부산대학교 도서관

Introduction Local and national shortages of medical doctors have necessitated nurses expanding into advanced roles and research has shown that nurse-led clinics generate similar or better health outcomes for a [...]
Ischaemic heart disease (IHD) is a leading cause of death for people in Aotearoa New Zealand and a highly-ranked cause of premature death. Maori have an increased risk of early heart disease, which can develop earlier than in non-Maori. Chest pain, which can be indicative of IHD, is subjective and obtaining a pain history can be difficult when verbal articulation is limited, delaying further investigations and treatment. This small, qualitative study aimed to explore whether the use of a nurse-developed pictogram during nurse-led rapid-access chest pain clinic consultations assisted patient communication. Participants' experiences (five Maori and five non-Maori) of using the pictogram were obtained by audio-recorded interviews, which were transcribed and analysed for emergent themes. The themes from the qualitative data suggest that the pictogram helped to overcome communication barriers such as shyness, lack of confidence in verbal ability, and poor health literacy, with all participants providing positive feedback about the use of the pictogram. For the nurse, the pictogram facilitated the accurate description of chest pain or discomfort efficiently and effectively in a way that the participants felt was understood. As a result of the use of the pictogram, the participants appeared to have a greater sense of empowerment. Additionally, the data from the interviews identified ways to improve the pictogram. A second version of the pictogram was consequently developed and is now in use at the clinic. In conclusion, the use of the pictogram was beneficial, facilitating more accurate communication of chest pain symptoms which is essential for diagnostic purposes. He putake matua te mate manawa papunitanga toto (IHD) o te mate o nga tangata i Aotearoa, a, he putake matamua mo te mate tomua. Kei runga rawa te morea o te mauiuitanga manawa mo ngai Maori, a, he tomua ke atu tona putanga i waenga i te iwi Maori, tena i a tauiwi. Kei tena tangata, kei tena tangata ana whakaaro mo nga mamaetanga poho, he mamaetanga ka noho hei tohu pea i te IHD, a, ka uaua te takutaku i nga ahuatanga kua pa mehemea kua kopi te waha, e araia ai te tuhura me te rongoa. Ta tenei matainga kounga iti he whai kia mohio mehemea he awhina to te whakamahi whakaahua i roto i nga toronga mamaetanga poho tomo hohoro na te tapuhi i arahi, i te taha whakawhitiwhiti korero ki te turoro. I hopukina nga wheako o etahi tangata whai wahi (tokorima he Maori, tororima ehara i te Maori) mo te whakamahi i te whakaahua i roto i etahi uiuinga ororongo i ata hopukina, i tuhia marire, i tataritia hoki mo nga kaupapa e puta ake ana i roto. E ai ki nga kaupapa matua mai i te raraunga kounga i awhina ano te whakaahua ki te whakamahea i nga maioro korero, penei i te whakama mo te ngoikore ki te korero, te iti o te mohio ki nga take hauora. I huri nga tangata katoa ki te whakapai i te whakamahi i te whakaahua. Mo te tapuhi, na te whakaahua i awhina tana whakamarama mo te mamaetanga poho, te he o te tinana ranei, kia kamakama, kia whai take, me te marama o nga korero, e ai ki te hunga whai wahi mai. Na te whakamahi i te whakaahua, kua piki ake te whainga mana o te hunga whai wahi, te ahua nei. Waihoki, na nga raraunga mai i nga uiuinga i waitohu eta hi huarahi whakapiki i te pai o te whakaahua. I whakawhanaketia tetahi putanga hou o te whakaahua i muri mai, a, ewhakamahia ana inaianei i te whare tiaki turoro. Hei kupu whakamutunga, he whai hua te whakamahinga i te whakaahua, i ngawari ake te whakawhiti korero mo nga tohu o te mamaetanga o te poho, he mea hira tenei mo nga putake tohu tika i te mate. Keywords / Nga kupu matua chest pain/mamaetanga poho; health literacy/mohio ki nga take hauora; health equity/oritenga hauora; heart disease / mauiuitanga manawa; nurse-led / na te tapuhi i arahi; pictogram / whakaahua; qualitative / kounga