Abstract: We hypothesized that the use of an Action Plan might assist self management for patients with chronic obstructive pulmonary disease (COPD).A pilot process and randomized, controlled study were undertaken to evaluate an action plan that provided advice on management of usual care and exacerbations, together with a booklet on self management. Fifty six subjects with COPD recruited through general practitioners (GPs) completed the six month study, 27 in the control group and 29 in the intervention group. The control group received usual care from their GP and the intervention group received a booklet and Action Plan from their practice nurse plus a supply of prednisone and antibiotic from their GP.The two groups were demographically similar with a mean age of 68 yrs. The resources were well received by GPs, practice nurses and the intervention group subjects. After six months there were no differences in quality of life scores or pulmonary function. There were significant changes in self management behaviour in the intervention group compared to controls. In response to seterioting symptoms, 34 versus7% (p= 0.014) initiated prednisone treatment and 44 versus 7 % (p=0.002 initiated antibiotics.Subjects in the intervention group readily adopted self management skills but did not shpw any difference in quality of life or lung function parameters. A larger prospective controlled clinical trial of this approach is warranted

Abstract: In 1991 a new labor relations regime was introduced which overturned a 100 year old pattern of 'historic compromise' between capital and labor. In a labor market structured by gender and race, this major change in bargaining arrangements has already widened the pay gap between men's and women's average earnings and reduced union coverage, particularly among women workers in low paid clerical, sales and service work. This study, documenting recent feminist struggle in the area of labor relations, provides a first look at the collective organisation of women under two different labor relations regimes.In the 1980s a particular conjunction of occupational unionism and feminism in New Zealand facilitated some significant improvements in the situation of women in paid employment. The thesis examines feminist strategies which led to a Working Women's Charter adopted by unions, an increase in women holding office in unions, complaints procedures for sexual harassment, standing committees to represent women and Maori in the union movement, and legislation to implement equal employment opportunity programmes and equal pay for work of equal value. It looks at how the institution-alisation of bargaining by occupation supported industrially weak workers and underpinned the unionisation of women, which occupational unions and women's own strategies of organisation provided the autonomous 'political space' to organise around issues specifically relevant to women.At the core of the thesis are three case studies of unions representing three of the occupations in which women are concentrated: clerical work, nursing and cleaning. It examines commonalities and contrasts in the industrial situations covered by these unions, and differences and similarities in the strategies they adopted. The focus of research, conducted between late 1990 and early1993, was the views of officials of these unions in the context of radical change in the regulation of wage bargaining. Particular attention was given to the way issues relating to women workers were prioritised in unions led by women or by men.These case studies are contextualised in chapters examining the position of women in the labor market, feminist organisation within the union movement, and corporatist change in labor relations legislation. In tracing the development of feminist unionism in the 1980s, the thesis considers the strategies of the NZ Council of Trade Unions and looks at what the radical change in bargaining structure will mean for collective organisation by women in paid employment

Abstract: High stress and staff turnover in a multi-specialty paediatric area prompted this study that aimed to :1) measure the burnout level of nurses in a multi-specialty paediatric area2) identify and validate causes of stress3) identify new ways of preventing stress on the wardFifty four percent (n=14) of the paediatric nurses completed the questionnaire booklet that included demographic data, the Maslach Burnout Inventory, the Nursing Situations Questionnaire the Hopkins Symptom Checklist-21 the Ways of Coping Checklist and open ended questions about sources of stress and satisfaction at work. Results indicated levelsof burnout and distress comparable with larger studies. Conflict with doctors was the major source of stress followed by workload, inadequate preparation in dealing with the emotional needs of patients and their families and death and dying. Conflict with doctors has not previously been identified as the major source of stress. However workload and death and dying are commonly identified as sources in the literature. Suggestions for further research and the low response rate are discussed

Abstract: The experience of loneliness within a people-centered profession has supported nursings silencing and invisibility. A literature expedition through communication texts and journals led to an awareness of the paucity of literature which explores and acknowledges how we dialogue together, rather than the more fashionable focus on how we should communicate with others.

Abstract: This phenomenological study explored the experiences of five men and four women whose lives have been shaped by chronic leg ulcers. It reveals the suffering that accompanies these wounds, and challenges health professionals to move from a focus on wound management to understanding the realities of chronic illness experience

Abstract: Up until the 1980s most of the historical writing about nursing and nurses in this country has been told from the points of view of past nursing leaders. The realities of day-to-day nursing in New Zealand general hospitals were relatively unknown.This thesis examines the experience of general hospital nursing between 1945 and 1960. The recollections of thirty-four nurses who nursed during this period have provided the key sources from which the major themes of this study have emerged. These themes, of dirty work, authoritarian control and discipline, and learning nursing are discussed within the context of an expanding hospital system and a shortage of nurses.The study demonstrates the vast differences between the recollections of nurses of the experience of nursing and the rather high-flown rhetoric of the nursing leadership.Changes to the amount of cleaning, the ;level of discipline and control, and ways in which learning nursing was organised were small and gradual and occurred in the late 1950s.Overall, though, nursing in general hospitals by 1960 ws almost unchanged from the 1930s.An ethos of selfless service, opposition to unionism, and Christian altruism was till dominant amongst the nursing leadership. Nurses in training still worked a six day week, were expected to stay on duty until the work was done, and were supervised closely in, on and off duty time

Abstract: This study investigated the degree of compliance and reasons for non-compliance with chemoprophylactic Rifampicin medication among 103 close contacts of memingococcal disease in the greater Auckland region during the period July to September 1996. The study showed a high degree of compliance among close contacts, with 96.1% taking Rifampicin as prescribed. Reasons for compliance were related to the contacts ' perceptions of susceptibility to the illness, the severity of the disease, and the benefits of medical intervention. The contacts found the service provided by the public health staff ws sufficient, and the information provided was valuable