RESUMEN
OBJECTIVES: This study was designed to obtain New Zealand data on beliefs related to a broad spectrum of injuries and their prevention. METHODS: A cross sectional phone survey was conducted of approximately 400 randomly selected households from each of 13 territorial local authorities across New Zealand, giving a total of 5282. Respondents were asked questions on awareness and attitudes to injury prevention, ownership and use of safety equipment, safety behaviours, and incidence of self reported injury. RESULTS: 84% agreed with the statement that "Most injuries are preventable" and 91% rated their homes as "very safe" or "reasonably safe". A high proportion of homes had smoke alarms (81%) and first aid kits (81%), and more than half (56%) had turned down the temperature of their hot water to 55 degrees C or lower. However, less than half of the respondents said that they practised the other safety behaviours. Significant associations were found between the practise of safety behaviours and respondents' home safety ratings. There was a significant association between home safety ratings and the incidence of injury occurring in all settings (p<0.0001), however there was no discernable association between home safety ratings and injury occurring in the home. CONCLUSIONS: Although this survey found that most respondents believed that injuries are preventable and considered their homes to be safe, the public need to be further encouraged to adopt common safety practices and behaviours in the home.
Asunto(s)
Actitud Frente a la Salud , Concienciación , Heridas y Lesiones/prevención & control , Accidentes Domésticos/prevención & control , Accidentes de Tránsito/prevención & control , Adolescente , Adulto , Anciano , Traumatismos en Atletas/prevención & control , Estudios Transversales , Femenino , Artículos Domésticos , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda , Equipos de Seguridad , Seguridad , Violencia , Heridas y Lesiones/psicologíaRESUMEN
INTRODUCTION: Cohort studies have contributed important scientific knowledge regarding the determinants of chronic diseases. Despite the need for etiologic investigations, this design has been infrequently used in injury prevention research. OBJECTIVES: To describe the baseline findings of the New Zealand Blood Donors' Health Study, a large prospective study designed to investigate relationships between lifestyle, psychosocial factors, and serious injury due to road crashes, falls, self harm, assault, work, sport, and recreation. METHODS: Participants were recruited from fixed and mobile collection sites of a voluntary non-profit blood donor program. Baseline exposure data (for example risk taking behaviors, alcohol and marijuana use, sleep habits, and depression) were collected using a self administered questionnaire. Outcome data regarding serious injury will be collected prospectively through computerized record linkage of participants' unique identifiers to national morbidity and mortality databases. RESULTS: In total, 22 389 participants enrolled in the study (81% response rate). The diverse study population included 36% aged 16-24 years, 20% rural residents, and large variability in exposures of interest. For example, in the 12 months before recruitment, 21% had driven a motor vehicle when they considered themselves over the legal limit for alcohol, and 11% had been convicted of traffic violations (excluding parking infringements). Twelve per cent had seriously considered attempting suicide sometime in their life. CONCLUSIONS: This is the first, large scale cohort study investigating determinants of serious injury in New Zealand and among the largest worldwide. Preliminary findings from prospective analyses that can inform injury prevention policy are expected within five years.
Asunto(s)
Heridas y Lesiones/epidemiología , Adolescente , Adulto , Donantes de Sangre , Femenino , Humanos , Estilo de Vida , Masculino , Nueva Zelanda/epidemiología , Estudios Prospectivos , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
The aim of this study was to describe the population of Pacific young people in the Auckland region who were treated at Emergency Departments as a result of a suicide attempt. Data collection involved a review of Auckland regional public hospital Emergency Department (ED) medical records of Pacific young people (16-25 years) who made suicide attempts from 01 January 1999-31 December 1999. A total of 56 records were reviewed. Results indicated that: 71% were young Pacific females and 29% were young Pacific males; just over half identified as Samoan; 19 year olds presented more than any other age group between the ages of 16-25 years; 43% were employed; the highest month recorded for presentations was June; there was a low incidence of attempts between midnight and 6 am; the most common method used was poisonings by solid or liquid solids; the majority of attempts were at home; 62% were not under the influence of alcohol or illegal drugs; and 85% were given a post-discharge treatment plan. This study is an attempt to provide information to enhance health outcomes and inform future mental health service delivery for Pacific young people in New Zealand.
Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Intento de Suicidio/etnología , Revisión de Utilización de Recursos , Adolescente , Adulto , Femenino , Humanos , Masculino , Nueva Zelanda/epidemiología , Islas del Pacífico/etnología , Intento de Suicidio/estadística & datos numéricosRESUMEN
OBJECTIVE: To evaluate the Waitakere Community Injury Prevention Project (WCIPP). METHODS: Process and outcome evaluations were conducted over a three year period. Process activities included analysis of project documentation, participant observation, key informant interviews, and two post-implementation case studies. A quasiexperimental design was used for the outcome evaluation. Three primary sources of data were collected and analysed: injury statistics; a pre-post telephone survey (n=4,000); and a pre-post organisation survey (n=144). RESULTS: Process evaluation provided a comprehensive account of the operation and activities of the WCIPP. Findings stress the pivotal role of the coordinators and highlight the value of incorporating a multicultural approach. A positive impact on changes to Waitakere City Council safety policies and practices was also evident. Outcome evaluation findings demonstrated significant reductions in rates of Waitakere child injury hospitalisations (p<0.05), while comparison communities showed an increase in child hospitalisation rates. In addition, compared with pre-intervention and comparison data, significantly more Waitakere residents were aware of injury prevention safety messages (p=0.0001) and had acquired appropriate child safety items (p=0.0001). CONCLUSION: The community injury prevention model appears to be an effective strategy for injury prevention. The support provided by the council for the WCIPP has provided a benchmark for the role of local governments in injury prevention.
Asunto(s)
Educación en Salud , Evaluación de Procesos, Atención de Salud , Heridas y Lesiones/prevención & control , Adolescente , Adulto , Niño , Preescolar , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Modelos Logísticos , Persona de Mediana Edad , Nueva Zelanda , Proyectos Piloto , Evaluación de Programas y Proyectos de SaludRESUMEN
AIM: To explore the opinions and attitudes of staff and residents among selected licensed residential institutions in the Auckland region concerning hip protective underwear. METHOD: Six focus group discussions were held with principal nurse/managers, caregivers and residents from private hospitals, rest homes, and large combination complexes in the Auckland region. A semi-structured interview schedule about hip protective underwear was used to obtain information relating to perceived effectiveness; acceptability; identification of suitable wearers; barriers to use; and strategies to enhance use. RESULTS: Nursing staff would be willing to supervise the use of hip protective underwear and residents would be willing to wear it. Attention to certain design features could enhance overall acceptability. CONCLUSION: The findings that both staff and residents are receptive to the use of hip protective underwear as a strategy to prevent hip fractures is encouraging. Attention now needs to focus on ensuring that this product is available and accessible.
Asunto(s)
Fracturas de Cadera/prevención & control , Hogares para Ancianos , Casas de Salud , Ropa de Protección , Anciano , Actitud del Personal de Salud , Femenino , Grupos Focales , Humanos , Masculino , Nueva Zelanda , Satisfacción del PacienteRESUMEN
OBJECTIVE: To describe the long term effectiveness of a community based program targeting prevention of burns in young children. DESIGN: Quasiexperimental. SETTING: The Norwegian city of Harstad (main intervention), six surrounding municipalities (intervention diffusion), and Trondheim (reference). PARTICIPANTS: Children under age 5 years in the three study populations. METHODS: Outpatient and inpatient hospital data were coded according to the Nordic system, and collected as part of a national injury surveillance system. Burn data collection started in May 1985. The first 19.5 months of the study provided baseline data, while the last 10 years involved community based intervention, using a mix of passive and active interventions. RESULTS: The mean burn injury rate decreased by 51.5% after the implementation of the intervention in Harstad (p < 0.05) and by 40.1% in the six municipalities (not significant). Rates in the reference city, Trondheim, increased 18.1% (not significant). In Harstad and the six surrounding municipalities there was a considerable reduction in hospital admissions, operations, and bed days. Interventions with passive strategies were more effective, stove and tap water burns being eliminated in the last four years, while active strategies were less effective. CONCLUSIONS: A program targeting burns in children can be effective and sustainable. Local injury data provided the stimulus for community action.
Asunto(s)
Quemaduras/prevención & control , Planificación en Salud Comunitaria/organización & administración , Programas de Gobierno/organización & administración , Quemaduras/economía , Quemaduras/epidemiología , Preescolar , Femenino , Costos de la Atención en Salud , Humanos , Incidencia , Lactante , Tiempo de Internación/economía , Masculino , Noruega/epidemiología , Vigilancia de la Población , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Factores de RiesgoRESUMEN
OBJECTIVES: To use research on adolescent risk taking behaviour as an impetus for a community to develop locally based injury prevention strategies. DESIGN: Case study, based on a community action model and formative evaluation. This involved: a community profile on adolescent risk taking behaviour; interviews with service providers; dissemination of research findings to local policy makers; development and implementation of a community action plan to address adolescent risk taking; and assessment of its impact. SETTING: A rural town with a population of 10,195 situated in the North Island of New Zealand. SUBJECTS: School aged adolescents and the safety policies and practices of community organisations involved with adolescents. RESULTS: Risk taking behaviours identified by the community profile included: drink-driving, substance abuse, carrying of weapons with intent to harm, and suicidal ideation. Community members identified that risk taking behaviour associated with alcohol in relation to: (1) violence (self directed and assault) and (2) road related injuries should be the focus of their activities. The strategies identified focused on advocacy, education, legal/regulatory change, and environmental modification. Evaluation conducted six months after intervention identified increased community awareness of the adverse effects of adolescent risk taking and some changes in policies and practice related to adolescent safety. CONCLUSIONS: Providing a community with local information that has high relevance for its members may act as a stimulus for the development of injury prevention initiatives. While this case study illustrated that a comprehensive approach focusing on adolescent risk taking behaviour, rather than on isolated injury problems, may be an appropriate way to highlight escalating adolescent injury rates, it also demonstrates the limitations of a short time frame for a community development project.
Asunto(s)
Conducta del Adolescente , Participación de la Comunidad , Asunción de Riesgos , Adolescente , Humanos , Nueva Zelanda , Investigación , Población RuralRESUMEN
AIMS: To identify existing falls prevention activities and support for future initiatives among residential institutions for older people. METHODS: A self-administered questionnaire was sent to all principal nurses/managers of residential institutions. Information was sought on whether falls were perceived to be a problem in the Auckland region, current falls prevention practice and interest in future prevention initiatives. RESULTS: Falls were perceived to be a problem by over 75% of 175 participating institutions. Assessments of footwear, medication use and environmental audits were the most common prevention strategies employed by over 80% of institutions. Almost 70% of institutions indicated their willingness to participate in future prevention projects. CONCLUSION: The current use of fall prevention strategies in institutions is encouraging. However, the strategies that are being employed are not consistent with current evidence about effectiveness. Increased use of vitamin D and possibly calcium supplementation needs to be encouraged as does the use of hip protectors and lower extremity strength training.
Asunto(s)
Accidentes por Caídas/prevención & control , Hogares para Ancianos , Casas de Salud , Administración de la Seguridad/métodos , Anciano , Anciano de 80 o más Años , Recolección de Datos , Humanos , Nueva ZelandaRESUMEN
Suicide is a leading cause of morbidity and mortality among people aged 15-24 years of age. This paper illustrates the use of focus groups with young people to enhance knowledge of ways to address youth suicide. Analysis of the findings identified three themes perceived by participants as being warning signs of a suicidal friend (personality changes, risk-taking behaviour and unusual actions). An important finding, which has implications for the planning of further suicide prevention strategies, was that young people would either cope alone or turn to a friend if they were feeling suicidal. The fact that a lack of knowledge was identified as the major barrier to youth using existing services/resources suggests that health promotion awareness campaigns which provide information on where young people could access help need to be developed. The use of focus groups with young people has provided valuable insights into ways to address youth suicide. We urge other researchers to incorporate similar methodologies.
Asunto(s)
Actitud Frente a la Salud , Psicología del Adolescente , Suicidio/psicología , Adolescente , Servicios de Salud del Adolescente , Adulto , Síntomas Conductuales , Intervención en la Crisis (Psiquiatría) , Salud de la Familia , Femenino , Grupos Focales , Promoción de la Salud/métodos , Humanos , Relaciones Interpersonales , Masculino , Nueva Zelanda , Aceptación de la Atención de Salud , Grupo Paritario , Prevención del SuicidioRESUMEN
Violence has become increasingly recognised as a public health issue, with significant impact on the health of individuals. In addition, there is increasing awareness that there are substantial economic costs associated with violence. The present study estimated the economic costs associated with homicide in New Zealand, using a human capital approach. Direct costs were assessed using information on incidence and costs from government agencies, and indirect costs were assessed based on loss of productivity resulting from death. The total estimated cost of homicides in 1992 was NZ $82997065 (U.S. $53948092), averaging NZ $1012159 per homicide (U.S. $657903). This total was comprised of the estimated total cost associated with homicide victims of NZ $37017010 (U.S. $24061056) and the estimated total cost associated with homicide perpetrators of NZ $45980055 (U.S. $29887035). Limitations of the incidence data and the methods employed suggest that these costs are likely to be underestimates. Nevertheless, the figure calculated represents an enormous drain on New Zealand's economic resources.
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Homicidio/economía , Adolescente , Adulto , Costos y Análisis de Costo , Humanos , Masculino , Nueva ZelandaRESUMEN
We surveyed the risk-taking behaviour of students aged 16 years and over in two New Zealand high schools, with a particular focus on road safety, substance use, sexual behaviour and personal safety. The questionnaire was completed by 471 students, a participation rate of 99 per cent. We found that seven out of 10 students who had ridden either a bicycle or motorcycle in the previous 12 months had not always worn a helmet; that 56 per cent had driven a car without a licence; and 23 per cent had been involved in a motor vehicle crash. A lifetime incidence of 63 per cent for cigarette smoking, 34 per cent for marijuana use and 78 per cent for alcohol use was found. Forty per cent of the students reported ever having sexual intercourse. During the previous 12 months, 49 per cent of these had not always used contraceptives and 61 per cent reported not always wearing condoms as protection for sexually transmitted diseases. Twenty-five per cent had physically harmed another person and 10 per cent reported carrying a weapon with the intent of harming someone else. This study shows that adolescents are willing to provide information on risk taking and that they are engaging in high levels of health-harming behaviour. Such information is important for designing health promotion programs to address adolescent risk taking.
Asunto(s)
Promoción de la Salud , Asunción de Riesgos , Accidentes de Tránsito/prevención & control , Adolescente , Adulto , Femenino , Humanos , Masculino , Nueva Zelanda , Conducta Sexual , Trastornos Relacionados con Sustancias/prevención & control , Violencia/prevención & controlRESUMEN
It is increasingly acknowledged that suicidal behavior has a considerable impact on both individuals and society in terms of acute physical and mental health problems, long-term disability, and death, as well as quality of life and resource provision. In recent years there has been increasing concern about youth suicide rates. The escalation in suicide rates among individuals in the 15-24-year age group began around 1980 and has continued to rise. While this trend is evident in most OECD countries, the increase in New Zealand has been more substantial and sustained than in other countries. This article examines the occurrence of youth suicide in New Zealand. Next, an outline of New Zealand government and nongovernmental responses to youth suicide are presented. Finally, a variety of intervention options which take into account New Zealand societal conditions are outlined.
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Prevención del Suicidio , Suicidio/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Participación de la Comunidad , Humanos , Nueva Zelanda/epidemiología , Vigilancia de la Población , Prevalencia , Administración en Salud Pública , Factores de Riesgo , Suicidio/tendenciasRESUMEN
AIM: To provide estimates of the occurrence of back pain among nurses employed in the public health sector in Auckland, New Zealand. METHOD: A cross sectional survey was undertaken of all nurses employed by the Auckland Area Health Board as at July 1992. RESULTS: The lifetime prevalence of back pain was 74.4%. The lifetime prevalence of nursing-related back pain was 62.3%; the annual prevalence was 36.8%; and the point prevalence was 11.6%. Pacific Island nurses had a higher annual and point prevalence of nursing-related back pain compared with New Zealand European and Maori nurses. The annual and point prevalence was also higher among those working on geriatric, medical, orthopaedic and rehabilitation wards compared with other nursing environments. CONCLUSION: This study found a high prevalence of back pain among nurses, and in particular, nurses working in four specific work environments were identified as having greatest risk. These findings provide support for the targeting of intervention strategies which focus on work organisational factors.
Asunto(s)
Dolor de Espalda/epidemiología , Enfermería , Enfermedades Profesionales/epidemiología , Adulto , Dolor de Espalda/etnología , Estudios Transversales , Europa (Continente)/etnología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Enfermedades Profesionales/etnología , Islas del Pacífico/etnología , PrevalenciaRESUMEN
Pedestrian injuries are a leading cause of childhood mortality. In this paper a case study of a child pedestrian death is presented in order to examine the apportionment of responsibility for child pedestrian injuries. The case presented illustrates how responsibility is located with the child, whilst structural contributors, in particular aspects of the transport system, are ignored. The strength and pervasiveness of the ideology of victim blaming in child pedestrian injuries is explained by the special position that the road transport system holds in relation to dominant economic interests. Victim blaming ideology is a strategy that serves to maintain these interests at the expense and suffering of children. Increased recognition of the political roots of the ideology of victim blaming in child pedestrian injuries, by the sectors of the community who suffer its consequences, will be an important step towards effective preventive action.