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Author Hardy, D.J.; O'Brien, A.P.; Gaskin, C.J.; O'Brien, A.J.; Morrison-Ngatai, E.; Skews, G.; Ryan, T.; McNulty, N.
Title Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand Type Journal Article
Year 2004 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 46 Issue 1 Pages 95-109
Keywords Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori
Abstract The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements.
Call Number (up) NRSNZNO @ research @ Serial 1060
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Author Carter, H.; MacLeod, R.; Brander, P.; McPherson, K.
Title Living with a terminal illness: Patients' priorities Type Journal Article
Year 2004 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 45 Issue 6 Pages 611-620
Keywords Terminal care; Quality of life; Nursing models; Cancer
Abstract The aim of this paper is to report on an exploratory, qualitative study exploring what people living with terminal illness considered were the areas of priority in their lives. Ten people living with terminal cancer were interviewed. Analysis of the interviews incorporated principles of narrative analysis and grounded theory. Over 30 categories were identified and collated into five inter-related themes (personal/intrinsic factors, external/extrinsic factors, future issues, perceptions of normality and taking charge) encompassing the issues of importance to all participants. Each theme focused on 'life and living' in relation to life as it was or would be without illness. Practical issues of daily living and the opportunity to address philosophical issues around the meaning of life emerged as important areas. The central theme, 'taking charge', concerned with people's levels of life engagement, was integrally connected to all other themes. The findings suggest that the way in which health professionals manage patients' involvement in matters such as symptom relief can impact on existential areas of concern. The findings challenge some aspects of traditional 'expert-defined' outcome measures. As this was an exploratory study, further work is needed to test and develop the model presented.
Call Number (up) NRSNZNO @ research @ Serial 1061
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Author Crowe, M.; Carlyle, D.
Title Deconstructing risk assessment and management in mental health nursing Type Journal Article
Year 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 43 Issue 1 Pages 19-27
Keywords Psychiatric Nursing; Risk management; Policy; Culture
Abstract The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.
Call Number (up) NRSNZNO @ research @ Serial 1069
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Author Polaschek, N.
Title Living on dialysis: Concerns of clients in a renal setting Type Journal Article
Year 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 41 Issue 1 Pages 44-52
Keywords Nurse-patient relations; Psychology; Attitude to health; Terminal care
Abstract This article reports a study that sought to understand the experience of a group of Caucasian men with end stage renal failure managing their own haemodialysis therapy in their homes. The study used a critical interpretive methodology. The renal setting was critically viewed as a specialised health care context constituted by several interrelated discourses. Although established by the dominant professional discourse, it also includes a number of others, in particular an obscure client discourse that is a response to the dominant discourse. Initially, participants' own interpretations of their individual experiences were outlined. These were then collectively reinterpreted by contextualising them in terms of the critical view of the renal setting, in order to discern their own views as renal clients that were obscured by the language and ideas of the dominant discourse with which they had been enculturated. From an analysis of the set of accounts derived from interviews with six participants, four concerns of the renal client discourse were identified. These concerns were: (1) suffering from continuing symptoms of end stage renal failure and dialysis; (2) limitations resulting from negotiating dialysis into their lifestyle; (3) ongoingness and uncertainty of life on dialysis; and (4) altered relationship between autonomy and dependence inherent in living on dialysis. One specific implication of this study is that the distinctive potential of the nursing role in renal settings lies beyond the performance of a range of technical tasks, in addressing the experience of people living on dialysis, described here as the concerns of the renal client discourse.
Call Number (up) NRSNZNO @ research @ Serial 1072
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Author Wilson, H.V.
Title Power and partnership: A critical analysis of the surveillance discourses of child health nurses Type Journal Article
Year 2001 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 36 Issue 2 Pages 294-301
Keywords Paediatric nursing; Nurse-family relations; Nursing philosophy; Plunket
Abstract The aim of this research was to explore surveillance discourses within New Zealand child health nursing and to identify whether surveillance practices have implications in this context for power relations. Five experienced and practising Plunket nurses were each interviewed twice. The texts generated by these semi-structured interviews were analysed using a Foucauldian approach to critical discourse analysis. In contrast with the conventional view of power as held and wielded by one party, this study revealed that, in the Plunket nursing context, power is exercised in various and unexpected ways. Although the relationship between the mother and the nurse cannot be said to operate as a partnership, it is constituted in the nurses' discourses as a dynamic relationship in which the mother is actively engaged on her own terms. The effect of this is that it is presented by the nurses as a precarious relationship that has significant implications for the success of their work.
Call Number (up) NRSNZNO @ research @ Serial 1085
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Author Crowe, M.; O'Malley, J.; Gordon, S.
Title Meeting the needs of consumers in the community: A working partnership in mental health in New Zealand Type Journal Article
Year 2001 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 35 Issue 1 Pages 88-96
Keywords Community health nursing; Psychiatric Nursing; Patient satisfaction; Mental health
Abstract The aim of this study was to evaluate whether the services that community mental health nurses provide are meeting the needs of consumers in the community. This was a joint project between nurses and consumers. It was a service-specific descriptive research project utilising qualitative methods of data collection and analysis that provides a model for working in partnership. The results of this research identify collaboration in planning care and sharing information as two areas of concern but generally the consumers were very satisfied with the care provided by community mental health nurses. The analysis of the data suggests that consumers value nursing care because nurses provide support in their own home; they help consumers develop strategies for coping with their illness and their life; they provide practical assistance when it is required; they are vigilant about any deterioration or improvement; and they are available and accessible. The results of this study have demonstrated that nurses will remain critical to the success of community-based care because of their ability and willingness to be flexible to the demands of their own organisation and the users of services.
Call Number (up) NRSNZNO @ research @ Serial 1087
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Author Kinealy, T.; Arroll, B.; Kenealy, H.; Docherty, B.; Scott, D.; Scragg, R.; Simmons, D.
Title Diabetes care: Practice nurse roles, attitudes and concerns Type Journal Article
Year 2004 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 48 Issue 11 Pages 68-75
Keywords Diabetes Type 2; Practice nurses; Attitude of health personnel; Primary health care
Abstract The aim of this paper is to report a study to compare the diabetes-related work roles, training and attitudes of practice nurses in New Zealand surveyed in 1990 and 1999, to consider whether barriers to practice nurse diabetes care changed through that decade, and whether ongoing barriers will be addressed by current changes in primary care. Questionnaires were mailed to all 146 practice nurses in South Auckland in 1990 and to all 180 in 1999, asking about personal and practice descriptions, practice organisation, time spent with patients with diabetes, screening practices, components of care undertaken by practice nurses, difficulties and barriers to good practice, training in diabetes and need for further education. The 1999 questionnaire also asked about nurse prescribing and influence on patient quality of life. More nurses surveyed in 1999 had post-registration diabetes training than those in 1990, although most of those surveyed in both years wanted further training. In 1999, nurses looked after more patients with diabetes, without spending more time on diabetes care than nurses in 1990. Nevertheless, they reported increased involvement in the more complex areas of diabetes care. Respondents in 1999 were no more likely than those in 1990 to adjust treatment, and gave a full range of opinion for and against proposals to allow nurse prescribing. The relatively low response rate to the 1990 survey may lead to an underestimate of changes between 1990 and 1999. Developments in New Zealand primary care are likely to increase the role of primary health care nurses in diabetes. Research and evaluation is required to ascertain whether this increasing role translates into improved outcomes for patients.
Call Number (up) NRSNZNO @ research @ Serial 1100
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Author Polaschek, N.
Title Negotiated care: A model for nursing work in the renal setting Type Journal Article
Year 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 42 Issue 4 Pages 355-363
Keywords Chronically ill; Nursing models; Nurse-patient relations; Communication
Abstract This article outlines a model for the nursing role in the chronic health care context of renal replacement therapy. Materials from several streams of literature are used to conceptualise the potential for nursing work in the renal setting as negotiated care. In order to present the role of the renal nurse in this way it is contextualised by viewing the renal setting as a specialised social context constituted by a dominant professional discourse and a contrasting client discourse. While performing specific therapeutic activities in accord with the dominant discourse, renal nurses can develop a relationship with the person living on dialysis, based on responsiveness to their subjective experience reflecting the renal client discourse. In contrast to the language of noncompliance prevalent in the renal setting, nurses can, through their relationship with renal clients, facilitate their attempts to negotiate the requirements of the therapeutic regime into their own personal life situation. Nurses can mediate between the dominant and client discourses for the person living on dialysis. Care describes the quality that nurses actively seek to create in their relationships with clients, through negotiation, in order to support them to live as fully as possible while using renal replacement therapy. The author concludes that within chronic health care contexts, shaped by the acute curative paradigm of biomedicine, the model of nursing work as negotiated care has the potential to humanise contemporary medical technologies by responding to clients' experiences of illness and therapy.
Call Number (up) NRSNZNO @ research @ Serial 1186
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Author Neville, S.J.; Henderson, H.M.
Title Perceptions of lesbian, gay and bisexual people of primary healthcare services Type Journal Article
Year 2006 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 55 Issue 4 Pages 407-415
Keywords Sexuality; Attitude of health personnel; Primary health care
Abstract This paper reports a study exploring people's perceptions of disclosure about lesbian, gay and bisexual identity to their primary healthcare providers. Disclosure of sexual identity to healthcare professionals is integral to attending to the health needs of lesbian, gay and bisexual populations, as non-disclosure has been shown to have a negative impact on the health of these people. From April to July 2004, a national survey of lesbian, gay and bisexual persons was carried out in New Zealand. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues, and 2269 people completed the questionnaire, either electronically or via hard copy. The 133-item instrument included a range of closed-response questions in a variety of domains of interest. In this paper, we report results from the health and well-being domain. More women than men identified that the practitioner's attitude toward their non-heterosexual identity was important when choosing a primary healthcare provider. Statistically significantly more women than men reported that their healthcare provider usually or always presumed that they were heterosexual and in addition more women had disclosed their sexual identity to their healthcare provider. The authors advise that nurses reconsider their approach to all users of healthcare services by not assuming everyone is heterosexual, integrating questions about sexual identity into health interviews and ensuring that all other aspects of the assessment process are appropriate and safe for lesbian, gay and bisexual people.
Call Number (up) NRSNZNO @ research @ 1059 Serial 1043
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Author Madjar, D.I.
Title The experience of pain in surgical patients – a cross cultural study Type
Year 1981 Publication Australian Journal of Advanced Nursing Abbreviated Journal Massey University Library
Volume 2 Issue 2 Pages 29-33
Keywords
Abstract A study of 33 adult patients – 20 Anglo – Australian, 13 Yugoslav- who were admitted for arranged abdominal surgery to three Australian hospitals between January and June 1980. Focusing on the role of cultural factors in the experience of post operative pain the study confirmed the existence of some behavioral differences between Anglo – Australian and Yugoslav patients in terms of their responses to pain. The greatest degree of difference between the two groups however was found in their underlying attitudes to pain
Call Number (up) NRSNZNO @ research @ 112 Serial 112
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Author Jonsdottir, H.; Litchfield, M.; Pharris, M.
Title The relational core of nursing practice as partnership Type Journal Article
Year Publication Journal of Advanced Nursing Abbreviated Journal
Volume 47 Issue 3 Pages 241-250
Keywords Nurse-patient relations; Nursing philosophy; Nursing research
Abstract This article elaborates the meaning of partnership in practice for nurses practising in different and complementary way to nurses in specialist roles and medical practitioners. It positions partnership as the relational core of nursing practice. Partnership is presented as an evolving dialogue between nurse and patient, which is characterised by open, caring, mutually responsive and non-directive approaches. This partnership occurs within a health system that is dominated by technologically-driven, prescriptive, and outcome-oriented approaches. It is the second of a series of articles written as a partnership between nurse scholars from Iceland, NZ and USA.
Call Number (up) NRSNZNO @ research @ 1188 Serial 1173
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Author Butler, A.M.
Title Towards a staffing formula: a staffing system for general and obstetric wards Type Journal Article
Year 1980 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 73 Issue 3 Pages 8-10
Keywords
Abstract A system of staffing is described which can be used to distribute existing staff equitably throughout wards according to patient numbers and the degree of patient/ nurse dependency
Call Number (up) NRSNZNO @ research @ 137 Serial 137
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Author Butler, A.M.
Title Towards a staffing formula: home visit rating scales for community health nurses Type
Year 1980 Publication Journal of Advanced Nursing Abbreviated Journal Auckland Hospital
Volume 73 Issue 9 Pages 9-14
Keywords
Abstract Reports the development of a set of Rating scales which can be used to measure the Home visiting part of the workload of Community Health Nurses. The scales provide a useful tool for the equitable distribution of Home visits among existing staff and can assist in the assessment of the total workload of the Community Health Nurses
Call Number (up) NRSNZNO @ research @ 138 Serial 138
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Author van Wissen, K.A.; Woodman, K.
Title Nurses' attitudes and concerns to HIV/AIDS: a focus group approach Type Journal Article
Year 1994 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 20 Issue 6 Pages 1141-1147
Keywords
Abstract An exploratory qualitative study was investigated to further identify nurses'' attitudes to the care of people with human immunodeficiency virus (HIV) and acquired immunodefiency syndrome (AIDS). This follows as a sequel to a study using questionnaire. Data collected from nine focus groups attended by a total of 29 nurses at a hospital within a new Zealand regional health authority. The principal findings suggest that nurses' attitudes to this patient group are varied and depend on social influences, personal experiences and the extent of knowledge regarding HIV/AIDS. Other concerns raised included nurses' rights to choose to care for HIV-positive patients and the issue of universal precautions. Theses findings may have implications for further educational initiatives and information of hospital policy
Call Number (up) NRSNZNO @ research @ 356 Serial 356
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Author Horsburgh, M.
Title Graduate nurses' adjustment to initial employment Type
Year 1987 Publication Journal of Advanced Nursing Abbreviated Journal University of Auckland, Auckland Institute of Te
Volume 14 Issue Pages 610-617
Keywords
Abstract An ethnographic study which attempts to understand what initial employment means to graduates from a comprehensive nursing course. The researcher participated in the first 3-4 months of the nurses' employment in general hospital settings. Five major themes emerge from the study indicating that the rhetoric practice of the school of nursing is different from the rhetoric and practice within general hospital settings. The reality of initial employment for the new graduated conflicts with the values and ideals of nursing promulgated by the comprehensive nursing course. The educational program stressed patient centred nursing, where nurses accepted responsibility for the continuing care of individuals. In contrast the hospital settings stress nursing as management of tasks across different patients. This conflict was a major source of frustration for the 'beginning' nurses. Ultimately they accept the reality of nursing as the management of tasks, but not without some personal cost. Orientation programs and the early employment period focus on 'fitting in to the system'. A significant determinant of the practice of new graduates are context effects such the time of their shift and the availability of experienced nurses. A number of management practices foster and maintain a beginning level of practice and new graduates have no opportunity to practice as autonomous nurses within a multi disciplinary health care team. Beginning practice is identified in new graduates through their difficulties in coping with unplanned or unexpected events. The initial employment period is dominated by shift work, resulting tiredness and adjustment to social activities.It is argued that management practices which support the ideals of comprehensive nursing courses and totally qualified nursing workforce have yet to occur. There are implications in this study for nursing education and nursing practice
Call Number (up) NRSNZNO @ research @ 59 Serial 59
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