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Brunton, M., Cook, C., Walker, L., & Clendon, J. (2017). Where are we?: workplace communication between RNs in culturally-diverse healthcare organisations; Analysis of a 2-phase, mixed-method study: a report prepared for the New Zealand Nursing Education and Research Foundation. Wellington: Massey University.
Abstract: Examines cultural influences on perceptions and practices of cross-cultural communication among registered nursing staff from diverse ethnicities in NZ. Employs an exploratory approach to obtain qualitative feedback by means of semi-structured interviews with 36 Internationally Qualified Nurses (IQN) and 17 NZ Registered Nurses (NZRN). Uses data from the interviews to construct a questionnaire survey to seek responses from a random national sample of RNs.
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Crawford, R. (2019). Using focused ethnography in nursing research. Kai Tiaki Nursing Research, 10(1), 63–67.
Abstract: Details how the author employed focused ethnography in her doctoral research to investigate nurses' and parents' experience of emotional communication in the context of a children's unit of a regional hospital in NZ. Interviews 10 parents and 10 nurses after the children were discharged. Validates the ethnographic method as a means of inspecting the hidden as well as observable aspects of nurse-parent interaction.
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Cook, C., & Brunton, M. (2014). The influence of the Cartwright Report on gynaecological examinations and nurses' communication. Nursing Praxis in New Zealand, 30(2), 28–38.
Abstract: Reports findings from semi-structured interviews with 6 nurses and 7 women patients at a sexual health clinic where the women reported positive experiences of speculum examinations. Combines data with that from interviews with 16 patients and 16 clinicians regarding positive examinations, and analyses data to identify which clinical communication strategies were used, and how the women responded. Highlights the legacy of the Cartwright Report of the Cervical Cancer Inquiry of 1987/88.
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Ferguson, K. M. (2021). The appropriation of cultural safety: A mixed methods analysis. Ph.D. thesis, University of Otago, Dunedin. Retrieved July 4, 2024, from http://hdl.handle.net/10523/12207
Abstract: Argues that the concept of cultural safety (CS) has been appropriated from an indigenous-led bicutural context to an inclusive cross-cultural framework for working with diverse patient populations. Investigates nurses' understanding of the 'Guidelines for Cultural Safety, the Treaty of Waitangi and Maori Health in Nursing Education and Practice' published in 2011 by the Nursing Council of NZ. Conducts a mixed-methods survey using both closed and open-ended questions to gauge nurses' confidence in applying the guidelines and their view of their relevance. Describes differences between NZ Registered Nurses (RN) and Internationally Qualified Nurses (IQN) in their understanding of CS. Argues that the CS model should be by Maori, for Maori.
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Polaschek, L., & Polaschek, N. (2007). Solution-focused conversations: A new therapeutic strategy in Well Child health nursing telephone consultations. Journal of Advanced Nursing, 59(2), 111–119.
Abstract: This paper reports a study to explore Well Child nurses' perceptions of outcomes resulting from the use of solution-focused conversations in their telephone consultations with clients. The standard problem-solving approach used to address physical issues is less effective for various non-physical concerns, where different communication strategies may be helpful. In this qualitative, action-oriented study, a small group of Well Child telenurses in New Zealand was introduced to a specific communication strategy, called 'solution-focused conversations', during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. The nurses considered that the solution-focused conversations enabled clients to: recognise the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. This study suggested the value of learning a specific communication strategy for the practice of a group of Well Child telenurses.
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Evans, S. (2006). Silence kills: Communication around adverse events in ICU. Ph.D. thesis, , .
Abstract: The aim of this dissertation is to assess the preventability or reduction of adverse events in the intensive care unit (ICU) through a literature review. Research shows the ICU is at high risk for errors, nevertheless there is a huge gap between knowing something should be done and applying this knowledge to practice. That being the case, this dissertation identifies and discusses several proven and transferable quality improvement proposals. These include: instituting anonymous error reporting; documentation of a daily goal-of-care; a nurse as ICU team co-ordinator; conflict resolution processes and communication training for all ICU staff. NThe author concludes that nurse-doctor collaboration requires the support of medicine, with recognition of the unique contribution nurses make to patient safety.
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Davies, B. (2008). Same person different nurse: A study of the relationship between nurse and patient based on the experience of shifting from secondary care to home-based nursing. Ph.D. thesis, , .
Abstract: This study focuses on power themes in the nurse-patient relationship. The study is a critical reflection of the author's practice using a humanistic perspective from Hartrick Doane and Varcoe's (2005) model of relational family practice. It reviews the literature relating to power relationships in communication between nurses and patients and compares the ability to provide relational care in the home with hospital care. Practice examples demonstrate the shift in power relationships that the author had noticed since changing roles from hospital based to home care nursing. This is related to cultural, socio-environmental, historical and traditional influences on power in communication. The study is based on her reflection of the paradigm shift in her practice. Her practice moved from a problem solving approach to an empowerment, strengths based approach within partnership. The ethical challenges of discussing her practice in relation to clients has been managed by scrambling patient data so that it is not related to a single person and is focused on the author's nursing practice.
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Tritschler, E., & Yarwood, J. (2007). Relating to families through their seasons of life: An indigenous practice model. Kai Tiaki: Nursing New Zealand, 13(5), 18–3.
Abstract: In this article the authors introduce an alternative way that nurses can be with families, using a relational process that can enhance nurses' responses when working with those transitioning to parenthood. Seasons of Life, a framework adapted from the Maori health model He Korowai Oranga, emerged from practice to offer a compassionate and encouraging stance, while at the same time respecting each family's realities and wishes. The model allows the exploration of the transition to parenthood within a wellness model, and takes a strengths-based approach to emotional distress. This approach provides a sense of “normality”, rather than of pathology, for the emotions experienced by new parents. The specific issues men may face are discussed, where despite recent culture change that allows men a more nurturing parental role, there is still no clear understanding of how men articulate their sense of pleasure or distress at this time. Practitioners are encouraged to examine their own assumptions, values and beliefs, and utilise tools such as reflective listening, respect, insight and understanding. The most significant aspect of relationship between nurse and parents is not the outcome, but how nurses engage with families. Examples from practice will demonstrate some of the differing ways this relational process framework has been effective.
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Wong, G., & Sakulneya, A. (2004). Promoting EAL nursing students' mastery of informal language. Nursing Praxis in New Zealand, 20(1), 45–52.
Abstract: This article describes the development, delivery and evaluation of a pilot programme designed to help nursing and midwifery students from Asian and non-English speaking backgrounds improve their conversational skills in practice settings. Many such students, although previously assessed as competent in English, find that communication with patients and their families, and other health professionals is difficult. The study was conducted in a large tertiary educational institution in a major metropolitan centre. Each week for a period of 11 weeks students participated in an interactive session. Content for these was based on areas highlighted by a needs assessment involving interviews with both students and lecturers, and was subject to ongoing modification in response to feedback from participants. Evaluation questionnaires completed at the conclusion of the series indicated that students perceived the impact as positive. Students who attended regularly and were actively involved in the practice activities described gains in communication skills. From this it was concluded that further development of the pilot scheme was warranted in order to benefit English as an additional language (EAL) students enrolled in nursing and midwifery courses
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Walsh, C. (2007). Personal and professional choices, tensions, and boundaries in the lives of lesbian psychiatric mental health nurses. Doctoral thesis, , .
Abstract: This study aimed to articulate how sexual identity impacts on the therapeutic relationship between the client and the lesbian nurse in psychiatric mental health nursing. There is little consideration given in the literature or in research as to how sexuality of the nurse impacts on nursing practice. Most attitudes held by the public and nursing staff are based on the assumption that everyone is heterosexual, including nurses. Fifteen lesbian psychiatric mental health nurses from throughout New Zealand volunteered for two interviews and shared their experiences of becoming and being a lesbian psychiatric mental health nurse. The stories they told give new insights into how these nurses negotiate and position their lesbian identity in the therapeutic relationship. To work therapeutically with people in mental distress the nurse uses personal information about themselves to gain rapport with the client through appropriate self-disclosure. Being real, honest and authentic are also key concepts in this relationship so the negotiation of reveal/conceal of the nurse's identity is central to ongoing therapeutic engagement. One of the most significant things arising from the research is that participants are able to maintain their honesty and authenticity in the therapeutic relationship whether they self-disclose their lesbian identity or not. This is because the experiences in their personal lives have influenced how the participants 'know themselves' and therefore guide how they 'use self' in their therapeutic nursing. The concept of a 'licensed narrative' has also been developed during this research reflecting the negotiated understandings between the researcher and the participants. Further, the use of NVivo a qualitative software package helps to track and make transparent the research processes. These two aspects make a unique contribution to the field of narrative inquiry.
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Corner, K. (2020). Perceptions of Indian IQNs transitioning into a bachelor of nursing programme in New Zealand. Kai Tiaki Nursing Research, 11(1), 61–62.
Abstract: Aims to understand the experiences of Indian internationally-qualified nurses (IQN) making the transition into a NZ bachelor of nursing (BN) programme. Conducts a focus group with four Indian IQN students enrolled in an 18-month bridging course. Identifies four themes: adaptation to a new way of learning; cultural differences in living and working in NZ; adaptation to a different clinical environment; and cultural safety.
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Gare, L. (2006). Patient experience of joint replacement education: A joint venture. Ph.D. thesis, , .
Abstract: The aim of this research was to explore patients' educational experiences and the usefulness and benefits of this health education in the rehabilitation period, when undertaking a total joint replacement. An exploratory, qualitative descriptive study method was used to describing patients' experiences of health education. Five participants, convenience sampled, were interviewed eight to twelve weeks post surgery following unilateral total joint replacement in a tertiary hospital. Participants valued the education they received pre operatively, which included written material, video and individual interaction with varied health professionals. Although this was provided in a timely manner, evidence showed limited post operative reinforcement and follow up of given education and preparation for discharge. Three 'partnership' themes were identified from data, Communicative, Subservient and Knowledge. 'Communicative Partnership' conceptualised the participants' experiences of the nurse-patient relationship, whilst 'Subservient Partnership' captured the participants' experiences of 'being' patients. 'Knowledge Partnership' combined the participants' ideas about knowledge and their retention of this knowledge to assist with their rehabilitation post surgery. The needs and experiences of patients after total joint replacement reflect on transitional change – changes in roles, behaviour, abilities and relationships. Educational contents need to reflect a realistic recovery process to assist with this transitional period, delivered by health care professionals in a manner best suited for patients.
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Woods, M. (2008). Parental resistance. Mobile and transitory discourses: A discursive analysis of parental resistance towards medical treatment for a seriously ill child. Ph.D. thesis, , .
Abstract: This qualitative thesis uses discourse analysis to examine parental resistance towards medical treatment of critically ill children. It is an investigation of the 'mobile and transitory' discourses at play in instances of resistance between parents, physicians and nurses within health care institutions, and an examination of the consequences of resistance through providing alternative ways of perceiving and therefore understanding these disagreements. The philosophical perspectives, methodology and methods used in this thesis are underpinned by selected ideas taken from the works of Michel Foucault and Pierre Bourdieu and supported by relevant literature in the fields of media, law, children, parenting, caring, serious childhood illness, medicine and nursing. It is argued that from an examination of interview based texts, parental resistance is an omnipresent but transitory occurrence that affects many of the interactions between the parents of seriously ill children and clinical staff. It is maintained that within these interactions, the seeds of this resistance are sown in both critical decision making situations and in everyday occurrences between doctors, nurses and parents within healthcare institutions. Contributing factors to parental resistance include the use of power games by staff, the language of medicine, forms of symbolic violence, the presence or absence of trust between parents and medical staff, the effects of medical habitus, and challenges to the parental role and identity. Overall, it is proposed in this thesis that parents who resist treatment for their seriously ill child are not exceptions to the normative patient-physician relationship.
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MacDonald, L. M. (2003). Nurse talk: Features of effective verbal communication used by expert district nurses. Ph.D. thesis, , .
Abstract: This thesis represents an appreciative enquiry to identify features of effective verbal communication between nurses and patients. Using a method developed by the Language in the Workplace Project (Stubbe 1998) two nurse participants recorded a small sample of their conversations with patients as they occurred naturally in clinical practice. These six conversations constitute the main body of raw data for the study. The data was analysed using a combination of discourse and ethnographic analysis. Experience in nursing, particularly insider knowledge of the context of district nursing, helped me to uncover the richness of meaning in the conversations. The subtle interconnections and nuances could easily have been missed by an outside observer. The study has shown that in their interactions with patients, expert nurses follow a pattern in terms of the structure and content of the conversations and it is possible to identify specific features of effective nurse-patient communication within these conversations. The most significant of these are the repertoire of linguistic skills available to nurses, the importance of small talk and the attention paid by nurses to building a working relationship with patients, in part, through conversation. The findings have implications for nursing education and professional development.
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Polaschek, N. (2003). Negotiated care: A model for nursing work in the renal setting. Journal of Advanced Nursing, 42(4), 355–363.
Abstract: This article outlines a model for the nursing role in the chronic health care context of renal replacement therapy. Materials from several streams of literature are used to conceptualise the potential for nursing work in the renal setting as negotiated care. In order to present the role of the renal nurse in this way it is contextualised by viewing the renal setting as a specialised social context constituted by a dominant professional discourse and a contrasting client discourse. While performing specific therapeutic activities in accord with the dominant discourse, renal nurses can develop a relationship with the person living on dialysis, based on responsiveness to their subjective experience reflecting the renal client discourse. In contrast to the language of noncompliance prevalent in the renal setting, nurses can, through their relationship with renal clients, facilitate their attempts to negotiate the requirements of the therapeutic regime into their own personal life situation. Nurses can mediate between the dominant and client discourses for the person living on dialysis. Care describes the quality that nurses actively seek to create in their relationships with clients, through negotiation, in order to support them to live as fully as possible while using renal replacement therapy. The author concludes that within chronic health care contexts, shaped by the acute curative paradigm of biomedicine, the model of nursing work as negotiated care has the potential to humanise contemporary medical technologies by responding to clients' experiences of illness and therapy.
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