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Cowan, L. M. (1999). Alcohol and drug treatment for women: clinicians beliefs and practice. Ph.D. thesis, , .
Abstract: The aim of this study is to investigate whether clinicians consider women have different needs to men. To identify what specific treatment clinicians provided for women with alcohol and drug problems and ascertain whether various clinician variable, are elated to differences in beliefs and treatment provision.The questionnaire items for this study were included in the National Centre for Treatment Development (Alcohol, Drug & Addiction) New Zealand wide telephone survey of alcohol and drug clinicians. Independent interviewers surveyed 217 clinicians. Clinicians were first asked whether they believed women with alcohol and drug problems have differing treatment needs to men. Clinicians responses were compared with various clinician Socio-demographic characteristics (gender, age, ethnicity, professional group, years working in the alcohol and drug treatment field, work setting, qualifications/courses attended, location, and personal alcohol use).Key findings are that almost a quarter (24%) of the clinicians surveyed did not believe that women have different treatment needs to men. However the majority (76%) of clinicians do believe that women have different treatment needs to men. Furthermore findings from this study suggest that significant differences exist in relation to clinicians' practice in new Zealand in relation to clinician, gender, work setting (Crown Health Enterprise, outpatient and residential), and gender mix of caseload
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Tilah, M. S. W. (1999). Well child care services in New Zealand: an investigation into the provision and receipt of well child services in a Hawkes Bay sample. Ph.D. thesis, , .
Abstract: Maternal child care in New Zealand has traditionally been given by a variety of providers from the private and public sector. The reorganisation of the health services has effected all forms of health delivery including maternal and well child care or well child care services. Contracting of services in a competitive environment has been an important feature of the reorganisation process. Ashton (1995) notes that the system of contracting has facilitated the introduction of new approaches to health from new provider groups, which are not necessarily based on primary health care principles. This has led to confusion for providers and consumers alike. In 1996 a new national schedule which described the services recommended for maternal and child care was introduced called WellChild/Tamariki Ora. A questionnaire based on this schedule was administered to a sample of 125 parents of children under five years of age in Hawkes Bay to investigate issues relating to the provision and receipt of well care services.Descriptive data showed that the major providers in the present study were doctors. There were significant differences found in the number of services received by the less educated, the unemployed, single parent families, and Maori and Pacific Island people.Perceptions about the helpfulness of services received were not related to ratings of the child's health. Parents who received a greater number of Family/Whanau support services rated their children's health more highly. Findings are discussed in relation to the previous literature and recommendations are presented with particular emphasis on the implications for nursing and the role of nurses in providing well child care services
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Orchard, S. H. (1999). Characteristics of the clinical education role as percieved by registered nurses working in the practice setting. Ph.D. thesis, , .
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Sylvester, M. R. (1999). First antenatal visit: meeting now for the future: a grounded theory study of the meeting between the independent midwife and the pregnant woman. Ph.D. thesis, , .
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Brown, E. F. (1999). Work-related back pain among nurses: nurses perceptions of the causative factors. Ph.D. thesis, , .
Abstract: Work-related back pain among nurses is a problem of significant proportion. Nurses have a high rate of back pain compared to the general population and other occupational groups. There has been little reduction in the rates of nurses back pain and solutions to this complex problem continue to be elusive. Many quantitative studies have been undertaken examining and identifying the risk factors contributing to a high risk of back pain among nurses. Few of these studies focus on the complexities and context of the nurses physical and social environment. An exploration of these factors may assist to explain why interventions have not been successful and why the risk of back pain among nurses remains high.This study, using a qualitative methodology, explores nurses views and perceptions of the factors that they believe contribute to nurses having a high risk for work-related back pain. In-depth interviews were conducted with nurses working in previously identified high risk areas asking them about their perceptions of the risk factors and the activities that lead to risk situations for back pain. The strongest theme to emerge from the participant interviews was that it is the work demands from nursing that create and expose nurses to high levels of risk. Other risk factors identified were environmental hazards, equipment management and the physical work environment. The interview responses were analysed using two theoretical models of risk. The Health Belief Model examines risk behaviour using a cognitive psychological approach and the Social Model of Risk views all behaviour as influenced by the social environment. Both models offer explanations as to why nurses take actions that place them at risk for back pain. This study highlights the main ideas and concerns raised by the participants. It makes recommendations for managing the problem of work-related back pain in the nursing profession, and suggests areas where more research is needed
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Crowe, M. (1999). Mad talk: attending to the language of distress. Nursing Inquiry, (March).
Abstract: This paper will examine how one woman, Madeleine's narrative can be constructed as symptomatic of the diagnosis of schizophrenia and how it can also be read from other perspectives, particularly a post-structural feminist one. The readings are presented as possibilities for understanding the woman's experiences and the implications of this for mental health nursing practice. A post-structural feminist reading acknowledges the gendered experiences of subjectivity and how those experiences are constructed in language.The purpose of this paper is to identify for mental health nursing practice an approach which recognises the figurative and literal characteristics of language in order to provide nursing care which positions the individual's experience of mental distress as central. This requires an acknowledgment of Madeleine's path into mental distress rather than simply a categorisation of what is observed in a clinical setting. Intervention may need to include a range of strategies: medical and non-medical, psychotherapeutic and social, physical and environmental. It may also require the provision of sanctuary and security while these options are explored
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McKenna, B. (1999). Patient perception of coercion on admission to acute psychiatric services: the New Zealand experience. International Journal of Law and Psychiatry, 22(2), 143–153.
Abstract: This study considers the influence of legal status, interactive processes, and mediating factors upon patient perception of coercion, within the context of admission to mental health services in New Zealand. The admission experiences of 69 involuntary inpatient psychiatric admissions and 69 informal admissions are compared using the MacArthur Admission Experience Survey. The influence of demographic, clinical and situational variables on the experience are considered. The results indicate there is a strong significant difference in the perception of coercion between involuntary and informal patients, with legal status having predictive value in relation to patient perception of coercion. Patient perception of procedural justice is strongly negatively correlated with perception of coercion. Perception of negative interactive processes is strongly felt by involuntary patients. This experience is not fully explained by identifiable incidents throughout the admission process. In the New Zealand context, there remains a need to highlight the aspects of procedural justice which could be improved in order to reduce patient perception of coercion. Current methodology focuses on the experience of admission rather than the expectation of that experience. This point needs to be considered in relation to the experience of Maori (the indigenous people of New Zealand)
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McKenna, B. (1999). Joint appointment: bridging the 'theory-practice' gap through collaboration. Kai Tiaki: Nursing New Zealand, 5(2), 14–16.
Abstract: In New Zealand, there is a festering debate over a theory-practice gap in nursing. Joint appointments present as a potential solution to this issue. Joint appointments refer to a variety of arrangements whereby concurrent employment occurs within an educational institution and a clinical setting.Advantages for the appointees include job satisfaction, and professional growth. Clinical credibility for nurse educators enables improved facilitation of student learning. In clinical areas, benefits in patient care are associated with the marrying of academic rigor with clinical practice. Some appointees input into staff development, act as consultants on nursing issues and undertake research. Disadvantages in the concept focus on role conflict (incongruity between the roles) and role ambiguity (lack of clarity concerning expectations). Success of the ventures depends upon the personal attributes of appointees; realistic expectations; flexibility to allow the concept to evolve; and support from colleagues and management.This research describes a case study of a joint appointment between a nurse lecturer and a senior staff nurse in an acute forensic psychiatry unit. Advantages, disadvantages and reasons for success are discussed in relation to the literature findings. The discussion focuses on the need to develop research methodology to further clarify potential benefits and advantages
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Clendon, J. (1999). The Nurse Practitioner-led Primary Health Care Clinic; A Community Needs Analysis. Ph.D. thesis, , .
Abstract: Aim: To determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a primary school environment as an alternate or complementary way of addressing the health needs of 'at risk' children and families to the services already provided by the public health nurse.Method: Utilising needs analysis method, data was collected from three sources – known demographic data, 17 key informant interviews and two focus group interviews. Questions were asked regarding the health needs of the community, the perceptions of participants regarding the role of the public health nurse in order to determine if a public health nurse would be the most appropriate person to lead a primary health care clinic, and the practicalities of establishing a clinic including services participants would expect a clinic to provide. Analysis was descriptive and exploratory.Results: A wide range of health needs were identified from both the demographic data and from participant interviews. Findings also showed that participant's understanding of the role of the public health nurse was not great and that community expectations were such that for a public health nurse to lead a primary health care clinic further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed model that would serve to address the health needs of children and families in the area the study was undertaken.Conclusion: Overall findings indicated that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment is feasible. While a public health nurse may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required. It is likely that a similar model would also be successful in other communities in New Zealand, however the health needs identified in this study are specific to the community studied. Further community needs assessments would need to be completed to ensure health services target health needs specific to the communities involved.
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Spence, D. (1999). Prejudice, paradox and possibility.
Abstract: This study explores the the experience of nursing a person, or people, form cultures other than one's own. Informed by the tradition of philosophical hermeneutics, and drawing specifically on some of the notions articulated by Hans-Georg Gadamer and Charles Taylor, it seeks to understand everyday nursing practices within their cultural and historical context.Against a background of Maori resurgence, nurses in New Zealand have been challenged in Aotearoa-New Zealand to recognise and address racism in their practice. Meeting the health needs of all people has long been important in nursing yet the curricular changes implemented in the early 1990s to enhance nursing's contribution to a more equitable health service created uncertainty and tension both within nursing, and between nursing and the wider community.In this study, I have interpreted the experiences of seventeen nurses practising in an increasingly ethnically diverse region. Personal understandings and those from relevant literature have been used to illuminate further the nature of cross-cultural experience from a nurse's perspective. The thesis asserts that the notions of prejudice, paradox and possibility can be used to describe the experience of nursing a person from another culture. Prejudice refers to the prior understandings that influence nursing action in both a positive and a negative sense. Paradox relates to the coexistence and necessary interplay of contradictory meanings and positions, while possibility points to the potential for new understandings to surface from the fusion of past with present, and between different interpretations. As New Zealand nurses negotiate the conflicts essential for ongoing development of their practice, the play of prejudice, paradox and possibility is evident at intra-personal and interpersonal levels as well as in relation to professional and other social discourses. This thesis challenges nurses to persist in working with the tensions inherent in cross-cultural practice. It encourages continuation of their efforts to understand and move beyond the prejudices that otherwise preclude the exploration of new possibilities.
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Manssen, A. (1999). Aseptic technique in New Zealand. aseptic technique, 34(14), 24–28.
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Woodward, J. (1999). Nurse case management: A review of the literature. Ph.D. thesis, , .
Abstract: This literature review is an exploration of nurse case management and it will provide the background for the introduction of a nursing case management model in the acute surgical environment at Western Bay Health. Case management is a collaborative process which assesses, plans, implements, co-ordinates, monitors and evaluates options and services to meet an individual's health needs through communication and available resources to promote quality, cost-effective outcomes (Newell, 1996:.3). In undertaking this review it was the author's intention to include the findings as background to a business case seeking the introduction of a surgical nurse case management model within the surgical service.
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Gallaher, L. (1999). Expert public health nursing practice: A complex tapestry. Nursing Praxis in New Zealand, 14(3), 16–27.
Abstract: The research outlined in this paper used Heideggerian phenomenology to examine the phenomenon of expert public health nursing practice within a New Zealand community health setting. Narrative interviews were conducted with eight identified expert practitioners who are currently practising in this speciality area. Data analysis led to the identification and description of themes which were supported by paradigm cases and exemplars. Four key themes were identified which describe the finely tuned recognition and assessment skills demonstrated by these nurses; their ability to form, sustain and close relationships with clients over time; the skilful coaching undertaken with clients; and the way in which they coped with the dark side of their work with integrity and courage.
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Neville, S. J., & Alpass, F. (1999). Factors influencing health and well-being in the older adult. Nursing Praxis in New Zealand, 14(3), 36–45.
Abstract: This article offers a literature review of selected factors influencing the health and well-being of older people, with a particular emphasis on the older male. Implications for nursing practice in New Zealand are discussed.
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Christensen, D. J. C. (1999). Integrating the terminology and titles of nursing practice roles: Quality, particularity and levelling. Nursing Praxis in New Zealand, 14(1), 4–11.
Abstract: The author reconsiders the meaning of expert, specialist and advanced practice. She proposes that they are distinctive and complementary aspects of every nursing role and suggests a set of attributes for each. Expertise is discussed in terms of the quality of performance, speciality in relation to particularity of performance, and advanced practice with regard to the level of performance.
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