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    Principles of effective long-term condition management, including pathophysiological concepts, for assessing the impact of chronic conditions and application with best practice clinical guidelines. Early detection, practice-based resources, patient self-management, and end of life care are addressed.

    This paper explores the concept of long-term condition management and the nurse's role within the interdisciplinary team. The focus is on the promotion of population health monitoring and evaluating the effectiveness of risk reduction. The aim of this paper is to support individuals in reducing the risk of developing long-term conditions. The paper also addresses the needs of those with existing long-term conditions, and a key focus is on improving the patient journey through integrated care models and self-management strategies.

    About this paper

    Paper title Long-term Conditions: Pathophysiology and Management
    Subject Nursing
    EFTS 0.25
    Points 30 points
    Teaching period Semester 1 (Distance learning)
    Domestic Tuition Fees ( NZD ) $2,984.25
    International Tuition Fees Tuition Fees for international students are elsewhere on this website.
    NURX 427
    Limited to
    MAdvNP, MHealSc, PGCertHealSc, PGDipHealSc

    The applicant will:

    • Have registration as a nurse from a three-year programme or course, congruent with the Health Practitioners Competence Assurance (HPCA) Act 2003
    • Hold a current Practising Certificate
    • Be working in a clinical area with patients who have long-term conditions
    Teaching staff

    Dr Virginia Maskill

    Dr. Kit Doudney

    Paper Structure

    The paper covers a general background of long-term conditions and the underlying pathophysiology. There is an exploration of models, concepts and recent innovations in this area. It is underpinned by evidence-based practice. A range of subject areas that are significant are covered in more depth, for example: diabetes, cardiovascular disease (CVD) and respiratory health.

    The paper is focused toward Nurse Prescribing for Long-Term Conditions in order to meet the Nursing Council of New Zealand requirements and Educational Standards as published (NCNZ 2016).

    Teaching Arrangements

    The Distance Learning offering of this paper is a combination of remote and in-person teaching.

    Three 2-day study blocks

    View Timetable information.


    The required textbooks for this paper are:

    Craft & Gordon (2019). Understanding Pathophysiology (3rd ed.). Elsevier.

    Chang, E. & Johnson (2017). A living with chronic illness and disability: Principles for nursing practice (3rd ed.). Elsevier

    National Health Committee. (2007). Meeting the needs of people with chronic conditions: Hāpai te whānau mo ake ake tonu. Wellington, New Zealand: National Advisory Committee on Health and Disability.

    Ministry of Health (2016). Self-management support for people with long-term conditions (2nd ed.). Wellington: Ministry of Health.

    Graduate Attributes Emphasised
    Interdisciplinary perspective, Critical thinking, Cultural understanding, Ethics, Information literacy, Research, Self-motivation, Teamwork.
    View more information about Otago's graduate attributes.
    Learning Outcomes

    At the end of this paper the RN student will:

    1. Critically appraise aetiology, epidemiology, pathophysiology and clinical manifestations with respect to gender, age, ethnicity, chronicity and multimorbidity and apply this knowledge in practice to ensure optimal patient outcomes
    2. Critically appraise clinical manifestations of pathophysiology states and common conditions to inform clinical reasoning and decision making in clinical practice
    3. Support individuals with long-term conditions to achieve and maintain optimum health throughout their illness trajectory
    4. Analyse factors that contribute to risk with chronic disease and multimorbidity to promote management strategies for health and well-being
    5. Accurately inform and assist individuals to reduce their risk through integrated planned care and education
    6. Critique and develop the role for nurses in chronic disease management and how the RN role relates to other team members


    Semester 1

    Teaching method
    This paper is taught through Distance Learning
    Learning management system
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