Nursing and Midwifery

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End date: 2009Subject: search.filters.subject.New Zealand

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    Safeguarding the practices of nursing : the lived experience of being-as preceptor to undergraduate student nurses in acute care settings : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Albany, New Zealand
    (Massey University, 2001) Rummel, Louise G.
    An Heideggerian Hermeneutic approach has been adopted to explore the experience of being-as preceptor to undergraduate student nurses in the acute care setting. This thesis addresses the question: What is the experience of being a preceptor to undergraduate student nurses in an acute care setting? Fifteen preceptor-participants were interviewed twice, with each interview being approximately one hour. Heideggerian Hermeneutical Analysis was used to reveal the experience of preceptors as they precept undergraduate student nurses. The thesis begins by placing nursing education in an historical, socio-political and professional context that provides the background to current New Zealand nursing practice. Student nurses undergoing their nursing education learn the meaning of being a nurse in many different contexts. This research is situated in the acute care context where both preceptors and student nurses engage in the practice of nursing. The methodological background shapes the way the research is presented to explicate the meaning of being-as preceptor. The four data chapters reveal the preceptors' experience and open with dialogue showing how nurses become preceptors. This is followed by exploration of how preceptors assessed where the student was at, moves to preceptors promoting learning and closes with discussion of how preceptors keep students and patients safe. Many practices were uncovered during the revelations of the preceptors as they disclosed to the researcher narratives of their everyday practice world. Common themes that emerge from the data include: Becoming attuned- the call, The Emerging Identity of 'being-as' Preceptor: Keeping the student in mind, Assessing where the student is at: The Preceptor and Preceptee Working and Growing Together, and The Preceptor as Builder of Nursing Practice: Teaching Reality Nursing. A number of common themes support the relational themes which are of greater complexity. A constitutive pattern, the highest form of interpretation that emerges from the data, was Safeguarding the Practices of Nursing. This constitutive pattern lies within every text either directly or is inferred from each participant's dialogue. It contains the central meaning of the thesis. It is constituted from common and relational themes as they present themselves in the analytical process. In this thesis the experience of being-as preceptor is unveiled through the participants' own words as the researcher takes the reader back to the 'things themselves' as is espoused by hermeneutic phenomenology.
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    Responding to the call to care : women's experience of breastfeeding in New Zealand : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Wellington, New Zealand
    (Massey University, 2004) McBride-Henry, Karen Sharee
    New Zealand breastfeeding experts have long contended that New Zealand does not have a breastfeeding culture, as demonstrated by anecdotal evidence suggesting that women find breastfeeding difficult to initiate and sustain. A review of the literature indicates that, in New Zealand, breastfeeding knowledge falls within the domain of health care professionals, which marginalises women's own experiential knowledge about breastfeeding. Therefore, this study explores the experience of breastfeeding for women in New Zealand. A reflective lifeworld research methodology underpins this study, allowing the participants' narratives to be explored without the use of pre-existing theoretical frameworks that may close down on aspects of the interpretive analysis. Nineteen women were interviewed for this study, all of whom were New Zealanders who were either breastfeeding at the time of the interviews, or had breastfed within the last two years. Many of the participants had breastfed more than one child. What emerges as the central thesis of this study is that breastfeeding is a priori to unique embodied experiences. A number of sub-themes, which further explicate this central thesis, include: the silencing of the reality of breastfeeding within the public domain, the pervasive influence of society, or 'the they', through the accepted frameworks by which breastfeeding women interpret their individual breastfeeding experiences, and breastfeeding as a means of facilitating close relationships between women and their infants. The findings of this study will assist health care professionals working alongside breastfeeding women, as it offers fresh understandings of what it is to be a breastfeeding woman. It is important that health care professionals lay aside their previously-held perceptions about breastfeeding, and pay careful attention to individual women's experiences prior to planning interventions. If health care professionals value women's embodied breastfeeding narratives, women will be supported to articulate their breastfeeding experiences, thereby increasing women's confidence in their embodied breastfeeding knowledge and capabilities
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    'Being there' when one's spouse is hospitalised in a non-local tertiary centre : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand
    (Massey University, 2006) Mercer, Christine Joy
    Illness that requires hospitalisation is a potential cause of anxiety for the entire family. Furthermore, increases in technology and specialisation of hospital services have resulted in increasing numbers of patients being transferred to centralised tertiary hospitals. There is limited international and national literature that explores the phenomenon of having one's spouse hospitalised in non-local tertiary centres. Therefore, this study was conducted with the aim of exploring the experiences of those whose spouses were hospitalised in non-local tertiary settings. Understanding of the experiences of 14 people affected by such hospitalisations was underpinned by a Heideggerian phenomenological perspective. Three major themes emerged from this study. Those who have their spouse hospitalised in non-local tertiary settings spend time waiting; a time best described as being-in-suspense. Despite being-in-suspense the research participants adjusted to their understanding of the situation; a period of time interpreted as fitting being out-of-town into being-in-the-world. The final theme that emerged from this study is that there were times when the research participants perceived that they were alone, unable to support or be supported by their spouses: being with and without others. Overall the findings of this research indicate that those whose spouses were hospitalised in a non-local tertiary centre lived day by day, with little or no social support, awaiting outcomes over which they had limited control. The worst potential outcome for these individuals would be that of the spouse's death in the non-local centre. When the outcomes of the non-local hospitalisation could be predicted, the events of living day by day were manageable. It also emerged from conducting this study that in living day by day, the supporting spouse dealt with the circumstances by being focussed on the temporality of the present and a vision of a positive future. However, their spouses were not always able to conceive the future in such a positive way. Nurses and other health professionals must remain cognisant of the fact that while they are familiar with the everydayness of non-local hospitalisations, [abstract incomplete].
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    The meaning of social inclusion to people with enduring mental health problems : a thesis presented in partial fulfilment of the requirement for the degree of Master of Arts in Nursing at Massey University, Auckland, New Zealand
    (Massey University, 2009) Cheer, Jennifer Ann
    The purpose of this qualitative research project has been to explore what social inclusion means to people with an enduring mental health problem. A review of the general literature on social inclusion revealed that little research has been conducted in relation to mental health, particularly in New Zealand. Even fewer studies have investigated the meanings that people with severe and enduring mental health problems place on their experiences. A life story narrative approach was employed in order to explore the experience of social inclusion and enduring mental health problems. Data were collected by way of unstructured, individual interviews with five users of mental health services living in supported housing in a small rural New Zealand town. Thematic analysis was carried out on the narratives, identifying six major themes. The findings indicated that, for this group of service users, social inclusion means having someone to love, something to do and somewhere to live. They want relationships with family and friends, to engage in recreational or leisure activities, to be employed, to have financial security, and to have safe and comfortable housing. The major barriers to achieving these are stigma and discrimination. New Zealand’s mental health services have adopted a recovery approach to mental health. Whereas social inclusion has a broad political and social focus that places responsibility for reducing social exclusion on society, recovery focuses on individuals’ personal journeys towards mental health and well-being. Despite international recognition of the value of social inclusion, New Zealand’s mental health services have not yet embraced it, although policy advisory organisations such as the Mental Health Commission state its aims as desirable for services. However, the concept of recovery sits within the framework of social inclusion and is an integral part of it. Mental health nurses need to understand what social inclusion means to people who experience it, so that they are able to empower them to make a positive contribution to their community, as citizens, friends, family members, employees and neighbours.
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    Me aro ki te ha o hineahuone : women, miscarriage stories, and midwifery : towards a contextually relevant research methodology : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Midwifery at Massey University, Palmerston North, New Zealand
    (Massey University, 2009) Kenney, Christine M.
    Professional ethics and legal competencies require midwives practising in New Zealand to provide care for childbearing women in a partnership characterised by continuity, equality, mutual respect, trust, shared responsibility and decision making. New Zealand is culturally and legislatively a bi-cultural environment and the cultural safety of Maori (indigenous peoples) are prioritised within health legislation. The midwifery philosophy of partnership and bi-cultural legislation, have provided a foundation for developing a research methodology for the profession. This thesis stories the interweaving of multiple epistemologies, theoretical tenets, philosophical concepts, indigenous and Western European world views as well as women’s narratives in creating and implementing a contextually relevant qualitative research methodology, ‘Te Whakamaramtanga’. The methodology was trialled in the field of miscarriage; a practice issue for midwives in New Zealand. Research participants were recruited through ‘word of mouth’ and snowballing methods. Twenty women participated in the research project and of these nine identified as midwives. Twelve participants were of Non Maori descent, including four women who were immigrants to New Zealand, and eight participants identified as Maori. Participants’ stories were gathered through dialogical interviews, which recognised the co-construction and exploration of knowledge. Ethical tenets outlined in the methodology involved the use of extensive, ongoing consultation with Maori, midwifery and local communities. Maori, women, and midwives share an oral culture that values narratives as facilitating the constitution of identities, creation and transmission of knowledge, and the development of social relationships. Whole narrative, thematic and narrative elements analyses of participants’ miscarriage-related talk have been developed through drawing on kaupapa Maori philosophy, the social theories of Pierre Bourdieu, Michel Foucault, Bruno Latour, Paul Ricouer, and Rom Harre as well as the narrative concepts of Arthur Frank and Margaret Somers. Substantive chapters explore whakapapa, corporeal temporalities, narrative silences and women’s desires for recognition and relationships. A new theory is advanced that methodologies, narratives, genealogies, temporalities, silences and women voices are simultaneously co-constituted metaphysical and material technologies. These heterogeneous and relational entities are collectively perceived as actants, hybrid actors, actor networks as well as technologies, which exist within a range of dynamic and hierarchical networks and/or fields in which this thesis is also embedded. My development of a multicultural midwifery research methodology informed by multidisciplinary theoretical approaches is innovative for midwifery research and theory, and potentially other health disciplines. My research also addresses gaps in midwifery, miscarriage–related, professional development, Maori health and health research literature.