Issue 296 - 21 March 2024

Welcome to the fortnightly Health Improvement and Innovation Digest. The Digest has links to key evidence of interest, with access to new content arranged by topic.

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Article Access

For articles that aren't open access, contact your DHB library, or organisational or local library for assistance in accessing the full text. If your organisation has a subscription, you may be able to use the icon under full text links in PubMed to access the full article.

Health Equity (New Zealand)

‘‘The past is rich in glory and knowledge’’—The intersection of indigenous evaluation and culturally responsive evaluation
In this article, published in New Directions for Evaluation, each author describes the development of what is loosely referred to as Indigenous Evaluation (IE), and how IE has contributed to and benefited from connecting with the larger stream of Culturally Responsive Evaluation.

Living with dementia in Aotearoa New Zealand: Samoan families’ perspectives
There is very little research about dementia in Aotearoa (New Zealand) New Zealand (NZ) Pacific communities, but information available suggests that Pacific people are presenting with dementia at a younger age and with more severe cognitive symptoms than do non-Pacific. The Samoan ethnic group is NZ’s largest Pacific population. This study, published in AlterNative, explores experiences and understanding of dementia from family sessions with 25 people from 10 Samoan families living with dementia.

The lived experience of chronic pain for Māori: how can this inform service delivery and clinical practice? A systematic review and qualitative synthesis
The aim of this article, published in The New Zealand Medical Journal, was to synthesise the literature describing experiences of chronic pain and pain management for Māori, and to understand how this experience could inform service delivery and clinical practice.

Investigating major trauma in Māori youth at Te Whatu Ora Counties Manukau
The Ninth Perioperative Mortality Review Committee (POMRC) report found the likelihood of death was over three times higher in Māori youth compared to non-Māori (age: 15-18 years) in the 30-days following major trauma. The aim of this study, published in the ANZ Journal of Surgery, is to investigate variations in care provided to Māori youth presenting to Te Whatu Ora Counties Manukau (TWO-CM) with major trauma, to inform policies and improve care.

Hospital Productivity (International)

Admission avoidance hospital at home
Admission avoidance hospital at home provides active treatment by healthcare professionals in the patient's home for a condition that would otherwise require acute hospital inpatient care, and always for a limited time period. This is the fourth update of this review. The objective of this Cochrane Review was to determine the effectiveness and cost of managing patients with admission avoidance hospital at home compared with inpatient hospital care.

Factors influencing the implementation of early discharge hospital at home and admission avoidance hospital at home: a qualitative evidence synthesis
Worldwide there is an increasing demand for Hospital at Home as an alternative to hospital admission. Although there is a growing evidence base on the effectiveness and cost‐effectiveness of Hospital at Home, health service managers, health professionals and policy makers require evidence on how to implement and sustain these services on a wider scale. The objective of this Cochrane Review was to identify, appraise and synthesise qualitative research evidence on the factors that influence the implementation of Admission Avoidance Hospital at Home and Early Discharge Hospital at Home, from the perspective of multiple stakeholders, including policy makers, health service managers, health professionals, patients and patients’ caregivers.

Cancer Services (New Zealand)

The factors involved in surgical decision-making in younger women diagnosed with breast cancer in Aotearoa New Zealand: A qualitative analysis
Women diagnosed with breast cancer must make important surgical decisions. The decision-making process for younger women is complex, with this group more likely to have an advanced diagnosis and life-stage considerations that can impact on treatment. This study, published in the Journal of Health Psychology, investigated the decision-making process of women aged <50 years who had undergone breast cancer surgery within the preceding 12 months in Aotearoa New Zealand.

"Beyond Feasibility": A Qualitative Study of Patients, Their Whānau (Family) and Staff Perspectives and Experiences of a Non- Pharmacological Delirium-Prevention Intervention in Two Aotearoa/New Zealand Hospices
Delirium is prevalent in the hospice population. Despite causing significant distress to patients and families, delirium is under-recognised. There is a need to better understand delirium prevention and outcomes in this population including people's experiences of delirium-prevention strategies in different cultural contexts. The objective of this study, published in the Journal of Pain and Symptom Management, was to determine whether the "PRESERVE Aotearoa" delirium prevention intervention was feasible and acceptable for Māori (indigenous peoples of Aotearoa/ New Zealand) and non-Māori patients with advanced cancer, their families (called whānau in this paper), and clinical staff.

Emergency Department Services (International)

Patient flow in emergency departments: a comprehensive umbrella review of solutions and challenges across the health system
Globally, emergency departments (EDs) are overcrowded and unable to meet an ever-increasing demand for care. The aim of this study, published in BMC Health Services Research, is to comprehensively review and synthesise literature on potential solutions and challenges throughout the entire health system, focusing on ED patient flow.

Cardiovascular Disease and Diabetes (International)

Exercise‐based cardiac rehabilitation for adults with heart failure
People with heart failure experience substantial disease burden that includes low exercise tolerance, poor health‐related quality of life, increased risk of mortality and hospital admission, and high healthcare costs. The objective of this Cochrane Review was to assess the effects of exercise‐based cardiac rehabilitation on mortality, hospital admission, and health‐related quality of life of adults with heart failure.

Primary Health Care (International)

Models for delivery and co‐ordination of primary or secondary health care (or both) to older adults living in aged care facilities 
The number of older people is increasing worldwide and public expenditure on residential aged care facilities (ACFs) is expected to at least double, and possibly triple, by 2050. Co‐ordinated and timely care in residential ACFs that reduces unnecessary hospital transfers may improve residents' health outcomes and increase satisfaction with care among ACF residents, their families and staff. These benefits may outweigh the resources needed to sustain the changes in care delivery and potentially lead to cost savings. This Cochrane Review comprehensively and systematically presents the available evidence of the effectiveness, safety and cost‐effectiveness of alternative models of providing health care to ACF residents.

Increased Immunisation (New Zealand)

Migration and infant immunization timeliness in New Zealand: Evidence from the Growing Up in New Zealand study
Migration has been recognized as an important determinant of child health outcomes including childhood vaccination status. This paper, published in Vaccine, aims to examine the association between parental migration status and a less studied aspect of child immunisation outcomes, namely timeliness, within the context of New Zealand (NZ), a country characterized by a substantial proportion of its resident population born overseas.

Smoking Cessation (New Zealand)

Psychological predictors of vaping uptake among non-smokers: A longitudinal investigation of New Zealand adults
Demographic and health factors are known to predict vaping. Less is known about psychological predictors of vaping uptake, particularly among non-smoking adults using longitudinal designs. This study, published in Drug and Alcohol Review, aimed to model how psychological factors related to personality and mental health predicted the likelihood of vaping uptake over time in non-smoking adults ages 18+ using longitudinal data.

Smoking Cessation (International)

An overview of systematic reviews on predictors of smoking cessation among young people
Understanding the factors that influence smoking cessation among young people is crucial for planning targeted cessation approaches. The objective of this review, published in PloS One, was to comprehensively summarise evidence for predictors of different smoking cessation related behaviours among young people from currently available systematic reviews.

Scoping review of smoking cessation interventions in pregnant women attending primary care
Smoking during pregnancy has many adverse effects for infant and mother. Despite this, many pregnant women continue smoking. Primary care is a suitable area to provide smoking cessation interventions. The aim of this study, published in BJGP Open, was to investigate available literature regarding effectiveness of smoking cessation interventions for pregnant women in primary care, the factors contributing to this effectiveness and to provide suggestions for future research.

Oral Health (New Zealand)

Impact of dental visiting patterns on oral health: A systematic review of longitudinal studies
The aim of this study, published in BDJ Open, was to systematically review longitudinal studies investigating the impact of dental visiting patterns on oral health across the life course.

“I lost my first tooth here”: Syrian former refugees' experiences of oral healthcare in Dunedin, New Zealand
Oral health conditions are highly prevalent among former refugees; however, little is known about their experiences of accessing dental care. This study, published in The New Zealand Medical Journal, aimed to explore Syrian former refugees’ experiences of oral healthcare in New Zealand.

Ministry of Health Consultations & Events

Proposed revised Code of Practice for the Safe Transport of Radioactive Material: ORS C6
Following section 90(a) of the Radiation Safety Act 2016 the Director for Radiation Safety is reviewing codes of practice. Under section 89(2) the Director is consulting with persons likely to be affected by a proposed amendment or revocation to C6. Submissions close 11.00 pm, Wednesday 10 April 2024.

Proposed revised Code of Practice for Nuclear Medicine: ORS C2 for consultation
Following section 90(a) of the Radiation Safety Act 2016 the Director for Radiation Safety is reviewing codes of practice that have been issued under section 86(1) of the Act. Following a review, the Director has made amendments and revocations to ORS C2: Code of Practice for Nuclear Security (C2). Under section 89(2) the Director is consulting with persons likely to be affected by a proposed amendment or revocation to C2. Submissions close 11.00 pm, Tuesday 16 April 2024.

Health Sector Initiative

First NZ training programme for cardiac ultrasound launches
A new training programme in specialist heart imaging, crucial for diagnosing, treating and researching heart disease, has started for the first time in Aotearoa New Zealand.

The information available on or through this newsletter does not represent Ministry of Health policy. It is intended to provide general information to the health sector and the public, and is not intended to address specific circumstances of any particular individual or entity.