a) Employment is one of the most common socio-political health determinants in New Zealand (Islam, 2019). This determinant is believed to influence the health and lifestyle of individuals, whanaus, and/or communities. Unemployment in this respect has a negative impact on both mental and physical health, with the unemployed in New Zealand reported to have a much worse quality of health than those in employment (Health.gov.nz, 2021). This is directly related to financial stress, job satisfaction and job stress.
b) Cultural determinants and/or factors can influence health standards and health outcomes both positively and negatively. New Zealand ethnicity significantly increases risk for those who still follow Aboriginal lifestyles. As a study from Health.gov.nz (2021) suggests, ethnicity is directly related to the underlying socioeconomic make-up of individuals and community members in New Zealand and can induce stress. is influencing in Chronic stress problems and ongoing financial burden increase the risk of developing and progressing some chronic diseases. For example, for individuals and communities in New Zealand, ethnicity was chosen as a cultural factor in this regard.
c) Aotearoa is believed to be the Maori name of what is now New Zealand. Discrimination is a major health factor limiting access for ethnic groups in Aotearoa, New Zealand. In this regard, her three ethnic groups in Aoteroa are Europeans, Maori, and Pacific. It is well known that discrimination in this respect is associated with cultural competence, but in remote health care facilities, such discrimination is often the case, especially when caring for ethnic groups who do not have an adequate command of English. is practically not observed. Miscommunication, lack of access to primary health care, emotional bullying and assault are therefore common occurrences that New Zealand’s above populations frequently face within the health care system. In addition, selected population groups also have increased risk and prevalence of chronic diseases such as hypertension, type II diabetes and cardiovascular disease. Finally, discrimination (such as linguistic and cultural discrimination) by healthcare providers in primary care settings prevents them from providing appropriate disease-specific and discharge education to patients, leading to further complications and worsening of patients’ clinical symptoms. I’m here. This event is reflected in New Zealand’s ethnic population mortality rates.
d) New Zealand recognizes that income is one of the most common health determinants that has a significant impact on the health status of New Zealand residents. According to Health.govt.nz (2021), income is considered the most important modifiable health determinant and is closely linked to an individual’s quality of health and well-being. On average, after-tax household income in the country declined from 1981 to 1993, with single-parent, Pacific Rim and Māori households still experiencing the biggest declines in income. Poverty rates in New Zealand are also very high for Māori and Pacific households, making it difficult for them to seek medical attention or buy medicines to treat various chronic disease progression due to financial hurdles. , nor is early laboratory testing possible (Chin et al., 2019). All of the above disorders have a negative impact on health. Poverty increases the economic burden, promotes drinking and smoking, and further increases the risk and progression of chronic diseases such as cancer, cardiovascular disease, obesity, type 2 diabetes and hypertension. Health.govt.nz (2021) shows that both income inequality and poverty have increased significantly in New Zealand over the past decade. As noted above, with some exceptions such as New Zealand’s poorest ethnic and/or demographic financial status and experience, high morbidity and premature mortality, the link between disease and poverty is clear.
Primary health care requires extensive knowledge, understanding, and a range of skills that are qualitatively different from those required to treat injuries and illnesses properly (Behzadifar, Taheri Mirghaed, & Aryankhesal, 2017). A major goal of primary health care is to work with communities and their inhabitants to ensure a sustainable improvement in living standards. Key principles of primary health care in this particular aspect include:
In this context:
i) Equity in primary health care can be defined as a systemic approach and framework for health care institutions that helps ensure equitable access to the health system for patients who need it most. However, in Aotearoa, New Zealand, people display many differences in physiological and psychological characteristics that are not only negligible, but unjustified and unfair. Primary health care systems in rural New Zealand do not ensure accessibility and equity for ethnic groups (health.govt.nz, 2021). Factors most relevant to this aspect include language barriers, cultural barriers, and economic constraints.
ii) Access: Access to primary health facilities is categorized as the extent or ease with which individuals/patients or communities are given the opportunity to access appropriate services according to their needs (health.govt.nz, 2021). For example, New Zealand has several primary health centers that provide a wide range of medical services to people of almost all cultural and religious backgrounds. Services offered by New Zealand include clinical diagnostics, health education, evidence-based treatment, screening and disease prevention (Glass et al., 2019).
iii) Empowerment: With this primary health care principle in mind, health professionals working in this field will empower patients, health care providers, and families after they are taken to the emergency department (Behzadifar, Taheri Mirghaed, Aryankhesal, 2017). Given the prevalent burden of chronic disease in New Zealand, physicians and other health care professionals (nurses) should be encouraged to ensure that patients are sufficiently motivated to make specific changes. empowering the patient. For example, blood sugar self-monitoring and fall prevention (health.govt.nz, 2021). Without proper training, it is very difficult to expect improved patient quality. Therefore, this particular aspect also requires evidence-based interventions for the above interventions.
iv) Self-determination: In health care, especially primary care, self-determination theory is a general theory of human motivation, emphasizing the degree of autonomy of patient characteristics and characteristics, particularly relative to relative ones. I’m here. Patient-controlled behaviors (Migliorini, Cardinali & Rania, 2019). Chronic disease management plans are facilitated through behavior modification interventions, while self-determination segments are pursued to motivate patients and engage them in care plans and therapeutic interventions. In New Zealand primary care settings, patient empowerment is facilitated by health professionals (such as doctors and nurses). This is most commonly observed in chronically ill patients, where caregivers first organize a motivational interview approach for self-assessment and assessment (govt.nz, 2021).
v) Intersectoral Collaboration: Because the determinants of health are complex and complex, and it is difficult for an organization to address all public health issues, we believe the term “intersectoral collaboration” is of great importance in the medical literature. It is Multifaceted team engagement is an important example of cross-functional communication. Cross-departmental cooperation is well promoted in New Zealand primary care settings. For example, if a patient has her type II diabetes, cardiovascular disease, hypertension, obesity, and asthma, it is impossible to develop a care plan for her entire course of illness on her own. To solve this problem and ensure the gradual recovery and health of patients, health professionals in New Zealand’s primary care facilities are pursuing evidence-based interventions.
Considering all the above facts and insights, it can be said that the principle of primary care hospital is essential to ensure the gradual recovery of patients and sustainable development and improvement. The New Zealand government is prioritizing the modernization of healthcare, facilities and systems. Therefore, it is somewhat easier for physicians to follow all the above principles of primary care institutions and services. Health professionals also have several other important responsibilities (e.g., reducing discrimination in care settings, adhering to national care guidelines, ensuring reasonable access to care facilities for both patients and their families). securing, etc.).
In this section of the study, the authors select key current issues in New Zealand and develop evidence-based program plans to ensure the gradual recovery and well-being of patients. A very common disease in New Zealand is obesity, but recently, lack of physical activity and proper dietary management have significantly increased the progression and prevalence of this disease in older New Zealanders. The vision of the project is:
Vision: To enable primary health center nurses to learn and practice more skills to manage the development and progression of obesity. In this regard, they add that early screening of participants in health promotion programs can also help reduce the prevalence of obesity and related complications in adults.
Background: Obesity is one of her most common chronic diseases with rapid onset, especially in adults. Lifestyle factors such as sedentary lifestyle, snacking, dependence on takeout food, and several other external factors play a significant role in the development and progression of this disease (Norman et al., 2021). . Therefore, to address this gap, New Zealand is developing an evidence-based approach to health promotion that focuses on reducing the burden of chronic disease.
1) Health promotion project challenges include language barriers. All participants have different cultural backgrounds and some may not be able to communicate properly in English, which can cause problems for project coordinators and other stakeholders in dealing with participants. Yes (Osae-Larbi, 2016).
ii) Another major challenge for health promotion programs is dietary interventions (e.g., the DASH diet) to manage the progression of obesity, as not all participants prefer to follow the clinical protocol due to cultural barriers. Yes (Pestoni et al., 2019). ).
Future Plans: Reduce the burden of chronic disease in primary care hospitals.
b) His two major action plans for the Ottawa Charter Health Promotion Project Plan include individual skills development and sound public policy development (Fry & Zask, 2017). As in this study, obesity has been chosen as a chronic source of disease, and both the stated action plans according to the model proposed by the Ottawa Charter will be helpful. For example, in the development of personal skills, trainers will provide guidance and appropriate training on developing a comprehensive understanding of the early signs, symptoms, and cues of obesity and overweight; therefore, patients who are at risk of developing obesity and associated complications will be able to self-manage the diseased condition with the following guidelines shared by trainers (Fry & Zask, 2017). On the other hand, building health public policy incorporates the importance of exercises (e.g., aerobic, stretch-building exercise, and mild to moderate weight lifting exercise depending on the patient`s age, other comorbidities, and ongoing medications). Nutritional intervention, on the other hand, also needs to be performed in a precise manner when the participants are provided with a diet chart depending on their BMI and other anthropometrical assessment findings that suggest abnormalities.
c) An underpinning theory of the developed health promotion project that aligns well with the project developed is considered behavior change theory, which significantly derives from both behavioral theory and psychological theory with the foundation that the two elements of health-associated characteristics are i) the intention to avoid physical illness, ii) the trust and confidence that a particular health action will prohibit the further progression of the disease, and lastly, the trust that a particular health action will prohibit helps in recovery and wellness (Rejeski & Fanning, 2019). Behavioral change theories or models specifically focus on the impact of behavior and lifestyle on disease development and progression, and thus the need for further lifestyle changes to reduce risk (Rejeski & Fanning, 2019).
Behzadifar, M., Taheri Mirghaed, M., & Aryankhesal, A. (2017). Primary Health Care: An Important Approach for Health Sector, Missed in Iran’s Health System Evolution Plan. Iranian journal of public health, 46(9), 1307–1308.
Chin, M. H., King, P. T., Jones, R. G., Jones, B., Ameratunga, S. N., Muramatsu, N., & Derrett, S. (2018). Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States. Health policy (Amsterdam, Netherlands), 122(8), 837–853. https://doi.org/10.1016/j.healthpol.2018.05.001
Fry, D., & Zask, A. (2017). Applying the Ottawa Charter to inform health promotion programme design. Health promotion international, 32(5), 901–912. https://doi.org/10.1093/heapro/daw022
Glass, D. P., Kanter, M. H., Jacobsen, S. J., & Minardi, P. M. (2017). The impact of improving access to primary care. Journal of evaluation in clinical practice, 23(6), 1451–1458. https://doi.org/10.1111/jep.12821
health.govt.nz. (2021). LOCATING NURSING IN PRIMARY HEALTH CARE:. Health.govt.nz. Retrieved 21 March 2022, from https://www.health.govt.nz/system/files/documents/publications/det-health.pdf.
Islam M. M. (2019). Social Determinants of Health and Related Inequalities: Confusion and Implications. Frontiers in public health, 7, 11. https://doi.org/10.3389/fpubh.2019.00011
Migliorini, L., Cardinali, P., & Rania, N. (2019). How Could Self-Determination Theory Be Useful for Facing Health Innovation Challenges?. Frontiers in psychology, 10, 1870. https://doi.org/10.3389/fpsyg.2019.01870
Norman, K., Chepulis, L., Burrows, L., & Lawrenson, R. (2021). Adult obesity management in New Zealand general practice: a review. Journal of primary health care, 13(3), 249–259. https://doi.org/10.1071/HC20135
Osae-Larbi J. A. (2016). Bridging the language barrier gap in the health of multicultural societies: report of a proposed mobile phone-based intervention using Ghana as an example. SpringerPlus, 5(1), 900. https://doi.org/10.1186/s40064-016-2602-x
Patient empowerment can lead to improvements in health-care quality. (2017). Bulletin of the World Health Organization, 95(7), 489–490. https://doi.org/10.2471/BLT.17.030717
Pestoni, G., Krieger, J. P., Sych, J. M., Faeh, D., & Rohrmann, S. (2019). Cultural Differences in Diet and Determinants of Diet Quality in Switzerland: Results from the National Nutrition Survey menuCH. Nutrients, 11(1), 126. https://doi.org/10.3390/nu11010126
Rejeski, W. J., & Fanning, J. (2019). Models and theories of health behavior and clinical interventions in aging: a contemporary, integrative approach. Clinical interventions in aging, 14, 1007–1019. https://doi.org/10.2147/CIA.S206974
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