Abstract: This aim of this thesis was to explore and describe registered nurses' experiences of undertaking the statutory role of Responsible Clinician under the Mental Health (Compulsory Assessment and Treatment) Act 1992. The role of Responsible Clinician has been available to nurses since 1992 yet to date there has been little research into nurses' experiences of undertaking this role. An exploratory descriptive approach was therefore used in this study. A convenience sample of four nurses who had been undertaking the role of Responsible Clinician was recruited. Their experiences were elicited through in-depth interviews. Analysis of the interview material revealed the themes of legitimacy, relationships, expanding practice, responsibility and accountability, approaches to care, nurses' responsiveness to the role and support of the role. The author points to this research being important to nurses who are working in the psychiatric mental health area so that they can understand the role more fully. In this way, more nurses may choose to undertake the role of Responsible Clinician.

Abstract: This chapter focuses type 2 diabetes as it relates to one rural Maori community within New Zealand. It provides an in-depth discussion relating to diabetes including the burden of diabetes in New Zealand and evidence for prevention which is played out in an increasing obesogenic environment. The process and findings of a research project to 'map out' the food environment within the Southern Lakes District are reported. Purposive sampling was used to survey 124 food outlets in the area, and findings confirmed the existence of an obesogenic environment for Maori. Such an environment is characterised by an abundance of cheap, energy dense foods, and pricing gradients that favour consumption of such foods.

Abstract: This thesis traces the journey of the author's inquiry into family members' experience of the relinquishment of the personhood of a loved one with a dementia; a journey in which she reports that her own prior understandings were significantly challenged. The study was prompted by her experience of working in the area of dementia care and hearing, in the course of the working day, comments such as 'there's nobody there' made in relation to someone suffering from severe dementia. Such comments appear to imply that the person of the dementia sufferer in some way is no longer present. They are comments which relate to the very nature of personhood. The study takes impetus from the fact that the ways in which nurses view the personhood of dementia sufferers has significant consequences for the ways in which they respond to dementia sufferers and their families. This thesis, which retells the stories of four family members who each have a loved one with a dementia illness, reveals that rather than there being a unified concept of personhood in dementia, and in spite of the fact that particular understandings of dementia and personhood dominate our cultural conversations, in their day to day lives these four family members managed and made sense of their experience through particular and different ways of looking at the impact dementia has on the personhood of dementia sufferers. Not all did, in fact, relinquish the personhood of their family member. In their lived lives, the four research participants had recourse, each in different ways, to multiple discourses of personhood. For some, in addition to loss, there was also unexpected gain. This finding necessitated and shaped further inquiry into discourse and the role of discourse in shaping, constraining and opening up possibilities for meaning, and into the two substantive areas of dementia and personhood. Nurses work closely alongside the family of dementia sufferers who are daily faced with the challenge of managing and making meaning of that situation. It is critically important that they are able to recognise, validate and support the variety of needs that family members have. Nurses, whose education is traditionally based on a biomedical framework, are nevertheless often required to mediate between different understandings. Not only do they need currency of knowledge in the rapidly changing biomedical field of dementia, but they need also an understanding of the role and the power of discursive constructions of both dementia and personhood. Such understanding will provide insight into alternate ways of understanding these concepts. However, although such understanding is critical for nurses working in this area, the author suggests that nursing literature has not brought these discussions to the fore.

Abstract: This paper explores the concept of innovation in nursing, the inherent set of characteristics that need to be present in order for innovations to succeed, and the barriers that impede innovation from occurring. Successful innovations developed and implemented by nurses are featured, and organisational factors necessary to support innovation are described. This paper is based on a presentation given by the author at the 23rd Quadrennial ICN Congress and 7th International Regulation Congress in Taipei in May 2005.

Abstract: This paper provides an overview of the evolving meaning of 'culture' in New Zealand nursing. Then, drawing upon the findings of research that used hermeneutic phenomenology to explore the experience of nursing people from cultures other than one's own, a description of the constituent parts is of this phenomenon is briefly outlined and followed by an exemplar that describes the coalescent and contradictory nature of the phenomenon as a whole. As New Zealand nurses negotiate the conflicts essential for ongoing development of their practice, interplay of the notions of prejudice, paradox and possibility is evident at intrapersonal and interpersonal levels as well as in relation to professional and other discourses.

Abstract: The aim of this study was to describe the recruitment strategy and association between facility and staff characteristics and success of resident recruitment for the Promoting Independence in Residential Care (PIRC) trial. A global impression of staff willingness to facilitate research was gauged by research nurses, facility characteristics were measured by staff interview. Forty-one (85%) facilities and 682 (83%) residents participated, median age was 85 years (range 65-101), and 74% were women. Participants had complex health problems. Recruitment rates were associated (but did not increase linearly) with the perceived willingness of staff, and were not associated with facility size. Design effects from the cluster recruitment differed according to outcome. The recruitment strategy was successful in recruiting a large sample of people with complex comorbidities and high levels of functional disability despite perceptions of staff reluctance. Staff willingness was related to recruitment success.