Abstract: A paper presenting the findings of a small research project involving a group of self-selected senior nurses of Wellington Hospital to explore the nature of nursing practice in the care and management of hospitalised patients and to formalise the language that would acknowledge its significance in the current effort of hospitals to define patient care pathways. The nature of hospital nursing practice was described in themes of a generic process of nurse-patient care that articulates a distinct specialism of hospital nursing, whatever the hospital department in which nurses hold positions.

Abstract: This phenomenological research project focused on one womans experience following total removal of her larynx and aimed to faithfully capture the essential structure of the phenomenon of voice as it emerged for her. For women in particular gaining a new artifical voice following surgery that is considerably lower sounding, plus the large visible opening in the lower neck is psychologically challenging and can be socially isolating. Most literature relating to laryngectomy and rehabilitation comprises quantitative research with limited attention to womens issues. This could be attributed to the small number of women undergoing this surgery. A review of nursing literature revealed minimal research, with none referring specifically to women. Nor were any studies using entirely qualitative methods identified.This research project used a phenomenological approach informed by the work of Michael Crotty, described as within the parameters of mainstream phenomenology. Based on a traditional common core foundation which is critical, holistic and individualistic, mainstream phenomenology requires achieving co-researchership between researcher and participant while exploring phenomena as objects of authentic human experience.The study began with discussing Crottys stepwise method emphasising the activity of bracketing. The co-researcher was then left to ponder or meditate on her experience following bracketing all her prior understandings and ideas, as if this was the first time she had encountered the phenomenon. Three conversations followed which allowed exploration of the co-researchers written statements. The seven interwoven dimensions that emerged represented the essential structure, meaning and essence of 'what voice is for this woman following total laryngectomy

Abstract: We hypothesized that the use of an Action Plan might assist self management for patients with chronic obstructive pulmonary disease (COPD).A pilot process and randomized, controlled study were undertaken to evaluate an action plan that provided advice on management of usual care and exacerbations, together with a booklet on self management. Fifty six subjects with COPD recruited through general practitioners (GPs) completed the six month study, 27 in the control group and 29 in the intervention group. The control group received usual care from their GP and the intervention group received a booklet and Action Plan from their practice nurse plus a supply of prednisone and antibiotic from their GP.The two groups were demographically similar with a mean age of 68 yrs. The resources were well received by GPs, practice nurses and the intervention group subjects. After six months there were no differences in quality of life scores or pulmonary function. There were significant changes in self management behaviour in the intervention group compared to controls. In response to seterioting symptoms, 34 versus7% (p= 0.014) initiated prednisone treatment and 44 versus 7 % (p=0.002 initiated antibiotics.Subjects in the intervention group readily adopted self management skills but did not shpw any difference in quality of life or lung function parameters. A larger prospective controlled clinical trial of this approach is warranted

Abstract: Otago women who had been treated for breast cancer were asked by questionnaire about patterns of arm swelling post treatment. Almost one third indicated they had had swelling at some time. Few had received preventive advice or what to do should arm swelling occur