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Author |
Kuehl, S. |
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Title |
Emergency Department re-presentations following intentional self-harm |
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Year |
2008 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords  |
Emergency nursing; Psychiatric Nursing; Mental health; Clinical assessment |
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Abstract |
The aim of this research was to describe what factors contribute to people re-presenting to the emergency department (ED) within one week of a previous visit for intentional self-harm. Objectives identified were to describe the people using demographic and clinical features; describe and evaluate ED management; and identify possible personal or system reasons as to why people re-present to ED within one week. A retrospective observational design was selected for a period of one year. The data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations. Missing data limited the number of inferential analyses. Outcome measures were divided into information regarding the person and the presentation. This study made several discoveries: many representations (55%) occurred within one day; the exact number of people who represented many times to ED is unknown, but is far higher than reported in other studies; fewer support people were present for the second presentation; the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population; cultural input for Maori was missing; physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations; and the medical and mental health inpatient admission rates were approximately 50% higher for second presentations. Recommendations in regard to the use of a triage assessment tool, the practice of reviewing peoples' past presentations and the need for a mental health consultation liaison nurse in ED are made. Staff education, collaboration between services with consumer involvement and further research of this group are required. This study supports the need for holistic and expert care for people who present at emergency departments with intentional self-harm. |
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NRSNZNO @ research @ |
Serial |
1214 |
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Author |
Cleary, H. |
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Title |
Caring and bioethics: Perspectives, predicaments and possibilities |
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Year |
2001 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Ethics; Feminist critique; Nurse-patient relations |
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Abstract |
This thesis presents an explorative study of the place of caring in bioethics. Through the examination of various sources of literature from the disciplines of nursing, feminist theory and ethics, and bioethics, a case is developed that argues for a valid respected place for caring, as an ethic of care in bioethical decision-making. The case is built by providing evidence to support the fundamental importance of caring to human life, health, relationships, and survival at the broad societal level. This is presented from the feminist and nursing perspectives, along with a critique of the negative aspects of caring practices. The next stage of the case presents a layout of the discipline of bioethics, using an historical perspective to illuminate the influences of bioethics' deep past, as it still affects the discipline in the present. The development of contemporary bioethics' current status is presented along with critiques from bioethicists themselves, and nursing and feminist theory and ethics. In the case at this point, from a bioethical perspective, two major predicaments appear to prevent an ethic of care obtaining a valid place in ethical decision-making in bioethics. These are the justice/care duality, and the conflict between different conceptions of care and autonomy. The bioethical objections and arguments put forward regarding these predicaments are examined and refuted, and the author suggests a case is established for the inclusion of an ethic of care in bioethical decision-making. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1198 |
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Author |
Polaschek, N. |
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Title |
The concerns of Pakeha men living on home haemodialysis: A critical interpretive study |
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Year |
2000 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Gender; Chronically ill; Nursing |
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Abstract |
This nursing study seeks to understand the experience of one group of people with chronic renal failure using renal replacement therapy, Pakeha men living on home haemodialysis. It is based on the assumptions that people living on dialysis have distinctive experiences that are characterised by common concerns reflecting their shared position as subjects of renal illness and therapy. In order to understand the experience of people living on dialysis, this study develops a critical interpretive approach, seeking the participant's own interpretation of their individual experiences. The experiences are then reinterpreted them from a critical standpoint, recognising that they can only be adequately understood by contextualising them. This enables the researcher to discern the common perspective underlying them in contrast to the dominant professional viewpoint in the renal setting. The concerns identified include symptoms from chronic renal failure and dialysis, limitations resulting from the negotiation of the therapeutic regime into their lifestyle, their sense of ongoingness and uncertainty of living on dialysis, and the altered interrelationship between autonomy and dependence inherent in living on dialysis. The study suggests that the individual accounts can be understood as resulting from the interaction of the various dimensions of their own personal social locations, including their gender and ethnicity, with the concerns of client discourse, reflecting their common position as people living on dialysis. The author concludes that one implication of this understanding is that the role of nursing in the renal setting can be articulated as a response to the experience of the person living on dialysis. The nurse can support the renal client in seeking to integrate the requirements of the therapeutic regime into their personal situation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1195 |
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Author |
Lidiard, B. |
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Title |
Implementing the Rating Scale for Aggressive Behaviours in the elderly: Can it make a difference to nursing management of aggressive behaviours in elderly patients with dementia? |
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Year |
2006 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Geriatric nursing; Dementia; Workplace violence; Older people |
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Abstract |
The Rating Scale for Aggressive Behaviours in the Elderly (RAGE) is a twenty-one item rating scale, designed specifically to measure aggressive behaviours in the elderly in the psychogeriatric inpatient setting. The purpose of the scale is to qualify the aggressive behaviour, note any changes in the behaviour, and record intervention and/or treatments. This study combines both qualitative and quantitative methods with exploratory and descriptive designs to explore nurses' experiences of using a consistent tool for monitoring, measuring and managing aggressive behaviours. Data gathered over a three month period of implementing RAGE aimed to provide a 'snapshot' of the prevalence, extent and type of aggressive behaviours within the inpatient setting, providing evidence to nurses in developing strategies for the management of aggression. Focus group interviews were used to enable nurses to discuss their experiences of utilising a clinically validated tool in their practice and how this made a difference to their practice. Findings from this research indicate that nurses within the setting found that RAGE is a consistent tool with which nurses can record, measure and monitor aggressive behaviours. Responses from nurses' experiences of utilising RAGE in their practice were varied, with some being unable to articulate how RAGE had made a difference to their practice. Despite this there was an overwhelming positive response for the continued use of RAGE within the setting as a clinically validated tool by which to measure, record and manage aggressive behaviours. |
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Call Number |
NRSNZNO @ research @ |
Serial |
798 |
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Author |
Schumacher, A.T. |
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Title |
More than meets the eye: Explicating the essence of gerontology nursing |
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Year |
2001 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Geriatric nursing; Nursing philosophy; Nursing specialties |
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Abstract |
The purpose of this hermeneutic phenomenological was to unveil a deeper meaning and understanding of gerontology nursing, thus contributing to its value and worth as a speciality area of nursing. Conversations with four gerontology nurses were taped, transcribed and then analysed using van Manen's (1990) approach to researching lived experience. From the analysis, four cardinal elements emerged: true acceptance, personal knowing, being present, and being alive. Those four cardinal elements were reworked and further analysed to reveal three central aspects or essences of gerontology nursing. These essences were the centrality of temporality, the interconnectedness of human relationships, and the significance of the lived body. Temporality is demonstrated by nursing application of objective, or clock time, as well as subjectively in regards to the lived time of the clients. Interconnectedness is the lived human relationship between nurse and client and is represented by commitment, presencing/giving of self, connecting, and knowing the client holistically. The third essence is corporeality, which is portrayed by the gerontology nurses' distinguishing characteristics and their perception of the lived body of the nursed. The final analysis unveiled caring for the body, the act of seeing, and the joy of care as emergent essences of gerontology nursing. Language of nursing in relationship to 'basic nursing care' is critiqued for its potential to devalue gerontology nursing and, by association, old people. |
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Call Number |
NRSNZNO @ research @ 1157 |
Serial |
1142 |
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Author |
Watson, S. |
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Title |
Humane caring: Quality of life issues for those elderly people wanting to remain in their own environment |
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Year |
2001 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Geriatric nursing; Older people; Home care |
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Abstract |
This thesis explores the issues surrounding the elderly remaining in their own environment and why remaining 'at home' becomes so essential for them. There are many elderly people who have moved to residential care settings on the advice of others. The author explores the implications of such moves through the stories of several elderly persons, and her own experiences as a nurse working with the elderly in institutional care. |
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NRSNZNO @ research @ |
Serial |
1217 |
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Author |
Stewart, A. |
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Title |
When an infant grandchild dies: Family matters |
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Year |
2000 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Grief; Nurse-family relations; Infants; Nursing research |
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Abstract |
This research undertaken by a nurse working with bereaved families, aimed to explore how grandparents, parents and health/bereavement professionals constructed grandparent bereavement when an infant grandchild died unexpectedly. The 26 participants, living in New Zealand and the United Kingdom, included 16 grandparents and 6 parents from 11 families, in addition to three health/bereavement professionals. A constructivist inquiry informed by writings on nursing, storying and postmodernism was used. Through an exploration of the methodological and ethical issues that arose and were addressed during the study, this work adds to knowledge of how constructivist inquiry can be used in nursing and bereavement research. In addition, the context of this research as a partnership with multiple family members contributes to the ongoing debate about whether participation in bereavement research may be harmful or therapeutic. Conversations in this research formed a series of interviews and letters, which led to the development of a joint construction and each individual's story. A grandchild's death was constructed as a challenge which grandparents faced, responded to and then managed the changes that arose from the challenge. The context of their bereavement was seen as underpinned by their relationship as “parents of the adult parents” of the grandchild who died. This meant that grandparents placed their own pain second to their wish to support and “be with” the parents. Outside the family was where many grandparents found friends, colleagues or their community forgot, or chose not to acknowledge, their bereavement. This work shows how some grandparents help to create a space within the family which maintains a continuing relationship with the grandchild who died. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1205 |
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Author |
Pearson, J.R. |
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Title |
Health promotion in one New Zealand primary school: A case study |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Health promotion; Evaluation; Students; Maori; Pacific peoples; Health education |
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Abstract |
The objectives of this study were to explore the concept of the 'health-promoting school' in a specific New Zealand context; to develop and use appropriate research methods to assess a single low decile school in relation to World Health Organization health-promoting school components and checkpoints; to work with the school community to identify health issues; and, to record external and internal changes that could impact on school health over a finite time period. Case study was selected as the most appropriate method to collect both quantitative and qualitative evidence with the aim of providing a clear understanding of the particular case. Results confirmed that the school was working appropriately within the scope of their educational practice to provide a health-promoting school environment for the school community. Gaps and issues identified included an element of talking past each other between the cultures of the education organisation and the nominated health service provider respectively that contributed to a lack of appropriate and accessible health service delivery for the school population. Teaching staff considered that they had insufficient access to health knowledge, and input from health service staff did not meet health education requirements for the school. Staff preference for increased school nurse involvement was not realised. The consequence was that two outside agencies (KiwiCan and Life Education Trust) delivered the bulk of the Health and Physical Education curriculum which resulted in a degree of fragmentation of health education for students. The issues that were identified demonstrated that health services in the area were not satisfactorily meeting the needs of the community and were not addressing the health inequities for the predominantly Pacific Island and Maori students and of their families that formed the school community. The researcher concluded that a full-service school approach should be considered by the school and the local district health board as one way to overcome the current lack of access to health services for the school community. Assertions included the potential integration of locally available services by a school-based nurse coordinator supported by health professionals (nurse practitioner and Pacific Island Community Health Worker) and social workers. The vision included professionals working within their professional scopes of practice as part of a Primary Health Organisation with the aim of appropriately addressing the health inequities experienced by the school population. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1184 |
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Author |
Stojanovic, J.E.E. |
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Title |
Leaving your dignity at the door: Maternity in Wellington 1950 – 1970 |
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Year |
2002 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Hospitals; Nursing specialties; Maternity care; Patient satisfaction |
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Abstract |
This thesis describes the maternity system in Wellington between 1950 and 1970 particularly from the perspectives of consumers and midwives. Four women consumers who experienced maternity in Wellington and two midwives who worked in Wellington's maternity hospitals during this period provided their oral testimonies as the main primary sources for this study. The author's experience of being a student nurse and a consumer in Wellington and other primary and secondary sources are used to substantiate, explore and explain the topic. The study traces the socio-political changes in New Zealand maternity from 1900 to 1970 creating a backdrop against which Wellington's maternity system, including the women, the hospitals, the workforce, maternity practices and the childbearing process are illuminated using the insights of women and midwives who experienced them. The oral testimonies of the six participants described positive and negative aspects of their maternity experiences, but the three strong themes that arose from their accounts included 'being alone', 'lack of autonomy' and 'uncaring attitudes'. |
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Call Number |
NRSNZNO @ research @ 1223 |
Serial |
1208 |
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Author |
Ryder-Lewis, M. |
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Title |
Reliability study of the Sedation-Agitation Scale in an intensive care unit |
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Year |
2004 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Pages |
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Keywords |
Intensive care nursing; Interprofessional relations |
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Abstract |
This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the Sedation-Agitation Scale (SAS) in a natural Intensive Care Units (ICU) setting. The author notes that it is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1203 |
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Author |
Falleni, P.M. |
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Title |
The implications of stress and the effect it has on Maori who have type 2 diabetes in Aotearoa/New Zealand |
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Year |
2007 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Pages |
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Keywords |
Maori; Diabetes Type 2; Stress; Community health nursing |
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Abstract |
In this review, the author illustrates the connection between diabetes, stress and barriers to care, and the impact these have on Maori who have type 2 diabetes. A literature review, which focused mainly on indigenous peoples, and more specifically on Maori was undertaken. The connections between all the factors involved are explored, and combined with reflections from the author's own clinical practice experience. She argues that stress, diet, exercise and barriers to care place a heavy burden on the lives of Maori who live in Aotearoa/New Zealand, suffering from the disease of diabetes. By empowering them to face their situation and see this from a wellness rather than an illness perspective, they can take control of their diabetes and so will live a healthy, longer life, ensuring quality time with their mokopuna/grandchildren. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1155 |
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Author |
Elbe, E. |
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Title |
The private world of nursing related to incident reporting |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Pages |
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Keywords |
Medical errors; Organisational culture; Risk management; Nursing |
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Abstract |
The purpose of this project was to explore the experience of nurses related to incident reporting. The reporting of incidents is important as it identifies professional risks for nurses. A descriptive qualitative approach was the methodology used and individual interviews of five senior nurses was the method of data collection. Attention was given to finding out about the supports for and barriers against nurses in reporting incidents; the outcomes for nurses of incident reporting; and the organisational culture and scope of 'professional' behaviour of nurses around incident reporting. The findings revealed that nurses identified themselves as the major reporters of incidents. They considered there was not 'a level playing field' for all professionals around who, how and why incidents were reported, investigated and within the post incident processes. The nurses reported that they made daily decisions about what was an incident, and whether to report events as incidents. They identified aids and supports to the decisions they made such as the medium for reporting and fear of what happened when the incident form left the nurse and went to management. A number of significant implications were identified for nursing, management and organisations in this research. Nurses need to feel they work in organisations which have a culture of safety around incident reporting. Management need to clearly communicate policies, processes and organisational expectations related to incident reporting. This should include how incidents will be reported, investigated and the purposes for which management use incident reporting information. It is also important that adequate structures are in place to support nurses when an incident occurs as thay can have stressful consequences for the nurses involved. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1147 |
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Author |
Esera, F.I. |
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Title |
If a client is operating from a Samoan world view how can s/he be holistically and appropriately treated under the western medical model? |
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Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Psychiatric Nursing; Cultural safety; Cross-cultural comparison; Pacific peoples |
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Abstract |
This paper is an analysis of the cultural and traditional factors that the author presents as essential considerations in the treatment of Samoan people who have been diagnosed with a mental illness. Just as important to any clinical diagnosis, is the spiritual nature of Samoan culture and traditions, which inform belief systems. A full understanding of these will explain how the traditional beliefs and cultural values of Samoan people have an impact on their perception of mental illness, its causes and cures. The thesis places emphasis on 'ma'i -aitu', the Samoan term for most ailments pertaining to the mind or psyche. The focus is on defining 'ma'i -aitu' as part of a Samoan world view and likewise a description of a similar type of manifestation in the Papalagi (western) context of a psychiatric disorder and how treatment and management is usually undertaken. The issues addressed in this paper aim to highlight the Samoan client's world view from a Samoan perspective of mental illness which then poses the question of how they can be managed holistically and appropriately under the Papalagi medical system. Furthermore, it questions if the traditional belief system of Samoans run deeper than originally thought and can the replacement thereof by a foreign culture be responsible for the increased mental problems in Samoans living in New Zealand? This paper emphasises the importance of integrating the western medical model and Samoan health models, for appropriate mental health service delivery to Samoan people. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1231 |
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Author |
Phillips, B.N. |
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Title |
An interpretation of four men's experiences of suicidality |
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Year |
2004 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Psychiatric Nursing; Gender; Qualiltative research |
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Abstract |
This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of the author's own particular horizon of meaning as researcher and mental health nurse. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, he explores the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. Recovering was a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change. |
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Call Number |
NRSNZNO @ research @ 1214 |
Serial |
1199 |
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Author |
Chenery, K. |
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Title |
'Can mummy come too?' Rhetoric and realities of 'family-centred care' in one New Zealand hospital, 1960-1990 |
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Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse-family relations; Policy; Hospitals; History of nursing; Paediatric nursing |
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Abstract |
This study explores the development of 'family-centred care' in New Zealand as part of an international movement advanced by 'experts' in the 1950s concerned with the psychological effects of mother-child separation. It positions the development of 'family-centred care' within the broader context of ideas and beliefs about mothering and children that emerged in New Zealand society between 1960 and 1980 as a response to these new concerns for children's emotional health. It examines New Zealand nursing, medical and related literature between 1960 and 1990 and considers both professional and public response to these concerns. The experiences of some mothers and nurses caring for children in one New Zealand hospital between 1960 and 1990 illustrate the significance of these responses in the context of one hospital children's ward and the subsequent implications for the practice of 'family-centred care'. This study demonstrates the difference between the professional rhetoric and the parental reality of 'family-centred care' in the context of one hospital children's ward between 1960 and 1990. The practice of 'family-centred care' placed mothers and nurses in contradictory positions within the ward environment. These contradictory positions were historically enduring, although they varied in their enactment. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1206 |
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