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Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
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Journal of Primary Health Care

Journal of Primary Health Care

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HC24057Student-run falls prevention programmes for older adult community members: a pilot study

JiaRong Yap 0000-0002-8352-682X, Patrick Broman 0000-0003-3491-4137, Glynis Longhurst and Sharon Brownie 0000-0001-7204-2451

What is known about the topic: Falls among community-dwelling older adults are a significant public health concern. Previous research has highlighted the importance of strength and balance exercises and falls prevention education in reducing fall incidence among older adults. What this study adds: This study shows the potential for student-run interventions in contributing to falls prevention efforts and improving the wellbeing of aging populations.

What is known about the topic: Palliative care significantly enhances the quality of life for advanced-stage cancer patients by addressing their comprehensive needs. The Chinese ethnic population faces substantial barriers in Australia to accessing palliative care services due to cultural and linguistic differences. There is generally a low awareness and many misconceptions about palliative care within ethnic communities, including Chinese Australians. What this study adds: The study highlights the specific challenges faced by Chinese Australian cancer patients and their caregivers in accessing palliative care services. It identifies language as the primary barrier, despite a strong interest in palliative care services among the Chinese ethnic community. The study highlights the need for local health authorities, medical associations, and community groups to develop and disseminate culturally and linguistically appropriate information to improve palliative care service uptake among the culturally and linguistically diverse community.

What is known about the topic: Routinely collected administrative and health data have potential to be used for research that provides real-world health insights that can inform policy and improve clinical practice and population health. Engaging stakeholders to establish priorities can help ensure research is fit for purpose, provides important health benefits, and has the greatest potential to improve health equity. What this study adds: Primary care clinicians and academics identified the top research areas to improve health equity in primary care as the health workforce, health services, mental health, and models of primary health care. The top research questions include evaluating the impacts of annual health checks for people with intellectual disability, the role of allied health as front-line primary health care providers, and the role of an embedded social worker in a general practice clinic setting.

HC24096Knee pain dilemma and the initial step to predicting diagnoses in general practice: a cross-sectional study

Valerie H. J. Debie 0009-0004-1448-2837, Ann-Sophie Puls, Luc J. M. Heijnens, Jochen W. L. Cals, Ralph T. H. Leijenaar and Ramon P. G. Ottenheijm

What is already known: Knee pain is a common reason to consult a general practitioner (GP), but accurate diagnosis poses a challenge for GPs. To support GPs with this diagnostic dilemma in patients with knee pain, a prediction model could be a useful diagnostic decision support tool, however, this has not yet been developed. What this study adds: In patients with knee pain, for whom GPs experience diagnostic challenges, osteoarthritis is by far the most prevalent diagnosis, followed by patellofemoral pain and meniscal lesions. An age threshold of roughly 50 years is a strong predictor for knee osteoarthritis, patellofemoral pain, and meniscal lesions.

What is known about this topic: There is a current paucity of research in emergency simulation training in primary care. Although there is literature on the use that emergency simulation education has in secondary care services such as emergency medicine (EM) or for intensive care unit (ICU) staff, it is not well established or validated in primary care. What this study adds: To the best of the author's knowledge, this is the first literature review of studies that evaluate the use of emergency care simulations for primary care clinicians. The findings from this review can help inform and guide the appropriate education and training of primary care clinicians.

What is already known: Although telerehabilitation offers the potential to improve access to rehabilitation for people with mild traumatic brain injury (mTBI) and reduce health disparities, the services must be tailored to meet the specific needs of this population. What this study adds: This study provides information about the aspects of rehabilitation that are most valued by patients and how telerehabilitation services can be designed to best meet the specific needs of this population in Aotearoa New Zealand. Considering the travel time, cost and familiarity with their therapist, the results suggest that long telerehabilitation sessions would be the most valued option.

HC24142Nutrition care provided to patients discharged from hospital post alcohol withdrawal: a mixed methods study

Cameron McLean 0000-0002-6636-737X, Linda Tapsell, Hannah Mozejko, Sara Grafenauer and Anne-Therese McMahon

What is known about the topic: Individuals who hazardously consume alcohol may also present with nutritional problems such as weight loss, underweight, malnutrition, micronutrient deficiency and/or low food security. Previous research has shown limited input from the dietitian during admission to hospital for alcohol withdrawal. What this study adds: Healthcare professionals working within Primary Health Networks have variable confidence providing nutrition-related care to patients discharged from hospital post alcohol withdrawal, indicating a gap in nutrition-related service provision. These insights support the need for best practice guidelines for nutritional management in this population to enhance the role of dietitians within the multidisciplinary team.

What is already known: Child abuse is highly prevalent in NZ. Primary health care (PHC) nurses work across a variety of settings, and are therefore more likely than other health professionals to encounter children whom they suspect are at risk. Recognising suspected abuse and the decision making on reporting is challenging, particularly amidst the ethical, moral, and legal complexities. What this study adds: The relationships PHC nurses in NZ develop with children and their families when they are suspicious of child abuse or neglect, mean they are well placed to lead best practice development on how best to support those with whom they work.

What is already known: Degenerative cervical myelopathy (DCM) is the leading cause of adult spinal cord dysfunction, with average diagnostic delays of 2.5 years often resulting in irreversible neurological impairment. Primary care clinicians are well positioned to identify DCM early, yet international research suggests that condition awareness is lacking. What this study adds: This study is the first to assess DCM awareness and diagnostic confidence among primary care clinicians in Aotearoa New Zealand, revealing critical knowledge gaps. The findings highlight the need for targeted education and standardised referral criteria to facilitate timely detection and surgical consultation.

Psychological distress in Aotearoa New Zealand has risen sharply from 2011 to 2023, especially among young women, Māori, Pacific peoples, and those living in poverty. Primary care services are under strain, facing growing mental health needs while grappling with workforce shortages and funding challenges. The study highlights an urgent need for investment in culturally responsive, integrated, and accessible mental health support across New Zealand communities.

What is already known: Inequities related to long-term conditions for Pacific people in Aotearoa New Zealand have been reported over several decades. Evidence suggests that when models of care reflect diverse understandings of health, it has benefits for people living with long-term conditions and their families that can help reduce longstanding health disparities. What this study adds: Health research about Pacific people that offers insight to holistic understandings of health and wellbeing, highlights the potential of family-centred long-term condition models of care designed to look beyond the treatment of single conditions.

HC25020The Southern Primary Care Research Network 3years on – reflections from the end of the beginning

Sharon Leitch 0000-0001-9939-8773, Abigail Pigden 0000-0002-6260-7647, Alex Ryde, Carol Atmore 0000-0002-4031-7016, Jing-Ru Li, Tania Moerenhout 0000-0002-6742-5260, Wenna Yeo, Anna Williams 0009-0009-4853-9631, Alesha Smith 0000-0003-1056-9527, Robin Turner and Tim Stokes 0000-0002-1127-1952

The Southern Primary Care Research Network (PCRN) is a regional research database that facilitates access to primary care data for research that improves health and health equity. This article describes the Southern PCRNs governance and infrastructure development and research undertaken so far. Three data linkage projects, a scoping review, research prioritisation exercises, and the development of an ethical framework for data use are described. Ongoing network funding will help realise the potential of routinely collected health data to inform equitable service delivery, policy, and innovation in population health.

HC25025Impact of a clinical diabetes specialist mentoring programme on type 2 diabetes management among nurses in primary care: a qualitative study

Sara Mustafa 0000-0001-5902-5622, Hamish Crocket, Timothy Kenealy 0000-0001-6002-4766, Rinki Murphy, Jo Scott-Jones 0000-0002-8490-9072, Leanne Te Karu, Ryan Paul and Lynne Chepulis

What is already known: Type 2 diabetes management in primary care in New Zealand could be improved. International research has shown that upskilling healthcare professionals involved in diabetes management can positively influence health outcomes and patient engagement. What this study adds: The study provides insights into the usefulness of mentoring programmes for nurses in New Zealand and supports future initiatives for the continuous professional development of health professionals in primary care settings within the scope of type 2 diabetes management.

What is already known: Weight stigma and lack of size inclusion are widespread in healthcare systems and society. People with high body mass index were prioritised for COVID-19 vaccinations and a long needle was recommended for this population group. What this study adds: Despite prioritisation, findings from people with high body mass included in this study show that this population group was not routinely factored into the design or implementation of vaccination centres that could accommodate their needs. This included lack of suitable seating, barriers to physical access within vaccination centres, and inconsistency in the use of long needles for vaccinations. The findings of this study should inform strategies to enhance inclusivity and equity for future population health programmes.

HC25035Primary health care utilisation in Aotearoa New Zealand: a descriptive study of trends from 2008 to 2023

Mona Jeffreys 0000-0002-2617-0361, Maite Irurzun Lopez 0000-0003-4846-5862, Claire O’Loughlin 0000-0001-6249-6169, Tessa Senior and Jacqueline Cumming 0000-0002-8369-2465

What is already known: The Primary Health Care Strategy and subsequent government health policy have aimed to improve access to and expand the role of nurses in primary health care. Utilising nurse expertise had been identified as a potential solution to ease GP workloads. It remains unclear the degree to which this has occurred. What this study adds: This research contributes an up-to-date analysis of trends in primary healthcare consultation rates by practitioner type at a national level, across a 16-year study period that includes those years when the COVID-19 pandemic was at its height.

What is known about the topic: Variations in context are thought to drive the variable outcomes from quality improvement in health care. Despite the importance of primary care to the health system, research into primary contextual factors and tools to understand and measure factors in primary care are rare. What this study adds: This research evaluates the use of MUSIQ in primary care and provides direction for improving its applicability in this area. Duplicated levels have been removed and specific primary care factors added to improve applicability, particularly for small to medium-sized general practice settings. The primary care adaptation of MUSIQ can be used to assess the primary care context surrounding quality improvement efforts and guide action to improve the likelihood of success.

HC25042Strategies for research capacity building by family physicians in primary care: a scoping review

Margarida Gil Conde 0000-0001-9367-5899, Carolina Penedo, Francisco Freitas Barcelos, Raquel Carmona Ramos, Sofia Silvério Serra 0000-0002-8953-4126, Cristina Ribeiro and Paulo Jorge Nicola

What is already known: This scoping review explores and synthesises strategies for enhancing research capacity among family physicians in primary care (PC), identifying approaches that can facilitate their involvement in research. The review highlights five key strategic approaches – Training and mentoring programmes, Networking, Development of strategic models (blueprints), Strategic communication interventions, and Knowledge transfer and exchange – which can strengthen research engagement and improve the integration of research into clinical practice. What this study adds: Implementing multifaceted capacity-building strategies can foster a stronger research culture in PC, ultimately leading to improved evidence-based care. Future research should focus on assessing these strategies’ adaptability and long-term impact across different healthcare settings.

HC25051Enhancing Pacific Health Services: the growth and innovation of Pacific providers in Aotearoa

Debbie Ryan 0000-0002-2259-7990, Lisa Kitione 0000-0002-6843-1099, Harriette Kimiora 0009-0005-9597-7272, Gerard Sonder 0000-0003-1349-4225 and Jacqueline Cumming 0000-0002-8369-2465

What is already known: There is some existing historical information about Pacific health providers receiving Pacific Provider Development Funding and the issues they face, but no recent or comprehensive analysis. What this study adds: This study provides an in-depth analysis of the work of Pacific health providers in 2023–2024, including a first-ever categorisation of these providers, the services they provide, and the locations they provide services from. It also provides information on finances and growth over time.

What is known about the topic: Improved health outcomes for patients are achieved when consideration of spiritual and social domains are included with the physical and mental in a medical care model. Understanding health as the capacity to adapt and self-manage requires a high level of patient self-efficacy. What this study adds: This report proposes a strategy for implementation in general practice and primary care settings that addresses the four domains of wellbeing and promotes self-efficacy and patient activation. Measures of health outcomes, both quantitative and qualitative, demonstrate the effectiveness of this strategy.

HC25036A qualitative study on the primary care research priorities of people in Southern Aotearoa New Zealand

Anna Williams 0009-0009-4853-9631, Sharon Leitch 0000-0001-9939-8773, Liza Edmonds 0000-0002-7349-449X, Jing-Ru Li, Garry Nixon 0000-0002-8192-1412 and Tim Stokes 0000-0002-1127-1952

What is already known: Consultation with key stakeholders is important to inform health research. Including health users from populations with significant health needs is necessary to ensure health research addresses health inequities. What this study adds: This study provides themes from a health user perspective to support future research in the primary health service area to improve and optimise health and wellbeing and reduce health inequities.

HC24190Sport, healthcare and educational organisations’ perceptions of a framework for managing concussion in New Zealand schools: a qualitative study

Marelise Badenhorst, Debbie Skilton 0009-0004-8271-0221, Anja Zoellner 0000-0002-8860-0267, Patricia Lucas 0000-0002-3726-6617, Danielle M. Salmon, Simon Walters 0000-0002-6467-4982, Kate Mossman, Sierra Keung, Kylie Thompson and Gisela Sole 0000-0002-1632-0338

What is already known: We had co-designed a framework for management of concussion in Aotearoa New Zealand secondary schools with school stakeholders and students with concussion and their parents. What this study adds: Participants from national, regional, and local sports, education, and healthcare organisations suggested that the framework would be of high value to address inconsistent implementation of post-concussion student support, and provided recommendations for wider implementation.

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