Accessibility Skip to Global Navigation Skip to Local Navigation Skip to Content Skip to Search Skip to Site Map Menu

An evaluation of the diabetes service for young people

Synopsis

A study of the paediatric diabetes service in the Otago area was undertaken to assess the satisfaction with, utilization and cost of the present health services.  Details of diabetes related readmissions were also examined and correlated with certain demographic data in an attempt to identify an ‘at-risk’ group for readmission.  Fifty four young people were included in the study, which was carried out by a questionnaire and review of medical notes.

We found that the most frequently used services were provided by gerneral practitioners, diabetes educators and the combined clinic.  Diabetes related costs to the patients varied widely, particularly in relation the extra costs of the portion diet – the average cost being $548.  GP costs varied, but 49% incurred no cost by GP visits.  In general, patients were satisfied with the services; 90% found access easy or very easy and 95% felt they had good or excellent understanding of the management of their diabetes.

Factors found to be associated with readmission were a high mean glycated haemoglobin (p<0.025), cigarette smoking (p<0.002) and single parent families (P<0.001).  Other findings of special note were that 52% of the adolescent group consumed alcohol, and that 45.8% of the adolescents test their blood glucose rarely or only when feeling ill.

Adequate education and careful supervision by a specialized diabetes team is essential for young people with diabetes.  It is recognized that the adolescent group offer particular management difficulties in that they tend to adhere less closely to medical advice and experiment with risk-taking behaviour.

We recommend that young diabetics who are from single parent families, those who smoke, and those with high glycated haemoglobin should be provided with additional attention and support.

Authors of Report

Rachel Atkinson, Chris Cresswell, Shona Dalzell, Alan Forrester, Rupert Handy, Peter Laws, Jill McKenzie, Stephen Pitman.

^ Top of Page

Audit of patients’ satisfaction with gastroscopy performed with or without sedation

Abstract

In May 1993, the policy of the Dunedin Public Hospital Gastroscopy Unit was changed to give patients the choice of whether they would like midazolam for sedation or not during their gastroscopy.  The study was performed in order to assess patient satisfaction with this new policy of offering a choice.

Forty one patients were surveyed over two weeks, twenty one patients chose sedation and twenty patients chose no sedation.  Overall patients who had had a gastroscopy in the past reported being significantly less anxious and expected the procedure to be less unpleasant than those who had never had gastroscopy.  Surprisingly reported anxiety was not related to the decision to have sedation or not.

Of the people who shoes sedation, 19% would change their decision to non-sedation for a further gastroscopy, and 33% of non-sedated patients would choose sedation next time.  This difference was not statistically significant.  There was no difference according to the sex of the patients, but younger patients were more likely to change their decision next time.  Seventy five percent of people would not change their decision.  This was interpreted as the proportion of people satisfied with their choice.

The main problems identified among those who would change their decision in the future were a failure of midazolam to alter awareness in those sedated, and insufficient information about gastroscopy in those not sedated.  Recommendations based on the study findings have been made.

In order to make the study more powerful, greater numbers are required.  We recommend that the study be continued with minor modifications, or that a modified study be conducted in the future.

Authors of Report

Aaron Bell, Alastair Cameron, Cherie Castaing, Lisa Chapman, Louise Couch, Lisa Fuller, Gabriel Lau, Rachel Thomson.

^ Top of Page

Breakfree smoking cessation – can we sustain it?

Abstract

In order to evaluate the effectiveness of the Otago Area Health Board’s Breakfree smoking cessation programme, a telephone survey of course participants was conducted by a group of Trainee Interns.  Two hundred names were randomly selected from an eligible population of 301, and from these 104 interviews were completed.  It was found that 39.4% of this sample population had quit smoking by the end of the 8 week course.  However six months after course completion only 15.4% had sustained their non-smoking status.  There was no significant difference between the group of people who paid to attend the course and those who did not.  Variables that were significantly associated with likelihood of success at quitting smoking were found to be a longer smoking history (p=0.03), greater number of sessions attended (p=0.002), and completion of the course (p=0.002).

Authors of Report

Kristin Kenrick, Dean Quinn, Kerry Smith, Jenny Spring, Lisa Stamp, Shirani Vetharaniam, David Williams.

^ Top of Page

Child health research what the public wants

Introduction

Children of today are parents of tomorrow.  Therefore we, as adults of today should do everything in our power to protect our children from diseases that would otherwise cause them to be lost from us forever.

The first ever telethon funded the establishment of the National Child Health Research Foundation (NCHRF).  It also provided for a research chair in Paediatrics at the Auckland School of Medicine.  Since then the NCHRF has funded a significant amount of Paediatric research in New Zealand.  It has however recently encountered severe funding problems.  In a recent meeting of the Foundation, the question arose as to how to find a research project that would catch the public eye and encourage subscription to a fund-raising exercise.  A suggestion by Professor Vint Chadwick was that they could do no better than to go and ask what the general public actually thought were important areas for child health research.

The health research project that our trainee intern group undertook was on behalf of Professor Holdaway, who is the Head of the Paediatrics Department here in Dunedin.  Our aim was to conduct a survey of the general public of Otago to ascertain what they thought should be priorities for child health research.

Authors of Report

David Allen, Kuinileti Chang-Wai, Michael Devlin, Katya Gunn, David Hailes, Katherine Henry, Tinika MacDonald, Rachael McLean.

^ Top of Page

Practice nurses and the Otago cervical screening programme

Aim

It was the aim of this project to identify, from practice nurses working in the general practices within Otago, how cervical screening, including call and recall, is carried out within practices, and the impact of the Otago Cervical Screening Programme on their work, particularly since the opt-off option was implemented.

In Britain, practice nurses have successfully taken administrative and clinical responsibility for preventative health programmes including cervical screening interventions of call, recall and smear taking (8).  Hart has indicated that practice nurses are an underused resource (9).  With training, practice nurses can effectively implement preventative health programmes, become important members of the health team, and gain credibility (10).  Robson, et al, showed improved coverage with cervical smears (76% vs 49%) when the practice nurse was responsible for the screening programme with the general practitioner, compared to the general practitioner alone (8).

Authors of Report

Priscilla Campbell-Stokes, Chris Hanna, Ramila Magam, Naresh Mondraty, Barbara Sinclair, Lilian van Alphen.

^ Top of Page

Sun Protection in Dunedin Schools

Abstract

Little is known about the progress made towards sun protection policies in schools.  Questionnaires were directed at principals teachers and school pupils (std 2, forms 2 and 6).

The results showed 60% of schools had formal sun protection policies and 86% used teaching resources.  91% of teachers promoted sun protection but 88% of children had been sunburnt and 55% still sunbathed.  The most common protection used was sunscreen although this dropped from std 2 to form 6.  Results were similar for males and females but females used more sunscreen and wore sunglasses more often.  Only 10% knew correct Cancer Society danger time in the sun but 94% stated cancer was one of the long term consequences of repeated sunburn.  Even with this knowledge, the pupils were still sunbathing.

We concluded that knowledge about the harmful effects of the sun is known and being taught, but this is having little effect on behaviour.  Education needs to be targeted at specific ages and gender.  It should emphasise behavioural approaches delivered in the right medium.

Authors of Report

Glenda Barber, Lisa Bron, Karen Cairns, Peter Enright, Michael Fay, Mark Gardener, Murray Govan, Kirsten Haggitt.

^ Top of Page

‘8B or not to Be?’ – A geriatric acute assessment and rehabilitation unit for Dunedin Hospital

Introduction

Our group was asked by Professor A J Campbell, Head of Medicine Department for Dunedin Hospital, to carry out research aiming to assess the needs of such a ward and identify a group of elderly patients from both Wakari and Dunedin Hospitals who would benefit from admission to this ward.

Authors of Report

Anthony March, Paul Murphy, Lynda Priest, Matthew Rowbotham, Bevan Roy, Tevita Taka.

^ Top of Page