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, prioritized 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. We 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.
INTRODUCTION: Despite a 10-year history of nurse practitioner (NP) development in New Zealand (NZ) there is no formalised or universal process for ensuring the transition of willing nurses to NP status. This unmet need is of particular interest in the rural context where workforce issues are paramount. The aim of this study was to explore the transition from rural nurse to NP in NZ. METHOD: A qualitative descriptive survey was sent to all NZ nurses with a rural address. Ninety-two questionnaires were returned, of which 21 respondents were working in a rural location and aiming to become an NP. Data analysis included description of demographic data and thematic analysis of open-ended question responses. FINDINGS: Four themes encompassed the experiences of the 21 potential NP candidates: uncertainty about opportunities for employment as an NP and legislative and funding barriers for NP practice; support or resistance from GPs and nurse colleagues, self-doubt, and the importance of mentoring; difficulties with the NP authorisation process; and meeting the NP competencies within the challenges imposed by rural location. CONCLUSION: At the systems level of workforce design, stronger linkages between policy development, investment, employment creation, funding streams, professional regulation and overall communication require attention. KEYWORDS: Rural health; nurse practitioners; workforce; health policy
The purpose of this study was to determine the extent to which older persons in rural Northeast Thailand felt abandoned by the emigration of their children and the impact this may have on their quality of life. A cross sectional survey, consisting of 113 questions including the 26-item WHOQOL-BREF and the 24-item WHOQOL-OLD was administered to 212 participants. Participants ranged in age from 60 to 107 with a mean age of 71. While only 9% were found to live alone, 20% stated that they felt abandoned to some degree. A one-way between groups MANOVA was conducted to determine if those who felt abandoned differed from those who did not on a single-item question of Overall QOL and the total scores for the WHOQOL-BREF and WHOQOL-OLD. A statistically significant difference was found between the groups on the combined dependent variable [F (3, 208) = 4.75, p = .003; Wilks' Lambda = .94]. When the results for each of the dependent variables were considered separately, statistically significant differences were found on the WHOQOL-BREF [F (1, 210) = 13.61, p < .001] and the WHOQOL-OLD [F (1, 210) = 9.85, p = .001] only.
This study aimed to reveal the process of achieving peace and harmony in life by Thai Buddhists living with HIV/AIDS in Southern Thailand. Data were gathered from 28 Thai Buddhist participants aged 18 years or older, who had lived with HIV/AIDS for 5 years or more. Purposive, snowball and theoretical sampling techniques were used to recruit the participants. Data collection, using in‐depth interviews, was carried out over a 7 month period between 2011 and 2012. Grounded theory was used to guide the process of data analysis. Two categories emerged to describe the core category ‘Achieving Peace and Harmony in life’: (i) understanding and accepting that nothing is permanent and (ii) living life with contentment. Findings are valuable for health professionals in enhancing peace and harmony for their patients.
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