Abstract: A research portfolio submitted in partial fulfilment of the requirements for the degree of Master of Nursing, The University of Auckland, 2009
This paper is a report of a study seeking to understand the experience of New Zealand rural dwelling Mäori clients with end-stage renal disease who receive haemodialysis. End stage renal disease (ESRD) is related to lifestyle, genetic factors and environment, and Mäori are at higher risk of renal disease which results of need for renal replacement therapy to sustain their lives. Dialysis clients are a group of ?silent? clients under the care of the dominant health professionals. Adherence with therapeutic regimes has been a main issue for health care professionals and service delivery, as it directly contributes to the efficacy of the treatment and cost effectiveness. Mäori clients? experience of living with haemodialysis has not been explored. Although there are a number of studies describing the experience of patients living on dialysis so far, no studies have yet focused specifically on the experience of Mäori clients towards their renal replacement therapy. The continual demands of dialysis treatment are significant and given the high proportion of Mäori having dialysis. It is timely to explore the experience of Mäori clients and their family/whänau in order to understand the need for quality of care and to promote Mäori health outcomes in chronic kidney disease management

Abstract: A dissertation submitted in partial fulfilment for the degree of Master of Health Sciences.
Primary nursing as a framework within which nurses deliver patient care has been a nursing care delivery system of choice in New Zealand for the last two decades. A number of studies have been carried out, with a review of the literature suggesting inconclusive support for this delivery system over other functional nursing care models. However, there is support for the philosophy underpinning this model, with documented evidence that this framework can help nurses achieve a degree of professional development and autonomous practice that other models cannot. Using documented information created during the move from one model of nursing care to another this work evaluates what were the drivers for the change, how it was managed and what the outcomes were.
Findings indicated that this change project was a success. Analysis of the data collected pre and post implementation indicated some positive shifts, but more importantly it was the information gathered from both patients and nurses that gave creditability to the new model of nursing care.

Abstract: Current research has confirmed that cigarette smoking is a risk factor for cervical cancer. The objective of this pilot study was to observe if women who smoked and were referred to the colposcopy department at Christchurch Women?s Hospital, required more follow up visits, treatments and re-referrals compared to non-smokers. New patients (n=494) who attended at the Christchurch Women?s Hospital colposcopy department in 2001 had their data observed for a six year period. The results identified that women who smoked were three times more likely to need a third follow up visit and twice more likely to need further treatments to remove abnormalities when compared to non-smokers. This pilot study also identified that 71% of Maori women attending the clinic were smokers compared to 44% of non-Maori women. The results are being used to highlight to health professionals that treatment has a greater chance of success if patients cease smoking. The results have also supported the maintenance and development of the smoking cessation clinic for colposcopy patients at Christchurch Women's Hospital where the link to cervical abnormalities and smoking is explained and behaviour modification is offered. We also found that Maori women were poor attendees for colposcopy when compared to non-Maori and these results identified a need for further research and development of strategies to improve attendance.