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Records |
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Author |
Crowe, M.; Ward, N.; Dunnachie, B.; Roberts, M.H. |
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Title |
Characteristics of adolescent depression |
Type  |
Journal Article |
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Year |
2006 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
15 |
Issue |
1 |
Pages |
10-18 |
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Keywords |
Psychiatric Nursing; Mental health; Adolescents |
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Abstract |
This is a descriptive study of the characteristics of depression in a sample of 121 adolescents attending an outpatient specialist adolescent mental health service in New Zealand. The adolescents were required to complete two self-report measures to assess presence of depressive symptoms, severity of depression, and particular characteristics of the depression. The findings revealed that irritability was the most common characteristic along with other interpersonal and thought processing symptoms. It is important that mental health nurses are able to identify the specific characteristics of adolescent depression that may differ from adult depression in order to manage this patient population effectively. |
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Call Number |
NRSNZNO @ research @ 1065 |
Serial |
1050 |
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Author |
McKenna, B.; Simpson, A.I.F.; Coverdale, J. |
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Title |
Best practice management strategies for mental health nurses during the clinical application of civil commitment: An overview |
Type |
Journal Article |
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Year |
2006 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
21 |
Issue |
1 |
Pages |
62-70 |
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Keywords |
Psychiatric Nursing; Law and legislation; Nurse-patient relations; Patient satisfaction |
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Abstract |
The aim of this article is to outline best practice management strategies for nurses during the clinical application of civil commitment of mentally ill persons. A literature search on 'coercion' and 'civil commitment' was undertaken. Published and unpublished research undertaken by the authors in New Zealand on this topic was drawn upon. This research considered the use of civil commitment during admission to acute mental health services, acute forensic mental health services and community mental health services. The experience of coercion by service users coincides with the degree of restriction associated with the service they are involved in. Socio-demographic factors, clinical factors and the experience of coercive events have little bearing on the amount of coercion experienced. Rather, it is the pattern of communication and the use of 'procedural justice' that has the potential to ameliorate the amount of perceived coercion. The authors conclude that 'Procedural justice' aligns with the emphasis placed on the therapeutic relationship in mental health nursing and is an important consideration for nurses during the clinical application of civil commitment |
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Call Number |
NRSNZNO @ research @ |
Serial |
1051 |
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Author |
McCloskey, B.A.; Diers, D. |
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Title |
Effects of New Zealand's health reengineering on nursing and patient outcomes |
Type |
Journal Article |
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Year |
2005 |
Publication |
Medical Care |
Abbreviated Journal |
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Volume |
43 |
Issue |
11 |
Pages |
1140-1146 |
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Keywords |
Patient safety; Organisational change; Nursing; Hospitals |
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Abstract |
This study sought to examine the effects that hospital re-engineering may have on adverse patient outcomes and the nursing workforce. In 1993, New Zealand implemented policies aimed at controlling costs in the country's public health care system through market competition, generic management, and managerialism. The study was a retrospective, longitudinal analysis of administrative data. Relationships between adverse outcome rates and nursing workforce characteristics were examined using autoregression analysis. All medical and surgical discharges from New Zealand's public hospitals (n=3.3 million inpatient discharges) from 1989 through 2000 and survey data from the corresponding nursing workforce (n=65,221 nurse responses) from 1993 through 2000 were examined. Measures included the frequency of 11 nurse sensitive patient outcomes, average length of stay, and mortality along with the number of nursing full time equivalents (FTEs), hours worked, and skill mix. After 1993, nursing FTEs and hours decreased 36% and skill mix increased 18%. Average length of stay decreased approximately 20%. Adverse clinical outcome rates increased substantially. Mortality decreased among medical patients and remained stable among surgical patients. The relationship between changes in nursing and adverse outcomes rates over time were consistently statistically significant. The authors conclude that in the chaotic environment created by re-engineering policy, patient care quality declined as nursing FTEs and hours decreased. The study provides insight into the role organisational change plays in patient outcomes, the unintended consequences of health care re-engineering and market approaches in health care, and nursing's unique contribution to quality of care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1052 |
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Author |
Wareham, P.; McCallin, A.; Diesfeld, K. |
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Title |
Advance directives: The New Zealand context |
Type |
Journal Article |
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Year |
2005 |
Publication |
Nursing Ethics |
Abbreviated Journal |
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Volume |
12 |
Issue |
4 |
Pages |
349-359 |
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Keywords |
Law and legislation; Patient rights; Nursing; Ethics |
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Abstract |
Advance directives convey consumers' wishes about accepting or refusing future treatment if they become incompetent. There are associated ethical issues for health practitioners and this article considers the features that are relevant to nurses. In New Zealand, consumers have a legal right to use an advance directive that is not limited to life-prolonging care and includes general health procedures. Concerns may arise regarding a consumer's competence and the document's validity. Nurses need to understand their legal and professional obligations to comply with an advance directive. What role does a nurse play and what questions arise for a nurse when advance directives are discussed with consumers? This article considers the cultural dimensions, legal boundaries, consumers' and providers' perspectives, and the medical and nursing positions in New Zealand. |
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Call Number |
NRSNZNO @ research @ 1069 |
Serial |
1054 |
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Author |
O'Brien, A.P.; Boddy, J.M.; Hardy, D.J.; O'Brien, A.J. |
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Title |
Clinical indicators as measures of mental health nursing standards of practice in New Zealand |
Type |
Journal Article |
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Year |
2004 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
13 |
Issue |
2 |
Pages |
778-788 |
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Keywords |
Psychiatric Nursing; Professional competence; Administration; Quality of health care; Mental ealth |
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Abstract |
This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1059 |
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Author |
Hardy, D.J.; O'Brien, A.P.; Gaskin, C.J.; O'Brien, A.J.; Morrison-Ngatai, E.; Skews, G.; Ryan, T.; McNulty, N. |
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Title |
Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand |
Type |
Journal Article |
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Year |
2004 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
46 |
Issue |
1 |
Pages |
95-109 |
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Keywords |
Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori |
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Abstract |
The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1060 |
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Author |
Carter, H.; MacLeod, R.; Brander, P.; McPherson, K. |
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Title |
Living with a terminal illness: Patients' priorities |
Type |
Journal Article |
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Year |
2004 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
45 |
Issue |
6 |
Pages |
611-620 |
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Keywords |
Terminal care; Quality of life; Nursing models; Cancer |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1061 |
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Author |
Richardson, S. |
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Title |
Aoteaoroa/New Zealand nursing: From eugenics to cultural safety |
Type |
Journal Article |
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Year |
2004 |
Publication |
Nursing Inquiry |
Abbreviated Journal |
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Volume |
11 |
Issue |
1 |
Pages |
35-42 |
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Keywords |
Cultural safety; History of nursing; Nursing philosophy |
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Abstract |
The concept of cultural safety offers a unique approach to nursing practice, based on recognition of the power differentials inherent in any interaction. Clarification of the concept is offered, together with a review of the historical shift in nursing attitudes that has led to the emergence of “cultural safety” as a viable and valued component of nursing practice. The argument is made that cultural safety has allowed for a more reflective, critical understanding of the actions of nursing to develop. This includes recognition that nurses' attitudes and values have inevitably been influenced by social and political forces, and as such are in part reflective of those within the wider community. Comparison between the support given by nurses in the early 1900s to the theory of eugenics and the current acceptance of cultural safety is used to highlight this point. An examination of the literature identifies that ideological and conceptual changes have occurred in the approach of Aoteaoroa/New Zealand nurses to issues with cultural implications for practice. A review of background factors relating to Maori health status and the Treaty of Waitangi is presented as a necessary context to the overall discussion. The discussion concludes with an acknowledgement that while the rhetoric of cultural safety is now part of nursing culture in New Zealand, there is no firm evidence to evaluate its impact in practice. Issues identified as impacting on the ability to assess/research a concept, such as cultural safety, are discussed. For cultural safety to become recognised as a credible (and indispensable) tool, it is necessary to further examine the “end-point” or “outcomes” of the process. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1062 |
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Author |
Gaskin, C.J.; O'Brien, A.P.; Hardy, D.J. |
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Title |
The development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand |
Type |
Journal Article |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
4 |
Pages |
259-270 |
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Keywords |
Professional competence; Psychiatric Nursing; Clinical decision making; Nursing research |
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Abstract |
This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1064 |
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Author |
Wilson, D. |
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Title |
The nurse's role in improving indigenous health |
Type |
Journal Article |
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Year |
2003 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
15 |
Issue |
3 |
Pages |
232-240 |
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Keywords |
Transcultural nursing; Maori; Health status |
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Abstract |
The health status of indigenous peoples is a global concern with mortality and hospitalisation data indicating that the health of indigenous groups falls below that of other ethnic groups within their countries. The preliminary findings of grounded theory research project undertaken with a group of 23 New Zealand Maori women about their health priorities and 'mainstream' health service needs provide the foundation for an exploration of issues impacting on the health status of indigenous people. The role that nursing and nurses have in improving access and use of health services by indigenous people is discussed. Strategies are suggested that nurses can utilise within their practice when working with local indigenous groups. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1065 |
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Author |
Bishop, D.; Ford-Bruins, I. |
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Title |
Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study |
Type |
Journal Article |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
3 |
Pages |
203-212 |
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Keywords |
Psychiatric Nursing; Clinical assessment; Attitude of health personnel; Nursing models |
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Abstract |
This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed. |
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Call Number |
NRSNZNO @ research @ 1082 |
Serial |
1067 |
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Author |
Crowe, M.; Carlyle, D. |
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Title |
Deconstructing risk assessment and management in mental health nursing |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
43 |
Issue |
1 |
Pages |
19-27 |
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Keywords |
Psychiatric Nursing; Risk management; Policy; Culture |
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Abstract |
The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1069 |
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Author |
Carter, H.; McKinlay, E.M.; Scott, I.; Wise, D.; MacLeod, R. |
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Title |
Impact of a hospital palliative care service: Perspective of the hospital staff |
Type |
Journal Article |
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Year |
2002 |
Publication |
JBI Reports |
Abbreviated Journal |
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Volume |
18 |
Issue |
3 |
Pages |
160-167 |
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Keywords |
Palliative care; Hospitals; Attitude of health personnel; Cancer |
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Abstract |
The first New Zealand hospital palliative care support service was established in 1985. Different service models have now been adopted by various major hospitals. In 1998, a palliative care service, funded by Mary Potter Hospice, was piloted at Wellington Public Hospital. Twelve months post-implementation, the hospital staff's views of the service were evaluated. It was found that referrals to palliative care from hospital specialities outside the Cancer Centre increased. While most doctors, nurses and social workers strongly agreed or agreed that the service positively influenced patients' care and effectively addressed their symptom management needs, spiritual needs were less often met. Over 90 percent of each discipline strongly agreed or agreed that the service had assisted them in caring for patients, but, only about a half agreed that useful discharge planning advice and staff support was provided. Significant differences in responses were found between different disciplines and specialities. One fifth of the staff identified palliative care education needs. Recommendations are made concerning the development of a future hospital palliative care service. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1075 |
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Author |
Kirkham, S.; Smye, V.; Tang, S.; Anderson, J.; Blue, C.; Browne, A.; Coles, R.; Dyck, I.; Henderson, A.; Lynam, M.J.; Perry, J.(see also C.); Semeniuk, P.; Shapera, L. |
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Title |
Rethinking cultural safety while waiting to do fieldwork: Methodological implications for nursing research |
Type |
Journal Article |
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Year |
2002 |
Publication |
Research in Nursing & Health |
Abbreviated Journal |
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Volume |
25 |
Issue |
3 |
Pages |
222-232 |
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Keywords |
Cultural safety; Hospitals; Health behaviour; Culture; Nursing research |
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Abstract |
The authors trace a series of theoretical explorations, centered on the concept of cultural safety, with corresponding methodological implications, engaged in during preparation for an intensive period of fieldwork to study the hospitalisation and help-seeking experiences of diverse ethnocultural populations. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1078 |
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Author |
McLeland, A.; Williams, A. |
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Title |
An emancipatory praxis study of nursing students on clinical practicum in New Zealand: Pushed to the peripheries |
Type |
Journal Article |
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Year |
2002 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
12 |
Issue |
2 |
Pages |
185-193 |
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Keywords |
Nursing; Education; Clinical supervision; Preceptorship |
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Abstract |
The purpose of this qualitative study was to analyse the learning experiences of nine nursing students on clinical placement in New Zealand. The students were in their third and final year of their baccalaureate nursing degree. The study specifically examined what impinged upon their learning experience in the clinical venue. Data was obtained from interviewing the students, initially individually and finally in a focus group. Themes emerged through words and concepts as the data was analysed. The themes included powerlessness; marginalisation; the move from a holistic to a reductionist approach in care; the exploitation of minority students and the myth of praxis. Clinical practice was a time for nursing students to apply their knowledge to their practice, and to gain experience and confidence. Their clinical practice was normally a positive experience, but, each student spoke of the occasional negative episode. These left them with feelings of powerlessness and marginalisation. The Maori students felt exploited. The students were concerned about the lack of time to debrief at the end of the day, and to share their experiences with their educator and colleagues. The students' negative experiences were often the result of a clinical practitioner's high workload, under resourcing and the nurse educator's unavailability. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1081 |
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