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Author |
Holloway, K. T.; Pearson, J.R. |
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Title |
Trailblazers: Primary health care programme evaluation |
Type |
Conference Article |
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Year |
2005 |
Publication |
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Abbreviated Journal  |
coda, An Institutional Repository for the New Zealand ITP Sector |
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Volume |
Paper presented June 2004 at Royal New Zealand Plu |
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Pages |
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Keywords |
New graduate nurses; Primary health care; Evaluation research; Professional development |
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Abstract |
This report is an evaluation of the academic journey undertaken by a group of newly graduated nurses who were sponsored by a New Zealand district health board to work in a variety of primary health care nursing settings. The impetus for this pilot employment option was the Ministry of Health's focus on primary health care nursing and workforce development for this sector and the Expert Advisory Committee for primary health care nursing's recommendations to district health boards regarding employment of graduate nurses and support for them to engage in post graduate study. Evaluation participants were primarily the graduate nurses who were interviewed at the end of their first year of practice which was following programme completion then again nine to ten months later. Findings include the nurses reflections on what supported them and what acted to impede as barriers to their learning success and practice development. The report concludes with five recommendations that can be used to ensure that the travels of future newly graduated nurses taking this pathway are supported, safe and successful. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1200 |
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Author |
Gohns, A. |
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Title |
Management of opioid substitution treatment in the primary health care setting: A national training course for service providers |
Type |
Journal Article |
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Year |
2002 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
Full text online from the Royal New Zealand College of General Practitioners' website |
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Volume |
29 |
Issue |
3 |
Pages |
172-175 |
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Keywords |
Pharmacology; Evaluation; Primary health care |
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Abstract |
The aim of this research was to describe a national opioid treatment training programme that was introduced into primary health care, and evaluate its effectiveness following its first year of operation. The programme was introduced as a strategy to recruit, train and support a primary health care workforce in the provision of methadone treatment. For the evaluation a written questionnaire was sent to the general practitioner, practice nurse and pharmacist participants of training programmes held throughout New Zealand in 2000. One hundred and forty-five (98%) participants reported that the overall quality of the course was good or better, and that relevant issues were, in general, covered. However a recurring theme related to difficulties in designing a course relevant to the three different professional groups, with some material not equally applicable to all. Another prominent theme pertained to the issue of funding. general practitioners lamented the failure to address the issue of transferring patients from a free specialist clinic to their practice for care. The evaluation of this pilot programme indicates that this training in methadone maintenance treatment was well-received by primary health care providers. However, the author notes that there is no benchmark with which to compare it. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1099 |
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Author |
Adams-Smith, P.H. |
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Title |
An exploration of issues of primary health services for Taranaki Te Atiawa children based on the expectations and perceptions of their female caregivers |
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Year |
2002 |
Publication |
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Abbreviated Journal |
http://hdl.handle.net/10063/75 |
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Volume |
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Issue |
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Pages |
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Keywords |
Parents and caregivers; Primary health care; Access; Maori; Children |
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Abstract |
The intention of this research is, through collaborative discussion and selective conversations, to explore female caregivers' expectations and perceptions of primary health services for some Te Atiawa Maori children. The research process was developed in a partnership between the Maori women participants and the researcher. In addition, two local kuia actively participated in and supported the process. Emancipatory critical social theory underpinned and informed the project. Power relationships between the researcher and the participants can be overtly explored within this theoretical framework. In terms of this particular exploratory study, participatory research appeared to be applicable. The participants are female caregivers of Te Atiawa children. Data collection was done using group interactions and semi-structured interviews in the winter of the year 2000. A thematic analysis of the data was used, in which common themes were identified, compared and discussed. From the analysis of the data of the participants' conversations, key ideas were identified. The major findings have been identified within two main themes. These are: a concept of health is not the same for Pakeha as for Maori, and access issues are still problematic for the participants in this study. Many quotes from the interview participants are included in order to keep the focus of the project on the voices of the women interviewed. In terms of the significant contribution of this research, this study aims to allow voices of female caregivers of Te Atiawa Maori children to be heard. Individual and collaborative interactions offer insights into what is important to them in terms of Maori child health. Clearly, the primary health initiatives promoted by the New Zealand government are not reaching at least some of the people for whom they are intended. The research participants offered their ideas as to how these deficits could be remedied in their community. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1216 |
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Author |
Litchfield, M. |
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Title |
The innovation effort: ?Are you in or are you out?? |
Type |
Miscellaneous |
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Year |
2007 |
Publication |
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Abbreviated Journal |
http://www.moh.govt.nz/moh.nsf/pagesmh/7696/$File/mlitchfield.pdf |
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Issue |
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Pages |
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Keywords |
Nursing; Primary health care; Policy |
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Abstract |
A graphic presentation in PDF format (April 2007) of the findings and policy implications of the developmental evaluation research programme for the Turangi Primary Health Care Nursing Innovation. |
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Call Number |
NZNO @ research @ |
Serial |
1327 |
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Author |
Davies, D.C. |
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Title |
Practice nurses' perceptions of their contribution to the care of individuals with chronic health conditions |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Massey University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; Chronic diseases; Patient satisfaction; Nursing |
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Abstract |
Table of Contents: 1. Background and overview; 2. Research design and method; 3. Literature review; 4. Preparation of the individual for an appointment at the general practice; 5. Care provided by the practice nurse at the general practice; 6. The giving of information; 7. A discussion of the dualities of the contribution of practice nurses to the care of individuals with chronic conditions; 8. Study summary and conclusions. |
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Call Number |
NRSNZNO @ research @ 492 |
Serial |
478 |
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Author |
Armstrong, S.E. |
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Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Interprofessional relations; Rural nursing; Primary health care |
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Abstract |
A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors. This study is framed as investigating a specific component of rural nursing practice and as being representative of the primary-secondary care interface. The primary-secondary care interface is crucial for the delivery of patient-centered care, and there is an increased focus on preventive primary health care. The New Zealand government sees the repositioning of professional roles and increasing emphasis on collaboration as an opportunity to re-define and address the current constraints to nursing practice. This has resulted in tensions between the medical and nursing professions. These tensions are not new, with the relationship sometimes marred by conflict which has been attributed to historical medical dominance and nursing deference. This study explores some specific areas which affect collaboration and makes recommendations at the national, regional and individual level to address them. |
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Call Number |
NRSNZNO @ research @ 780 |
Serial |
764 |
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Author |
Mackay, B. |
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Title |
An analysis of innovative roles in primary health care nursing |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Northland Polytechnic Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse practitioners; Primary health care; Maori; Policy; Careers in nursing |
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Abstract |
An analytical tool of Force Field Analysis was used to identify and describe forces influencing the development of innovative roles, including the nurse practitioner role, in primary health care nursing. At the commencement of the study an initial analysis of research, literature and policy identified forces driving or restraining the development of innovative roles. A mixed research method of surveys and focus group interviews with key stakeholders, namely nurses in innovative roles, general practitioners and nurse leaders, was then used to identify factors influencing development within the Northland District Health Board. Descriptive statistics and interpretative methods were used to analyse the data. A final analysis enabled a picture of forces influencing innovative role development to be presented. Driving forces reflected international trends and were strongly influenced by economics and a political imperative to reconfigure health care services towards a primary health focus. The Treaty of Waitangi was also a key influence. Driving forces had greatest impact on the development of new roles. Forces were identified as drives towards cost-effective evidence-based health care (effective services), equity for Maori, response to local needs and workforce reorganisation. The major forces restraining the development of innovative roles were reinforced by attitudes, customs and support systems. These forces were identified as poor professional identity and support, an outdated nursing image, inadequate education and training and slow transition from traditional practices and structures (tradition). These forces had a negative influence on support for innovative roles. Promotion of kaupapa Maori, involvement of the local community, local Maori and nursing in decision-making and promotion of a team culture have the potential to support further development of innovative roles. Political ideology and the Treaty of Waitangi will continue to be major influences directed through policy and the contracting and funding process. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1124 |
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Author |
Mason, B. |
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Title |
An analysis of the role of the practice nurse in primary health care, 2000/2001 |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
NZNO Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; Practice nurses |
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Abstract |
In 1999 primary health care in New Zealand was in the process of change from the current personal health care model, which focuses on general practitioner based care, to a population and community based health care programme. Carryer, Dignam, Horsburgh, Hughes and Martin (1999) submitted a report to the National Health Commission entitled “Locating Nursing in Primary Health Care”. This report envisaged that nurses in primary health care would be part of interdisciplinary teams, act autonomously and undertake community consultation and education. The submission suggested that nurses, currently working in primary health care, were alraedy prepared and able to move across into the new form of primary health care, without further education or training. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1130 |
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Author |
Williams, H. |
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Title |
One for the boys: An evaluative study of primary health care access by men in Tairawhiti |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
NZNO Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Gender; Primary health care; Access; Male |
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Abstract |
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Call Number |
NRSNZNO @ research @ |
Serial |
1138 |
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Author |
Gibbons, V.; Rice, S.; Lawrenson, R |
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Title |
Routine and rigidity: Barriers to insulin initiation in patients with Type 2 Diabetes |
Type |
Journal Article |
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Year |
2010 |
Publication |
Kai Tiaki Nursing Research |
Abbreviated Journal |
NZNO Library |
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Volume |
1 |
Issue |
1 |
Pages |
19-22 |
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Keywords |
Medication compliance; Diabetes Mellitus, Non-Insulin-Dependent; Primary health care |
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Abstract |
It has been shown that intensive management of diabetes with type 2 diabetes is effective and has led to wider use of insulin. The conversion of patients from oral medication to insulin is usually managed in primary care. The study discussed here aimed to explore how patients with type 2 diabetes mellitus (T2DM) perceived insulin. The study was conducted in 2009 in an urban general practice in a large town in New Zealand with more than 300 patients with type 2 diabetes. A qualitative study was conducted with face-to-face interviews with 13 participants. The question focused on insulin initiation, lifestyle and routine. The transcribed responses were subject to thematic anaylsis. Interviews showed participants felt restricted by the prospect and eventuality of the routine and restrictions of being on insulin. Results show there needs to be a greater emphasis on the disease being progressive. This study provides the ground work for developing resources that will benefit patients with T2DM. |
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Call Number |
NZNO @ research @ |
Serial |
1339 |
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Author |
Miles, M.A.P. |
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Title |
A critical analysis of the relationships between nursing, medicine and the government in New Zealand 1984-2001 |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
NZNO Library, University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; Interprofessional relations; Policy |
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Abstract |
This thesis concerns an investigation of the tripartite arrangements between the government, the nursing and the medical sectors in New Zealand over the period 1984 to 2001 with a particular focus on primary health care. The start point is the commencement of the health reforms instituted by the Fourth New Zealand Labour Government of 1984. The thesis falls within a framework of critical inquiry, specifically, the methodology of depth hermeneutics (Thompson, 1990), a development of critical theory. The effects of political and economic policies and the methodologies of neo-liberal market reform are examined together with the concept of collaboration as an ideological symbolic form, typical of enterprise culture. The limitations of economic models such as public choice theory, agency theory and managerialism are examined from the point of view of government strategies and their effects on the relationships between the nursing and medical professions. The influence of American health care policies and their partial introduction into primary health care in New Zealand is traversed in some detail, together with the experiences of health reform in several other countries. Post election 1999, the thesis considers the effect of change of political direction consequent upon the election of a Labour Coalition government and concludes that the removal of the neo-liberal ethic by Labour may terminate entrepreneurial opportunities in the nursing profession. The thesis considers the effects of a change to Third Way political direction on national health care policy and on the medical and nursing professions. The data is derived from various texts and transcripts of interviews with 12 health professionals and health commentators. The histories and current relationships between the nursing and medical professions are examined in relation to their claims to be scientific discourses and it is argued that the issue of lack of recognition as a scientific discourse is at the root of nursing's perceived inferiority to medicine. This is further expanded in a discussion at the end of the thesis where the structure of the two professions is compared and critiqued. A conclusion is drawn that a potential for action exists to remedy the deficient structure of nursing. The thesis argues that this is the major issue which maintains nursing in the primary sector in a perceived position of inferiority to medicine. The thesis also concludes that the role of government in this triangular relationship is one of manipulation to bring about necessary fundamental change in the delivery of health services at the lowest possible cost without materially strengthening the autonomy of the nursing or the medical professions. |
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Call Number |
NRSNZNO @ research @ 1146 |
Serial |
1131 |
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Author |
Morgan, F.A. |
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Title |
Primary health care nurses supporting families parenting pre-term infants |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
NZNO Library, University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; Community health nursing; Paediatric nursing; Premature infants |
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Abstract |
This thesis reviews the role of primary health care nurses, who have an opportunity to play a unique role in teaching, touching and empowering families with newly discharged pre-term babies. Birth of a baby earlier than 37 weeks gestation ushers in a period of uncertainty and stress for parents. Uncertainties may centre on whether their infant will survive and what ongoing growth and developmental issues their infant will face. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1132 |
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Author |
O'Malley, J. |
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Title |
Critical social analysis of acute institutionally based mental health nursing following an action research project |
Type |
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Year |
2001 |
Publication |
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Abbreviated Journal |
NZNO Library, Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; Hospitals; Quality of health care |
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Abstract |
This study using action research involving twelve registered nurses worked toward improving nursing care in an acute mental health in-patient service. Following focus groups with consumers, families, nurses, doctors, and allied health professionals, the action research group developed projects over eighteen months to improve continuity and consistency of nursing care. There was a subsequent restructuring of nursing service to better define leadership, accountability and to strengthen care delivery. The second half of the thesis involves a critical social analysis of the research data and produces a theory of mental health nursing which, the author suggests, has wide application in practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1133 |
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Author |
Litchfield, M.; Ross, J. |
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Title |
The role of rural nurses: National survey |
Type |
Report |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Online on the Ministry of Health's Centre for Rural Health pages |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Personnel; Nursing specialties; Primary health care |
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Abstract |
A survey was used to reach as many nurses as possible involved with nursing in “rural” areas throughout New Zealand and to build a profile of nurses involved in the provision of healthcare beyond the urban centres. The contact also sought to inform nurses of the rural healthcare project and encourage them to contribute their experience to the development of health services in the new health service structure. Data is presented on the characteristics and employment conditions of nurses and access to resources including information technology. The inadequacy of information on the rural nurse workforce is identified: nurse roles are historically defined yet employment patterns are changing according to the workforce demands of new structures, and the existing definitions of rural health service design and delivery are only in terms of general medical practices and on-call coverage. Recommendations are made for definitions of “rurality” and “rural nurse” that will allow a more useful depiction of the nurse workforce. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1175 |
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Author |
Litchfield, M. |
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Title |
The successful design and delivery of rural health services: The meaning of success |
Type |
Report |
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Year |
2002 |
Publication |
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Abbreviated Journal |
Online on the Ministry of Health's Centre for Rural Health pages |
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Volume |
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Issue |
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Pages |
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Keywords |
Evaluation; Rural health services; Primary health care |
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Abstract |
This is the report of the analysis of data from an in-depth survey designed by Sue Dawson, previously Rural Health Researcher in the Centre for Rural Health, and follow-up interviews. The study purpose was to construct a definition of “successful design and delivery of rural health services” as a step towards a measurement tool. Participants were grouped as general practitioners, nurses and community representatives. A format for a participatory approach to evaluation of rural health services is derived from the criteria of success identified, with its relevance for the implementation of the new Government primary health care strategy explicit. This format provided the basis for a subsequent evaluation case study undertaken in a small rural forestry township by the Centre for Rural Health. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1177 |
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