Health Needs Assessment and Nurse-Led Health Care Services of a Small Island Community: Methodology and Results of a Pilot Study of the Health Status of Residents of Stewart Island, New Zealand

Abstract

Context: Provision of health care needs to small remote communities is a challenge requiring careful consideration. Stewart Island is a small island located at the far south of New Zealand. First-line primary health care services are provided by two rural nurse specialists supported on the mainland by a general practitioner and regional hospital 72 kms away. Geographical and professional isolation factors and maintaining personal privacy were key aspects in the design of the study.
Purpose: To undertake a health needs assessment of a small isolated community considering both resident and health professional perspectives.
Methods: A mixed methodology was employed to undertake the health needs assessment: self administered resident survey and semi-structured interviews with four health professional stakeholders (two on the island and two on the mainland).
Findings: The survey attracted 106 returns (approx. 30% of adult residents). Stewart Islanders reported similar rates of established chronic conditions compared to New Zealanders as a whole, indicating the need for access to a full range of primary health care services: acute and chronic care; health promotion and illness prevention. Residents and health professional stakeholders supported the current model of nurse-led health service provision with remote interdisciplinary support. Reported gaps included visiting allied health services, and issues of professional isolation and professional development for the rural nurses.
Conclusion: Researching health needs of a confined community raises particular issues in confidential data collection and reporting. Remote health service provision brings unique challenges but Stewart Islanders believe the current model of nurse-led service provision largely meets their needs.