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新西兰奥特亚罗瓦初级保健中毛利人主导的老年毛利人伤害预防与护理模式的可接受性及探索性效果:试点研究

Acceptability and exploratory efficacy of a Māori-led injury prevention and care model for older Māori in primary care in Aotearoa New Zealand: pilot study.

作者信息

Hikaka Joanna, Cavadino Alana, Ihimaera Louise, Taylor Lynne, Maxwell-Crawford Kirsty, Merito Pare, Vercoe Hariata, Li Miaotian, Kool Bridget, Parsons John, Aramoana-Arlidge Brooke, Kerse Ngaire

机构信息

Faculty of Medical and Health Sciences, Te Kupenga Hauora Māori, The University of Auckland, Auckland, New Zealand.

Faculty of Medical and Health Sciences, General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand.

出版信息

J R Soc N Z. 2025 Jul 9;55(6):2233-2254. doi: 10.1080/03036758.2025.2525222. eCollection 2025.

Abstract

In Aotearoa New Zealand (NZ), healthcare access inequities exist for unintentional injuries between older Māori and non-Māori. We investigated the acceptability and exploratory efficacy of a co-designed paeārahi (navigator)-led injury prevention and care model for koeke (older Māori) in a prospective, non-randomised, pilot study. We enrolled 192 community-dwelling older Māori participants (≥ 55 years) from three primary healthcare clinics. The primary outcome was intervention acceptability, using an acceptability framework and kaupapa Māori theory to analyse focus group and interview data. Exploratory efficacy outcomes included changes in mobility, fall rates, koeke confidence in injury care, and healthcare utilisation. 132 koeke (mean ± SD age: 68.3 ± 8.5 years) completed the study, and 25 people participated in acceptability data collection (focus groups/interviews). The care model was acceptable to koeke, whānau (family), paeārahi and other health providers, and perceived as having a positive impact across multiple wellbeing domains and improving koeke and whānau control over healthcare. Paeārahi working within healthcare teams contributed to acceptability by assisting with referrals and healthcare access. Participants' confidence in preventing injury and accessing support increased ( = 0.004 and  = 0.009, respectively). Although assessment points need streamlining, these findings support further evaluation of this model among koeke in more community settings.

摘要

在新西兰的奥特亚罗瓦,毛利族老年人与非毛利族老年人在意外伤害的医疗保健可及性方面存在不平等现象。在一项前瞻性、非随机的试点研究中,我们调查了一种共同设计的由帕埃阿希(导航员)主导的针对科埃克(毛利族老年人)的伤害预防与护理模式的可接受性和探索性效果。我们从三家初级医疗保健诊所招募了192名居住在社区的毛利族老年参与者(≥55岁)。主要结果是干预的可接受性,使用可接受性框架和毛利族理论来分析焦点小组和访谈数据。探索性效果结果包括行动能力的变化、跌倒率、科埃克对伤害护理的信心以及医疗保健利用率。132名科埃克(平均±标准差年龄:68.3±8.5岁)完成了研究,25人参与了可接受性数据收集(焦点小组/访谈)。该护理模式为科埃克、瓦瑙(家庭)、帕埃阿希和其他医疗服务提供者所接受,并被认为在多个幸福领域产生了积极影响,提高了科埃克和瓦瑙对医疗保健的掌控力。在医疗团队中工作的帕埃阿希通过协助转诊和获得医疗保健服务,提高了该模式的可接受性。参与者预防伤害和获得支持的信心有所增强(分别为=0.004和=0.009)。尽管评估要点需要简化,但这些发现支持在更多社区环境中的科埃克群体中进一步评估该模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c71/12315219/554ca8b2c573/TNZR_A_2525222_F0001_OB.jpg

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本文引用的文献

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Australas J Ageing. 2025 Mar;44(1):e13413. doi: 10.1111/ajag.13413.
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