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Kolandai K, Milne B, von Randow M, Bullen C, Marsh S, Crump JA. Public opinion on global COVID-19 vaccine procurement and distribution policies: A nationally representative survey in Aotearoa New Zealand 2022. Vaccine 2024; 42:1372-1382. [PMID: 38326132 DOI: 10.1016/j.vaccine.2024.01.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/13/2024] [Accepted: 01/25/2024] [Indexed: 02/09/2024]
Abstract
The World Health Organisation and many health experts have regarded vaccine nationalism, a "my country first" approach to vaccines procurement, as a critical pandemic response failure. However, few studies have considered public opinion in this regard. This study gauged public support for vaccine nationalism and vaccine internationalism in a representative survey in New Zealand (N = 1,135). Support for vaccine internationalism (M (mean rating) = 3.64 on 5-point scales) was significantly stronger than for vaccine nationalism (M = 3.24). Additionally, support for openly sharing COVID-19 vaccine manufacturing knowledge and technology (M = 4.17 on 5-point scales) was significantly stronger than support for safeguarding vaccine manufacturers' intellectual property (M = 2.66). The public also supported a utilitarian approach that would see distributions based on need (M = 3.76 on 5-point scales) over an equal proportional international distribution (M = 3.16). Akin to the few preceding studies, the present observations suggest that the public is likely to be more supportive of pandemic responses that are globally equitable and long-term orientated. Our findings have substantial implications for pandemic preparedness as the congruence or lack thereof of public vaccine-related values with government policies can affect public trust, which, in turn, can affect public cooperation. It may pay for governments to invest in proactive public engagement efforts before and during a pandemic to discuss critical ethical issues and inequities in global vaccine procurement and distributions.
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Affiliation(s)
- Komathi Kolandai
- COMPASS Research Centre & Public Policy Institute, Faculty of Arts, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
| | - Barry Milne
- COMPASS Research Centre, Faculty of Arts, University of Auckland, New Zealand
| | - Martin von Randow
- COMPASS Research Centre, Faculty of Arts, University of Auckland, New Zealand
| | - Chris Bullen
- General Practice and Primary Healthcare, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Samantha Marsh
- General Practice and Primary Healthcare, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - John A Crump
- Centre for International Health & Otago Global Health Institute, University of Otago, New Zealand
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Ingham TR, Jones B, Perry M, von Randow M, Milne B, King PT, Nikora LW, Sporle A. Measuring Māori Health, Wellbeing, and Disability in Aotearoa Using a Web-Based Survey Methodology. Int J Environ Res Public Health 2023; 20:6797. [PMID: 37754656 PMCID: PMC10530808 DOI: 10.3390/ijerph20186797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/01/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023]
Abstract
High-quality evidence on the prevalence and impact of health, wellbeing, and disability among Māori, and other Indigenous peoples, is crucial for mitigating health inequities. Current surveys are predominantly centred within a biomedical paradigm, with the constructs mismatched with Indigenous worldviews. We aimed to develop and deploy an accessible and culturally grounded survey exploring Māori health, wellbeing, and disability using a Kaupapa Māori Research methodology. An extensive codesign process with Māori community partners interrogated all aspects of the design to ensure the process and outcomes met the needs of Māori. A large-scale, nationally representative survey of people of Māori descent was conducted. We used a multi-modal deployment approach that included online and alternate methods of completion. Our analysis included a novel dual-weighting system to ensure generalisability of results to the national Māori population. This achieved a survey of 7230 participants, a sample size comparable with government-administered surveys. The response rate was 11.1%, with 7.3% opting for alternate methods. A high completion rate of 93.4% was observed. This approach demonstrated a high level of engagement, resulting in an unprecedented collection of Māori health, wellbeing, and disability data. This highlights the importance of Indigenous codesign for ensuring accessible and culturally appropriate survey methods.
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Affiliation(s)
- Tristram R. Ingham
- Department of Medicine, University of Otago, Wellington 6242, New Zealand;
- Foundation for Equity and Research New Zealand, Wellington 6147, New Zealand
- Te Ao Mārama Aotearoa Trust, Wellington 6037, New Zealand
| | - Bernadette Jones
- Department of Medicine, University of Otago, Wellington 6242, New Zealand;
- Foundation for Equity and Research New Zealand, Wellington 6147, New Zealand
| | - Meredith Perry
- School of Physiotherapy, University of Otago, Dunedin 9016, New Zealand;
| | - Martin von Randow
- Compass Research Centre, University of Auckland, Auckland 1142, New Zealand; (M.v.R.); (B.M.)
| | - Barry Milne
- Compass Research Centre, University of Auckland, Auckland 1142, New Zealand; (M.v.R.); (B.M.)
| | - Paula T. King
- Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, Wellington 6242, New Zealand;
| | - Linda W. Nikora
- Nga Pae o te Māramatanga, Faculty of Arts, University of Auckland, Auckland 1142, New Zealand;
| | - Andrew Sporle
- iNZight Analytics Ltd., Auckland 1010, New Zealand
- Department of Statistics, Faculty of Science, University of Auckland, Auckland 1142, New Zealand
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Kolandai K, Milne B, McLay J, von Randow M, Lay-Yee R. Anthropause appreciation, biophilia, and ecophilosophical contemplations amidst a global pandemic. J Environ Psychol 2023; 85:101943. [PMID: 36531128 PMCID: PMC9747233 DOI: 10.1016/j.jenvp.2022.101943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 05/03/2023]
Abstract
In 2020, COVID-19 mitigation measures, including lockdowns and travel bans to curtail disease transmission, inadvertently led to an "Anthropause" - a unique global pause to anthropogenic activities. While there was a spike in ecological studies measuring Anthropause effects on environmental indicators, people's experiences of the Anthropause or its potential to inspire change were hardly considered. Hence, we aimed to measure people's appreciation of the environmental outcomes of the Anthropause, ecophilosophical contemplations about the pandemic, and experiences of lockdown-triggered biophilia (human's innate love for and draw towards nature) and test the hypothesis that these experiences would be consistently more prominent among the already environmentally inclined. To that end, we developed and tested three measures on a representative sample of 993 New Zealanders. Anthropause Appreciation received the highest overall mean ratings, followed by Lockdown-Biophilia and Eco-Contemplation. Pre-existing pro-environmental dispositions and behaviours did not consistently influence our three measures as expected. Demographic variables had little influence, while experiences of financial and mental health impacts due to COVID-19 had no influence. We interpreted the limited influence of explanatory variables as indicative of a degree of uniformity in people's experiences. High appreciation of Anthropause benefits suggests that the public may be supportive of policies and ways of living that can lead to similar outcomes post-pandemic - offering environmental policymakers and communicators a basis for action. Ecophilosophical contemplations and biophilic draw among the public suggest an awareness of the significance of the human-nature relationship - offering a symbolic global keystone for communicating and advocating conservation and the many values of pauses in life to connect with nature. Building women's environmental leadership capabilities and the ongoing greening of Christianity may be essential steps for global post-pandemic environmental behaviour transformations.
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Affiliation(s)
- Komathi Kolandai
- COMPASS Research Centre and Public Policy Institute, University of Auckland, New Zealand
| | - Barry Milne
- COMPASS Research Centre, University of Auckland, New Zealand
| | - Jessica McLay
- Department of Statistics, University of Auckland, New Zealand
| | | | - Roy Lay-Yee
- COMPASS Research Centre, University of Auckland, New Zealand
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Tiatia-Seath J, Lay-Yee R, von Randow M. Morbidity from intentional self-harm among Pacific peoples in New Zealand 1996-2015. N Z Med J 2017; 130:23-31. [PMID: 29240737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM The aim of this study was to describe trends in intentional self-harm for Pacific peoples in New Zealand by reviewing official data over the period 1996-2015. METHOD Publicly funded hospitalisations where the external cause was intentional self-harm were examined and areas of interest were identified and are presented. RESULTS Over a 19-year period (1996-2015), there were 1,608 intentional self-harm events for Pacific peoples (2.8%) out of 58,643 intentional self-harm events nationally for New Zealand's total population. CONCLUSION This study has been able to delineate Pacific ethnic-specific information not previously available for a prolonged period of 19 years. There are differences in Pacific peoples' experiences between ethnic groups. Furthermore, disparities persist between Pacific and non-Pacific. This study exposes priority areas for more targeted interventions according to ethnic, socioeconomic status, gender and age variations.
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Affiliation(s)
- Jemaima Tiatia-Seath
- Te Wananga o Waipapa, School of Māori Studies and Pacific Studies, University of Auckland, Auckland
| | - Roy Lay-Yee
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland
| | - Martin von Randow
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland
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Lay-Yee R, Pearson J, Davis P, von Randow M, Kerse N, Brown L. Changing the balance of social care for older people: simulating scenarios under demographic ageing in New Zealand. Health Soc Care Community 2017; 25:962-974. [PMID: 27709717 DOI: 10.1111/hsc.12394] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2016] [Indexed: 06/06/2023]
Abstract
The demographic ageing of New Zealand society, as elsewhere in the developed world, has dramatically increased the proportion of older people (aged 65 years and over) in the population. This has major policy implications for the future organisation of social care. Our objective was to test the effects on social care use, first, of putative changes in the overall disability profile of older people, and second, of alterations to the balance of their care, i.e. whether it was community-based or residential. In order to undertake these experiments, we developed a microsimulation model of the later life course using individual-level data from two official national survey series on health and disability, respectively, to generate a synthetic version which replicated original data and parameter settings. A baseline projection under current settings from 2001 to 2021 showed moderate increases in disability and associated social care use. Artificially decreasing disability levels, below the baseline projection, only moderately reduced the use of community care (both informal and formal). Scenarios implemented by rebalancing towards informal care use moderately reduced formal care use. However, only moderate compensatory increases in community-based care were required to markedly decrease the transition to residential care. The disability impact of demographic ageing may not have a major negative effect on system resources in developed countries like New Zealand. As well as healthy ageing, changing the balance of social care may alleviate the impact of increasing demand due to an expanding population of older people.
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Affiliation(s)
- Roy Lay-Yee
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
| | - Janet Pearson
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
| | - Peter Davis
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
| | - Martin von Randow
- Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
| | - Ngaire Kerse
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Laurie Brown
- National Centre for Social and Economic Modelling (NATSEM), University of Canberra, Canberra, ACT, Australia
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Tiatia-Seath J, Lay-Yee R, von Randow M. Suicide mortality among Pacific peoples in New Zealand, 1996-2013. N Z Med J 2017; 130:21-29. [PMID: 28449013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM The aim of this study was to describe trends in suicide mortality for Pacific peoples in New Zealand by reviewing official data over the period 1996-2013. METHOD Death registrations where the underlying causes of death were intentional self-harm was examined and area of interest was identified and presented. RESULTS Over a 17-year period (1996-2013), there were 380 total Pacific suicides (4.1%) out of 9,307 suicides nationally for New Zealand's total population. CONCLUSION Priority areas for effective suicide prevention include: Pacific young males, Pacific ethnic foci, clear ethnic disparities and inequalities for Pacific suicide mortality when compared to New Zealand's total population; safe, ethical and culturally appropriate messaging around suicide methods; the importance of the role of mental health and addictions in suicide prevention. On average, there are at least 22 Pacific suicides annually in New Zealand. Irrespective of small numbers, further Pacific ethnic breakdown is needed other than Samoan, Cook Islands and Tongan, as this is problematic for suicide prevention efforts for the exclusion of other Pacific groups.
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Affiliation(s)
| | - Roy Lay-Yee
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland
| | - Martin von Randow
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland
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Lay-Yee R, Pearson J, von Randow M, Kerse N, Brown L, Davis P. Rebalancing health service use for older people: simulating policy-relevant scenarios under demographic ageing. N Z Med J 2016; 129:25-35. [PMID: 27657156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIMS The demographic ageing of New Zealand society has greatly increased the proportion of older people (aged 65 years and over), with major policy implications. We tested the effects on health service use of alterations to morbidity profile and the balance of care. METHODS We developed a microsimulation model using data from an official national health survey series to generate a synthetic replicate for scenario testing. RESULTS Projections on current settings from 2001 to 2021 showed increases in morbidity-long-term illness (2%)-and in health service use-doctor visits (21%), public hospital admissions (16%). Scenarios with decreasing morbidity levels showed moderate reductions in health service use. By contrast, rebalancing towards the use of practice nurses showed a large decrease in public hospital admissions for people aged 85 years and over. CONCLUSION Demographic ageing may not have a major negative effect on system resources in New Zealand and other developed countries. Rebalancing between modalities of care may soften the impact of increasing health service use required by a larger older population.
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Affiliation(s)
- Roy Lay-Yee
- Senior Research Fellow, Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland
| | - Janet Pearson
- Statistician, Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland
| | - Martin von Randow
- Analyst, Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland
| | - Ngaire Kerse
- Professor, School of Population Health, University of Auckland, Auckland
| | - Laurie Brown
- Professor, National Centre for Social and Economic Modelling (NATSEM), University of Canberra, Australia
| | - Peter Davis
- COMPASS Research Centre, University of Auckland, Auckland
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Hider P, Parker K, von Randow M, Milne B, Lay-Yee R, Davis P. Can patient safety indicators monitor medical and surgical care at New Zealand public hospitals? N Z Med J 2014; 127:32-44. [PMID: 25399040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Increasing interest has focused on the safety of hospital care. The AusPSIs are a set of indicators developed from Australian administrative data to reliably identify inpatient adverse events in hospitals. The main aim of this study was to explore the application of the AHRQ/AusPSIs to New Zealand administrative hospital data related to medical and surgical care. Variation over time and across hospitals were also considered for a subset of the more common indicators. METHOD AHRQ/AusPSIs were adapted for use with New Zealand National Minimum Dataset administrative data for the period 2001-9. Crude positive event rates for each of the 16 indicators were assessed across New Zealand public hospitals. Variation over time for six more common indicators is presented using statistical control charts. Variation between hospitals was explored using rates adjusted for differences in patient variables including age, sex, ethnicity, rurality of residence, NZDep score and comorbidities. RESULTS The AHRQ/AusPSIs were applied to New Zealand administrative hospital data and some 99,366 admissions were associated with a positive indicator event. However rates for some indicators were low (<1% of denominator admissions). Over the study period considerable variation in the rate of positive events was evident for the six most common indicators. Likewise there was substantial variation between hospitals in relation to risk adjusted positive event rates DISCUSSION Patient safety indicators can be applied to New Zealand administrative hospital data. While infrequent rates hinder the use of some of the indicators, several could now be readily employed as warning flags to help monitor rates of adverse events at particular hospitals. In conjunction with other established or emerging tools, such as audit and trigger tools, the PSIs are now available to promote ongoing quality improvement activities in New Zealand hospitals.
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Affiliation(s)
- Phil Hider
- Department of Population Health, University of Otago, Christchurch, PO Box 4345, Christchurch 8140, New Zealand.
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Boyd M, Broad JB, Kerse N, Foster S, von Randow M, Lay-Yee R, Chelimo C, Whitehead N, Connolly MJ. Twenty-Year Trends in Dependency in Residential Aged Care in Auckland, New Zealand: A Descriptive Study. J Am Med Dir Assoc 2011; 12:535-40. [DOI: 10.1016/j.jamda.2011.01.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 01/27/2011] [Accepted: 01/27/2011] [Indexed: 10/18/2022]
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Broad JB, Boyd M, Kerse N, Whitehead N, Chelimo C, Lay-Yee R, von Randow M, Foster S, Connolly MJ. Residential aged care in Auckland, New Zealand 1988-2008: do real trends over time match predictions? Age Ageing 2011; 40:487-94. [PMID: 21628389 DOI: 10.1093/ageing/afr056] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND in Auckland, New Zealand in 1988, 7.7% of those aged over 65 years lived in licenced residential aged care. Age-specific rates approximately doubled for each 5-year age group after the age of 65 years. Even with changes in policies and market forces since 1988, population increases are forecast to drive large growth in demand. This study shows previously unrecognised 20-year trends in rates of care in a geographically defined population. METHODS four cross-sectional surveys of all facilities (rest homes and hospitals) licenced for long-term care of older people were conducted in Auckland, New Zealand in 1988, 1993, 1998 and 2008. Facility staff completed survey forms for each resident. Numbers of licenced and occupied beds and trends in age-specific and age-standardised rates in residential aged care are reported. RESULTS over the 20-year period, Auckland's population aged over 65 years increased by 43% (from 91,000 to 130,000) but actual numbers in care reduced slightly. Among those aged over 65 years, the proportion living in care facilities reduced from 1 in 13 to 1 in 18. Age-standardised rates in rest-home level care reduced from 65 to 33 per thousand, and in hospital level care, from 29 to 23 per thousand. Had rates remained stable, over 13,200 people, 74% more than observed, would have been in care in 2008. CONCLUSION growth predicted in the residential aged care sector is not yet evident. The introduction of standardised needs assessments before entry, increased availability of home-based services, and growth in retirement villages may have led to reduced utilisation.
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Affiliation(s)
- Joanna B Broad
- Freemasons' Department of Geriatric Medicine, University of Auckland, New Zealand.
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Kerse N, Peri K, Robinson E, Wilkinson T, von Randow M, Kiata L, Parsons J, Latham N, Parsons M, Willingale J, Brown P, Arroll B. Does a functional activity programme improve function, quality of life, and falls for residents in long term care? Cluster randomised controlled trial. BMJ 2008; 337:a1445. [PMID: 18845605 PMCID: PMC2565754 DOI: 10.1136/bmj.a1445] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess the effectiveness of an activity programme in improving function, quality of life, and falls in older people in residential care. DESIGN Cluster randomised controlled trial with one year follow-up. SETTING 41 low level dependency residential care homes in New Zealand. PARTICIPANTS 682 people aged 65 years or over. INTERVENTIONS 330 residents were offered a goal setting and individualised activities of daily living activity programme by a gerontology nurse, reinforced by usual healthcare assistants; 352 residents received social visits. MAIN OUTCOME MEASURES Function (late life function and disability instruments, elderly mobility scale, FICSIT-4 balance test, timed up and go test), quality of life (life satisfaction index, EuroQol), and falls (time to fall over 12 months). Secondary outcomes were depressive symptoms and hospital admissions. RESULTS 473 (70%) participants completed the trial. The programme had no impact overall. However, in contrast to residents with impaired cognition (no differences between intervention and control group), those with normal cognition in the intervention group may have maintained overall function (late life function and disability instrument total function, P=0.024) and lower limb function (late life function and disability instrument basic lower extremity, P=0.015). In residents with cognitive impairment, the likelihood of depression increased in the intervention group. No other outcomes differed between groups. CONCLUSION A programme of functional rehabilitation had minimal impact for elderly people in residential care with normal cognition but was not beneficial for those with poor cognition. Trial registration Australian Clinical Trials Register ACTRN12605000667617.
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Affiliation(s)
- Ngaire Kerse
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1001, New Zealand.
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