The benefits of a nurse-led service in the identification and management of symptoms of irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a common, functional disorder, affecting up to 20% of the population in the Western world, becoming more prevalent in developing countries. Currently in New Zealand, patients are managed by their general practitioner but are not able to be seen in the public system as it is not a life-threatening disease. This means many have no access to help. It takes significantly more time in consultation to identify causes and triggers of IBS symptoms than the average time allocated for consultation in most primary healthcare facilities. New patients seen over an 8-month period attending an advanced nurse practitioner-led IBS service in Christchurch, New Zealand, were invited to participate in a study investigating whether or not attending this service improved the identification and management of symptoms of IBS. Forty percent of patients were found to have an alternate diagnosis, the most common being inflammatory bowel disease (IBD). Forty-five patients (82%) completed 2 questionnaires 3 months apart where it was found that there was greater satisfaction in being managed by the nurse-led service than by their initial healthcare provider. There was also a significant improvement in quality of life, and a significant reduction in symptoms, symptom severity, and frequency, although there was no improvement in coping strategies. This indicates that the provision of such specialist nurse-led services can support medical colleagues by providing a specialty service for patients with symptoms of IBS or other functional disorders.

The first decade of nurse practitioners in New Zealand: a survey of an evolving practice.

BACKGROUND: Nurse practitioners (NPs) have been registered in New Zealand (NZ) since 2002. This article describes a sample of their practices and outcomes across a variety of healthcare specialties. The PEPPA model was used as a guide for the organization of data, the discussion of findings, and recommendations for the future. METHODS: Two e-mailed surveys of registered NPs (including qualitative and quantitative data) were conducted by the professional organization, NPNZ in 2011 and 2012. CONCLUSIONS: After 10 years, NPs in NZ demonstrated efficient practice and have produced measurable improved healthcare outcomes. IMPLICATIONS FOR PRACTICE: NP practices are continuing to develop and are contributing to increased access to health care and improved health outcomes in NZ.

Listening to the body and talking to myself - the impact of chronic lower back pain: a qualitative study.

AIMS: The aim was to investigate peoples' experiences of the impact of chronic low back pain. BACKGROUND: Chronic low back pain is a complex disorder with wide-ranging adverse consequences that can impact on people's lifestyles and self-image. It is also a condition that can sometimes be treated with some scepticism by health care providers and other people in the person's life. It has been suggested that further research into the subjective experience of chronic blow back pain is needed to develop a better understanding of its impact. DESIGN: This study is a qualitative analysis of semi-structured interviews with 64 participants identified as having chronic low back pain who were interviewed about the impact of the condition on their lives. The data were analysed using a method of inductive thematic analysis. FINDINGS: Four main themes were identified: the unpredictability of the pain, the need for vigilance, the externalization/objectification of the body and the alteration to sense of self. CONCLUSION: Nurses have an important role to play in working with patients experiencing chronic low back pain to identify any patterns associated with exacerbations of the condition, validating their experiences of chronic low back pain and facilitating the accommodation of chronic low back pain into a more satisfying sense of self.

Testing the feasibility and initial effects of iron and vitamin C to enhance nursing home residents' immune status following an influenza vaccine.

Influenza infections pose a serious threat to residents living in nursing homes and are a major cause of morbidity and mortality in older adults. It is estimated that influenza vaccination is only 30%-40% effective in the frail elderly. This 2-group experimental design study examined the efficacy of giving iron supplements to nursing home residents aged 65 and older to improve immune response following influenza vaccination. Specific aims of the study were to test study procedures and explore initial immune response. A number of barriers were encountered during the recruitment and consent phase limiting subject recruitment. Only serum transferrin was significantly different following the 30-day administration of iron supplementation. It was concluded that to achieve sufficient power to examine the effect of the intervention on immune response and infection rates, aggressive recruiting strategies at multiple sites are necessary.

Women maintaining physical activity at midlife: contextual complexities.

Health benefits associated with being active are well recognised and yet for many, particularly women at midlife, how this activity is maintained is both complex and poorly understood. This paper describes a qualitative feminist study in which 10 midlife women participated in two semi-structured interviews to explore factors influencing their ability to maintain physical activity over time. A thematic analysis uncovered participants' beliefs and behaviours regarding their experience of, and strategies used to maintain, regular activity. Four core themes emerged; 'exercise is part of me, part of my life', 'the importance of being fit and healthy', 'exercise interweaves and changes with life situations', and 'constraints and conflicts'. Encompassed within these four was a desire for life long good health and physical fitness. Maintaining regular physical activity was intrinsically connected to family, relationships and work. Findings from this study indicate how important it is for nurses to consider contextual realities when encouraging and supporting midlife women to maintain physical activity.

Interpersonal violence issues in the nursing classroom.

Interpersonal violence in the United States has been called a health issue of epidemic proportions (Rudman & Alpert, 2000). Reports of interpersonal violence appear daily in popular media, and specific cases have been sensationalized. The nursing profession traditionally has attempted to respond to major health issues through education, political activity, and direct patient care. So, what have nurse educators done to prepare nurses to address this issue in their clinical practices and communities?

Nurse practitioner curriculum for the 21st century: a model for evaluation and revision.

The popularity and acceptance of the nurse practitioner (NP) role, developed in response to a need for additional health care providers, have led to large numbers of educational programs that prepare nurses for NP practice. These programs, following guidelines developed by the National Organization of Nurse Practitioner Faculties Curriculum Guidelines Task Force prepare NPs who are able to provide care to individuals and families throughout the life span. However, in the present health care environment, the NP curriculum constantly must be monitored and evaluated to reflect change. The authors developed a model for curricula revision that incorporates the elements of health policy, community needs and demands, and curriculum goals. This model promotes ongoing reflection on the educational product and assesses graduates' abilities to serve clients and communities within the constraints and opportunities afforded by the current health care system. This model is proactive and embraces the nurse practitioner curriculum guidelines as its core.