Gohns, A. (2002). Management of opioid substitution treatment in the primary health care setting: A national training course for service providers. Full text online from the Royal New Zealand College of General Practitioners' website, 29(3), 172–175.
Abstract: The aim of this research was to describe a national opioid treatment training programme that was introduced into primary health care, and evaluate its effectiveness following its first year of operation. The programme was introduced as a strategy to recruit, train and support a primary health care workforce in the provision of methadone treatment. For the evaluation a written questionnaire was sent to the general practitioner, practice nurse and pharmacist participants of training programmes held throughout New Zealand in 2000. One hundred and forty-five (98%) participants reported that the overall quality of the course was good or better, and that relevant issues were, in general, covered. However a recurring theme related to difficulties in designing a course relevant to the three different professional groups, with some material not equally applicable to all. Another prominent theme pertained to the issue of funding. general practitioners lamented the failure to address the issue of transferring patients from a free specialist clinic to their practice for care. The evaluation of this pilot programme indicates that this training in methadone maintenance treatment was well-received by primary health care providers. However, the author notes that there is no benchmark with which to compare it.
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Gibbons, V., Rice, S., & Lawrenson, R. (2010). Routine and rigidity: Barriers to insulin initiation in patients with Type 2 Diabetes. NZNO Library, 1(1), 19–22.
Abstract: It has been shown that intensive management of diabetes with type 2 diabetes is effective and has led to wider use of insulin. The conversion of patients from oral medication to insulin is usually managed in primary care. The study discussed here aimed to explore how patients with type 2 diabetes mellitus (T2DM) perceived insulin. The study was conducted in 2009 in an urban general practice in a large town in New Zealand with more than 300 patients with type 2 diabetes. A qualitative study was conducted with face-to-face interviews with 13 participants. The question focused on insulin initiation, lifestyle and routine. The transcribed responses were subject to thematic anaylsis. Interviews showed participants felt restricted by the prospect and eventuality of the routine and restrictions of being on insulin. Results show there needs to be a greater emphasis on the disease being progressive. This study provides the ground work for developing resources that will benefit patients with T2DM.
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Fletcher, S. (2021). “It's one less thing I have to do” : does referring patients to a co-located psychology service impact on the well-being of primary care health providers?.
Abstract: Investigates wheether the impact of a co-located psychological service to which Primary Care Providers cn refer patients with mild to moderate mental health needs, would impact on the well-being of the providers at work. Describes Focused Acceptance and Commitment Therapy (FACT) services delivered by psychologists working in a a large primary care practice in the lower North Island. Conducts interviews with GPs, nurse practitioners (NP) and registered nurses (RN), analysing the data using thematic analysis. Finds an inverse relationship between the FACT service and the well-being of staff.
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Findlay, W. (2006). The effect of peer learning and review groups on practice nurses' clinical practice: A mixed method survey. Ph.D. thesis, , .
Abstract: The aim of the study was to explore how practice nurses perceive engagement in Peer Learning and Review Groups impacts personally and professionally on their clinical practice. An anonymous self-administered postal questionnaire was completed by 55 practice nurses who attend Peer Learning and Review Groups in the South Island. A mixed method design was utilised to obtain both qualitative and quantitative data. Practice nurses considered group attendance was important for professional development with the majority perceiving that their attendance had a positive effect on their clinical practice. The nurses perceived clear linkages between the significant learning that occurred in the groups and changes in delivery of patient care. Additional benefits included improved collegial relationships, professional awareness and personal growth. The author concludes that, together, these findings underline the importance of Peer Learning and Review Groups as an effective tool for ongoing personal and professional development within nursing.
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Field, J., McClunie-Trust, P., Kearney, C., & Jeffcoat, J. (2020). Language and communication: a vital component of health for people with refugee backgrounds. Kai Tiaki Nursing Research, 11(1), 42–49.
Abstract: Reports on a collaborative project that explores trans-disciplinary understanding of the implications of learning English for the health and well-being of refugees. Argues that English literacy is a significant factor in health literacy and access to health care. Uses secondary analysis to analyse primary research with 60 predominantly female adult refugees aged 18 to 64 years. Highlights the experiences of these English language learners and reflects on their relevance for primary health care and nursing practice.
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Farmer, D. (2008). Wairarapa Primary Health Care Nursing Workforce Survey – 2007: A replication. Ph.D. thesis, , .
Abstract: The introduction of the 2001 New Zealand Primary Health Care Strategy has seen increased emphasis on the development of the national primary health care nursing workforce. National and local nursing workforce development initiatives, in response to the strategy, have seen evolving models of primary health care nursing practice in New Zealand. Research was undertaken in 2007 to review the current position of the Wairarapa primary health care nursing workforce. Quantitative, descriptive data was generated through the application, at a local level, of the 2001 Ministry of Health Primary Health Care and Community Nursing Workforce survey tool. Many of the regional challenges highlighted by survey respondents in 2007 are similar to those identified in the national 2001 survey. These include predominantly low numbers of Maori, Pacific and male primary health care nurses and a fragmented, part-time and aging workforce with many respondents indicating they undertake more than one nursing role in their organisation. Respondents were similarly unsure or did not have clear clinical career pathways available to them, a mechanism by which nurses can advance their clinical practice. Some unique service provision and workforce development issues related to Wairarapa's rural context include: geographical barriers, population spread and the high health needs of its rural population. Some unique regional differences compared to the 2001 data are: lower numbers of nurses studying toward further qualifications and specific barriers to accessing education opportunities that can be linked to living in a rural region. More respondents indicated they could work collaboratively with other nurses and health professionals within their own and other organisations. While many respondents were able to provide insightful examples of specific nursing strategies in their practice targeted towards reducing inequalities for groups at risk, others could not. Enrolled nurses remain part of the Wairarapa primary health care nursing workforce. Ten percent of the respondents were actively practising enrolled nurses with an average of 24 years experience in primary health care nursing. Direction and delegation requirements by registered nurses for this group and national attrition trends with corresponding loss of workforce experience of enrolled nurses highlight an area in the Wairarapa primary health care nursing workforce that requires further consideration. Overall this study contributes to current knowledge by establishing a regional nursing workforce baseline from which to measure and enable focused future workforce development initiatives and research. Regional findings can be used to inform recommendations within the Wairarapa Primary Health Care Nursing Action Plan 2006-11 to enhance the delivery of well-developed primary health care nursing services with benefits for the Wairarapa community.
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Dillon, D. R. (2006). Islands, islandness and nursing: Advanced nursing practice in rural remote and small island areas. Ph.D. thesis, , .
Abstract: This dissertation focuses on the concepts of island, island-ness, and isolation. It aims to further advance the national and international literature relating to the health beliefs of island people as linked to the provision of primary health care services within New Zealand. New Zealand is an island nation made up of two main islands and numerous outlying islands, relatively isolated from the rest of the world by water. This geography means going anywhere from New Zealand involves traveling either “over” or “on” the sea. All people of New Zealand since the first inhabitants, whether residents or visitors, have arrived to New Zealand either by sea or more recently by plane. The population of New Zealand is 25% rural, with most of these rural dwellers residing in the South Island, and several of the smaller off shore Islands. This builds a sense of culture of the people, or tangata whanua (the people of the land), for whom there are degrees of island-ness, and the characteristics of this can be seen amongst the people of New Zealand. A further challenge which is discussed comes in the form of the “island penalty” which encompasses high transport costs, long distances to travel to main centres, lack of specialists and trained health workers, effects of migration and tourism, and communication difficulties. The more isolated people are, the tougher the challenges become. Most rural island populations are served by lay care workers, volunteers, and rural and remote nurses. Nurses are often the main health care providers to small island populations, and they demonstrate advanced nursing practice which is acknowledged internationally as meeting Nurse Practitioner competencies. As a group these nurses possess knowledge of the extrinsic and intrinsic factors involved in the health needs and health determinants of these island communities. Researching these advanced nursing roles adds to the body of knowledge around isolated and island communities. The author suggests that studying the concepts of islands, islandness, and isolation in relation to health beliefs will bring more understanding of services for the advanced rural nurse to consider in developing appropriate, accessible, affordable and adaptable Primary Health Care which is fair and equitable.
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Desmond, N. (2007). Aspects of nursing in the general practice setting and the impact on immunisation coverage. Ph.D. thesis, , .
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Dennis, J. (2005). How will transformative primary health care nursing leadership facilitate better health outcomes for Southlanders? Ph.D. thesis, , .
Abstract: Changes within the New Zealand health system have led to an emphasis on primary health care. The New Zealand government and the Southland District Health Board have identified that nurses can make significant contribution to improving the primary health outcomes for New Zealanders. However, within Southland there exist barriers to nurses influencing health outcomes. A Southland draft Primary Health Care Nursing Strategic Plan 2005 recommended that the employment of a primary health care nursing leader would reduce these barriers and lead to a comprehensive primary health care nursing service. This dissertation argues, using literature, that the employment of a transformative nursing leader, using a facilitative style, would implement changes that would develop a community responsive nursing service, establish a primary health care educational structure and ensure quality nursing care. Successful implementation would occur as the leader facilitates experiential learning within groups and with individuals to review current experiences and implement transformative primary health care nursing changes that improves health for all. The dissertation introduces the background to the changing primary health care environment in New Zealand and to the Southland current situation in chapter one. Chapter two describes the unique features of transformative leadership style and how it is applies to nursing and specifically to Southland's changing primary health care environment. The chapter specifically emphasises the role of and the art of facilitation which is a critical transformative leadership process. Chapter three describes the process of the experiential learning cycle, which the author argues will improve health outcomes, when used by the transformative leader to enable nurses to learn from their experiences and make nursing changes that improve health care. Chapter four addresses the dissertation question by describing how transformative leadership will facilitate the experiential learning process to Southlanders and improve health outcomes, reduce inequalities and increase accessibility through a comprehensive primary health care nursing service.
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Day, D. R., Mills, B., & Fairburn, F. (2001). Exercise prescription: Are practice nurses adequately prepared for this? New Zealand Journal of Sports Medicine, 29(2), 32–36.
Abstract: This study sought to examine whether practice nurses were prepared to provide exercise prescriptions to clients. It involved administering questionnaires to 53 practice nurses in Otago to examine their understanding of green prescriptions and their knowledge and participation in exercise prescription.
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Davis, J., Wiapo, C., Rehana-Tait, H., Clark, T. C., & Adams, S. (2021). Steadfast is the rock: Primary health care Maori nurse leaders discuss tensions, resistance, and their contributions to prioritise communities and whanau during COVID-19. Nursing Praxis in Aotearoa New Zealand, 37(3).
Abstract: Recounts the experiences of 3 Maori nurses in a primary health entity in Northland, NZ as they negotiated with health providers and organisations to protect the health of Maori communities during the first lockdown, in 2020. Emphasises the role of matauranga Maori (Maori knowledge and tradition) in ensuring local Maori were prioritised in the pandemic response in the region.
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Davies, D. C. (2006). Practice nurses' perceptions of their contribution to the care of individuals with chronic health conditions. Ph.D. thesis, , .
Abstract: Table of Contents: 1. Background and overview; 2. Research design and method; 3. Literature review; 4. Preparation of the individual for an appointment at the general practice; 5. Care provided by the practice nurse at the general practice; 6. The giving of information; 7. A discussion of the dualities of the contribution of practice nurses to the care of individuals with chronic conditions; 8. Study summary and conclusions.
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Crowe, M., Jones, V., Stone, M. - A., & Coe, G. (2019). The clinical effectiveness of nursing models of diabetes care: A synthesis of the evidence. International Journal of Nursing Studies, 93. Retrieved June 1, 2024, from http://dx.doi.org/https://doi.org/10.1016/j.ijnurstu.2019.03.004
Abstract: Determines the clinical effectiveness, in terms of glycaemic control, other biological measures, cost-effectiveness and patient satisfaction, of nurse-led diabetes interventions led by primary health care nurses. Uses PRISMA guidelines for reporting the results of a systematic review of the literature. Compares quantitative studies of physician-led care and cost-effectiveness, with qualitative studies of patient experiences of nurse-led care.
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Connor, M. J., Nelson, K. M., & Maisey, J. (2009). Impact of innovation funding on a rural health nursing service : the Reporoa experience. Nursing Praxis in New Zealand, 25(2), 4–14.
Abstract: Examines the impact of innovation funding through the MOH primary health-care nursing innovation funding scheme on Health Reporoa Inc, which offers a first-contact rural nursing service to the village of Reporoa and surrounding districts. Looks at funding impact during the project period of 2003-2006, and in the two years that followed.
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Clissold, C. (2006). How discourses stifle the Primary Health Care Strategy's intent to reduce health inequalities. Ph.D. thesis, , .
Abstract: The Primary Health Care Strategy (PHCS) has a stated commitment to defined populations who suffer disproportionately from ill health. This thesis examines whether some prevailing discourses actually decrease the focus on health inequalities. A study of the nursing and medical media found that it focused predominantly on professional and industrial issues, leaving health workers focused mainly on their own professional interests, rather than considering the effects on health inequalities. She goes on to suggest that current Ministry of Health discourse values decentralised community health decision making. This may gloss over factors in community health which are affected by Government policy such as employment policy, and thus should be dealt with centrally by legislation. These factors have been found to be the most pertinent in health inequalities. So while models of community partnerships may seem to place communities as agents in their own health, this downplays the determinants of health which are beyond their control. Having shown that discourse can decrease the focus on health inequalities due to other professional and political drivers, the author then looked at health initiative concepts which are effective, efficient and equitable given the current set up of PHOs and nursing innovations.
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