scholarly journals How to use interpreters in general practice: the development of a New Zealand toolkit

2012 ◽  
Vol 4 (1) ◽  
pp. 52 ◽  
Author(s):  
Ben Gray ◽  
Jo Hilder ◽  
Maria Stubbe
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
New Zealand ◽  
Limited English Proficiency ◽  
Ethical Behaviour ◽  
Patient Relations ◽  
Primary Care Practitioners ◽  
The Cost ◽  
Patient Resistance

BACKGROUND AND CONTEXT: New Zealand is becoming more ethnically diverse, with more limited English proficiency (LEP) people. Consequently there are more primary care consultations where patients have insufficient English to communicate adequately. Because effective communication is essential for good care, interpreters are needed in such cases. ASSESSMENT OF PROBLEM: The literature on the use of interpreters in health care includes the benefits of using both trained interpreters (accuracy, confidentiality, ethical behaviour) and untrained interpreters (continuity, trust, patient resistance to interpreter). There is little research on the actual pattern of use of interpreters. RESULTS: Our research documented a low use of trained interpreters, despite knowledge of the risks of untrained interpreters and a significant use of untrained interpreters where clinicians felt that the communication was acceptable. A review of currently available guidelines and toolkits showed that most insist on always using a trained interpreter, without addressing the cost or availability. None were suitable for direct use in New Zealand general practice. STRATEGIES FOR IMPROVEMENT: We produced a toolkit consisting of flowcharts, scenarios and information boxes to guide New Zealand practices through the structure, processes and outcomes of their practice to improve communication with LEP patients. This paper describes this toolkit and the links to the evidence, and argues that every consultation with LEP patients requires clinical judgement as to the type of interpreting needed. LESSONS: Primary care practitioners need understanding about when trained interpreters are required. KEYWORDS: Communication barriers; primary health care; New Zealand; quality of health care; professional–patient relations; cultural competency

scholarly journals Access to general practice for Pacific peoples: a place for cultural competency

2012 ◽  
Vol 4 (2) ◽  
pp. 123 ◽  
Author(s):  
Melissa Ludeke ◽  
Ronald Puni ◽  
Lynley Cook ◽  
Maria Pasene ◽  
Gillian Abel ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
New Zealand ◽  
Cultural Competency ◽  
Access To Health Care ◽  
Structured Interview ◽  
Service Utilisation ◽  
Snowball Sampling ◽  
Care Services

INTRODUCTION: Access to primary health care services has been identified as a problem for Pacific peoples. Although cost is the most frequently cited barrier to Pacific service utilisation, some research has indicated that access may also be influenced by features of mainstream primary care services. This study aimed to identify features of mainstream general practice services that act as barriers to accessing these services for Pacific peoples in order to explore strategies that providers could adopt to enable their practices to be more welcoming, accessible and appropriate for Pacific peoples. METHODS: Pacific participants were recruited through Pacific networks known to Pegasus Health and via ‘snowball’ sampling. In total, 20 participants participated in one of three focus groups. A semi-structured interview explored the participants’ views and experiences of mainstream general practice care. Thematic analysis was utilised to interpret the data. FINDINGS: The analysis revealed five themes highlighting non-financial features of mainstream general practice services that may influence the availability and acceptability of these services to Pacific peoples: language and communication; rushed consultations; appointment availability; reception; and Pacific presence. CONCLUSION: The findings indicate that all personnel within the primary care setting have the ability to directly engage in the improvement of the health status of Pacific peoples in New Zealand by developing cultural competency and incorporating flexibility and diversity into the care and service they provide. KEYWORDS: Pacific health care; access to health care; inequalities; cultural competency; New Zealand

Understanding the general practice nursing workforce in New Zealand: an overview of characteristics 2015–19

2021 ◽  
Vol 27 (1) ◽  
pp. 22
Author(s):  
Sarah L. Hewitt ◽  
Nicolette F. Sheridan ◽  
Karen Hoare ◽  
Jane E. Mills
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
New Zealand ◽  
Survey Data ◽  
Nursing Workforce ◽  
Roles And Responsibilities ◽  
Primary Health ◽  
Part Time ◽  
Role Confusion

Limited knowledge about the nursing workforce in New Zealand general practice inhibits the optimal use of nurses in this increasingly complex setting. Using workforce survey data published biennially by the Nursing Council of New Zealand, this study describes the characteristics of nurses in general practice and contrasts them with the greater nursing workforce, including consideration of changes in the profiles between 2015 and 2019. The findings suggest the general practice nursing workforce is older, less diverse, more predominately New Zealand trained and very much more likely to work part-time than other nurses. There is evidence that nurses in general practice are increasingly primary health care focused, as they take on expanded roles and responsibilities. However, ambiguity about terminology and the inability to track individuals in the data are limitations of this study. Therefore, it was not possible to identify and describe cohorts of nurses in general practice by important characteristics, such as prescribing authority, regionality and rurality. A greater national focus on defining and tracking this pivotal workforce is called for to overcome role confusion and better facilitate the use of nursing scopes of practice.

scholarly journals Providing gender-affirming hormone therapy through primary care: Service users' and health professionals' experiences of a pilot clinic

2020 ◽  
Author(s):  
A Ker ◽  
Gloria Fraser ◽  
Antonia Lyons ◽  
C Stephenson ◽  
T Fleming
Keyword(s):  
Primary Care ◽  
Health Care ◽  
New Zealand ◽  
Hormone Therapy ◽  
Health Care Providers ◽  
Health Professionals ◽  
Care Service ◽  
Gender Diversity ◽  
Service Users ◽  
Care Providers

© 2020 CSIRO Publishing Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a. INTRODUCTION: Primary health care providers are playing an increasingly important role in providing gender-affirming health care for gender diverse people. This article explores the experiences of a primary care-based pilot clinic providing gender-affirming hormone therapy in Wellington, New Zealand. AIM: To evaluate service users' and health professionals' experiences of a pilot clinic at Mauri Ora (Victoria University of Wellington's Student Health and Counselling Service) that provided gender-affirming hormones through primary care. METHODS: In-depth interviews were conducted with four (out of six) service users and four health professionals about their perspectives on the clinic. Interviews were transcribed verbatim and analysed using thematic analysis. RESULTS: Three themes were identified in service users' interviews, who discussed receiving affirming care due to the clinic's accessibility, relationship-centred care and timeliness. Three themes were identified in the health professionals' interviews, who described how the clinic involves partnership, affirms users' gender and agency, and is adaptable to other primary care settings. Both service users and health professionals discussed concerns about the lack of adequate funding for primary care services and the tensions between addressing mental health needs and accessing timely care. DISCUSSION: The experiences of service users and health professionals confirm the value of providing gender-affirming hormone therapy in primary care. Models based in primary care are likely to increase accessibility, depathologise gender diversity and reduce wait times.

Community Health and General Practice: The Impact of Different Cultures on the Integration of Primary Care

2001 ◽  
Vol 7 (1) ◽  
pp. 65 ◽  
Author(s):  
Hal Swerissen ◽  
Jenny Macmillan ◽  
Catuscia Biuso ◽  
Linda Tilgner
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Community Health ◽  
Community Health Centres ◽  
Care Services ◽  
Primary Health ◽  
Health Centres ◽  
The Relationship

This study examined the existing relationship between community health centres and General Practice Divisions in the State of Victoria, including the nature of joint working arrangements and the identification of barriers to greater collaboration. Improved integration of primary health care services has been advocated to improve consumer and population health outcomes and to reduce inappropriate use of acute and extended care services. General practitioners (GPs) and community health centres are two key providers of primary health care with potential for greater integration. The current study conducted telephone interviews with 20 community health centre CEOs and 18 Executive Officers of divisions, which were matched according to catchment boundaries. Results suggest, while some joint planning is occurring, especially on committees, working parties and projects, there is an overall low level of satisfaction with the relationship between community health centres and GPs and GP divisions. Major barriers to greater integration are the financial or business interests of GPs and misunderstanding and differences in perceived roles and ideology between GPs and community health centres. Improved communication, greater contact and referral and follow-up procedures are identified as a means of improving the relationship between GPs, GP divisions and community health centres. Community health centres and general practitioners (GPs) are key providers of primary care (Australian Community Health Association, 1990).

scholarly journals Why are there gaps in our management of those with high cardiovascular risk?

2012 ◽  
Vol 4 (1) ◽  
pp. 21 ◽  
Author(s):  
Fiona Doolan-Noble ◽  
Jocelyn Tracey ◽  
Stewart Mann
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Cardiovascular Risk ◽  
New Zealand ◽  
Barriers And Facilitators ◽  
Care Providers ◽  
High Cardiovascular Risk ◽  
Text Data ◽  
Primary Health

INTRODUCTION: Multiple New Zealand and other international studies have identified gaps in the management of those identified at high risk of a future cardiovascular (CV) event. This study sought to explore the views of health professionals about the barriers and facilitators present within the current primary health care system to the optimal management of those at high CV risk. METHODS: This qualitative study utilised a focus group methodology to examine the barriers and facilitators within primary health care (PHC), and employed a general inductive approach to analyse the text data. FINDINGS: The analysis of text data resulted in the emergence of interrelated themes, underpinned by subthemes. The patient, their circumstances and their characteristics and perceptions provided the first key theme and subthemes. The next key theme was primary health care providers, with subthemes of communication and values and beliefs. The general practice was the third theme and included multiple subthemes: implementation planning and pathway development, time and workload and roles and responsibilities. The final main theme was the health system with the subthemes linking to funding and leadership. CONCLUSION: This study determined the factors that act as barriers and facilitators to the effective management of those at high CV risk within the New Zealand PHC sector. General practice has a pivotal role in preventive health care, but to succeed there needs to be a refocusing of the PHC sector, requiring support from policy makers, District Health Boards and Primary Health Organisations, as well as those working in the sector. KEYWORDS: Primary health care; high cardiovascular risk management; general practitioners; practice nurses; barriers; facilitators

New Zealand general practice nurses' roles in mental health care

2011 ◽  
Vol 58 (2) ◽  
pp. 225-233 ◽  
Author(s):  
E. McKinlay ◽  
S. Garrett ◽  
L. McBain ◽  
T. Dowell ◽  
S. Collings ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Practice ◽  
New Zealand ◽  
Mental Health Care ◽  
Practice Nurses

scholarly journals General practice evolution in New Zealand: hybridisation in action

2017 ◽  
Vol 9 (3) ◽  
pp. 220 ◽  
Author(s):  
Carol Atmore
Keyword(s):  
Primary Care ◽  
General Practice ◽  
New Zealand ◽  
Ageing Population ◽  
Patient Centred Care ◽  
Fiscal Constraint ◽  
Current Climate ◽  
Primary Care Health ◽  
History Of ◽  
Care Health

ABSTRACT This viewpoint outlines a brief history of primary care health reforms over the last 25 years, and how this history has influenced the business of caring. It also suggests where we should next look to improve the provision of equitable patient-centred care in the current climate of fiscal constraint, while meeting the challenges of an ageing population and increasing multimorbidity.

scholarly journals Access to rural general practice and primary care: Time now for more equitable and sustainable solutions?

2004 ◽  
Vol 10 (3) ◽  
pp. 160
Author(s):  
Sam Heard
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Sustainable Solutions ◽  
Basic Service ◽  
Almost All

Australia has the resources to provide reasonable primary medical and health care to all of its population. It is a particularly worthwhile expense, with positive social and biophysical outcomes (Jarman et al., 1999; Starfield, 1998). In many aspects of health care, primary care provides most of the benefit and almost all of the value. Why, then, don?t we provide this basic service to all Australians?

scholarly journals The Pacific primary health care workforce in New Zealand: What are the needs?

2009 ◽  
Vol 1 (2) ◽  
pp. 126 ◽  
Author(s):  
Luisa Ape-Esera ◽  
Vili Nosa ◽  
Felicity Goodyear-Smith
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
New Zealand ◽  
Health Care Workforce ◽  
Pacific People ◽  
Advantages And Disadvantages ◽  
Pacific Population ◽  
Primary Health ◽  
The Impact

AIM: To scope future needs of the NZ Pacific primary care workforce. METHOD: Semi-structured interviews with key informants including Pacific primary care workers in both Pacific and mainstream primary health care organisations and managers at funding, policy and strategy levels. Qualitative thematic analysis using general inductive approach. RESULTS: Thirteen stakeholders interviewed (four males, nine females) in 2006. Included both NZ- and Island-born people of Samoan, Tongan, Niuean, Fijian and NZ European ethnicities; age 20–65 years. Occupations included general practitioner, practice nurse, community worker, Ministry of Health official and manager representing mainstream and Pacific-specific organisations. Key themes were significant differences in attributes, needs and values between ‘traditional’ and contemporary Pacific people; issues regarding recruitment and retention of Pacific people into the primary health care workforce; importance of cultural appropriateness for Pacific populations utilising mainstream and Pacific-specific primary care services and both advantages and disadvantages of ‘Pacific for Pacific’ services. CONCLUSION: Interviews demonstrated heterogeneity of Pacific population regarding ethnicity, age, duration of NZ residence and degree of immersion in their culture and language. Higher rates of mental disorder amongst NZ-born Pacific signpost urgent need to address the impact of Western values on NZ-born Pacific youth. Pacific population growth means increasing demands on health services with Pacific worker shortages across all primary health care occupations. However it is not possible for all Pacific people to be treated by Pacific organisations and/or by Pacific health workers and services should be culturally competent regardless of ethnicity of providers. KEYWORDS: Pacific Islands, New Zealand, manpower, ethnic groups, Oceanic Ancestry Group, primary health care

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