RESUMO
BACKGROUND: The 'Prospective Outcomes of Injury Study-10 years on' (POIS-10) aims to contribute to improving long-term disability, health and well-being outcomes for injured New Zealanders. This brief report describes recruitment, characteristics and key outcomes to 12 years post-injury. METHODS: Between 2007 and 2009, the study recruited 2856 people, including 566 Maori, from New Zealand's Accident Compensation Corporation's entitlement claims register. People experienced a range of injury types, causes and settings; 25% had been hospitalised for their injury. POIS-10 data were primarily collected via interviewer-administered structured questionnaires. RESULTS: Of the original participants, 2068 (92%) were eligible for follow-up in POIS-10. Of these, 1543 (75%) people participated between March 2020 and July 2021, including 240 Maori. Half of the participants (n=757; 50%) reported ongoing problems attributed to their injury 12 years earlier. Most reported difficulties with items assessing disability (WHO Disability Assessment Schedule II). For health-related quality of life (HRQoL), measured using the EQ-5D-5L, the prevalence of problems was higher 12 years post-injury compared with 12 months post-injury for four of five dimensions. Importantly, the prevalence of problems did not reduce to pre-injury levels for any HRQoL dimension. DISCUSSION: POIS-10 highlights the importance of early post-injury interventions to improve health, disability and well-being outcomes of injured New Zealanders.
Assuntos
Qualidade de Vida , Ferimentos e Lesões , Humanos , Nova Zelândia/epidemiologia , Masculino , Feminino , Estudos Prospectivos , Adulto , Ferimentos e Lesões/epidemiologia , Pessoa de Meia-Idade , Pessoas com Deficiência/estatística & dados numéricos , Avaliação da Deficiência , Inquéritos e Questionários , Adulto Jovem , AdolescenteRESUMO
Injury is a leading cause of health loss in Aotearoa me Te Waipounamu (New Zealand; NZ). The NZ Trauma Registry was established in 2015 to monitor outcomes in those experiencing severe injury and to identify ways of improving the quality of care for these patients. Few NZ studies have assessed outcomes in trauma patients using patient-reported outcome measures (PROMs) despite increasing recognition that the impacts of injury are better understood through PROMs. Our aim was to estimate the prevalence of self-reported problems with health-related quality of life (HRQoL) outcomes six months post-injury, and identify factors associated with these, in a cohort of Maori (the Indigenous population of NZ) and non-Maori individuals who had experienced major trauma. HRQoL outcomes were measured according to the five dimensions of the EQ-5D-5L. This information, along with sociodemographic data, was collected via structured telephone interviews. Participants (n = 870), aged 16 years or more, were recruited following admission to a trauma hospital in one of three (of NZ's four) trauma regions. Multivariable models were developed using modified Poisson Regression to identify factors associated with outcomes for both Maori and non-Maori patients. The prevalence and severity of problems across each of the five EQ-5D-5L dimensions was similar for Maori and non-Maori except for Anxiety/Depression. The prevalence and severity of problems with Anxiety/Depression was greater for Maori. Factors associated with HRQoL problems at six-months were also largely similar for each cohort. Those commonly associated with outcomes were age, hospital length of stay, adequacy of household income, and participants' expectations regarding recovery from injury. Further research examining recovery expectations in trauma patients to determine which factors contribute to formulating recovery expectations, and the potential impact of recovery expectations on treatment and rehabilitation, would be of value. Should expectations, at least in part, influence HRQoL outcomes, then routinely collecting data on patients' recovery expectations, adequacy of household income and potential barriers to treatment and rehabilitation, could help inform post-hospital treatment plans, and identify those who may require additional support following discharge from hospital.
Assuntos
Povo Maori , Qualidade de Vida , Humanos , Hospitalização , Nova Zelândia/epidemiologia , Prevalência , Adolescente , AdultoRESUMO
Introduction: Little appears to be known regarding the work-related injury (WRI) experiences of migrants (those born in a country other than their identified host country) and specifically, women migrants. Methods: As part of a wider PhD project investigating the WRI experiences of New Zealand (NZ) migrants, a review of NZ mainstream media coverage of migrants WRIs was undertaken, which identified no representations of migrant women's WRI experiences. In turn, a scoping review was undertaken to identify peer-reviewed publications reporting empirical findings about WRI experiences and outcomes for migrants in Organization for Economic Co-operation and Development (OECD) member countries, including NZ. This paper aims to identify and describe findings for migrant women specifically. From 2,243 potential publications, 383 proceeded to full text review; ultimately 67 were retained. These 67 publications were reviewed to identify findings specifically for occupationally injured migrant women; 22 such publications (from 21 studies) were found. This paper reports: the characteristics of identified studies; characteristics of migrant women within; frameworks and theories used, and knowledge (and gaps) related to occupationally injured migrant women. Results: Publications came from only four OECD countries, the United States, Canada, Australia, and Spain. A range of study designs, and topic areas (working conditions, legal rights, identities, the role of gatekeepers, and precarity), were identified; however, only three studies reported findings for longer-term experiences and outcomes of WRIs. Nine publications considered theoretical models underpinning research, including theories about precarious work, stigmatization, and citizenship. However, there was a paucity of analyses of the WRI experience throughout the life-course, highlighting a gap in understanding of how these experiences are "lived" over the long term by occupationally injured migrant women. Discussion: Scoping review findings were synthesized using a provisional "matryoshka framing narrative" model, to be refined through forthcoming qualitative interviews with occupationally injured NZ migrant women. This model highlights the multitude of influences in WRI experiences, potentially specific to migrant women, suggesting the consequences of WRIs may be uneven, with migrant women experiencing different, and potentially, greater disparities in outcomes. These findings provide an impetus to investigate knowledge gaps and urgently address potential disparities in WRI outcomes for migrant women specifically.