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Author |
Litchfield, M. |
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Title |
A framework of complementary models of nursing practice: A study of nursing roles and practice for a new era of healthcare provision in New Zealand |
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Report |
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Year |
2001 |
Publication |
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Abbreviated Journal |
Online on the Ministry of Health's Centre for Rural Health pages |
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Keywords |
Nursing models; Rural nursing; Policy; Scope of practice |
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Abstract |
This is the second of a series of research projects undertaken to present the contemporary picture of the nurse workforce and their work in rural settings to inform policy for development of rural healthcare. The document presents the findings of telephone interviews with nurses in different work rural work settings around the country discussing their practice. The analysis identified a framework of four models of nursing practice: two traditional models defined by the institutions employing nurses, and two emerging models defined by the new positions requiring nurses to respond directly to health need. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1176 |
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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 |
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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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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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Author |
Litchfield, M. |
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Title |
Towards a people-pivotal paradigm for healthcare: Report of the Turangi primary health care nursing innovation 2003-2006 |
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Manuscript |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Held by the Ministry of Health, publication pending |
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Keywords |
Evaluation; Community health nursing; Nursing models; Interprofessional relations |
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Abstract |
This report presents the findings of the developmental evaluation programme for the three-year innovation project. It includes the model of the integrative nursing service scheme with mobile whanau/family nurses as the hub of healthcare provision for a new paradigm of service design and delivery spanning primary-secondary-tertiary sectors. The form of healthcare the local people received, the nature of the nursing practice and role, service delivery and employment parameters required to support the nurses in practice are presented. The service configuration model subsequently gave the structure to Lake Taupo Primary Health Organisation with the hub of family nurses with a mobile comprehensive practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1178 |
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Author |
Kingsbury, K. |
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Title |
The illlusion of separateness, a philosophical study of nursing and naturopathic practice: Healing connections between people |
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Year |
2000 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Alternative therapies; Nurse practitioners; Nursing models |
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Abstract |
This thesis describes the journey of a practicing independent nurse practitioner and naturopath through the stories of five clients. The thesis is presented as a narrative and begins with an account of the events in the practitioner's life that lead to the specific study of natural therapies and the development of a cohesive practice using holistic health practices from a nursing perspective. The text essentially describes the process of establishing a private practice combining two disciplines of nursing and naturopathy in New Zealand. The study reveals how a nurse and naturopath's practice is based on the premise that it is crucial to recognise that the personal life and professional life of the nurse inform and influence each other and are always part of the process of care in such a practice. Three healing modalities that are central to the practice are described in detail. The description is informed by theory and research from nursing, the social sciences and the natural sciences. The study reveals the practical value of postmodern nurse theorists, Jean Watson and Margaret Newman to this practice. This study also briefly discusses the concepts from quantum theory, evolutionary theory and psychoneuroirnmunology that are used in the practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1181 |
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Author |
Anderson, P.R. |
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Title |
Determining competency for entry to nursing practice: A grounded theory study |
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Year |
2008 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Professional competence; Clinical supervision; Nursing; Education |
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Abstract |
Critical Comparative Nursing Assessment (CCNA) is a theory about how the competence of completing Bachelor of Nursing students in New Zealand is determined. Semi-structured, audio-taped interviews and field notes were used to collect data from twenty-seven nurses with experience in undertaking competency assessment. A Glaserian grounded theory approach was used to guide the data collection and analysis. This utilised the processes of constant comparative analysis, theoretical sampling and saturation to generate a middle range substantive grounded theory. This is presented as a model consisting of four emergent categories that explain how nurses formulate professional judgements about competence. These are a) gathering, which describes the processes used to collect evidence of practice to inform decisions; b) weighing up, which explains how evidence is analysed using the processes of benchmarking and comparative analysis; c) judging brings into focus the tensions inherent in making professional judgements about competence and how nurses formulated these, and d) moderating, which describes the processes nurses use to validate decisions and ensure that professional responsibilities and public safety are upheld. The basic social psychological process of comparing integrates these categories to explain how nurses resolve the tensions associated with making decisions about competence. This research presents a new way of viewing and understanding how nurses assess competence. It identifies where the challengers and tensions related to the assessment of competence lie and suggests strategies that if implemented, the author suggests could further enhance the validity and reliability of assessment outcomes. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1182 |
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Author |
Pearson, J.R. |
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Title |
Health promotion in one New Zealand primary school: A case study |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Health promotion; Evaluation; Students; Maori; Pacific peoples; Health education |
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Abstract |
The objectives of this study were to explore the concept of the 'health-promoting school' in a specific New Zealand context; to develop and use appropriate research methods to assess a single low decile school in relation to World Health Organization health-promoting school components and checkpoints; to work with the school community to identify health issues; and, to record external and internal changes that could impact on school health over a finite time period. Case study was selected as the most appropriate method to collect both quantitative and qualitative evidence with the aim of providing a clear understanding of the particular case. Results confirmed that the school was working appropriately within the scope of their educational practice to provide a health-promoting school environment for the school community. Gaps and issues identified included an element of talking past each other between the cultures of the education organisation and the nominated health service provider respectively that contributed to a lack of appropriate and accessible health service delivery for the school population. Teaching staff considered that they had insufficient access to health knowledge, and input from health service staff did not meet health education requirements for the school. Staff preference for increased school nurse involvement was not realised. The consequence was that two outside agencies (KiwiCan and Life Education Trust) delivered the bulk of the Health and Physical Education curriculum which resulted in a degree of fragmentation of health education for students. The issues that were identified demonstrated that health services in the area were not satisfactorily meeting the needs of the community and were not addressing the health inequities for the predominantly Pacific Island and Maori students and of their families that formed the school community. The researcher concluded that a full-service school approach should be considered by the school and the local district health board as one way to overcome the current lack of access to health services for the school community. Assertions included the potential integration of locally available services by a school-based nurse coordinator supported by health professionals (nurse practitioner and Pacific Island Community Health Worker) and social workers. The vision included professionals working within their professional scopes of practice as part of a Primary Health Organisation with the aim of appropriately addressing the health inequities experienced by the school population. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1184 |
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Author |
Joyce, M. |
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Title |
The Strengths Perspective: Relevance and application to mental health nursing and crisis resolution work |
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Year |
2004 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Psychiatric Nursing; Nursing models; Evidence-based medicine |
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Abstract |
This research paper aims to explore the contribution of the Strengths Perspective to mental health nursing practice. The Strengths Perspective emerged from the area of social work and is primarily concerned with emphasising the strengths and resources of the person, as they define them. The premise is that if a person is able to identify and call on those strengths then he or she is able to improve the quality of their life. The paper outlines the historical, philosophical and moral foundations of the Strengths Perspective and discusses the humanistic approach to mental health nursing. The aim is to demonstrate that the Strengths Perspective and mental health nursing have a strong alignment, particularly with regard to a person-centred approach to care. The influence and constraints of the biomedical model on both mental health nursing and strengths based practice is a theme of the paper. The contention is that the biomedical or pathological approach to care can often disable, not enable consumers of health care, whereas an approach that centres on a person and their strengths is more likely to empower and liberate. The paper concludes with a discussion of themes that emerged from reflection on the literature and propositions are then made about how mental health nurses might orientate their thinking and practice to utilise the Strengths Perspective to augment their clinical work. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1185 |
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Author |
Narbey, N. |
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Title |
Cognitive Behaviour Therapy in psychosis: Relevance to mental health nurses |
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Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; Psychology; Evidence-based medicine |
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Abstract |
The author uses his personal and professional experience to explore the application of Cognitive Behavioural Therapy in caring for people who experience psychosis. Psychosis can be a life-threatening illness; about one in ten young men with psychosis will take their own lives. Much of the progress in treatment has been predicated on a biological explanation of psychosis. The late 1990s have seen increasing interest in psychological approaches in the treatment of psychosis; not withstanding that this treatment does not work for all people. The first aim of this research report is to develop understanding about Cognitive Behavioural Therapy, through exploration of its origins and examining the theoretical basis and reviewing the evidence that may support its use. The second aim is to explore the evidence around mental health nurses' training and use of Cognitive Behavioural Therapy, by critically examining some of the major UK and Australian reports. The author considers that Cognitive Behavioural Therapy is theoretically and pragmatically compatible with contemporary nursing practice, and will have increasing prominence for New Zealand mental health nurses. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1187 |
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Author |
Lally, E.J. |
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Title |
An exploration of language and nursing practice to improve communication in the context of ear syringing |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Pages |
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Keywords |
Communication; Practice nurses; Economics |
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Abstract |
This action research inquiry explores communication and nursing practice in an effort to improve practice and enhance patient care. Action research is a critical reflective process that involves spirals or cycles of planning, acting, reflecting/evaluating and replanning the next cycle. Using ear syringing as a procedure, in the general practice setting and at two separate surgeries, the author and another practice nurse co-researched this study during working hours. Twelve people consented to participate in the research that involved the audiotaping of each ear syringing interaction. Following each transcription of the recording, the researchers read their own and then each other's transcripts, and listened to the recordings. They discussed and reflected on their findings and planned the next cycle. Throughout the process, the researchers found a number of areas of practice to change or enhance. Changes included the use of technical language such as “contraindications” and “auditory meatus”, the side effects of syringing, improvements in communicating situations where ear syringing is not recommended and the options available, and post procedure information. These changes became a significant challenge, for example when both researchers forgot the changes, thus repeating previous errors and omissions. This factor highlighted the need to practise any changes prior to interactions, and to have a cue card on hand to facilitate recollection and to cement improvements into practice. Although time constraints limited this inquiry to three cycles, at the final meeting the researchers agreed to continue the reflective process they had begun to explore their practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1189 |
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Author |
McLoughlin, N. |
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Title |
Dying to know: Advancing palliative care nursing competence with education in elderly health settings |
Type |
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Year |
2007 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Issue |
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Pages |
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Keywords |
Professional development; Nursing specialties; Palliative care; Nursing; Education |
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Abstract |
This paper explores the benefits of using education as one means to advance palliative care competence for nurses. A literature search was conducted revealing numerous educational initiatives and approaches have been developed to improve palliative care. Benefits include improved nursing knowledge, confidence and competence which directly correlate with improved patient outcomes. Accompanying the shift of palliative care from hospices to varied health care providers globally, are disparities in care provision. The literature suggests that reasons for such disparities include insufficient specialised palliative care knowledge and skills of nurses to effectively deliver this care within generalist health settings and lack of information for caregivers. In response, approaches aimed at improving palliative care include reviewing, redefining and implementing nursing roles, education courses, and theoretical frameworks to inform practice and improve outcomes. This paper focuses on the benefits of offering tailored palliative care education in work settings to improve patient care. One entrepreneurial education initiative aimed at advancing palliative nursing and which is currently being implemented in aged care contexts is shared. Careful strategic planning and working more collaboratively between all stakeholders, is strongly recommended in order to manage current and future challenges. Advancing palliative nursing care using appropriate education is achievable and beneficial but is fraught with complexities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1190 |
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Author |
McLauchlan, M.F. |
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Title |
Mobile computing in a New Zealand Bachelor of nursing programme |
Type |
Book Chapter |
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Year |
2006 |
Publication |
Consumer-Centered Computer-Supported Care for Healthy People. Studies in health technology and informatics, 122 (pp. 605-608) |
Abbreviated Journal |
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Issue |
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Pages |
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Keywords |
Technology; Curriculum; Nursing; Education; Professional competence |
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Abstract |
Mobile computing is rapidly becoming a reality in New Zealand health care settings. Personal Digital Assistants (PDAs) are the most frequently used of these mobile technologies, giving nurses access to clinical learning resources, including drug references, medical encyclopaedias and diagnostic information. The implementation of mobile computing at Waikato Institute of Technology (Wintec) will ensure graduates of our Bachelor of Nursing Programme are able to meet health care service demands for knowledge in contemporary information technologies as well as the information technology requirements defined by the Nursing Council of New Zealand and the Health Practitioners Competency Assurance Act 2003 for registration as a nurse in New Zealand. This paper presents strategies for the implementation of mobile computing as a core element of the curriculum for the Bachelor of Nursing Programme at Wintec in Hamilton. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1192 |
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Author |
McEldowney, R.A. |
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Title |
Shape-shifting: Stories of teaching for social change in nursing |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Issue |
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Keywords |
Nursing philosophy; Teaching methods; Feminist critique; Qualiltative research |
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Abstract |
This research explores why and how nurse educators teach for social change. Critical feminist educators provide a useful framework for theorising about teaching for change that addresses issues of hegemony, agency, praxis, individual voice, difference, justice and equity. Six women Pakeha/Tauiwi nurse educators from throughout New Zealand volunteered to participate in this research and share their lived experiences of teaching for social change. In-depth conversations over two years unfolded new and rich material about how and why these six women continue to teach the evaded subjects, like mental health, women's health, community development and cultural safety. All teach in counter-hegemonic ways, opening students' eyes to the unseen and unspoken. Among the significant things to emerge during the research was the metaphorical construct of shape-shifting as an active process in teaching for social change. It revealed the connectedness and integrity between life as lived and the moral imperative that motivates the participants to teach for difference. Shape-shifting was also reflected in other key findings of the study. As change agents, the participants have had significant shape-shifting experiences in their lives; they live and work as shape-shifters within complex social and political structures and processes to achieve social justice; and, they deal with areas of health practice where clients are socially and politically displaced. The research also generated new methods for gathering life-stories and new processes for analysis and interpretation of life-stories. It is hoped that this research will open pathways for other nurse educators to become shape-shifters teaching for social change. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1193 |
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Author |
Polaschek, N. |
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Title |
The concerns of Pakeha men living on home haemodialysis: A critical interpretive study |
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Year |
2000 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Pages |
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Keywords |
Gender; Chronically ill; Nursing |
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Abstract |
This nursing study seeks to understand the experience of one group of people with chronic renal failure using renal replacement therapy, Pakeha men living on home haemodialysis. It is based on the assumptions that people living on dialysis have distinctive experiences that are characterised by common concerns reflecting their shared position as subjects of renal illness and therapy. In order to understand the experience of people living on dialysis, this study develops a critical interpretive approach, seeking the participant's own interpretation of their individual experiences. The experiences are then reinterpreted them from a critical standpoint, recognising that they can only be adequately understood by contextualising them. This enables the researcher to discern the common perspective underlying them in contrast to the dominant professional viewpoint in the renal setting. The concerns identified include symptoms from chronic renal failure and dialysis, limitations resulting from the negotiation of the therapeutic regime into their lifestyle, their sense of ongoingness and uncertainty of living on dialysis, and the altered interrelationship between autonomy and dependence inherent in living on dialysis. The study suggests that the individual accounts can be understood as resulting from the interaction of the various dimensions of their own personal social locations, including their gender and ethnicity, with the concerns of client discourse, reflecting their common position as people living on dialysis. The author concludes that one implication of this understanding is that the role of nursing in the renal setting can be articulated as a response to the experience of the person living on dialysis. The nurse can support the renal client in seeking to integrate the requirements of the therapeutic regime into their personal situation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1195 |
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Author |
Clissold, C. |
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Title |
How discourses stifle the Primary Health Care Strategy's intent to reduce health inequalities |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Community health nursing; Policy; Primary health care |
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Abstract |
The Primary Health Care Strategy (PHCS) has a stated commitment to defined populations who suffer disproportionately from ill health. This thesis examines whether some prevailing discourses actually decrease the focus on health inequalities. A study of the nursing and medical media found that it focused predominantly on professional and industrial issues, leaving health workers focused mainly on their own professional interests, rather than considering the effects on health inequalities. She goes on to suggest that current Ministry of Health discourse values decentralised community health decision making. This may gloss over factors in community health which are affected by Government policy such as employment policy, and thus should be dealt with centrally by legislation. These factors have been found to be the most pertinent in health inequalities. So while models of community partnerships may seem to place communities as agents in their own health, this downplays the determinants of health which are beyond their control. Having shown that discourse can decrease the focus on health inequalities due to other professional and political drivers, the author then looked at health initiative concepts which are effective, efficient and equitable given the current set up of PHOs and nursing innovations. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1196 |
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Author |
Cleary, H. |
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Title |
Caring and bioethics: Perspectives, predicaments and possibilities |
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Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Ethics; Feminist critique; Nurse-patient relations |
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Abstract |
This thesis presents an explorative study of the place of caring in bioethics. Through the examination of various sources of literature from the disciplines of nursing, feminist theory and ethics, and bioethics, a case is developed that argues for a valid respected place for caring, as an ethic of care in bioethical decision-making. The case is built by providing evidence to support the fundamental importance of caring to human life, health, relationships, and survival at the broad societal level. This is presented from the feminist and nursing perspectives, along with a critique of the negative aspects of caring practices. The next stage of the case presents a layout of the discipline of bioethics, using an historical perspective to illuminate the influences of bioethics' deep past, as it still affects the discipline in the present. The development of contemporary bioethics' current status is presented along with critiques from bioethicists themselves, and nursing and feminist theory and ethics. In the case at this point, from a bioethical perspective, two major predicaments appear to prevent an ethic of care obtaining a valid place in ethical decision-making in bioethics. These are the justice/care duality, and the conflict between different conceptions of care and autonomy. The bioethical objections and arguments put forward regarding these predicaments are examined and refuted, and the author suggests a case is established for the inclusion of an ethic of care in bioethical decision-making. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1198 |
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