Generation of statements for the development of clinical indicators for mental heath nursing in New Zealand : achieving a bicultural focus

Aim : In this paper, the first of 4 stages of a large study aiming to develop culturally and clinically valid clinical indicators to flag the achievement of mental health nursing standards of practice in New Zealand are described.Methods : A bicultural design was employed throughout the research project to ensure that nurses\u27 views of practice and the cultural differences between New Zealand\u27s indigenous Maori and non-Maori peoples could be identified. Accordingly, separate focus groups of Maori- and non-Maori-experienced mental health nurses were asked to develop lists of statementd reflective of the Australian and New Zealand College of Mental Health Nurses\u27 Standards of Practice in New Zealand.Results : The focus group participants produces 473 statements, which were synthesized into 190 clinical indicator statements. In keeping with the bicultural research design, Maori and non-Maori data were analysed separately until the data were merged to provide a single set of indicator statements. Although both Maori and non-Maori groups wrote statements relevant to clinical practice, there was a difference in the way the 2 groups addressed cultural issues. The Maori focus group wrote statements about cultural issues for 4 of the 6 Standards of Practice, whereas the non-Maori focus group participants wrote statements about cultural issues for only the Standard focusing on cultural safety.Conclusion : The research design of this project in mental health nursing was unique in that it sought the perspectives of both indigenous and non-indigenous nurses about quality mental health nursing practice related to the professional standards of practice. The involvement of Maori and non-Maori mental health nurses enhanced the cultural and clinical validity of the study and the obtained from it. The bicultural approach adopted for the study highlights the need for more mental health nursing research involving indigenous partners.<br /

Mai i muri ka haere whakahaere : Maori woman [sic] in mental health nursing : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University, Palmerston North, New Zealand

For many years Maori women in mental health nursing have been subsumed within the dominant nursing and healthcare organisational cultures that are politically driven. This study aimed to examine the socio-political and cultural influences on the multiple realities (identities, role, relationship and status) of Maori women in mental health nursing in their homeplace, schoolplace and workplace. Maori women are distinguishable by their membership in three distinct groups derived from 1) whanau, hapu, iwi, 2) western patriarchal experiences, and 3) cultural and colonising experiences growing up in te ao Maori and te ao Pakeha. Six participants --were selected to meet the aim and study objectives which are to explore the challenges they encounter and the strategies they use to meet these challenges; and to identify the contribution they make to mental healthcare. Maori women in mental health nursing are in a strong position by virtue of their whakapapa, 'mana wahine' and clinical expertise to make a substantial contribution towards positive health outcomes for tangata whaiora and whanau. He Mana Wahine Tuku Iho framework was developed upon which to analyse the participants' korero. This framework is based in Maori cosmology and customary society and affirms the importance of whakapapa, te reo, tikanga and wairuatanga to Maori. There are three components to the framework 1) He Whakapapa o nga Atua, 2) He Whakapapa o Mana Wahine, and 3) He Tikanga o nga Wahine Rangatira. A qualitative methodology was used based in kaupapa rangahau which affirms Maori epistemology and ontology - matauranga, tikanga and mauri. From the initial contact and interview the participant's whakapapa was acknowledged. The participant's were afforded opportunities to authenticate the transcripts, ensure anonymity for themselves and whanau, review chapters during the early writing-up phase, and contacted for clarification concerning points as needed during the later stages of the writing-up process. Findings confirmed that growing up Maori in te ao Pakeha was challenging. Tension is evident at the interface of te ao Maori and te ao Pakeha with te ao Pakeha perniciously imposing its values and beliefs in a way that actively undermined mana Maori and 'mana wahine'. Experiences beginning in childhood and continuing into adulthood served to strengthen the participants' identities as Maori women. These experiences also affirmed the importance of whakapapa, te reo, and tikanga in attainment of wairuatanga as a manifestation of well-being. Knowledge of and confidence in their multiple identities as Maori women enable the participants to contest and create space that allows them to successfully live in both worlds, meet the challenges of te ao hurihuri and fulfil both whanau obligations and professional responsibilities

New Zealand development and trial of mental health nursing clinical indicators - a bicultural study

This paper describes the development and validation of bicultural clinical indicators that measure achievement of mental health nursing practice standards in New Zealand (ANZMCHN, 1995, Standards of practice for mental health nursing in New Zealand. ANZCMHN, Greenacres). A four-stage research design was utilised including focus groups, Delphi surveys, a pilot, and a national field study, with mental health nurses and consumers as participants. During the national field study, consumer files (n=327) from 11 District Health Boards, and registered nurses (n=422) completed an attitude questionnaire regarding the regularity of specific nursing and service activities. Results revealed a variation in the mean occurrence of the clinical indicators in consumer case notes of 18.5&ndash;89.9%. Five factors with good internal consistency, encompassing domains of mental health nursing required for best practice, were derived from analysis of the questionnaire. This study presents a research framework for developing culturally and clinically valid, reliable measures of clinical practice.<br /