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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. |
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Title |
Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand |
Type |
Journal Article |
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Year |
2004 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal  |
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Volume |
46 |
Issue |
1 |
Pages |
95-109 |
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Keywords |
Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1060 |
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Author |
Carter, H.; MacLeod, R.; Brander, P.; McPherson, K. |
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Title |
Living with a terminal illness: Patients' priorities |
Type |
Journal Article |
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Year |
2004 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
45 |
Issue |
6 |
Pages |
611-620 |
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Keywords |
Terminal care; Quality of life; Nursing models; Cancer |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1061 |
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Author |
Richardson, S. |
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Title |
Aoteaoroa/New Zealand nursing: From eugenics to cultural safety |
Type |
Journal Article |
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Year |
2004 |
Publication |
Nursing Inquiry |
Abbreviated Journal |
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Volume |
11 |
Issue |
1 |
Pages |
35-42 |
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Keywords |
Cultural safety; History of nursing; Nursing philosophy |
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Abstract |
The concept of cultural safety offers a unique approach to nursing practice, based on recognition of the power differentials inherent in any interaction. Clarification of the concept is offered, together with a review of the historical shift in nursing attitudes that has led to the emergence of “cultural safety” as a viable and valued component of nursing practice. The argument is made that cultural safety has allowed for a more reflective, critical understanding of the actions of nursing to develop. This includes recognition that nurses' attitudes and values have inevitably been influenced by social and political forces, and as such are in part reflective of those within the wider community. Comparison between the support given by nurses in the early 1900s to the theory of eugenics and the current acceptance of cultural safety is used to highlight this point. An examination of the literature identifies that ideological and conceptual changes have occurred in the approach of Aoteaoroa/New Zealand nurses to issues with cultural implications for practice. A review of background factors relating to Maori health status and the Treaty of Waitangi is presented as a necessary context to the overall discussion. The discussion concludes with an acknowledgement that while the rhetoric of cultural safety is now part of nursing culture in New Zealand, there is no firm evidence to evaluate its impact in practice. Issues identified as impacting on the ability to assess/research a concept, such as cultural safety, are discussed. For cultural safety to become recognised as a credible (and indispensable) tool, it is necessary to further examine the “end-point” or “outcomes” of the process. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1062 |
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Author |
Hughes, C. |
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Title |
Perioperative nurses in NZ & evidence-based practice |
Type |
Journal Article |
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Year |
2004 |
Publication |
Dissector |
Abbreviated Journal |
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Volume |
31 |
Issue |
4 |
Pages |
8, 10-1 |
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Keywords |
Evidence-based medicine; Nursing specialties; Access |
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Abstract |
This project is a study of the barriers perceived by perioperative nurses to accessing and using research-based information. A survey questionnaire was distributed to 184 perioperative nurses working in five public and two private hospitals in the Auckland area. The number of completed questionnaires was 106 (57.6%). The results showed that the lack of time during work hours was ranked as the highest barrier. The results also showed that many nurses feel they do not have the skills to find and appraise research articles. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1063 |
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Author |
Gaskin, C.J.; O'Brien, A.P.; Hardy, D.J. |
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Title |
The development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand |
Type |
Journal Article |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
4 |
Pages |
259-270 |
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Keywords |
Professional competence; Psychiatric Nursing; Clinical decision making; Nursing research |
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Abstract |
This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1064 |
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Author |
Wilson, D. |
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Title |
The nurse's role in improving indigenous health |
Type |
Journal Article |
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Year |
2003 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
15 |
Issue |
3 |
Pages |
232-240 |
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Keywords |
Transcultural nursing; Maori; Health status |
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Abstract |
The health status of indigenous peoples is a global concern with mortality and hospitalisation data indicating that the health of indigenous groups falls below that of other ethnic groups within their countries. The preliminary findings of grounded theory research project undertaken with a group of 23 New Zealand Maori women about their health priorities and 'mainstream' health service needs provide the foundation for an exploration of issues impacting on the health status of indigenous people. The role that nursing and nurses have in improving access and use of health services by indigenous people is discussed. Strategies are suggested that nurses can utilise within their practice when working with local indigenous groups. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1065 |
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Author |
Crowe, M.; Carlyle, D. |
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Title |
Deconstructing risk assessment and management in mental health nursing |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
43 |
Issue |
1 |
Pages |
19-27 |
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Keywords |
Psychiatric Nursing; Risk management; Policy; Culture |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1069 |
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Author |
White, G.E.; Mortensen, A. |
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Title |
Counteracting stigma in sexual health care settings |
Type |
Journal Article |
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Year |
2003 |
Publication |
Insight: The Journal of the American Society of Ophthalmic Registered Nurses |
Abbreviated Journal |
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Volume |
6 |
Issue |
1 |
Pages |
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Keywords |
Sexual and reproductive health; Nursing specialties; Attitude to health |
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Abstract |
Sexual health clinics and the people who visit them commonly face stigma. Sexually transmitted infections have historically been used to divide people into “clean” and “dirty”. A grounded theory study of the work of sixteen nurses in six sexual health services in New Zealand was undertaken to explore the management of sexual health care. The study uncovered the psychological impact of negative social attitudes towards the people who visit sexual health services and to the staff who work there. Sexual health nurses manage the results of stigma daily and reveal in their interactions with clients a process of destigmatisation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1071 |
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Author |
Polaschek, N. |
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Title |
Living on dialysis: Concerns of clients in a renal setting |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
41 |
Issue |
1 |
Pages |
44-52 |
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Keywords |
Nurse-patient relations; Psychology; Attitude to health; Terminal care |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1072 |
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Author |
Muir-Cochrane, E.; Holmes, C.; Walton, J.A. |
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Title |
Law and policy in relation to the use of seclusion in psychiatric hospitals in Australia and New Zealand |
Type |
Journal Article |
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Year |
2002 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
13 |
Issue |
2/3 |
Pages |
136-145 |
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Keywords |
Psychiatric Nursing; Law and legislation; Policy; Patient rights; Cross-cultural comparison |
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Abstract |
This paper discusses legal issues associated with the seclusion of acutely disturbed patients in psychiatric hospitals in Australia and New Zealand. There continues to be great variation in opinion and operational definition as to whether seclusion is a medical treatment, nursing intervention and management tool, or merely a form of situational restraint. Reflecting this lack of clarity, mental health acts and policies concerning the regulation and practice of seclusion lack consistency and focus across geographical boundaries and jurisdictions. Australian and New Zealand legislation and institutional policy is discussed in order to shed light on the contemporary issues highlighted by this controversial nursing practice. The authors note that mental health professionals must continue to review the practice of seclusion and to actively promote the use of acceptable alternatives. In addition nurses and other mental health professionals have a responsibility to understand current legislation and policy frameworks and to influence change where this is necessary to ensure the best practice possible in their clinical area. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1074 |
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Author |
Carter, H.; McKinlay, E.M.; Scott, I.; Wise, D.; MacLeod, R. |
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Title |
Impact of a hospital palliative care service: Perspective of the hospital staff |
Type |
Journal Article |
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Year |
2002 |
Publication |
JBI Reports |
Abbreviated Journal |
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Volume |
18 |
Issue |
3 |
Pages |
160-167 |
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Keywords |
Palliative care; Hospitals; Attitude of health personnel; Cancer |
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Abstract |
The first New Zealand hospital palliative care support service was established in 1985. Different service models have now been adopted by various major hospitals. In 1998, a palliative care service, funded by Mary Potter Hospice, was piloted at Wellington Public Hospital. Twelve months post-implementation, the hospital staff's views of the service were evaluated. It was found that referrals to palliative care from hospital specialities outside the Cancer Centre increased. While most doctors, nurses and social workers strongly agreed or agreed that the service positively influenced patients' care and effectively addressed their symptom management needs, spiritual needs were less often met. Over 90 percent of each discipline strongly agreed or agreed that the service had assisted them in caring for patients, but, only about a half agreed that useful discharge planning advice and staff support was provided. Significant differences in responses were found between different disciplines and specialities. One fifth of the staff identified palliative care education needs. Recommendations are made concerning the development of a future hospital palliative care service. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1075 |
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Author |
Nicol, M.J. |
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Title |
The teaching of genetics in New Zealand undergraduate nursing programmes |
Type |
Journal Article |
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Year |
2002 |
Publication |
Nurse Education Today |
Abbreviated Journal |
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Volume |
22 |
Issue |
5 |
Pages |
401-408 |
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Keywords |
Curriculum; Nursing; Education |
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Abstract |
This paper reports the results of a survey to determine how much genetics is taught in the bioscience component of the three-year Bachelor of Nursing degree offered by 16 tertiary education institutes in New Zealand. A questionnaire was mailed to the bioscience lecturers seeking information on the bioscience and genetics content of current programmes. They were also asked to indicate their perception of the impact and relevance of new genetic knowledge on health care and nursing education. Results indicated that on average 250-350 hours are devoted to the teaching of biosciences. Less than 10 hours are devoted to genetics at 66% of institutes, one institute did not teach any aspect of genetics. None of the institutes taught more than 20 hours of genetics in the programme, although 47% of lecturers said they would like to teach more genetics if there were more time available in the curriculum. Lecturers teaching bioscience to Bachelor of Nursing students are aware of the importance of genetics in health care and to nursing in particular, and the majority are of the opinion that more genetics should be included in undergraduate programmes, however 'curriculum crowding' is a problem. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1076 |
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Author |
Crowe, M. |
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Title |
Reflexivity and detachment: A discursive approach to women's depression |
Type |
Journal Article |
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Year |
2002 |
Publication |
Nursing Inquiry |
Abbreviated Journal |
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Volume |
9 |
Issue |
2 |
Pages |
126-132 |
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Keywords |
Gender; Mental health; Psychiatric Nursing; Culture |
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Abstract |
This paper explores a discursive approach to understanding women's depression by presenting the results of research into women's narratives of their experiences. The discursive approach taken acknowledges women's immersion in cultural practices that determine the subject positions available to them and places a value on attributes of reflexivity and detachment that are not usually associated with their performance. The social and cultural context of the individual's experience is significant because if the focus is simply on the individual this supposes that the problem lies solely with the individual. An understanding of cultural expectations and their relation to mental distress is important to mental health nursing practice. The psychotherapeutic relationship that is fundamental to mental health nursing practice requires an understanding of the meaning of individual's responses in their cultural context in order to provide facilitative and meaningful care for the women that they nurse. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1077 |
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Author |
Kirkham, S.; Smye, V.; Tang, S.; Anderson, J.; Blue, C.; Browne, A.; Coles, R.; Dyck, I.; Henderson, A.; Lynam, M.J.; Perry, J.(see also C.); Semeniuk, P.; Shapera, L. |
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Title |
Rethinking cultural safety while waiting to do fieldwork: Methodological implications for nursing research |
Type |
Journal Article |
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Year |
2002 |
Publication |
Research in Nursing & Health |
Abbreviated Journal |
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Volume |
25 |
Issue |
3 |
Pages |
222-232 |
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Keywords |
Cultural safety; Hospitals; Health behaviour; Culture; Nursing research |
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Abstract |
The authors trace a series of theoretical explorations, centered on the concept of cultural safety, with corresponding methodological implications, engaged in during preparation for an intensive period of fieldwork to study the hospitalisation and help-seeking experiences of diverse ethnocultural populations. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1078 |
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Author |
Kyle, W. |
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Title |
Dementia specific nursing in New Zealand: History and practice today |
Type |
Journal Article |
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Year |
2002 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
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Volume |
8 |
Issue |
14 |
Pages |
3-9 |
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Keywords |
Dementia; Nursing specialties |
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Abstract |
The author examines influences on contemporary dementia specific nursing practice. She addresses the current situation and future developments in this area. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1079 |
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