hce_nchu
112年
英文
第 37 題
📖 題組：
PASSAGE 4 Bipolar Disorder (BD) is one of several serious mental health conditions that has a significant impact on a person’s life, and contributes to a high degree of health burden worldwide. Research suggests that some Indigenous populations experience higher community prevalence rates of BD, including Māori the Indigenous peoples of New Zealand. A recent systematic review of BD in Indigenous peoples noted an extremely limited evidence base, recommending Indigenous research designed to identify the impact of systemic factors on current health inequities. The New Zealand health system, while planning reform, is currently structured hierarchically. This includes: primary care delivered by doctors in General Practice (GPs); community-based services; outpatient and inpatient hospital services delivered regionally by 20 District Health Boards (DHBs); and non-governmental organizations (NGOs). Mental health care for BD generally requires a GP referral to DHB services, and can include periods of inpatient or community-based treatment delivered by multi-disciplinary teams (MDT) within a psychiatric care model. The composition of services and teams can differ between DHBs, meaning experiences of care may change depending on where in New Zealand a person lives. Based on a qualitative Kaupapa Māori Research methodology, a recent study analyzed critique from Māori patients with Bipolar Disorder (BD) and their *whānau* to identify barriers and propose changes to improve the structure and function of the New Zealand mental health system. Three themes reflected patients’ critique of structural features of the New Zealand health system and their impact on service provision for Māori with BD and their *whānau*. The operational-accessibility sub-theme included patients’ critique of the hours of service operation, including clinic hours, visitation times, and ward rounds; as well as processes for scheduling appointments, and the impact of these processes on access to BD services for Māori. In addition, patients identified constraints through insufficient resources in specific services or environmental features of facilities that limited their access to culturally safe, competent and equitable health care. Structural factors also influenced accessibility of staff with specialist skills to treat Māori with BD, like psychiatrists, psychologists and Māori mental health workers. Patients recognized that staffing-accessibility reflected current recruitment and retention priorities, meaning improved accessibility for Māori required prioritization of staff with proven clinical and cultural competencies. Transformational change therefore requires a commitment to monitor and address institutional racism driving inequitable access to effective care for Māori with BD and their *whānau* in the health system. As New Zealand prepares for significant health system reform, a commitment to equity and implementation of previously recommended structural change is needed, along with ongoing evaluation and **refinement** of structural changes to ensure the efficacy for *whānau* Māori.
PASSAGE 4 Bipolar Disorder (BD) is one of several serious mental health conditions that has a significant impact on a person’s life, and contributes to a high degree of health burden worldwide. Research suggests that some Indigenous populations experience higher community prevalence rates of BD, including Māori the Indigenous peoples of New Zealand. A recent systematic review of BD in Indigenous peoples noted an extremely limited evidence base, recommending Indigenous research designed to identify the impact of systemic factors on current health inequities. The New Zealand health system, while planning reform, is currently structured hierarchically. This includes: primary care delivered by doctors in General Practice (GPs); community-based services; outpatient and inpatient hospital services delivered regionally by 20 District Health Boards (DHBs); and non-governmental organizations (NGOs). Mental health care for BD generally requires a GP referral to DHB services, and can include periods of inpatient or community-based treatment delivered by multi-disciplinary teams (MDT) within a psychiatric care model. The composition of services and teams can differ between DHBs, meaning experiences of care may change depending on where in New Zealand a person lives. Based on a qualitative Kaupapa Māori Research methodology, a recent study analyzed critique from Māori patients with Bipolar Disorder (BD) and their *whānau* to identify barriers and propose changes to improve the structure and function of the New Zealand mental health system. Three themes reflected patients’ critique of structural features of the New Zealand health system and their impact on service provision for Māori with BD and their *whānau*. The operational-accessibility sub-theme included patients’ critique of the hours of service operation, including clinic hours, visitation times, and ward rounds; as well as processes for scheduling appointments, and the impact of these processes on access to BD services for Māori. In addition, patients identified constraints through insufficient resources in specific services or environmental features of facilities that limited their access to culturally safe, competent and equitable health care. Structural factors also influenced accessibility of staff with specialist skills to treat Māori with BD, like psychiatrists, psychologists and Māori mental health workers. Patients recognized that staffing-accessibility reflected current recruitment and retention priorities, meaning improved accessibility for Māori required prioritization of staff with proven clinical and cultural competencies. Transformational change therefore requires a commitment to monitor and address institutional racism driving inequitable access to effective care for Māori with BD and their *whānau* in the health system. As New Zealand prepares for significant health system reform, a commitment to equity and implementation of previously recommended structural change is needed, along with ongoing evaluation and **refinement** of structural changes to ensure the efficacy for *whānau* Māori.
Which of the following could best replace the word “*whānau*” as used in paragraphs 3 and 5?
- A structural reforms
- B community-based treatment
- C mental health conditions
- D health inequities
- E family or support networks
思路引導 VIP
請觀察文章第三段這句話：「...critique from Māori patients with Bipolar Disorder (BD) and their whānau...」。這裡的 'and their' 將 'patients' 與這個陌生詞彙連接在一起，暗示兩者之間存在某種親密的屬性或歸屬關係。在醫療體系的討論中，除了病人本身，通常還有哪一類「人」會與病人共同面對疾病，並同樣受到醫療體系架構的影響呢？
🤖
AI 詳解
AI 專屬家教
語境線索與文化詞彙的推論
太棒了！你能精準捕捉到這個毛利語詞彙在文中的含義，代表你對上下文語境（Context Clues）的掌握非常敏銳。在閱讀理解中，遇到這類外來語或文化專有名詞時，最有效的策略就是觀察它與周遭詞彙的關係。文中多次提到「Māori patients... and their whānau」，這種「病人與他們的──」的結構，強烈暗示了該詞彙指的是與病人密切相關的人群。結合文章討論醫療體系與照護模式的背景，推斷其為「家庭或支持網絡」是非常合理的邏輯。
題目難度與鑑別度評析
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