Litchfield, M., & Jonsdottir, H. (2008). A practice discipline that's here and now. Advances in Nursing Science, 31(1), 79–92.
Abstract: The article is a collaborative writing venture drawing on research findings from New Zealand and Iceland to contribute to the international scholarship on the status and future direction of the nursing discipline. It takes an overview of the international historical trends in nursing knowledge development and proposes a framework for contemporary nursing research that accommodates the past efforts and paradigms of nurse scholars and reflects the changing thinking around the humanness of the health circumstance as the focus of the nursing discipline. It addresses contemporary challenges facing nurses as practitioners and researchers for advancement of practice and delivery of health services, and for influencing health policy.
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Litchfield, M., & Laws, M. (1999). Achieving family health and cost-containment outcomes: Innovation in the New Zealand Health Sector Reforms. In Cohen,E. & De Back,V. (Eds.), The outcomes mandate: New roles, rules and relationships. Case management in health care today (pp. 306-316). St Louis: Mosby.
Abstract: The chapter presents the research findings of the 1992-1993 Wellington Nurse Case Management Scheme Project as a distinct model of nurse case management, which introduced a role and form of practice of a family nurse and a diagram of the service delivery structure required for support and relevant for the New Zealand health system reforms.
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Litchfield, M., & McCombie, M. - L. (1994). The introduction of an advanced nurse practitioner role in mental health: report of the evaluation research undertaken for the Mental Health Service of Capital Coast Health Ltd. Ph.D. thesis, , .
Abstract: The study was commissioned to define the role of Advanced Nurses Practitioner to inform the establishment of a clinical career pathway. Four new, loosely defined ANP positions were created and the role evolution over three months was described. The impact on the multidisciplinary team functioning was to be given particular attention. The research design was developed in collaboration with the ANP Project Team of the service. Data were derived from surveys of nurses in the units and other staff before and at the end of the 3 months period; interviews with the ANPs and official client advocates; daily journals and weekly logs kept by the ANPs; statistical records of patient loads and staffing. The findings presented the role as the interface of unit management and direct client care, with the ANPs orchestrating the activities of the unit. The ANPs developed the role differently according to quite distinct conceptualisations of nursing which influenced whether direct client care was pivotal or peripheral to the role. This had an effect on whether the strains of the service were seen as inhibitory of focal to the development of the ANP practice. There was little change in unit staff satisfaction. Attempts to incorporate client advocacy to determine change in client satisfaction were unsuccessful. The ANPs used the research as a process of role development
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Litchfield, M., & Noroian, E. (1989). Changes in selected pulmonary functions in patients diagnosed with myasthenia gravis. Journal of Neuroscience – Nursing, 21(6), 375–381.
Abstract: Patients with myisthenia gravis (MG) face major pulmary problems as a part of the disease process. In this descriptive study, changes in selected pulmonary functions (respiratory rate, negative inspiratory force, tidal volume and forced total capacity) in 14 patients diagnosed with mild or moderate MG were measured every two hours from 8.00 a.m. to 8.00 p.m. Females comprised 64% of the sample while 36% were males. All subjects received anticholnesterase medication, and some subjects received additional treatment modalities. Most of the subjects were non-smokers or previous smokers, but two subjects continued to smoke. Ninety-three recent of the sample had forced vital capacities less than 60% of their predicted values. Myasthenic forced vital capacities were significantly lower (p=.0000) than those predicted for normal subjects. The inspiratory force for the sample was low sat 8:00 a.m. as well as in females over 55 years of age. There was a wide variation in total volume to normal values derived from random tables and predicted equations ws not significant. Th major implications from this study are the need to assess pulmonary function in the hospitalized myasthenic every two hours, and the need for a program of coughing, deep breathing and sighing after medication administration when the muscles are strongest
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Litchfield, M., & Ross, J. (2000). The role of rural nurses: National survey. Christchurch: Centre for Rural Health.
Abstract: A survey was used to reach as many nurses as possible involved with nursing in “rural” areas throughout New Zealand and to build a profile of nurses involved in the provision of healthcare beyond the urban centres. The contact also sought to inform nurses of the rural healthcare project and encourage them to contribute their experience to the development of health services in the new health service structure. Data is presented on the characteristics and employment conditions of nurses and access to resources including information technology. The inadequacy of information on the rural nurse workforce is identified: nurse roles are historically defined yet employment patterns are changing according to the workforce demands of new structures, and the existing definitions of rural health service design and delivery are only in terms of general medical practices and on-call coverage. Recommendations are made for definitions of “rurality” and “rural nurse” that will allow a more useful depiction of the nurse workforce.
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van Wissen, K. A., Litchfield, M., & Maling, T. (1998). Living with high blood pressure. Journal of Advanced Nursing, 27(3), 567–574.
Abstract: An interdisciplinary (nursing-medicine) collaboration in a qualitative descriptive research project undertaken in the Wellington School of Medicine with New Zealand Health Research Council funding. The purpose was to inform the practice of nursing and medical practitioners. A group of patients were interviewed in their homes. Their experience of having a diagnosis of hypertension and prescription of long-term treatment requiring adjustment in their lives and the lives of their families is presented as themes.
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