Abstract: This phenomenological study describes what it is like to live with a schizophrenic illness and relates the understanding gained from this description to implications for nursing practice. The participants in the study were ten adults who have been diagnosed with schizophrenia, who take regular medication and who are living independant lives in the community. Over a period of sixteen months they were interviewed about effects of the illness on their everyday lives. During this time they explained the challenges and difficulties which have faced them, both during and long after the resolution of acute illness. As they describe it schizophrenia is a part of who they are.The narrative contained in this thesis presents the participants' stories in aggregated form, setting their experiences alongside ideas from the early work of Martin Heidegger, whose phenomenological writing informed the analysis and interpretation of the data. As the participants explain, schizophrenia has touched every aspect of their lives. Living with schizophrenia is shown to affect their whole being-in-the-world. It incorporates Being-with-others, living carefully and taking a stand on life. While hoping for a cure, their reality is of living with a chroinic ilness which has major effects on their lives. At the same time the participants are shown to define themselves not in terms of their illness and treatment, but in respect of their hopes and dreams and the stance each is taking on his or her own life. In this way their existential predicament is highlighted in the study. Participants are on the one hand very much like all people, while on the other hand they have to contend with very different concerns than do most others.

Abstract: Nursing students have only recently learnt in-depth physical assessment skills within degree programmes in New Zealand. The purpose of this qualitative study was to describe the experience of learning physical assessment skills for the first time from the student's experience. In exploring this experience it was hoped to uncover some of the factors, beneficial or not, which influence their learning process. Data was collected by two methods. Firstly through two non-participant observations of a class of sixteen pre-registration male and female nursing students at an urban tertiary institute. Secondly through taped in-depth interviews with a female and a male student, from the group, individually and then together. The data was analysed using coding categories suggested by Bogdan and Biklen (1992) and emerging themes related to the process of learning new knowledge and skills. The four themes identified were: students working at learning, tutors facilitating learning, students facilitating learning and learning in clinical practice

Abstract: Rheumatoid arthritis is a chronic, systemic inflammatory disease of the connective tissues. People with rheumatoid arthritis often experience chronic pain, chronic fatigue and functional impairment for a large apart of their lives. The cause of rheumatoid arthritis is unknown, with three times more women than men being affected. There are many women who live with rheumatoid arthritis throughout much of their adult lives. Women with rheumatoid arthritis face the challenges and stresses of parenting, partnerships, and employment along with the need to cope with a chronic and increasingly debilitating disease.A review of the literature related to rheumatoid arthritis reveals a dearth of qualitative research, with few studies that focus specifically on women even though they constitute a significant percentage of the client group. Little is known from the clients' perspective of what it is like to live with chronic rheumatoid arthritis. This study, a single-participant case study using a phenomenological analysis, explores one woman's' reality of living with rheumatoid arthritis. As this woman's story unfolds, it is revealed how daily living with rheumatoid arthritis had been incorporated into a new way of being-in-the world. Her way of being-in-the-world is such that rheumatoid arthritis is very much a reality, impacting on most aspects of her life. Yet it does not dominate, as she continues with a very full and active life despite this disease

Abstract: This report addresses the issue of computer literacy and its position in current nursing practice and nursing education.Two groups of nursing students in a three year Polytechnic provided programme were surveyed by questionnaire to gain information about their current computer usage. The first questionnaire was given to first year students at the end of the 1994 academic year. A basic self-paced word processing package was developed from the information. Following the teaching of the package to 1995 year students a questionnaire was given to this second group to gain information about the teaching programme and their intended computer use.A greater number of younger students were computer literate on course entry compared with mature students and personal computers were accessible to about 40% of students. Following completion of the computer package computers were being used by 8154 of the group for course work. Compared to approximately 44% of the previous (1994) group. It was concluded that the self paced package was a successful method of teaching basic computer literacy for the majority of students. However computer usage within the educational institution was affected by access to computers and the availability of computers and support personnel at times suitable for the student group. The findings had implications for the future planning of teaching progrrammes, computer access, and staffing for the Polytechnic, and recommendations addressed these issues

Abstract: Fatal illness is often short. Communication between patient and family is impaired and how to best meet family needs is unclear. We began a follow-up service to determine current next-of-kins outcomes and remedy service deficiencies. A critical care nurse identified deaths from our data base and completed a structured telephone interview with the next-of-kin. There were 374 admissions from 1/1/95 – 17/5/95, 55 died. Next- of-kin of 52 patients (M29, age 19-88 median 52) were contactable 16-70 (median 33)days later. All (defacto/wives 18, husbands 9, mothers 9, daughters 8, others 8) consented to interview (5 -80, median 15 minutes). Forty-nine had resumed normal home activities and 23/25 workers had returned to work. Thirty-three still had disturbed sleep, three were taking hypnotics. Twenty-four had had contact with their general practitioner because of the death (six were prescribed sedatives or hypnotics). Nineteen had financial problems. Forty-seven described DCCM care positively, 35 specifically (nursing care and compassion 15, communication 8, flexible visitors policy8) but 13 had particular difficulties (communication 4 , waiting 2, facilities 4) and 4 serious non-DCCM issues. Forty-six considered themselves well informed and understood well the sequence of events. Forty-eight identified family and friends as primary support. Three requested information about another agency (counseling), 9 asked us to contact as further relative. A telephone bereavement service is well received by next-of-kin. Most families members resolve their early grief without external agencies but sleep and money are problems. We have improved our facilities and are addressing communication and cultural issues

Abstract: The extent of early remediable morbidity after critical illness is unclear. We began a follow-up service to determine outcomes, facilitate rehabilitation and remedy service deficiencies. A critical care nurse identified hospital survivors (DCCM and hospital databases), completed a structured telephone interview with the patient and intervened according to predetermined guidelines. Of 261 admission 1/1/95 29/3/95 50 died in hospital (39in DCCM). Of 211 hospital survivors (M115, age 15-84 median40) 31 could not be contacted, one died at home and 179 contacts were made 21- 120 (median 51) days after DCCM. One refused interview, 178 interviews took 8-60, (median 15) minutes. Only 68/178 had resumed normal activities and 26/78 workers had returned to work. Seventy patients had contacted general practitioners because of critical illness sequelae. One hundred patients gad 191 problems (including unhealed wounds29, pain 28, impaired mobility26, neurological deficit 178, infection 10 weight loss 9, tiredness 6 depression 5, sleep disturbance 3, others 57). Sixty-five described DCCM staff as helpful, 37 had complaints (hallucinations 6, staff behaviour5, restraints5 sedation/analgesia inadequate5 or excessive 2, poor communication3, fear3, noise 2 other 4) and 5 raised serious non-DCCM issues. Forty-four patients were called again 6-84, median 42 days later when 69/112 health problems had resolved but 29/44 patients had not resumed normal activity. Four attended a clinic and were referred to other services. A follow-up service is well received. Morbidity is common but improves within three months after critical care. We are addressing service issues