Browsing by Author "Breheny, Mary"
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- Item“If medication isn’t helping me, maybe it’s just me” : narratives of treatment resistant depression : a thesis presented in partial fulfilment of the requirements of the degree of Doctor of Clinical Psychology at Massey University, Albany, New Zealand(Massey University, 2021) Kroch, EllaA significant proportion of people with depression do not experience expected improvement following treatment and are considered to have treatment resistant depression. Despite this, there is relatively little research exploring the experiences of this group, who represent a significant minority of those who experience depression. The current study explored how people with treatment resistant depression make sense of depression that has not resolved following adherence to professional advice and treatment. The accounts of nine people with treatment resistant depression recruited from a private psychiatry practice in Auckland, New Zealand were analysed using narrative analysis. The participants told stories about what it was like to experience depression that persisted over many years using two narratives: that of order and of disorder. The narrative of order was used to organise and make predictable their experiences. The narrative of disorder was used to describe the ways their depression defied predictability and management. The participants also told stories to account for why they had remained depressed long-term despite receiving treatment. At times, participants attributed their persistent distress to having a treatment resistant brain or personality. There were also two alternative accountings - a narrative of bad patient behaviour and a narrative of it just taking some time to find a suitable medication. These accounts were strongly shaped by narratives of mental distress and recovery that suggest that depression follows predictable patterns and that treatment results in resolution of symptoms. Today, these narratives are increasingly encompassed by powerful and pervasive narratives of neoliberalism. The participants in this research emphasised personal accountability and self-management, and self-blame when they did not achieve the desired and expected outcome of resolution of symptoms. The implications of these findings for those experiencing persistent distress, such as TRD, as well as for health professionals working in mental health domains are discussed.
- Item"It's hard being a young parent, it's even harder being a young Māori parent" : young Māori parents' experiences of raising a family : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Public Health at Massey University, Palmerston North, New Zealand(Massey University, 2019) Ware, FelicityYoung Māori parents play a significant part in growing the indigenous population of Aotearoa New Zealand and helping to raise the country’s future. Despite Māori only being about 15 percent of New Zealand’s total population, about half of all young parents in this country are Māori. While parents at any age may require support, being young and Māori while also needing support may present additional challenges. The disproportionate representation of young parents and of Māori in socioeconomic disadvantage has dual implications. These disparities fuel a deficit understanding of early parenting, indigeneity, and requiring assistance. The ongoing impacts of colonisation and racism further exacerbate these disparities and marginalise Māori. This research examines the historical, cultural, political and social contexts that influence early parenting for Māori. Key principles of Māori research, oral traditions and narrative inquiry were employed to explore the distinct experiences of young Māori parents. Māori principles were implemented throughout all of the research process; in the design, methodology and organisation of the research. A Māori narrative approach was developed to gather, present and analyse the perspectives of 19 young Māori parents from the Manawatū, New Zealand about support during pregnancy, birth and parenting. Their stories were examined using a Māori analytical framework. This approach identified interrelated layers of kōrero (story) that revealed how young Māori parents construct their own changing identity and contextualise their stories within significant relationships, a Māori worldview, and society. A cross-examination of their kōrero revealed that their experiences were also shaped by what it means to be a young person, a young parent, Māori and from disadvantage. This Māori narrative approach revealed a more complex and nuanced understanding of the interrelatedness and influence of societal expectations, indigeneity, Māori culture and whānau, on personal experience. The findings of the research demonstrate that support for young Māori parents in Aotearoa New Zealand is constrained by prevailing and intersecting ideas about being young, early childbearing, Māori identity and receiving welfare. For example, young Māori women are framed as more likely to become pregnant at a young age, have their education disrupted, require welfare assistance, and pass on socioeconomic disadvantage to their children. This deficit perception of their parenting potential is perpetuated in many different ways in society. This stigma and stereotyping has real consequences for the way young Māori parents construe their experience of parenting and how they are supported. This thesis discusses the consequences of deficit-based research, government rationalities for welfare provision, and the potential role of whānau. The kōrero from the young Māori parents resisted the assumptions that having a child at a young age and being Māori contribute to negative outcomes. As Māori they could draw on counter narratives about early parenting that may not be available to non-Māori. Māori understandings of reproduction, raising children and whānau celebrate a new baby as an extension of whakapapa (genealogy) and do not necessarily frame the age of the parents as an issue. However, young Māori parents also felt that taking up a Māori identity meant that their parenting was subject to increased scrutiny and there was added pressure to prove themselves as competent parents. Young Māori parents continuously navigate the tension between Māori beliefs and societal expectations in their own accounts of raising children. Whilst dominant narratives constrain whether they are treated as a suitable parent, Te Ao Māori beliefs help them to feel valued in their role as whakapapa nurturers and contributing whānau members. Support for young Māori parents would be helped by the authentic promotion of Māori knowledge, practices, language, identity and experiences associated with pregnancy, birth and parenting guaranteed in Te Tiriti o Waitangi and the United Nations Declaration of the Rights of Indigenous Peoples. Privileging the lived experiences of young Māori parents, such as those included in this thesis helps to critically deconstruct the negative assumptions about young parents and Māori, particularly those who are overrepresented in requiring assistance. The findings of this research are relevant to all people responsible for the outcomes of young Māori parents and will help to inform better research, policy and practice. Government, community, health and supporting professionals, iwi, and whānau all have important roles in supporting young Māori parents to develop positive identities, to reach full potential and to raise their children.
- ItemKnowledge of, and attitude to, hormone replacement therapy and menopause among mid-aged New Zealand women : thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University(Massey University, 1999) Breheny, MaryThe use of Hormone Replacement Therapy (HRT) by women at menopause is increasing in New Zealand, although there are controversies and confusion surrounding its prescription and efficacy. There has been very little research carried out in New Zealand regarding the variables that impact on HRT use by women, and the attitudes and knowledge of women regarding HRT use. To address this, a survey of 495 mid-aged women, randomly selected from the electoral roll was carried out. The survey measured demographic variables, knowledge of HRT, attitudes to HRT and menopause, and health variables.This study found that knowledge of HRT was high, however, many New Zealand women reported reasons for HRT use that are not empirically supported. This study also found that attitudes to HRT and menopause are important predictors of HRT use, possibly more important than health variables. The importance of attitudes in predicting HRT use needs further clarification to allow the promotion of appropriate information to inform mid-aged women's HRT decision making.
- ItemNegotiating grandmothering, paid employment and regular childcare in urban Aotearoa New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Public Health at Massey University, Manawatū, New Zealand(Massey University, 2021) Day, CarolineGrandmothers are increasingly called upon to provide regular childcare to enable parents to engage in paid employment. Many of these grandmothers are in paid employment themselves. Combining paid employment and regular childcare is managed in the context of their lives, which includes family relationships and broader societal expectations for older women. This thesis examined the experience of grandmothers living in Auckland City, who were in paid employment at least twenty hours a week and who provided regular weekly childcare of at least ten hours a week to their grandchildren. This research was based on feminist poststructuralism. Poststructuralism focusses on multiplicity and subjectivity, attending to the wider contexts in which language is located. Feminist poststructuralism focusses on gender and how gendered norms describe and establish the ‘right’ ways of behaving. These expectations contribute to assumptions that the accommodation of childcare and paid work is normal and natural for women. Semi-structured interviews were conducted with fifteen grandmothers and their accounts were analysed using narrative analysis. Narrative analysis focusses on the importance of stories as the primary way in which people make sense of their lives. These stories draw on wider social, cultural, political and gendered narratives. The analysis found that paid employment was particularly important in the participants’ lives, allowing for the construction of an identity which was different to a grandmother-focussed identity. This importance of paid employment also shaped participants’ understandings of the importance of paid employment in the lives of mothers; maternal paid employment was constructed as important for wellbeing and for enabling an identity different to that of ‘mother’. Two clear intentions for providing childcare were storied: supporting maternal paid employment, and childcare as a response to concerns about grandchildren’s wellbeing. Finally, holding multiple roles and balancing paid employment and childcare were storied as the juggling of identities rather than the juggling of the tasks involved in combining paid work and childcare. The research findings have contributed to how grandmothering is understood; it has contextualised participants’ experiences in wider societal expectations for how women can and should combine their paid employment and family lives in later life.