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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., Connor, M., Eathorne, T., Laws, M., McCombie, M. - L., & Smith, S. (1994). Family nurse practice in a nurse management scheme: a pilot service study for the health reforms. Ph.D. thesis, , .
Abstract: The independently funded 10 month pilot project demonstrated the autonomy of nursing practice for a new role family nurse. The findings were presented as the health experience of families in strife with complex health circumstances, a description of a beginning model for the nursing practice that addressed the needs of these families as their circumstances changed over time, and its cost-effectiveness. A caseload of nineteen families was found to be optimum. The evaluation research continued throughout as a form of praxis expressed as health patterning, a methodology developed in previous research (Litchfield, 1993). The family nurse'spractice demonstrated qualities common to all nurses: the caring relationship and fiscal responsibility. The unique practice was characterised by a professional partnership of limited duration: the families referred to the service in a predicament of strife, trapped in the immediate present, gained a view to a future, moved towards assuming control over health circumstances, seeking and using services with discernment, and increasing community as family/group members and citizens. Cost containment was achieved through: a) development of a co-operative approach amongst family members, between families and professionals, and amongst all health workers, and b) the families discerning use of services by anticipating a future. Through one family case, cost of saving over the 7 months with the family nurse was estimated as $4000, a possible saving of $16000 over 13 months if the family nurse had been involved earlier, and projected savings in the long term of over a million dollars. The satisfaction of clients, nurses and professionals was shown. The service was positioned within the new health system of health reforms
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Henderson, A. P. (1994). Nursing a colonial hangover: towards bicultural planning in New Zealand. Ph.D. thesis, , .
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Fleming, V. E. M. (1994). Partnership, power and politics: feminist perceptions of midwifery practice. Ph.D. thesis, Author, Palmerston North.
Abstract: Provides an interpretative critique of the partnership of a group of independent midwives and their clients in urban NZ. Uses a theoretical basis grounded in the principles of feminism, incorporating aspects of critical social science and post-modernism, to underpin both the methodological approach and the data analysis. Utilises the concepts of subjectivity, power/knowledge and praxis as tools for analysis of data which is collected through semi-structured interviews.
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Jones, S. (1994). Career transition : from professional to manager in the health service. Master's thesis, , .
Abstract: A thesis submitted in partial fulfilment of the requirements for Master of Philosophy in Management Studies and Labour Relations, University of Auckland.
The study addresses the question of career transition from a professional role to a management role within the health service – what changes and adjustments in role content (or tasks), relationships and identity are experienced? What skills, perspectives and values are brought forward from the old role to the new role, and which must be abandoned to accommodate a new identity?
Answers to these questions hold relevance for those planning management development and management recruitment in the health service, and also for those planning career development for health professionals.
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Wagener, S. (1994). The nursing management of the acutely ill child in communities without readily available specialist paediatric services. Margaret May Blackwell Travel Study Fellowship Reports. Northland, N.Z.: Nursing Education and Research Foundation (NERF).
Abstract: Observes how acutely ill children in remote areas of Australia are managed in the absence of specialist paediatric nursing services. Visits remote nursing stations, rural hospitals, and the Royal Flying Doctor Service. Part of the Margaret May Blackwell Scholarship Reports series.
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van Wissen, K. A., & Woodman, K. (1994). Nurses' attitudes and concerns to HIV/AIDS: a focus group approach. Journal of Advanced Nursing, 20(6), 1141–1147.
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
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Bland, M. F. (1994). Challenging the myths: the lived experience of chronic leg ulcers (Vol. 2). Ph.D. thesis, , .
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
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Litchfield, M. (1994). Viewpoint: Telling nursing stories. Kai Tiaki: Nursing New Zealand, 2(4), 28.
Abstract: A brief critique and comment on the ethical implications of nurse researchers using methodology that involves soliciting personal experiences of patients and subsequently publishing them as stories.
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Wheeler, C. (1994). The diagnosis of schizophrenia and its impact on the primary caregiver. Nursing Praxis in New Zealand, 9(3), 15–23.
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Stevenson, A. F. (1994). In search of New Zealand nursing history: a literature review. Ph.D. thesis, , .
Abstract: This paper examines some of the contributions to nursing history up to 1993, and also surveys published social and women's history in New Zealand for references to nursing work
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