Abstract: The researchers assessed the compliance rates with the rheumatic fever secondary prophylaxis programme established through the Auckland Rheumatic Fever Register and managed by community nursing services in Auckland. They undertook an audit of the 1998 and 2000 Auckland Rheumatic Fever Register data to establish the compliance rates of patients with the rheumatic fever secondary prophylaxis programme. The sample included all patients on the Auckland Rheumatic Fever Register during this time. Results showed compliance rates across the three Auckland DHBs ranging from 79.9% to 100% for individual community nursing offices. They found that a community-based nurse-led secondary prophylaxis programme for rheumatic fever heart disease is able to deliver excellent patient compliance levels. Secondary prophylaxis is the WHO-recommended cost effective first step to rheumatic fever/rheumatic heart disease control. Community health workers have a key role to play in facilitating this compliance.

Abstract: The research on which this thesis is based involves both a private narrative and a public narrative, with the story of cultural safety, and the history, theory and the future direction gathered into one qualitative work. The work is divided into three sections. The first is entitled, Ko Wai Matou? The Private Narrative. This section seeks to explore the historical, social, educational, physical, emotional, political and moral influences and ephiphanies which brought about the personality which introduced cultural safety ideas into nursing and midwifery. Early nursing practice is investigated and examples from practice are used to illustrate learning and consolidation of the ideas which led to Cultural Safety Theory. The second section is entitled He Huarahi Hou: A New Pathway. This section explains the progress of the theory and its relationship to education pedagogy and to nursing practice. Comparison between the work of Madeline Leininger and the Transcultural Theory of Nursing and the New Zealand concept of cultural safety is undertaken. The role and application of the Treaty of Waitangi to the theory of cultural safety is explored in this section. The third section, entitled He Whakawhanuitanga: The Public Narrative, looks at the introduction of cultural safety into the nursing education system and its implementation. The public and media reaction to the inclusion of cultural safety in the national examination for nursing registration and the subsequent parliamentary response are noted. The interviews with nursing and midwifery leadership, Maori and pakeha key players in the process and consumer views of the ideas are documented and pertinent excerpts have been included. The work concludes with a discussion on the likely future of cultural safety as a theory and in practice and outlines several issues which represent a challenge to the viability of the concept in nursing and midwifery education. The author notes that the story of cultural safety is a personal story, but also a very public one. It is set in neo-colonial New Zealand, but has implications for indigenous people throughout the world. It is about human samenesses and human differences, but is also a story about all interactions between nurses and patients because all are power laden. Finally, she points out that, although it is about nursing, it is also relevant to all encounters, all exchanges between health care workers and patients.

Abstract: The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. The authors conclude this is an area for the development of the nurse practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition.

Abstract: The report of a research project commissioned by the Wellington Division of the New Zealand Cancer Society to provide a foundation for policy to give direction to development of its services. The research approach and methodology had an ecological theory foundation. It involved a survey and in-depth interviews with people with cancer and those caring for them to understand their experience. Needs were identified from the data and presented according to three distinct phases in the course of living with cancer. People moved from the shock of diagnosis, through the time of treatment when usual living was suspended and focus narrowed on the intensive fight against the disease, then into a very different phase of on-going ?wait-and-see? time requiring a new way of living with uncertainty for both patient and carers. The last phase was where most of the unmet needs lay. Recommendations were made for services to provide a continuous caring relationship for patients and carers with a knowledgeable person from the point of diagnosis.

Abstract: The relevance of Nursing Curricula and the degree of effectiveness of their outcomes for the 'consumer' ( clients, students, a given society) are seen as commiserate to the degree that a curriculum is developed with due regard for the 'social realities' of a society. "Social realities' are defined as the actual conditions, pressures, disabilities and abilities, limitations and resources that exist in the lifespan of people and form the environment within which Nursing practices. A Curriculum relevancy process ( CRP) has been developed for use as the main analytical tool of the study. CRP has been designated as an information seeking, problem solving and evaluative process. It consists of three phases with a major emphasis on the first phase, information seeking. Information has been gathered about contemporary social realities ( the year of 1979) and related Socio- health disorders. Information has been gathered and analysed from official ad voluntary sources and the findings related to curricular choices for Nursing education

Abstract: The question for this study arose from the observation that health care often does not match the client's self-determined needs and desires, and hence is wasted care. As a result, the study proposed to discover what elements are involved when women with dependent children make health care choices and what they want in the way of health care.The exploratory study was conducted using strategies of grounded theory. Fourteen in-depth interviews, involving eleven women, were conducted. The selection of participants and of the questions for the interviews was basef on theoretical sampling. Constant comparative analysis and integrative diagramming were used to analyse the data.The theory that emerged from the data was Bonded Caring and its two essential categories; Interconnectedness and Caring. Bonded Caring requires an intimate and ongoing relationship in which there is development of in-depth knowledge of the unique characteristics of the person(s) involved. It is characterised by a strong and enduring effective quality, and by a concern, worry and serious attention to the needs of the person(s) involved. This concern necessitates the gathering of information about the nature of the needs, and making the best possible choices concerning their management.During this research for knowledge and skills needed to carry out health care, women assess their own knowledge and experience; the level(s) of health care needed by each individual; the availability, competence and expected response of the resource person or health care consultant; the perception of risk associated with a health concern; and the family's culture and life style. The women considered these elements within a structural framework of finite material and personal resources. The women juggled the distribution of these resources in a way that allowed them to select the avenues of health care that provided the best degree of safety and protection of development within the context of their circumstances

Abstract: The purpose of this thesis is to give voice to school nursing as a primary health care specialty, and to promote the development of school nursing in New Zealand. School nursing is an invisible practice specialty that is largely funded from within the education sector, to address the health needs of student clients. School nursing is a significant primary health care initiative that can positively influence student health outcomes. The author presents her own school nursing practice experience and philosophy, prior to reflecting upon the history of school nursing, and the health concerns present within the student population. The work then moves to review and critique school nursing literature from New Zealand, Australia, the United Kingdom, and the United States. This thesis highlights the need for collaborative policy and practice development initiatives including a legislative requirement for school nurses, school nursing competencies and standards, school nurse to student ratios, postgraduate training, professional liaison, practice funding, and research. A discourse on the reflective topical autobiographical method introduces autobiographical poetry from school nursing practice and reflective inquiry, as the central research endeavour of this thesis. Autobiographical poetry is offered as a window to this specialty practice, and accompanying reflections allow access to a further layer of practice knowledge.