Trial of a health surveillance screening instrument for community-dwelling elderly within a New Zealand setting

Abstract

The impetus for this study derived from research completed by Snell, Jamieson, and Crombie, 1997 of the Collaborative Health, Education and Research Centre at the Bendigo Health Care Group in Victoria, Australia. These researchers believed that a more anticipatory approach was required to plan health care for the elderly. They established the need for a health surveillance screening instrument (H.S.S.I.), which would detect mild impairment, then developed and trailed this instrument with seventy one community-dwelling elderly. The instrument was designed to provide a proactive approach to health maintenance for older people, and to assist General Practitioners in assessing and maintaining the health status of their elderly community-dwelling clients. Proactive approaches to health care for the elderly are also of major interest to New Zealand health care professionals. In this project an amended version of the H.S.S.I. was trailed and evaluated in New Zealand with a group of fifty nine community-dwelling elderly. The key findings are as follows. The H.S.S.I. was sensitive in detecting minor health impairments for referral with 39% of the participants. A similar percentage of people with mild impairments were identified in both studies, 39% in New Zealand and 35% in Australia. However the New Zealand study seemed to reveal a narrower range of impairments when compared to the Australian research. The H.S.S.I. also identified 29% of participants as being at actual or potential health risk with issues such as: reduced range of movement and mobility; carer stress; social isolation; recent bereavement; depression; and complex health/social issues. The eleven General Practitioners involved in the New Zealand study indicated, that minimal new information was revealed through the administration of the H.S.S.I. that was not already known by them. Given the findings of this study, the H.S.S.I. has some potential to be utilized by New Zealand health professionals involved in health screening of elderly people in primary health care settings. Nurses in particular have an important role to play in this area of health care, especially in the context of current and impending changes to health planning, policy, and legislation.