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Home / New Zealand

Improving health care for larger New Zealanders

By Erin Kavanagh-Hall
Wairarapa Midweek·
16 Mar, 2016 04:30 PM4 mins to read

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BIG INNOVATION: Lesley Gray (far right) and some of the team behind Bariatric Management Innovation, with Associate Health Minister Hon Peter Dunne at the project launch.

BIG INNOVATION: Lesley Gray (far right) and some of the team behind Bariatric Management Innovation, with Associate Health Minister Hon Peter Dunne at the project launch.

A Wairarapa academic is part of a nationwide project to help larger New Zealanders access safe, compassionate and equitable health care.

Lesley Gray, a senior lecturer at Otago University's Wellington campus, is part of the team behind Bariatric Management Innovation (BMI), launched by Associate Health Minister Peter Dunne last month.

BMI aims to create research based initiatives to improve quality of care for very large patients -- including handling guidelines, more sensitive doctor-patient interactions, and access to appropriately sized equipment.

For the project, Ms Gray has teamed up with Dr Caz Hales, a lecturer at Victoria University's Graduate School of Nursing, Midwifery and Health and Todd Bishop, whose company Essential Helpcare supplies bariatric equipment to a number of DHBs, including Capital & Coast.

Ms Gray said New Zealand health care services appear ill equipped to manage rising numbers of large patients -- for example, there are an estimated 2545 adults with a body mass index of 40 plus in Wairarapa -- particularly as the population ages.

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She said a large part of the project will be engaging with patients, as well as health practitioners, emergency services and palliative care organisations to find how they can be better supported in providing treatment and care.

"Our focus is not trying to change these patients," Ms Gray said. "There are preventative measures in place, but we're caring for people who are already very big, who may be too large for bariatric surgery.

"When very large patients come into care, they have basic needs which must be met. This could be anything from a hospital gown that fits, to equipment including beds that are appropriate."

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Ms Gray, originally from the UK, has had a career in health services since the early 80s.

At Otago University, she is undertaking research on weight bias stigma in the health profession and, along with another Wairarapa researcher, Dr Carol MacDonald, has an interest in disaster management and supporting very large people in the event of civil defence emergencies.

Ms Gray also teaches in Otago's Department of Primary Health Care and General Practice, lecturing on dealing with taboo subjects in clinical consultations.

With BMI, Ms Gray and her colleagues are currently focusing on three main research streams -- starting with a project looking at stigmatising language directed at large people.

International research has shown health practitioners may have negative attitudes to large patients, and this bias can impact on quality of care.

Ms Gray said the project will be examining the acceptability of words, such as "fat" or "obese", and working towards training on non-judgmental and respectful consultations. "Weight can be a very sensitive and upsetting issue. These words are loaded terms, and some patients are offended by words like obese.

"Also, doctors have told us they find it easier to talk about smoking or alcohol rather than weight -- so we need to give them tools to handle the issue."

Another research project will be looking at simulation suits, which have been trialled overseas.

These suits replicate the experience of a large body, and can be used as a training tool for health professionals.

The team are interested to find out if they help or hinder empathy with large patients.

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BMI's third project is looking at safe handling of large patients and whether manual handling guidelines work with very large sized equipment.

Ms Gray said BMI will also be looking at the efficacy and availability of specialised equipment, such as larger beds, chairs, walkers, crutches, hoists and blood pressure cuffs.

"Our community health care systems need to be prepared -- we are getting to the point where hospitals need larger scales, and funeral directors' trolleys aren't big enough."

The BMI team are keen to hear from very large people who have experienced additional needs while receiving care.

"But we don't want to hear from haters who say it's large people's fault -- people still need to fit into a hospital bed and receive quality health care, whatever their size."

If you wish to contribute to BMI's research, contact lesley.gray@bariatricmanagementinnovation.org.

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