-Pacific Talanoa Research Methodology to gather narratives in a relational and comfortable group space. Participants were recruited from the seniors group gathering. Group Talanoa were used to collect data, which were digitally voice-recorded, transcribed, translated, and de-identified. Ethical approval was granted by the University of Otago School of Physiotherapy Ethics Committee. Results Pacific seniors valued how these gathering The seniors recognised how interconnected and intertwined culture, spirituality, and family were and how this contributed to their sense of individual and collective health and wellbeing. The study highlights the need to consider health beyond the individual to the collective, embracing indigenous perspectives, and authentically nurturing relationships with Pacific health providers. The study recommends primary care funders are supported to understand what is important to Pacific people and partner with Pacific health providers to deliver care in ways that align with indigenous models of care. Discussion A weekly group gathering for Pacific seniors run by Allied Health professionals provides a welcoming, safe, and culturally meaningful environment where seniors can connect, share, and grow in health and wellbeing together. This study highlights the importance of adopting informed and inclusive approaches to promoting and addressing holistic health for Pacific people, especially in light of ongoing health reforms in Aotearoa NZ.

Introduction In Aotearoa New Zealand (NZ), there is inequity in rates of neural tube defects (NTDs). Among Maaori, NTD occur in 4.58/10 000 live births, and for Pacific peoples, it is 4.09/10 000 live births; this is compared to 2.81/10 000 live births for non-Maaori, non-Pacific peoples. Aim To describe self-reported pre-pregnancy folic acid supplementation and to determine the association between pregnancy intendedness, ethnicity, parity, maternal age, care provider and pre-pregnancy folic acid supplementation. Methods Secondary analysis of postpartum survey data collected at Te Whatu Ora Te Toka Tumai and Counties Manukau birthing facilities in 2020 was conducted. Descriptive analyses explored pregnancy intendedness and self-reported folic acid use by demographic variables. Multivariable logistic regression explored independent associations between demographic variables and folic acid use among intended pregnancies. Results In total, 398 participants completed the survey. The response rate was (140/149) 94% at Counties Manukau and (258/315) 82% at Te Toka Tumai. Pre-pregnancy supplementation was reported by 182 of 398 participants (46%). Use was higher among those who intended their pregnancy (151/262, 58%) compared to those who were 'pregnancy ambivalent' (9/33, 27%) or did not intend to become pregnant (22/103, 21%). Factors independently associated with supplementation among intended pregnancies included: 'Other ethnicity' (European, Middle Eastern, Latin American, African) compared to Maaori (aOR 5.3 (95% CI 1.3, 21.8)), age ≥30 years compared to Discussion Low rates of pre-pregnancy folic acid supplementation exist in Auckland with significant ethnic disparity. Mandatory fortification of non-organic wheat is important, but supplementation is still recommended to maximally reduce risk.

Introduction Delayed diagnosis of gut disease is a continuing problem, variously attributed to a range of patient, doctor, and health system factors. Gut disease often begins with indeterminate gut behaviours that are hard to classify. Aim This study aimed to investigate delayed diagnosis from the point of view of the patient, or prospective patient. How gut and gut disease was understood, what might prompt them to seek care, and their experiences of seeking care. Methods Using a qualitative design, we interviewed 44 people in New Zealand. Thirty-three had a diagnosis of gut disease, and 11 did not, though some of the patients in this latter group had symptoms. Results Some participants had a smooth trajectory from first noticing gut symptoms to diagnosis. However, a subgroup of 22 participants experienced long periods of troublesome gut behaviours without a diagnosis. For this subgroup of 22 participants, we found people struggled to work out what was normal, thus influencing when they sought health care. Once they sought health care, experiences of that care could be frustrating, and achieving a diagnosis protracted. Some who remained undiagnosed felt abandoned, though had developed strategies to self-manage. Discussion Indeterminate gut behaviours remain complex to deal with and it can difficult for both patients and doctors to assess when a symptom or group of symptoms need further investigation, watchful waiting or the use of other supportive strategies. Effectively communicating with healthcare staff can be a significant problem and there is currently a gap in support for patients in this regard.

Introduction For many countries, primary health care (PHC) serves as the gateway for individuals to access healthcare services. It has been shown to not only improve health but also health equity. To maximise this benefit, a substantial proportion of the population needs to be connected with PHC. The aim here was to assess the degree and evolution of enrolment in light of the coronavirus disease 2019 (COVID-19) pandemic in Aotearoa New Zealand. Methods We examined data on the enrolment of people in PHC organisations between 2016 and 2023. This analysis included breakdowns by sex, age groups, ethnicity, and socioeconomic deprivation levels. Poisson regression models were used to explore whether enrolment changed because of the COVID-19 pandemic. Results In 2016, Māori, young people and the most deprived had lower enrolment rates relative to their peers. Although young people's enrolment rate increased over time, especially during the COVID-19 pandemic, the Māori enrolment rate declined, as did the rate for Pacific people, and those who were the most deprived. The groups who had increases in enrolment rates were those with the lowest levels of socioeconomic deprivation and those in the 'Other' ethnic category, predominantly made up of European New Zealanders. Conclusion Enrolment statistics reveal disparities across sociodemographic lines. The COVID-19 pandemic was associated with changed patterns of enrolment that appear to have consequences for population health.