{"title":"The new coalition government: a step forward for primary care funding?","authors":"Felicity Goodyear-Smith, Tim Stokes","doi":"10.1071/HC23166","DOIUrl":"10.1071/HC23166","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805631","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}
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.
{"title":"The enrolment gap and the COVID-19 pandemic: an exploration of routinely collected primary care enrolment data from 2016 to 2023 in Aotearoa New Zealand.","authors":"Megan Pledger, Nisa Mohan, Pushkar Silwal, Maite Irurzun-Lopez","doi":"10.1071/HC23128","DOIUrl":"10.1071/HC23128","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805625","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":"Prompting lifestyle interventions to promote weight loss is safe, effective and patient-centred: Yes.","authors":"Ross Lawrenson","doi":"10.1071/HC23167","DOIUrl":"10.1071/HC23167","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805612","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}
Jane Cullen, Paul Childerhouse, Nihal Jayamaha, Lynn McBain
Introduction Primary care is under pressure to achieve accessible, equitable, quality health care, while being increasingly under resourced. There is a need to understand factors that influence quality improvement (QI) to support a high-performing primary care system. Literature highlights the impact of context on QI but there is little primary care research on this topic. Aim This qualitative case study research seeks to discover the contextual factors influencing QI in primary care, and how the relationships between contextual factors, the QI initiative, and the implementation process influence outcomes. Methods The Consolidated Framework for Implementation Research was used to frame this qualitative study exploring primary care experiences in depth. Six sites were selected to provide a sample of rural, urban and Kaupapa Māori settings. Qualitative data was collected via semi-structured interviews and compared and contrasted with the organisational documents and data provided by participants. Results Cases reported success in achieving improved outcomes for patients, practices, and staff. Strong internal cultures of 'Clan' and 'Adhocracy' typologies supported teamwork, distributed leadership, and a learning climate to facilitate iterative sensemaking activities. To varying degrees, external network relationships provided resources, knowledge, and support. Discussion Organisations were motivated by a combination of patient/community need and organisational culture. Network relationships assisted to varying degrees depending on need. Engaged and distributed leadership based on teamwork was observed, where leadership was shared and emerged at different levels and times as the need arose. A learning climate was supported to enable iterative sensemaking activities to achieve success.
{"title":"Developing a model for primary care quality improvement success: a comparative case study in rural, urban and Kaupapa Māori organisations.","authors":"Jane Cullen, Paul Childerhouse, Nihal Jayamaha, Lynn McBain","doi":"10.1071/HC23046","DOIUrl":"10.1071/HC23046","url":null,"abstract":"<p><p>Introduction Primary care is under pressure to achieve accessible, equitable, quality health care, while being increasingly under resourced. There is a need to understand factors that influence quality improvement (QI) to support a high-performing primary care system. Literature highlights the impact of context on QI but there is little primary care research on this topic. Aim This qualitative case study research seeks to discover the contextual factors influencing QI in primary care, and how the relationships between contextual factors, the QI initiative, and the implementation process influence outcomes. Methods The Consolidated Framework for Implementation Research was used to frame this qualitative study exploring primary care experiences in depth. Six sites were selected to provide a sample of rural, urban and Kaupapa Māori settings. Qualitative data was collected via semi-structured interviews and compared and contrasted with the organisational documents and data provided by participants. Results Cases reported success in achieving improved outcomes for patients, practices, and staff. Strong internal cultures of 'Clan' and 'Adhocracy' typologies supported teamwork, distributed leadership, and a learning climate to facilitate iterative sensemaking activities. To varying degrees, external network relationships provided resources, knowledge, and support. Discussion Organisations were motivated by a combination of patient/community need and organisational culture. Network relationships assisted to varying degrees depending on need. Engaged and distributed leadership based on teamwork was observed, where leadership was shared and emerged at different levels and times as the need arose. A learning climate was supported to enable iterative sensemaking activities to achieve success.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85864229","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}
Health promotion should underpin undergraduate nursing curricula but approaches to teaching nursing students about health promotion vary widely and are rarely evaluated. A practice development project was undertaken to develop a toolkit of resources that would enhance the health promotion practice of nursing students on placements in community settings. The project was a collaboration between a community public health nursing team and a university in the south west of England. It involved students from one cohort of first-year children’s nursing students and practice supervisors from a community placement setting. The authors used an emancipatory practice development methodology to explore the views and attitudes of five nursing students and 11 practice supervisors. The findings were used to develop a toolkit of resources that could enhance nursing students’ health promotion practice.
{"title":"Developing a toolkit to enhance nursing students’ health promotion practice","authors":"Rebecca Reynolds, Sarah Neill","doi":"10.7748/phc.2023.e1812","DOIUrl":"https://doi.org/10.7748/phc.2023.e1812","url":null,"abstract":"Health promotion should underpin undergraduate nursing curricula but approaches to teaching nursing students about health promotion vary widely and are rarely evaluated. A practice development project was undertaken to develop a toolkit of resources that would enhance the health promotion practice of nursing students on placements in community settings. The project was a collaboration between a community public health nursing team and a university in the south west of England. It involved students from one cohort of first-year children’s nursing students and practice supervisors from a community placement setting. The authors used an emancipatory practice development methodology to explore the views and attitudes of five nursing students and 11 practice supervisors. The findings were used to develop a toolkit of resources that could enhance nursing students’ health promotion practice.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135732537","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}
Non-clinical placements for nursing students may be beneficial in preparing students for providing care in integrated environments, supporting a focus on health promotion and increasing placement capacity. This article discusses the benefits and challenges of implementing the Clinical Placement Expansion Programme (CPEP) using a long-arm supervision model. Non-clinical practice learning opportunities were developed in partnership with local community organisations, in a spirit of civic engagement. As a result of these placements, nursing students developed their understanding of health inequalities, vulnerable populations and the effects of asset-based community development, while contributing positively to the activities of the organisation through involvement in well-being initiatives. The placements also improved students’ well-being, enhanced their knowledge of services and enabled them to experience alternative leadership models. To implement a civic engagement strategy for future healthcare professionals, further research is necessary to develop a sustainable framework for non-clinical placements. Additionally, universities will need to expand civic partnerships to affirm their role as anchor institutions for health in the community.
{"title":"Implementing civic engagement placements for nursing students in community organisations: a pilot project","authors":"Pamela Donaghy, Mark Arnold","doi":"10.7748/phc.2023.e1813","DOIUrl":"https://doi.org/10.7748/phc.2023.e1813","url":null,"abstract":"Non-clinical placements for nursing students may be beneficial in preparing students for providing care in integrated environments, supporting a focus on health promotion and increasing placement capacity. This article discusses the benefits and challenges of implementing the Clinical Placement Expansion Programme (CPEP) using a long-arm supervision model. Non-clinical practice learning opportunities were developed in partnership with local community organisations, in a spirit of civic engagement. As a result of these placements, nursing students developed their understanding of health inequalities, vulnerable populations and the effects of asset-based community development, while contributing positively to the activities of the organisation through involvement in well-being initiatives. The placements also improved students’ well-being, enhanced their knowledge of services and enabled them to experience alternative leadership models. To implement a civic engagement strategy for future healthcare professionals, further research is necessary to develop a sustainable framework for non-clinical placements. Additionally, universities will need to expand civic partnerships to affirm their role as anchor institutions for health in the community.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135591878","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}
A series of national resources aims to improve diabetes management for older people transferred to care homes
一系列国家资源旨在改善转移到养老院的老年人的糖尿病管理
{"title":"Improving diabetes care for care home residents","authors":"Jo-Anne Wilson","doi":"10.7748/phc.33.5.12.s4","DOIUrl":"https://doi.org/10.7748/phc.33.5.12.s4","url":null,"abstract":"A series of national resources aims to improve diabetes management for older people transferred to care homes","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135835265","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}
Practice supervision for students on placements is a role for all registered staff – and it can enhance practice too
对实习学生进行实践指导是所有注册教职员工的职责--这也能提高实践水平
{"title":"What you need to know about supervising students","authors":"Lynne Pearce","doi":"10.7748/phc.33.5.20.s8","DOIUrl":"https://doi.org/10.7748/phc.33.5.20.s8","url":null,"abstract":"Practice supervision for students on placements is a role for all registered staff – and it can enhance practice too","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135833652","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}
New NHS standards focus on assessment and consistency in wound care, by improving documentation, investigation of underlying causes and multidisciplinary approaches
新的NHS标准侧重于伤口护理的评估和一致性，通过改进文件，调查潜在原因和多学科方法
{"title":"Improving record-keeping and communication in chronic wound care","authors":"Nick Evans","doi":"10.7748/phc.33.5.6.s2","DOIUrl":"https://doi.org/10.7748/phc.33.5.6.s2","url":null,"abstract":"New NHS standards focus on assessment and consistency in wound care, by improving documentation, investigation of underlying causes and multidisciplinary approaches","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135835875","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}
Gender identity services for young people are in flux, but nurses can still help those who are struggling
针对年轻人的性别认同服务在不断变化，但护士仍然可以帮助那些挣扎的人
{"title":"Advice for nurses on gender dysphoria in young people","authors":"Daniel Allen","doi":"10.7748/phc.33.5.14.s5","DOIUrl":"https://doi.org/10.7748/phc.33.5.14.s5","url":null,"abstract":"Gender identity services for young people are in flux, but nurses can still help those who are struggling","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135833799","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}
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