| Records |
| Author |
Phillips, B.N. |
| Title |
An interpretation of four men's experiences of suicidality |
Type |
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| Year |
2004 |
Publication |
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Abbreviated Journal  |
ResearchArchive@Victoria |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Mental health; Psychiatric Nursing; Gender; Qualiltative research |
| Abstract |
This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of the author's own particular horizon of meaning as researcher and mental health nurse. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, he explores the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. Recovering was a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change. |
| Call Number |
NRSNZNO @ research @ 1214 |
Serial |
1199 |
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| Author |
Hall, K.A. |
| Title |
Soothing sounds: An investigation into the value of music in palliative care |
Type |
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| Year |
2003 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Palliative care; Nursing; Qualiltative research; Alternative therapies |
| Abstract |
This qualitative study focuses on van Manen's theory of the 'lived experience' in relation to two families and asks the first thesis question. What is the value of music in the care of someone who is dying? Over the course of their loved one's illness these families provided music in the patients home as part of their care. The study also captures the experiences of two nurses who work in the palliative setting, and their use of music in providing holistic care to their patients. Their experiences relate to the second question. How can nurses be assisted in introducing music into their planned care of patients? The results demonstrate the effectiveness of using taped music for someone who is dying, and the reduction in symptoms, such as anxiety, and pain. It also highlights the importance of the individual's choice, and the special moments that can be achieved for both patient and families when music is used in a caring, supportive environment. This encourages communication, especially in the sharing of emotions. This study may be the first qualitative study in New Zealand, that addresses the value of music in palliative care, therefore there is a need for continued research into this therapy as a treatment modality as part of planned care in palliative nursing. |
| Call Number |
NRSNZNO @ research @ 1216 |
Serial |
1201 |
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| Author |
Ryder-Lewis, M. |
| Title |
Reliability study of the Sedation-Agitation Scale in an intensive care unit |
Type |
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| Year |
2004 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Intensive care nursing; Interprofessional relations |
| Abstract |
This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the Sedation-Agitation Scale (SAS) in a natural Intensive Care Units (ICU) setting. The author notes that it is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1203 |
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| Author |
Stewart, A. |
| Title |
When an infant grandchild dies: Family matters |
Type |
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| Year |
2000 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Grief; Nurse-family relations; Infants; Nursing research |
| Abstract |
This research undertaken by a nurse working with bereaved families, aimed to explore how grandparents, parents and health/bereavement professionals constructed grandparent bereavement when an infant grandchild died unexpectedly. The 26 participants, living in New Zealand and the United Kingdom, included 16 grandparents and 6 parents from 11 families, in addition to three health/bereavement professionals. A constructivist inquiry informed by writings on nursing, storying and postmodernism was used. Through an exploration of the methodological and ethical issues that arose and were addressed during the study, this work adds to knowledge of how constructivist inquiry can be used in nursing and bereavement research. In addition, the context of this research as a partnership with multiple family members contributes to the ongoing debate about whether participation in bereavement research may be harmful or therapeutic. Conversations in this research formed a series of interviews and letters, which led to the development of a joint construction and each individual's story. A grandchild's death was constructed as a challenge which grandparents faced, responded to and then managed the changes that arose from the challenge. The context of their bereavement was seen as underpinned by their relationship as “parents of the adult parents” of the grandchild who died. This meant that grandparents placed their own pain second to their wish to support and “be with” the parents. Outside the family was where many grandparents found friends, colleagues or their community forgot, or chose not to acknowledge, their bereavement. This work shows how some grandparents help to create a space within the family which maintains a continuing relationship with the grandchild who died. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1205 |
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| Author |
Chenery, K. |
| Title |
'Can mummy come too?' Rhetoric and realities of 'family-centred care' in one New Zealand hospital, 1960-1990 |
Type |
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| Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Nurse-family relations; Policy; Hospitals; History of nursing; Paediatric nursing |
| Abstract |
This study explores the development of 'family-centred care' in New Zealand as part of an international movement advanced by 'experts' in the 1950s concerned with the psychological effects of mother-child separation. It positions the development of 'family-centred care' within the broader context of ideas and beliefs about mothering and children that emerged in New Zealand society between 1960 and 1980 as a response to these new concerns for children's emotional health. It examines New Zealand nursing, medical and related literature between 1960 and 1990 and considers both professional and public response to these concerns. The experiences of some mothers and nurses caring for children in one New Zealand hospital between 1960 and 1990 illustrate the significance of these responses in the context of one hospital children's ward and the subsequent implications for the practice of 'family-centred care'. This study demonstrates the difference between the professional rhetoric and the parental reality of 'family-centred care' in the context of one hospital children's ward between 1960 and 1990. The practice of 'family-centred care' placed mothers and nurses in contradictory positions within the ward environment. These contradictory positions were historically enduring, although they varied in their enactment. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1206 |
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| Author |
Stojanovic, J.E.E. |
| Title |
Leaving your dignity at the door: Maternity in Wellington 1950 – 1970 |
Type |
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| Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Hospitals; Nursing specialties; Maternity care; Patient satisfaction |
| Abstract |
This thesis describes the maternity system in Wellington between 1950 and 1970 particularly from the perspectives of consumers and midwives. Four women consumers who experienced maternity in Wellington and two midwives who worked in Wellington's maternity hospitals during this period provided their oral testimonies as the main primary sources for this study. The author's experience of being a student nurse and a consumer in Wellington and other primary and secondary sources are used to substantiate, explore and explain the topic. The study traces the socio-political changes in New Zealand maternity from 1900 to 1970 creating a backdrop against which Wellington's maternity system, including the women, the hospitals, the workforce, maternity practices and the childbearing process are illuminated using the insights of women and midwives who experienced them. The oral testimonies of the six participants described positive and negative aspects of their maternity experiences, but the three strong themes that arose from their accounts included 'being alone', 'lack of autonomy' and 'uncaring attitudes'. |
| Call Number |
NRSNZNO @ research @ 1223 |
Serial |
1208 |
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| Author |
Rudd, J. |
| Title |
From triage to treatment: An exploration of patient flow systems in emergency departments |
Type |
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| Year |
2005 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Emergency nursing; Hospitals; Risk management; Patient safety |
| Abstract |
To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1209 |
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| Author |
Turnwald, A.B. |
| Title |
Acute Hypercarbia in Chronic Obstructive Pulmonary Disease (COPD): Presentations to a New Zealand emergency department |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Chronically ill; Clinical assessment; Emergency nursing |
| Abstract |
A retrospective descriptive design was used to examine the records of all presentations to the emergency department of patients with COPD over a 3-month period to determine whether there is a subset group of people who present with hypercarbia. There were 114 presentations, amongst those there were 71 individuals, a number presenting more than once within the three months. 80% of the 71 individuals had a smoking history of which 53% were female. Of the 114 presentations, 76 had arterial blood gases taken during their emergency department presentation. Of these 76 presentations 30 had hypercarbia and 46 were non-hypercarbia. These 76 presentations involved 58 individuals, with some individuals presenting five times over the three-month period. Three groups emerged, some who were only hypercarbia (n= 18), some in the non-hypercarbia group (n=35) and 5 individuals who had presentations in both the hypercarbia and non-hypercarbia groups. Data showed that there was no definable subset group of hypercarbia patients within acute exacerbations of COPD presenting to the emergency department according to the variables. However the sample of presentations (with a blood gas) found within the study suffering hypercarbia was much higher (31.1%) than anticipated. Further analysis showed that the hypercarbia group had a significant lower forced expiratory volume in one second (FEV1) and a combination diagnosis of emphysema or asthma and congestive heart failure. An implication to the clinician is that identification of hypercarbia within COPD exacerbation is problematically difficult until the late signs are shown with the individual. By that time effective treatment patterns may have changed from the initial presenting problem. The author concludes that future areas of research within this field needs to lie within the community, and look at when these people start the exacerbation, what leads them to progression presentation to the emergency department, and whether these people are chronic sufferers of hypercarbia or presenting after a period of days exacerbation within their own home. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1210 |
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| Author |
Mosley, B. |
| Title |
Seclusion management in an acute in-patient unit |
Type |
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| Year |
2005 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Psychiatric Nursing; Patient rights; Hospitals; Workplace violence |
| Abstract |
This study was developed to explore the use of seclusion in an acute in-patient unit for people with mental illnesses. Investigation into this issue was considered important due to an identified large increase in seclusion use over the previous two years. The study used a qualitative research methodology with a descriptive and interpretive approach. Data collection included a retrospective file audit of patients who had been secluded over the past seven years, and one-to-one staff interviews. It also includes the author's personal reflections of seclusion events. The principle reason for using seclusion was violence and aggression in the context of mental illness. It was also used for people who were at risk of, or who had previously absconded from the unit. A recovery approach and the use of the strengths model was fundamental to nurses' way of working with patients in the unit. Nurses believed that the strengths process should be adapted to the person's level of acuity and to their ability to engage in this approach in a tangible way. Seclusion continues to be a clinical management option in the unit that is the subject of this study. However, in many circumstances there are other options that could be explored so that the utmost consideration is given to the dignity, privacy and safety of that person. |
| Call Number |
NRSNZNO @ research @ 1227 |
Serial |
1212 |
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| Author |
Kuehl, S. |
| Title |
Emergency Department re-presentations following intentional self-harm |
Type |
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| Year |
2008 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Emergency nursing; Psychiatric Nursing; Mental health; Clinical assessment |
| Abstract |
The aim of this research was to describe what factors contribute to people re-presenting to the emergency department (ED) within one week of a previous visit for intentional self-harm. Objectives identified were to describe the people using demographic and clinical features; describe and evaluate ED management; and identify possible personal or system reasons as to why people re-present to ED within one week. A retrospective observational design was selected for a period of one year. The data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations. Missing data limited the number of inferential analyses. Outcome measures were divided into information regarding the person and the presentation. This study made several discoveries: many representations (55%) occurred within one day; the exact number of people who represented many times to ED is unknown, but is far higher than reported in other studies; fewer support people were present for the second presentation; the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population; cultural input for Maori was missing; physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations; and the medical and mental health inpatient admission rates were approximately 50% higher for second presentations. Recommendations in regard to the use of a triage assessment tool, the practice of reviewing peoples' past presentations and the need for a mental health consultation liaison nurse in ED are made. Staff education, collaboration between services with consumer involvement and further research of this group are required. This study supports the need for holistic and expert care for people who present at emergency departments with intentional self-harm. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1214 |
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| Author |
Hammond, S. |
| Title |
Parallel journeys: Perceptions of palliative care |
Type |
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| Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Palliative care; Policy; Geriatric nursing |
| Abstract |
The delivery of palliative care within contemporary New Zealand society is discussed, in the light of the recent publication of The New Zealand Palliative Care Strategy (2001). The viewpoint taken is largely descriptive rather than prescriptive, being based on a literature survey of international research and academic theory, which is also informed by the author's professionally gained knowledge. Four different perspectives, comprising a mix of providers and recipients of care are investigated: those of central government planning; specialist palliative care units; aged-care complexes; and patients, family and whanau. As an area of healthcare which current demographic projections indicate will become increasingly significant, the provision of palliative care to residents of and patients within aged-care complexes receives special attention. A metaphor of “parallel travellers” on “parallel journeys” is used to provide a thematic basis to the paper. The lived experiences and perceptions of each group of “parallel travellers” are explored. Difficulties in defining and evaluating palliative care, the implications of main-streaming, the scope of palliative care provision, the educative role of specialist palliative care providers and the current focus on mechanistic outcome measures are discussed. It is contended that the values and goals, both explicit and implicit, of the four specified groups may not at present be sufficiently congruent to optimise the effective provision of palliative care from the point of view of all concerned. While adequate resourcing and a genuinely collaborative approach among healthcare providers are both acknowledged to be critical, the potential for palliative care nurse practitioners to be appointed to the role of “care co-ordinator” alluded to within The New Zealand Palliative Care Strategy (2001), is also seen as pivotal. Insights from a postmodern perspective are offered as one possible way of achieving greater congruence. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1215 |
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| Author |
Watson, S. |
| Title |
Humane caring: Quality of life issues for those elderly people wanting to remain in their own environment |
Type |
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| Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Geriatric nursing; Older people; Home care |
| Abstract |
This thesis explores the issues surrounding the elderly remaining in their own environment and why remaining 'at home' becomes so essential for them. There are many elderly people who have moved to residential care settings on the advice of others. The author explores the implications of such moves through the stories of several elderly persons, and her own experiences as a nurse working with the elderly in institutional care. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1217 |
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| Author |
Fairhall, M. |
| Title |
An observational study of Peripherally Inserted Central Cather(PICC)-related complications amongst oncology patients |
Type |
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| Year |
2008 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Patient safety; Equipment and Supplies; Nursing specialties; Cancer; Oncology |
| Abstract |
This thesis reports on a retrospective observational study that examined the complication rate of peripherally inserted central catheters (PICCs) within a regional cancer centre. PICCs are increasingly used for delivery of chemotherapy and other intravenous therapies in oncology patients. A literature review revealed that almost all published research on PICC complications reported on silicone (Groshong(TM)) catheter use, rather than the polyurethane (Arrow(TM)) PICCs used at Christchurch Hospital. Also, much literature referred to PICCs being inserted by non-nurses, whereas the Christchurch service uses specially-trained nurses to insert them. The purpose of the study was to identify the nature, incidence and rates of polyurethane (Arrow(TM)) PICC complications in an adult oncology cohort. Ethics Committee approval was gained to retrospectively follow all PICCs inserted in adult oncology patients at Christchurch Hospital over a 13-month period from 1st March 2006 until 31st March 2007. Data collected were analysed utilising the statistical computer package SPSS. One hundred and sixty-four PICCs were inserted into 156 individual oncology patients over this period. The median dwell time was 68 days for a total of 14,276 catheter-days. Complications occurred in 25 (15%) out of 164 PICC lines, in 22 (15%) of the 156 patients for an overall complication rate of 1.75 per 1000 catheter-days. However, only 16 of the 25 PICCs with complications required early removal (9.75% of the cohort) for a favourably low serious complication rate of 1.12 per 1000 catheter-days. The three commonest complications were infection at 4.3% (7/164) or 0.49 infection complications/1000 PICC-days, PICC migration at 3% (5/164) or 0.35/1000 catheter days, and thrombosis at 2.4% (4/164) or 0.28/1000 catheter days. The median time to complication was 41 days. Those with complications were more likely to have a gastro-intestinal or an ovarian cancer diagnosis, and less likely to have colorectal cancer. These findings provide support for the safe and effective use of polyurethane (Arrow(TM)) PICCs for venous access within the adult oncology context. Furthermore, it suggests that cost effective nurse-led (Arrow(TM)) PICC insertions can contribute to a low complication rate. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1222 |
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| Author |
Murphy, S.E.E. |
| Title |
Through mothers' eyes: The lived experience of caring for a child who has undergone and recovered from a liver transplantation |
Type |
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| Year |
2008 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Parents and caregivers; Paediatric nursing; Children; Surgery |
| Abstract |
Mothers, whose children had undergone a liver transplant more than one year ago at time of interview and whose children were outpatients of Starship Children's Hospital, were invited to participate in this research. A Heideggerian hermeneutic phenomenological approach, informed by the work of van Manen (1990) was used. Three mothers of children who had received a liver transplant were interviewed to reveal the meanings of the phenomenon – what is the meaning of lived experience of mothers in caring for their child who has undergone and recovered following liver transplantation? Little previous study regarding mothers' lived experience of caring for their child, who had recovered from a liver transplant, was found in the literature. The emerging themes were punctuated with stress being a consistent feature. Utilising Ruddick's (1983) concepts of maternal thinking, the emerging themes were merged within the three interests governing maternal practice; preservation, growth and acceptability. The absolute capacity for attentive love draws the experience together. An essential theme identified out of the analysis was the concept of survival relating to the unique features of liver transplantation and the consequences of liver rejection and failure. The findings contribute to the understanding of the phenomenon, emphasising the need for good support systems for families of children who have undergone transplantation; assistance in the establishment of maternal coping strategies and regular feedback on the children's progress acknowledging the role and care provided by mothers. |
| Call Number |
NRSNZNO @ research @ 1242 |
Serial |
1227 |
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| Author |
Brown, J.A. |
| Title |
“Let my spirit always sing”: A descriptive study of how four elderly rest home residents view spirituality and spiritual care at the end of life |
Type |
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| Year |
2004 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| Keywords |
Older people; Rest homes; Spirituality; Nursing |
| Abstract |
This descriptive, qualitative study, believed to be the first of its kind conducted in a New Zealand setting, focuses on spirituality issues of a spiritually vulnerable group of people, older people in residential care. Four rest home residents were recruited, to talk about their spirituality, spiritual needs and how their spirits were nurtured, the role of care staff in providing spiritual care, and their satisfaction with the spiritual care they were being offered. They were also asked to predict their spiritual needs as they were dying, their wishes for spiritual care in the perideath period, whether they had communicated these wishes to anyone, their views on advance planning to ensure these wishes would be met, and their comfort with the research process. The research data was collected from semi-structured, audiotaped interviews that were later transcribed. The spirituality of all participants had a strongly Christian focus that was revealed in the ten themes to emerge from a modified application of Colaizzi's analysis technique. The first themes to emerge were God as the focus of spirituality, God in control, the importance of relationship, and the purpose in life: serving God. Changes in spirituality with age, spirituality and residential care, and spiritual care: whose responsibility? were also identified as themes, as were end of life spirituality, planning for spiritual care, and the participants' satisfaction with the research process. All were able to articulate their spirituality, were generally satisfied with the spiritual care they were receiving, and had views on the spiritual care they wished to receive in the perideath period. Moreover, the participants trusted their families and the care staff to ensure that these wishes would be honoured. Recommendations are made for improving the spiritual dimension of care, and for further research. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1228 |
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