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Author |
Bland, M.F. |
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Title |
Patient observation in nursing home research: Who was that masked woman? [corrected] [published erratum appears in Contemporary Nurse 2002 Apr; 12(2): 135] |
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Journal Article |
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Year |
2002 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
12 |
Issue |
1 |
Pages |
42-48 |
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Keywords |
Nursing research; Ethics; Rest homes; Nurse-patient relations |
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Abstract |
This article discusses the issues that one nurse researcher faced during participant observation in three New Zealand nursing homes. These include the complexity of the nurse researcher role, the blurring of role boundaries, and various ethical concerns that arose, including the difficulties of ensuring that all those who were involved in the study were kept informed as to the researcher's role and purpose. Strategies used to maintain ethical and role integrity are outlined, with further debate and discussion around fieldwork issues and experiences for nurse researchers called for. |
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Call Number |
NRSNZNO @ research @ |
Serial |
892 |
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Author |
Bland, M.F. |
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Title |
All the comforts of home? A critical ethnography of residential aged care in New Zealand |
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Year |
2004 |
Publication |
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Abbreviated Journal |
NZNO Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rest homes; Older people; Patient satisfaction |
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Abstract |
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Call Number |
NRSNZNO @ research @ 1141 |
Serial |
1126 |
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Author |
Bland, M.F. |
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Title |
The challenge of feeling 'at home' in residential aged care in New Zealand |
Type |
Journal Article |
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Year |
2005 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
21 |
Issue |
3 |
Pages |
4-12 |
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Keywords |
Rest homes; Older people; Patient satisfaction; Nursing; Identity |
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Abstract |
In this research report, a resident reveals the challenges associated with firstly becoming a nursing home resident, and then trying to establish a new sense of 'home'. The story supports a conclusion that nurses' knowledge of the unique 'admission story' of each resident, and their individual understandings of home, is essential in promoting their ongoing comfort. Although approximately 30,000 older adults live in residential aged care, little research has been done on their experience. |
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Call Number |
NRSNZNO @ research @ 862 |
Serial |
846 |
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Author |
Bland, M.F. |
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Title |
Betwixt and between: A critical ethnography of comfort in New Zealand residential aged care |
Type |
Journal Article |
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Year |
2007 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
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Volume |
16 |
Issue |
5 |
Pages |
937-944 |
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Keywords |
Geriatric nursing; Rest homes; Patient satisfaction; Quality of health care |
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Abstract |
This research sought to explore the nature of comfort within the context of three New Zealand nursing homes and examine how nursing and other actions contribute to residents' comfort. A critical ethnographic approach was used and fieldwork included 90 days of participant observation, interviews with 27 residents and 28 staff and extensive document examination. Comfort was multidimensional, idiosyncratic, dynamic and context dependent, rather than merely the absence of discomfort. This multidimensional nature meant residents could be 'betwixt and between' comfort and discomfort simultaneously. The constraints of one-size-fits-all care delivery practices and the tensions inherent in communal living compounded residents' discomfort. The findings show that individualised care, based on comprehensive and accurate nursing assessment, is fundamental to the comfort of residents. |
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Call Number |
NRSNZNO @ research @ |
Serial |
657 |
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Author |
Brown, J.A. |
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Title |
“Let my spirit always sing”: A descriptive study of how four elderly rest home residents view spirituality and spiritual care at the end of life |
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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 |
Older people; Rest homes; Spirituality; Nursing |
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Abstract |
This descriptive, qualitative study, believed to be the first of its kind conducted in a New Zealand setting, focuses on spirituality issues of a spiritually vulnerable group of people, older people in residential care. Four rest home residents were recruited, to talk about their spirituality, spiritual needs and how their spirits were nurtured, the role of care staff in providing spiritual care, and their satisfaction with the spiritual care they were being offered. They were also asked to predict their spiritual needs as they were dying, their wishes for spiritual care in the perideath period, whether they had communicated these wishes to anyone, their views on advance planning to ensure these wishes would be met, and their comfort with the research process. The research data was collected from semi-structured, audiotaped interviews that were later transcribed. The spirituality of all participants had a strongly Christian focus that was revealed in the ten themes to emerge from a modified application of Colaizzi's analysis technique. The first themes to emerge were God as the focus of spirituality, God in control, the importance of relationship, and the purpose in life: serving God. Changes in spirituality with age, spirituality and residential care, and spiritual care: whose responsibility? were also identified as themes, as were end of life spirituality, planning for spiritual care, and the participants' satisfaction with the research process. All were able to articulate their spirituality, were generally satisfied with the spiritual care they were receiving, and had views on the spiritual care they wished to receive in the perideath period. Moreover, the participants trusted their families and the care staff to ensure that these wishes would be honoured. Recommendations are made for improving the spiritual dimension of care, and for further research. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1228 |
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Author |
Dulieu, F. |
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Title |
Collaborative practice: A study in bridging the gap to transform the delivery of specialist palliative nursing care in residential aged care facilities |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rest homes; Palliative care; Older people; Nursing; Advanced nursing practice; Terminal care; Geriatric nursing |
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Abstract |
This paper documents a practice development initiative with the aim of formulating a rationale for the professional practice development of a relatively recently conceived nursing initiative; that of a Palliative Care Liaison Nurse (PCLN) role. The project involved conducting an inquiry through a search of the literature with the aim of discovering ways to articulate, then develop, the role to meet the needs of elderly people living in Residential Aged Care Facilities (RACFs), their family and the whanau. The paper initially explores the concept of liaison roles globally, to consider how this role might be located as an interagency position between palliative care and aged care within the context of Aotearoa/New Zealand. The paper then reveals the perceived skills and personal attributes required by a person in the PCLN role that the author, drawing from personal and professional experience of having been appointed to this position, considers are necessary to effectively manage the diverse dimensions of this role. Bridging the gap is a key role discussed which centres on the capacity to organise and present an effective education programme while supporting, encouraging and role modeling for staff providing the day to day nursing care. This role involves practice wisdom and advocating for change and tolerance within everyday practice. An example of this dimension is discussed in depth, because the researcher considers that through staff working together, they can effectively bridge the knowledge-practice gap which exists between specialist palliative and gerontological nursing care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
580 |
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Author |
Kiata, L.; Kerse, N.; Dixon, R. |
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Title |
Residential care workers and residents: The New Zealand story |
Type |
Journal Article |
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Year |
2005 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
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Volume |
118 |
Issue |
1214 |
Pages |
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Keywords |
Rest homes; Maori; Pacific peoples; Asian peoples; Ethnicity; Recruitment and retention |
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Abstract |
The aim of this study was to describe the nature and size of long-term residential care homes in New Zealand; funding of facilities; and the ethnic and gender composition of residents and residential care workers nationwide. A postal, fax, and email survey of all long-term residential care homes in New Zealand was undertaken, with completed surveys received from an eligible 845 facilities (response rate: 55%). The majority of these (54%) facilities housed less than 30 residents. Of the 438 (94%) facilities completing the questions about residents' ethnicity, 432 (99%) housed residents from New Zealand European (Pakeha) descent, 156 (33%) housed at least 1 Maori resident, 71 (15%) at least 1 Pacific (Islands) resident, and 61 (13%) housed at least 1 Asian resident. Facilities employed a range of ethnically diverse staff, with 66% reporting Maori staff. Less than half of all facilities employed Pacific staff (43%) and Asian staff (33%). Registered nursing staff were mainly between 46 and 60 years (47%), and healthcare assistant staff were mostly between 25 and 45 years old (52%). Wide regional variation in the ethnic make up of staff was reported. About half of all staff were reported to have moved within the previous 2 years. The authors conclude that the age and turnover of the residential care workforce suggests the industry continues to be under threat from staffing shortages. While few ethnic minority residents live in long-term care facilities, staff come from diverse backgrounds, especially in certain regions. |
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Call Number |
NRSNZNO @ research @ 545 |
Serial |
531 |
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Author |
Latta, L. |
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Title |
Exploring the impact of palliative care education for care assistants employed in residential aged care facilities in Otago, New Zealand |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Palliative care; Rest homes; Training; Older people |
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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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Call Number |
NRSNZNO @ research @ |
Serial |
812 |
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Author |
McKenzie-Green, B. |
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Title |
Shifting focus: How registered nurses in residential aged care organise their work: A grounded theory study |
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Year |
2003 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rest homes; Older people; Registered nurses; Nurse-patient relations |
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Abstract |
Registered nurses in residential aged care work with older people who have complex care needs. Besides providing direct care, these nurses have a wide range of responsibilities which include supervising staff and attending to the smooth running of the care facility. This grounded theory study using dimensional analysis was aimed at answering the question: How do registered nurses organise their work? Indepth interviews were conducted with 10 registered nurses who worked in a range of positions in aged care facilities. Theoretical sampling and constant comparative analysis was used to guide both ongoing data collectiona and data analysis. Categories were examined for their relationships and dimensions to arrive at a substantive grounded theory which the author has named 'shifting focus'. Individual and institutional philosophies of care were core elements in the registered nurses' focus of work. There was a relationship between staffing adequacy, individual and institutional philosophies of care, and the focus of registered nurse work. These relationships created conditions where the registered nurse would focus on ensuring the delivery of individualised resident care or focus on getting through the routine of care. The relationship between staffing adequacy, philosophies of care and the registered nurses' focus of work remained consistent when staffing adequacy changed. In instances of decreased staffing adequacy, the participants' focus shifted to either maintaining individualised care or focusing on safety. When the registered nurse aimed to change the philosophy of care, an increase in staffing adequacy enabled some aspects of cultural change to commence. The relationships between residents, family and staff were significant contrasting elements within an individualised philosophy of care, and an institutional philosophy of care. In the former, relationships were valued and developed. In the latter, they were benevolent, functional or conflicted. The significance of this study is that it reveals how registered nurses and management personnel in aged care facilities, can create conditions where the relationships between residents, their families and staff, are valued and developed to result in positive care outcomes. It is recommended that future research be conducted to examine the resources required to maintain an individualised approach to the nursing care of residents in aged care facilities. |
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Call Number |
NRSNZNO @ research @ 912 |
Serial |
896 |
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Author |
Meldrum, L.B.B. |
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Title |
Navigating the final journey: Dying in residential aged care in Aotearoa New Zealand |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Palliative care; Older people; Rest homes |
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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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Call Number |
NRSNZNO @ research @ |
Serial |
683 |
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Author |
Peri, K.; Kerse, N.; Kiata, L.; Wilkinson, T.; Robinson, E.; Parsons, J.; Willingale, J.; Parsons, M.; Brown, P.; Pearson, J.R.; von Randow, M.; Arroll, B. |
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Title |
Promoting independence in residential care: Successful recruitment for a randomized controlled trial |
Type |
Journal Article |
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Year |
2008 |
Publication |
Journal of the American Medical Directors Association |
Abbreviated Journal |
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Volume |
9 |
Issue |
4 |
Pages |
251-256 |
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Keywords |
Research; Geriatric nursing; Rest homes; Evaluation; Attitude of health personnel |
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Abstract |
The aim of this study was to describe the recruitment strategy and association between facility and staff characteristics and success of resident recruitment for the Promoting Independence in Residential Care (PIRC) trial. A global impression of staff willingness to facilitate research was gauged by research nurses, facility characteristics were measured by staff interview. Forty-one (85%) facilities and 682 (83%) residents participated, median age was 85 years (range 65-101), and 74% were women. Participants had complex health problems. Recruitment rates were associated (but did not increase linearly) with the perceived willingness of staff, and were not associated with facility size. Design effects from the cluster recruitment differed according to outcome. The recruitment strategy was successful in recruiting a large sample of people with complex comorbidities and high levels of functional disability despite perceptions of staff reluctance. Staff willingness was related to recruitment success. |
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Call Number |
NRSNZNO @ research @ 803 |
Serial |
787 |
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Author |
Rodgers, V.; Neville, S.J. |
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Title |
Personal autonomy for older people living in residential care: An overview |
Type |
Journal Article |
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Year |
2007 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
23 |
Issue |
1 |
Pages |
29-36 |
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Keywords |
Geriatric nursing; Older people; Rest homes |
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Abstract |
This article looks at the concept of autonomy particularly in relation to the population of older persons living in residential care settings. It examines the values underpinning the exercise of personal autonomy and notes how individual autonomy may be enhanced or restricted. The implications for gerontological nursing practice are outlined and suggestions offered as to how personal autonomy for older persons living in residential care may be preserved and promoted. |
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Call Number |
NRSNZNO @ research @ 529 |
Serial |
515 |
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Author |
Whitehead, N. |
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Title |
Quality and staffing: Is there a relationship in aged residential care |
Type |
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Year |
2007 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rest homes; Patient safety; Older people; Nursing specialties |
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Abstract |
This thesis reports a mixed methods study, longitudinal in nature, of consenting Age Related Residential Care (ARRC) hospitals in the upper half of the North Island, which was conducted to examine several factors, including AARC hospital efficiency at producing adverse event free days for residents. An interpretativist approach examined what best practice strategies were implemented by the ARRC hospitals that were identified to be most successful at producing adverse event free days for the residents. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1159 |
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