THE AUSTRALIAN JOURNAL OF ADVANCED NURSING

VOLUME 21 NUMBER 3

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Editorial
Exploring cultural diversity

Margaret McMillan and Jane Conway

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Guest Editorial
The impact of culture on care

Dr Mee Young (Clare)

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BARRIERS TO CLINICAL DECISION-MAKING IN NURSES IN AUSTRALIA
The aim of this study was to examine whether nurses in Australia participated in clinical decision-making to the extent they desired. Some factors that could be inhibiting or promoting participation in clinical decision-making, namely educational level, occupational orientation (role values), level of appointment and area of practice (medical/surgical) were also examined.

Key Words: clinical decision-making, correlational study, participative decision-making, role values, educational level

Kerry Hoffman, RN, MN, is a Doctoral candidate, University of Technology, Sydney, Australia.
Professor Christine Duffield, RN, PhD, is Director, Centre for Health Services Management, University of Technology, Sydney, Australia.
Professor Judith Donoghue, RN, PhD, is Director, Acute Care Nursing Professorial Unit, The St George Hospital and University of Technology, Sydney, Australia.

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CONSUMER NOTES CLINICAL INDICATORS: DETERMINING INTER-RATER RELIABILITY WITH MULTIPLE RATERS, NOMINAL CATEGORIES AND SEVERAL CASES
A method of determining inter-rater reliability when there are multiple raters, nominal rating categories and several cases is described and applied in the development of an instrument for auditing the ANZCMHN (1995) standards of practice for mental health nursing in New Zealand.

Key Words: inter-rater reliability, rater agreement, mental health

Cadeyrn J. Gaskin, BBS (Hons), MBS, is a Research Officer, School of Health Sciences, Massey University, New Zealand, and PhD candidate, School of Human Movement, Recreation and Performance, Victoria University, Melbourne, Australia.
Anthony P. O’Brien, RN, RPN, RGN, BA, MEdStud, PhD, is Regional Academic Coordinator of Nursing Programs and Lecturer, School of Nursing and Health Care Practices, Southern Cross University, Lismore Australia and Research Associate, School of Health Sciences, Massey University, New Zealand.
Derrylea J. Hardy, BBS (Hons), is a Research Officer, School of Health Sciences, Massey University, New Zealand.

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METROPOLITAN REGIONAL DIFFERENCES IN PRIMARY HEALTH CARE OF POSTNATAL DEPRESSION
This study examines the psychological and social aspects of the transition to motherhood by primiparous women, including care received, in two regions of suburban Melbourne, Australia.

Key Words: postnatal depression, motherhood, distress, cultural sensitivity

Anne Buist, MD, FRANZCP, is Associate Professor of Psychiatry, University of Melbourne, Victoria, Australia.
Jeannette Milgrom, PhD, FAPS, is Professor of Psychology, University of Melbourne, Melbourne, Victoria, Australia.
Carol Morse, PhD, MAPS, is Professor of Psychiatry and Dean, Faculty of Human Development, Victoria University, Australia.
Sarah Durkin, BA, Research Assistant, Faculty of Human Development, Victoria University, Australia.

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NURSING AND THE DEVELOPMENT OF NURSING EDUCATION IN FIJI
The Ministry of Health in Fiji has recently introduced new nursing initiatives and is about to introduce a new pre-registered nurse curriculum in 2004. This paper will explore these new developments in nursing as well as provide an historical account of the development of nursing education in Fiji.

Key Words: Fiji, nursing, nursing education, change

Dr Kim Usher, RN, RPN, DipNEd, DipHSc, BA, MNSt, PhD, is Associate Professor and Head of School, School of Nursing Sciences, James Cook University, Townsville, Australia.
Iloi Rabuka, RN, RM, PH CERT (Fiji), AdvDip CH (NZ), MAHPED(NSW), is Principal, Fiji School of Nursing, Suva, Fiji.
Rigi Nadakuitavuki, RN, RM, DipNEd, BAppSc, Cardio Thoracic Cert, is Director Nursing Services, Fiji Ministry of Health, Suva, Fiji.
Joanne Tollefson, RN, BGS (Nurs), MSc (Trop Med,) is Deputy Head of School and Senior Lecturer, School of Nursing Sciences, James Cook University, Townsville, Australia.
Lauretta Luck, RN, BA (Psych), MA (Psych), is Campus Coordinator and Senior Lecturer, School of Nursing Sciences, James Cook University, Cairns, Australia.

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PROMOTING PATIENT AUTONOMY AND COMMUNICATION THROUGH ADVANCE CARE PLANNING: A CHALLENGE FOR NURSES IN AUSTRALIA
This article suggests that nurses can play a stronger role in promoting and facilitating advance care planning, through a number of roles consistent with mainstream nursing practice.

Key Words: patient autonomy, advance care planning, nurses’ roles, nursing practice, end-of-life decision making, Australia, advance care directives

Chris Shanley, MA RN, is Assistant Director, Centre for Education and Research on Ageing, Concord Hospital and Adjunct Senior Lecturer, Faculty of Health Sciences, University of Sydney, Australia. Sharon Wall, MPH, RN, is Director, Ageing by Caring, Coledale, Australia.

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