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Richardson, C. A. (2005). Ever decreasing circles: Non-curative terminal illness, empowerment and decision making: Lessons for nursing practice. Ph.D. thesis, , .
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Falleni, P. M. (2004). Whakaata ikei runga manaaki: Reflection on caring. International Journal of Palliative Nursing, 10(8), 390–392.
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McDonald, C. (2018). Working collaboratively in hospice and palliative care: Sharing time; a grounded theory. Doctoral thesis, Auckland University of Technology, Auckland.
Abstract: Addresses the concerns of health professionals working collaboratively in palliative care. Conducts 25 interviews wit 23 participants to arrive at a theory of sharing time to explain the social process of collaboration while individually managing and maintaining their own areas of concern. Explains the concept of health professionals making time in their work days for and with each other to find common ground.
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McChesney, R., & McClunie-Trust, P. (2021). Anticipatory prescribing in community palliative and end-of-life care: a realist review. Kai Tiaki Nursing Research, 12(1), 32–43.
Abstract: Argues that anticipatory prescribing and an interdisciplinary workforce could transform primary palliative care. Aims to identify the factors influencing such prescribing in palliative and end-of-life community care. Conducts a meta-synthesis of 7 primary research studies using a critical realist framework. Identifies expertise, teamwork and prioritisation as the factors influencing anitcipatory prescribing in end-of-life care.
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Henry, A. (2020). Staying at home: A qualitative descriptive study on Pacific palliative health. Master's thesis, University of Otago, Christchurch.
Abstract: Develops an understanding of the experiences of, and barriers for Pacific peoples in Canterbury utilising palliative care services. Considers the strengths and enablers for Pacific peoples accessing palliative care services and how such services, including home based palliative care, could better serve this community. Undertakes interviews using a semi-structured question guide, with nine family members who had provided palliative care within the last three years.
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Nolan, M., Featherston, J., & Nolan, J. (2003). Palliative care: Palliative care philosophy in care homes: Lessons from New Zealand. British Journal of Nursing, 12(16), 974–979.
Abstract: Drawing on data from a large convenience sample of caregivers in New Zealand, this article argues for a reappraisal of the way in which care homes view death and dying and advocates the more widespread adoption of a palliative care philosophy. Increasing numbers of people are dying in care homes yet little is known about the nature and quality of their deaths. The limited research available suggests that there is a need to promote a philosophy of palliative care that is not confined to the terminal phase of life. However, adopting such an approach appears to be inhibited by a lack of understanding, education and training, as well as continuing reluctance to discuss issues of death and dying in an open and honest way.
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Smit, C. (2017). Making self-care a priority. Whitireia Nursing and Health Journal, (24), 29–35.
Abstract: Highlights the importance of prioritising self-care for palliative care nurses whose prolonged exposure to work-related stress may result in burn-out. Recommends a self-care plan that addresses individual strengths and challenges, including physical, emotional, cognitive, relational and spiritual. Suggests the use of self-care strategies, such as the identification of professional and personal strengths, and the application of mindfulness and stress-reduction techniques to improve self-awareness.
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Johnson, S. (2007). Hope in terminal illness. Ph.D. thesis, , .
Abstract: Hope is considered an elusive, vague, over-used, and ambiguous concept in nursing practice which lacks clarity, but hope is essential to the quality of life in the terminally ill. Therefore, hope is an important concept to research further. A gap in nursing research has been identified in the area of hope in terminal illness. The aims of this research were to clarify the concept of hope as perceived by patients with a terminal illness; to develop hope as an evidence-based nursing concept; and to contribute new knowledge and insights about hope to the relatively new field of palliative care. Utilising Rodgers' (2000b) evolutionary concept analysis methodology and thematic content analysis, 17 pieces of research-based literature on hope as perceived by adult patients with any terminal illness pathology (from the disciplines of nursing and medicine) have been reviewed and analysed. Hope's attributes, antecedents, consequences, social-cultural variations, temporal variations, surrogate terms, and related concepts have been considered. An exemplary case of the concept in action is presented along with the evolution of the concept hope in terminal illness. Ten essential attributes of the concept were identified in this research: positive expectation, personal qualities, spirituality, goals, comfort, help / caring, interpersonal relationships, control, legacy, and life review. The evolution of hope in terminal illness has evolved from patients hoping for a prosperous healthy future to an enrichment of being is more important than having or doing. Patients' hopes and goals are scaled down and refocused in order to live in the present and enjoy the time they have left with loved ones. Hope in the terminal phase of one's illness is orientated in the past and the present, hope in the here and hope in the now. The author concludes that by completing all the steps to Rodgers' (2000b) evolutionary view of concept analysis, a working definition and clarification of the concept in its current use has been achieved, providing a solid conceptual foundation for further study. Recommendations are made for hope-enhansing strategies, that may help to maximise the quality of life of terminally ill patients in the future.
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Maries, V. J. (2004). Chosen moments: A reflective journey illustrating terminally ill patients choosing the moment to die.
Abstract: In this project the author reveals how she is observing and thinking as she cares for people who are dying. She records her reflections and insights and reveals that there is life right up to the moment of death, having observed terminally ill patients choosing the precise moment to die. She describes her observations of these moments by using poetry and stories, and explores the implications for her practice as a result. The author presents her reflections using an individualistic, reflective and exploratory perspective which is informed by the work of nursing scholars. This paper is framed using the metaphors of a journey and a window to indicate the reflective process that the author used to journal her observations in practice over time.
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Meldrum, L. B. B. (2006). Navigating the final journey: Dying in residential aged care in Aotearoa New Zealand.
Abstract: New Zealand statistics project that the aging population of people aged 65 years and over will more than double in the next decade. This has implications for palliative care providers including hospices and hospitals because long-term inpatient care is not generally provided by hospitals and hospices. When dying patients need long-term care, residential settings become an option. The level of palliative care in these facilities is dependent on staff training and numbers. In general, staff are not trained in palliative care, neither do they provide the multidisciplinary facets that define palliative care as undertaken by hospices. This paper describes a practice development initiative using storytelling as the vehicle for introducing the concept of the Liverpool Care Pathway (LCP) for the dying patient into residential aged care settings. With the emergence of a reflective paradigm in nursing the concept of storytelling as a teaching/learning tool has grown. Many staff in residential care settings come from diverse ethnic backgrounds where for some, English is their second language. Storytelling therefore can be a useful approach for learning because it can increase their communication skills. The author suggests that the Liverpool Care Pathway for the dying patient is a model that can be translated across care settings, hospice, hospital, and community. It can demonstrate a framework that facilitates multiprofessional communication and documentation and embraces local needs, culture and language to empower health care workers to deliver high quality care to dying patients and their family/whanau and carers. This paper also explores the role of a facilitator as an agent of change and discusses how the interplay of evidence, context and facilitation can result in the successful implementation of the LCP into residential aged care settings.
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Latta, L. (2007). Exploring the impact of palliative care education for care assistants employed in residential aged care facilities in Otago, New Zealand. Ph.D. thesis, , .
Abstract: Palliative care is a growing specialty in New Zealand with many well-established hospices and palliative care services around the country. However palliative care is not confined to specialist units and is in fact an element of all health services. The aged care sector is one of those services where patients with palliative care needs are prevalent and this is now beginning to be recognised. In these settings care assistants, most of whom have no training, make up a large component of the workforce providing care for residents with increasingly complex needs. In 2005, Hospice New Zealand responded to the recommendations made by the New Zealand Palliative Care Strategy (Ministry of Health, 2001) by developing an eight-hour palliative care course for care assistants employed in residential aged care facilities. The main objective of the course was to increase care assistants' ability to deliver a high standard of palliative care to their residents within their scope of practice.This qualitative study uses descriptive, semi-structured interviews to explore the impact that attending the course had on care assistants and their practice by inviting them to share stories of their experiences caring for dying residents. Factors influencing the implementation of learning in the workplace were identified. The results showed that while attending the course had a positive impact on participants, they were restricted in the extent to which they were able to apply new learning in the workplace, which was largely due to factors that were out of their control. As a result, recommendations are made to enhance workforce development in the aged care sector and to minimise the barriers to the implementation of learning.
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McCormick, G., & Thompson, S. R. (2019). Provision of palliative and end-of-life care by paramedics in New Zealand communities: a review of international practice and the New Zealand context. Whitireia Journal of Nursing, Health and Social Services, (26), 51–57.
Abstract: Reviews the international literature on paramedic preparedness to provide palliative and EOL care in in the community, and applies it to the NZ context. Finds that paramedics would like improved education and better integration with traditional care providers, encompassing patients, family, whanau and carers. and that they stress the psychological, spiritual and cultural needs of their patients.
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Latta, L. (2005). Reflective storytelling to enhance learning from practice experience. In J. McDrury (Ed.), Nursing matters: A reader for teaching and learning in the clinical setting (pp.67-82).. Dunedin: Otago Polytechnic.
Abstract: The author looks at the value of using reflective storytelling as a teaching/learning tool in the hospice setting and examines constructs that provide a theoretical underpinning. She also outlines processes that support the implementation of storytelling practice and the creation of a safe space for storytelling. At the end of the chapter, discussion questions are provided by Janice McDrury.
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Cleaver, H. (2005). Reflections on knowing, not knowing and being in palliative care nursing. Ph.D. thesis, , .
Abstract: The author notes that responses to questions from dying people and their families are as individual as each nurse, patient, family member, or situation. This is well recognised and an unspoken truth in palliative care practice. This paper explores the subjective nature of knowledge in palliative care generated through capturing moments of practice and subsequent reflections. This demonstrates how the author uses her model of care to open a space that enables the person and their family to find meaning from their experience and articulate what they need at the time. The author identifies her interest in the paradoxical reality of knowing and not knowing and describes how that paradox contributes to her role in supporting individuals' needs within their realities.
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Hammond, S. (2001). Parallel journeys: Perceptions of palliative care. Ph.D. thesis, , .
Abstract: The delivery of palliative care within contemporary New Zealand society is discussed, in the light of the recent publication of The New Zealand Palliative Care Strategy (2001). The viewpoint taken is largely descriptive rather than prescriptive, being based on a literature survey of international research and academic theory, which is also informed by the author's professionally gained knowledge. Four different perspectives, comprising a mix of providers and recipients of care are investigated: those of central government planning; specialist palliative care units; aged-care complexes; and patients, family and whanau. As an area of healthcare which current demographic projections indicate will become increasingly significant, the provision of palliative care to residents of and patients within aged-care complexes receives special attention. A metaphor of “parallel travellers” on “parallel journeys” is used to provide a thematic basis to the paper. The lived experiences and perceptions of each group of “parallel travellers” are explored. Difficulties in defining and evaluating palliative care, the implications of main-streaming, the scope of palliative care provision, the educative role of specialist palliative care providers and the current focus on mechanistic outcome measures are discussed. It is contended that the values and goals, both explicit and implicit, of the four specified groups may not at present be sufficiently congruent to optimise the effective provision of palliative care from the point of view of all concerned. While adequate resourcing and a genuinely collaborative approach among healthcare providers are both acknowledged to be critical, the potential for palliative care nurse practitioners to be appointed to the role of “care co-ordinator” alluded to within The New Zealand Palliative Care Strategy (2001), is also seen as pivotal. Insights from a postmodern perspective are offered as one possible way of achieving greater congruence.
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