Examines factors associated with post-traumatic stress (PTS) among both currently serving and retired NZ military personnel. Determines the prevalence of PTS (symptomology and presumptive clinical ...cases) and identifies protective and risk factors most strongly associated with PTS. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This study aims to examine opportunities for subsequent injury prevention from the perspectives of people who have recently experienced subsequent injury events.
This qualitative study involved ...individual semi-structured interviews with people who had >2 injury events in the previous 12 months. Interviews were audio-recorded, transcribed verbatim and thematic analysis undertaken.
Sixteen interviews were completed with participants who had experienced a range of index and subsequent injury types. Potential opportunities raised were wide-ranging. Some related to individuals, e.g., motivation to carry out prevention strategies. Other opportunities were related to healthcare providers and the health system. For instance, increasing consultation times to allow a focus on subsequent injury prevention, building rapport and tailoring their approach to the individual, proactively referring people to a range of healthcare providers, and ensuring people are aware of resources and supports available following injury. Broader environmental and societal opportunities were also suggested, such as ensuring adequate social support following injury, ensuring accessibility to rehabilitation and community facilities and the modification of built environments.
A broad range of potential opportunities to prevent subsequent injuries were raised. These opportunities are promising and future research to trial interventions raised in this study is warranted to determine their feasibility and effectiveness.
Examines if differences exist between injured Māori and non-Māori in accessing and receiving support from the Accident Compensation Corporation (ACC) for treatment and rehabilitation of subsequent ...injuries. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
•A substantial proportion of people who are injured go on to have subsequent injuries.•Preventing subsequent injuries is an opportunity to contribute to reducing the overall burden of ...injury.•Healthcare providers interviewed in this study suggested a variety of potential strategies to reduce subsequent injuries.•Subsequent injury prevention opportunities suggested ranged from individually oriented interventions to broader societal interventions.
Introduction: Many individuals who experience an injury go on to have subsequent injuries. This study examined the views of health professionals about potential opportunities to prevent subsequent injuries.
Methods: Semi-structured individual interviews were held with a range of health professionals involved in treating injuries. Interviews examined opportunities for the prevention of subsequent injuries, particularly opportunities that may be implemented by health professionals. A thematic analysis of the data was undertaken.
Results: Thirteen health professionals were interviewed, including physiotherapists, occupational therapists, and emergency department staff. Opportunities to prevent subsequent injuries aligned with the Dahlgren-Whitehead model of health determinants, representing opportunities to focus on demographic factors (e.g. older adults), individual lifestyle factors (e.g. alcohol consumption), social and community networks (e.g. social isolation), living and working conditions (e.g. access to preventive healthcare), and general socioeconomic, cultural, and environmental conditions (e.g. changes in legislation).
Conclusions: Health professionals identified a number of opportunities for subsequent injury prevention, ranging from individually oriented interventions to broader societal interventions. Within their roles, health professionals highlighted potential opportunities to provide education, modify attitudes, engage in multi-disciplinary teamwork, and serve as advocates. Use of these strategies could help to reduce the disability burden presented by subsequent injuries.
Purpose
To examine the life satisfaction outcomes after spinal cord injury (SCI) and to identify the factors associated with life satisfaction at 18 months and 10 years post-SCI in New Zealand (NZ).
...Methods
Adults (16–64 years) were recruited between 2007 and 2009 from NZ’s two spinal units following first admission for SCI. Interviews at 6 months, 18 months, and 10 years post-SCI examined demographic, physical, psychosocial, economic, and environmental characteristics. Multivariable regression models were used to identify predictors of life satisfaction at each timepoint.
Results
Overall, 118 people participated at 6 months, 103 at 18 months, and 63 at 10 years post-SCI. Pre-SCI, 90% of participants were satisfied with life, 67% were satisfied at 18 months, and 78% at 10 years. At 18 months post-SCI, participants who reported: never or sometimes using a wheelchair, no problems with self-care, no problems with anxiety or depression, no/lesser disability, or fewer secondary health conditions (SHCs) at 6 months post-SCI were more likely to be satisfied (
p
< 0.05), compared to those without these characteristics. Participants who experienced considerable disability at 6 months post-SCI were 22% less likely to be satisfied 10 years post-SCI compared to those experiencing no/lesser disability (
p
= 0.028).
Conclusions
A higher proportion of participants were satisfied at both 18 months and 10 years post-SCI than not satisfied. To improve the likelihood of satisfaction with life, increased focus on reducing disability and providing supports for those using wheelchairs, experiencing anxiety/depression or problems with self-care, and effects of SHCs are promising for future potential interventions.
Māori have been found to experience marked health inequities compared to non-Māori, including for injury. Accessing healthcare services post-injury can improve outcomes; however, longer-term ...experiences of healthcare access for injured Māori are unknown. This paper reports on data from the longitudinal Prospective Outcomes of Injury Study - 10 year follow up (POIS-10) Māori study in Aotearoa/New Zealand (NZ), to qualitatively understand Māori experiences of accessing injury-related healthcare services long-term.
Follow-up telephone interviews were conducted with 305 POIS-10 Māori participants, who were injured and recruited 12-years earlier, experiencing a range of injury types and severities. Free text responses about trouble accessing injury-related health services were thematically analysed.
Sixty-one participants (20%) reported trouble accessing injury-related health services and provided free text responses. Three related themes describing participants' experiences were connected by the overarching concept that participants were engaging with a system that was not operating in a way it was intended to work: 1) Competing responsibilities and commitments encapsulates practical barriers to accessing services, such as a lack of time and having to prioritise other responsibilities such as work or whānau (family); 2) Disrupted mana refers to the feelings of personal disempowerment through, for example, receiving limited support, care or information tailored to participants' circumstances and is a consequence of patients contending with the practical barriers to accessing services; and 3) Systemic abdication highlights systemic barriers including conflicting information regarding diagnoses and treatment plans, and healthcare provider distrust of participants.
Twelve years post-injury, a considerable proportion of Māori reported experiencing barriers to accessing healthcare services. To restore a sense of manaakitanga and improve Māori access to healthcare, Māori-specific supports are required and systemic barriers must be addressed and removed.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Injury is a leading cause of disability. Twenty years ago, we knew financial costs of injury were high but little was known about the short, medium and long-term outcomes after injury. In 2006, a ...Pilot Study and engagement with Māori across the country was undertaken to discuss the planned main study to understand how best to design a study that was meaningful and beneficial to Māori and policy-makers. Between 2007–2009, 2,856 injured New Zealanders (including 20% Māori) with an Accident Compensation Corporation (ACC) entitlement claim were recruited to the Prospective Outcomes of Injury Study (POIS). Participants shared detailed information (at 3, 12 and 24 months, and 12-years post-injury) about a broad range of topics including: the injury, socio-demographics, health, health services access, employment and wellbeing. Administrative data about injury-related hospitalisations, the sentinel injury and subsequent injuries were also collected, as well as in-depth qualitative interviews. This paper focuses on the why, how and impacts of POIS, especially in relation to Māori design and approaches, capability and capacity building, and leadership. Focusing on these aspects for Māori within POIS over time has ensured delivery of findings capable of informing and improving outcomes and policy. In particular, POIS has had considerable impact, influencing ACC's research strategy and outcomes' focus, and has provided disability, health, and wellbeing outcomes knowledge previously unavailable, especially for Māori.
In New Zealand, people receiving care from specialist mental health and addiction services experience poorer health outcomes compared to the general population. Māori (Indigenous) specialist mental ...health and addiction service users experience disproportionate inequities. This study aims to: (1) Describe and understand mental health staff perspectives on the quality of care delivered to specialist mental health and addiction service users in their service – including specifically for Māori; and (2) Identify areas staff report as opportunities for quality improvement. In 2020, Southern District Health Board (now Te Whatu Ora – Southern) mental health staff were invited to participate in a cross‐sectional study assessing their perceptions of a range of service aspects. This paper presents quantitative and qualitative analyses about quality of care. Among the 319 staff who completed the questionnaire; 272 provided quality‐of‐care responses. Among these, 78% reported the quality of care delivered to service users as ‘good’ or ‘excellent’; only 60% reported this for Māori service users. Participants identified individual, service and broader system level factors influencing the quality of care delivered to service users, including factors specific for Māori. This study has identified, for what appears to be the first time, empirical and concerning differences in staff ratings of the quality of care delivered to Māori and SMHAS users overall. Findings highlight the need for institutional and managerial prioritization of hauora Māori, and incorporating tikanga Māori and Te Tiriti into practice.
Objective:
Post-traumatic stress disorder following injuries unrelated to mass casualty events has received little research attention in New Zealand. Internationally, most studies investigating ...predictors of post-injury post-traumatic stress disorder focus on hospitalised patients although most survivors are not hospitalised. We compared the prevalence and predictors of symptoms suggestive of post-traumatic stress disorder 12 months following injury among hospitalised and non-hospitalised entitlement claimants in New Zealand’s Accident Compensation Corporation. This government-funded universal no-fault insurance scheme replaced tort-based compensation for injuries in 1974 since when civil litigation (which can bias post-traumatic stress disorder estimates) has been rare.
Methods:
A total of 2220 Accident Compensation Corporation claimants aged 18–64 years recruited to the Prospective Outcomes of Injury Study were interviewed at 12 months post-injury to identify symptoms suggestive of post-traumatic stress disorder using the Impact of Events Scale. Multivariable models examined the extent to which baseline sociodemographic, injury, health status and service interaction factors predicted the risk of post-traumatic stress disorder symptoms among hospitalised and non-hospitalised groups.
Results:
Symptoms suggestive of post-traumatic stress disorder were reported by 17% of hospitalised and 12% of non-hospitalised participants. Perceived threat to life at the time of the injury doubled this risk among hospitalised (adjusted relative risk: 2.0; 95% confidence interval: 1.2–3.2) and non-hospitalised (relative risk: 1.8; 95% confidence interval: 1.2–2.8) participants. Among hospitalised participants, other predictors included female gender, Pacific and ‘other’ minority ethnic groups, pre-injury depressive symptoms, financial insecurity and perceived inadequacies in healthcare interactions, specifically information and time to discuss problems. Among non-hospitalised survivors, predictors included smoking, hazardous drinking, assault and poor expectations of recovery.
Conclusion:
One in six hospitalised and one in eight non-hospitalised people reported post-traumatic stress disorder symptoms 12 months following injury. Perceived threat to life was a strong predictor of this risk in both groups. Identifying early predictors of post-traumatic stress disorder, regardless of whether the injury required hospitalisation, could help target tailored interventions that can reduce longer-term psychosocial morbidity.
•141 Participants described experiences of the first COVID-19 lockdown in New Zealand.•Thematic analysis of 141 records identified themes of loss and negative reflections.•A counter-narrative of ...affordances and positive reflections was observed.•These positive outcomes may be leveraged in future lockdowns or pandemics.
This study thematically analyses free text responses from telephone interviews with 141 participants from the Prospective Outcomes of Injury Study (POIS-10/POIS-10 Māori) to explore their “lived experiences” of the COVID-19 Alert Level 4 lockdown in Aotearoa/New Zealand (NZ). Interviews occurred in March-April 2020, at which time, NZ underwent some of the most stringent COVID-19 public health measures internationally. This study provides “real time” insights into participants’ experiences and views during this time in NZ.
Many participants experienced losses, limitations, and restrictions due to the COVID-19 Alert Level 4 lockdown. Nevertheless, positive outcomes and reflections were reported alongside, and sometimes in conjunction with, the negative. Although the lockdown was limiting for many participants, some highlighted that this unique environment facilitated certain affordances including positive experiences with work, supporting others, and being supported, family dynamics changing for the better, more free time and positive reflections such as enhanced feelings of unity, closeness to others and a sense of gratefulness.
The identification of affordances facilitated by the lockdown environment has implications for future pandemic response management, as these may be leveraged by policymakers, health care practitioners and individuals, potentially resulting in more favorable outcomes in future lockdowns.
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