Abstract: The aim of this paper was to articulate selected hermeneutic notions for the purpose of extending current understanding of cross-cultural nursing practice, and build on the author's work in this area. The project asserted that the notions of prejudice, paradox and possibility portray a nursing view of this phenomenon. The emphasis in this paper, rather than being methodological, is on showing how specific hermeneutic notions contribute to deeper understanding of the nature of cross-cultural practice. It is argued that contact with, and the capacity to explore, the play of conflicting prejudices and possibilities enhances understanding of the complex and paradoxical nature of cross-cultural nursing.

Abstract: This paper is a report of a study to explore the experiences of 'almost old' women as they grow older while living with a chronic condition. Little is known about the contextual effects of ageing and how it shapes and is shaped by a woman's chronic illness experience. Seven women aged between 50 and 58 years participated in this interpretive descriptive study that explored the issues of ageing with a chronic condition. Three focus groups were held between March 2003 and March 2004. Transcriptions were analysed after each focus group. Participants were given the opportunity to respond to the findings as the analysis progressed. The experience of living with a chronic illness foreshadowed what was to come with ageing and embodied the ageing process: it was just part of their lives. Alongside this, the women now felt less out of place. Their peers were catching up and beginning to experience aspects of participants' everyday reality. The women, however, experienced double jeopardy because ageing amplified the ongoing vulnerabilities of living with a chronic condition. The authors conclude that nurses who recognise the resourcefulness and expertise of women who live with a chronic condition can effectively be co-strategists in helping them to age well.

Abstract: The aim of this study was to determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a New Zealand primary school environment as a means of addressing the health needs of children and families. A secondary aim was to ascertain whether public health nurses were the most appropriate nurses to lead such a clinic. Utilising a community needs analysis method, data were collected from demographic data, 17 key informant interviews and two focus group interviews. Analysis was exploratory and descriptive. Findings included the identification of a wide range of health issues. These included asthma management and control issues, the need to address poor parenting, and specific problems of the refugee and migrant population. Findings also demonstrated that participant understanding of the role of the public health nurse was less than anticipated and that community expectations were such that for a public health nurse to lead a primary health care clinic it would be likely that further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed plan that would serve to address the health needs of children and families in the area the study was undertaken. Services that participants identified as being appropriate included health information, health education, health assessment and referral. The authors conclude that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment was feasible. While a public health nurse may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required.

Abstract: This paper reports a study exploring people's perceptions of disclosure about lesbian, gay and bisexual identity to their primary healthcare providers. Disclosure of sexual identity to healthcare professionals is integral to attending to the health needs of lesbian, gay and bisexual populations, as non-disclosure has been shown to have a negative impact on the health of these people. From April to July 2004, a national survey of lesbian, gay and bisexual persons was carried out in New Zealand. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues, and 2269 people completed the questionnaire, either electronically or via hard copy. The 133-item instrument included a range of closed-response questions in a variety of domains of interest. In this paper, we report results from the health and well-being domain. More women than men identified that the practitioner's attitude toward their non-heterosexual identity was important when choosing a primary healthcare provider. Statistically significantly more women than men reported that their healthcare provider usually or always presumed that they were heterosexual and in addition more women had disclosed their sexual identity to their healthcare provider. The authors advise that nurses reconsider their approach to all users of healthcare services by not assuming everyone is heterosexual, integrating questions about sexual identity into health interviews and ensuring that all other aspects of the assessment process are appropriate and safe for lesbian, gay and bisexual people.

Abstract: The aim of this paper is to report on an exploratory, qualitative study exploring what people living with terminal illness considered were the areas of priority in their lives. Ten people living with terminal cancer were interviewed. Analysis of the interviews incorporated principles of narrative analysis and grounded theory. Over 30 categories were identified and collated into five inter-related themes (personal/intrinsic factors, external/extrinsic factors, future issues, perceptions of normality and taking charge) encompassing the issues of importance to all participants. Each theme focused on 'life and living' in relation to life as it was or would be without illness. Practical issues of daily living and the opportunity to address philosophical issues around the meaning of life emerged as important areas. The central theme, 'taking charge', concerned with people's levels of life engagement, was integrally connected to all other themes. The findings suggest that the way in which health professionals manage patients' involvement in matters such as symptom relief can impact on existential areas of concern. The findings challenge some aspects of traditional 'expert-defined' outcome measures. As this was an exploratory study, further work is needed to test and develop the model presented.

Abstract: The aim of this study was to evaluate whether the services that community mental health nurses provide are meeting the needs of consumers in the community. This was a joint project between nurses and consumers. It was a service-specific descriptive research project utilising qualitative methods of data collection and analysis that provides a model for working in partnership. The results of this research identify collaboration in planning care and sharing information as two areas of concern but generally the consumers were very satisfied with the care provided by community mental health nurses. The analysis of the data suggests that consumers value nursing care because nurses provide support in their own home; they help consumers develop strategies for coping with their illness and their life; they provide practical assistance when it is required; they are vigilant about any deterioration or improvement; and they are available and accessible. The results of this study have demonstrated that nurses will remain critical to the success of community-based care because of their ability and willingness to be flexible to the demands of their own organisation and the users of services.

Abstract: This article elaborates the meaning of partnership in practice for nurses practising in different and complementary way to nurses in specialist roles and medical practitioners. It positions partnership as the relational core of nursing practice. Partnership is presented as an evolving dialogue between nurse and patient, which is characterised by open, caring, mutually responsive and non-directive approaches. This partnership occurs within a health system that is dominated by technologically-driven, prescriptive, and outcome-oriented approaches. It is the second of a series of articles written as a partnership between nurse scholars from Iceland, NZ and USA.

Abstract: This chapter describes the development of a nurse-led after-hours telephone triage service in a rural secondary hospital in the Hawke's Bay District Health Board area. This service was a response to the health restructuring in the 1990s, which had led to the shift of secondary services out of the rural areas, and workforce recruitment issues. Secondly, it discusses the process and findings of a research project undertaken to identify and describe telephone callers' reported outcomes after using the service. The study found a high level of satisfaction amongst callers and a high level of compliance to advice.