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Background: Nurse navigators are an emerging workforce providing care to people with multiple chronic conditions. The role of the navigators is to identify patients requiring support in negotiating their health care. Purpose: A critical discourse analysis was used to examine qualitative data collected from nurse navigators and consenting navigated patients to identify key indicators of how nurse navigators do their work and where the success of their work is most evident. Discussion: Nurse navigators help patients who have lost trust in the health system to re-engage with their interdisciplinary health care team. This re-engagement is the final step in a journey of addressing unmet needs, essential to hospital avoidance. Conclusion: Nurse navigators provide a continuum of authentic and holistic care. To acknowledge the true value of nurse navigators, their performance indicators need to embrace the value-added care they provide.

Aim: With increasing age and chronicity in populations, the need to reduce the costs of care while enhancing quality and hospital avoidance, is important. Nurse-led co-ordination is one such model of care that supports this approach. The aim of this research was to assess the impact that newly appointed Navigators have on service provision; social and economic impact; nurses’ professional quality of life and compassion fatigue; and analysis of the change that has occurred to models of care and service delivery. Design: A concurrent mixed-method approach was selected to address the research aims. Methods: The research project was funded in July 2018 and will conclude in December 2020. Several cohorts will be studied including; patients assigned to a navigator, patients not assigned to a navigator, family members of patients assigned a navigator; and a sample sized estimated at 140 navigators. Discussion: This study provides a comprehensive international longitudinal and mixed method framework for evaluating the impact of nurse navigators on quality of care outcomes for patients with chronic conditions. Impact—What problem will the study address?: Even with specialty focused co-ordinated care, patients get lost in the system, increasing the incidence of non-compliance and exacerbation of condition. Navigators work with patients across service boundaries allowing for care that is patient responsive, and permitting variables in clinical, social and practical elements of care to be addressed in a timely manner. This novel nurse-led approach, supports hospital avoidance and patient self-management, while encouraging expansion and opportunity for the nursing and midwifery workforce.

This dissertation investigates how women’s labour services and reproduces the institution of sport. The research is a feminist, sociological analysis based on qualitative data derived from semi-structured interviews with forty-six, mostly middle class women of Anglo origins in Western Australia. The women interviewed were grouped according to their various, frequently overlapping, relationships to one sporting code: tennis. They are mothers of junior tennis players, domestic partners/wives of adult male tennis players and women who are themselves long-term players of the sport. Collectively they provide an overview of the multiple ways women’s labour contributes to the sport and show how this mulitiplicity can strengthen the ideological foundations on which the contribution is made. The demands on women’s labour made by the sport of children and husbands are analysed, along with the consequences of this to the construction of women’s everyday lives. The ways in which this labour is marginalised and denied are also discussed. The conditions by which family members play tennis are contrasted with those under which women themselves participate. The research illustrates how women’s greater responsibility for childcare and domestic work provides the basis for their incorporation into servicing roles. To explain this, capitalist and patriarchal divisions of labour, the institution and ideologies of motherhood and heterosexual relations of marriage are discussed. It is hypothesised that Australian sport is maintained by these specific gendered relations which are further reproduced by its institutionalised practises.