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    What are the perceptions of nurses working in child health regarding their role in child protection? : a mixed method study : Master of Philosophy in Nursing at Massey University, New Zealand
    (Massey University, 2019) Shallard, Grace Ann
    The global and national figures of child abuse and neglect are overwhelming and highlight an imminent need to focus on the well-being of tamariki1. Due to the long-lasting individual and societal impact of child abuse and neglect, it is a profoundly important health issue. Nurses are not only the largest group of health professionals, but they are typically at the forefront of health care and have a unique and significant ability not only to detect, but also to intervene in and prevent situations of child abuse and neglect. Despite their potential impact, they have rarely been the focus of investigation in this area, particularly in New Zealand. This thesis presents research undertaken to explore the current perceptions of nurses working in child health in regards to their role in child protection. A mixed method study was conducted using a sequential explanatory (two-phase) design. These distinct stages comprised of a survey and subsequent, complementary interviews. The quantitative aspect of the design was conducted through a survey; there were 134 surveys included in the analysis and these data were used to inform the second phase which comprised of six complementary interviews. This qualitative aspect of the design drew on grounded theory approaches. The main findings of this research can be divided into the following categories. Eyes and ears: nurses are regularly exposed to children who have experienced child abuse or neglect and are well positioned to detect abuse and neglect. Hands: Nurses engage in this sphere in a number of ways-including medically caring for children who have been abused or neglected, coordinating care, making referrals, and practically supporting in a wide variety of ways. Head: Despite most nurses having received training in this area, only half of nurses describe feeling confident to identify child maltreatment. Furthermore, although there are discrepancies in area, there is little standardisation of how nurses engage with this sphere. There are a number of both supports and barriers; the main barriers being lack of certainty and limited confidence in social services. Heart: Nurses experience deep and profound emotions when engaging in this sphere, which not only effects nurses personally, but also affects decision making and quality of care. Gut: Nurses rely on gut feelings to make decisions, an important and advanced way of knowing. Finally, it was clear, that nurses deeply care for the children they work with and the wellbeing of children is at the centre of all they do.
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    Bonded caring : health care choices of women with dependent children : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing Studies at Massey University
    (Massey University, 1991) Enslow, Beverly Ann
    The question for this study arose from the observation that health care often does not match the client's self-determined needs and desires, and hence is wasted care. As a result, the study proposed to discover what elements are involved when women with dependent children make health care choices and what they want in the way of health care. The exploratory study was conducted using strategies of grounded theory. Fourteen indepth interviews, involving eleven women, were conducted. The selection of participants and of the questions for the interviews was based on theoretical sampling. Constant comparative analysis and integrative diagramming were used to analyse the data. The theory that emerged from the data was Bonded Caring and its two essential categories; Interconnectedness and Caring. Bonded Caring requires an intimate and ongoing relationship in which there is development of indepth knowledge of the unique characteristics of the person(s) involved. it is characterised by a strong and enduring affective quality, and by concern, worry and serious attention to the needs of the person(s) involved. This concern necessitates the gathering of information about the nature of the needs, and making the best possible choices concerning their management. During this search for knowledge and skills needed to carry out health care, women assess their own knowledge and experience; the level(s) of health care needed by each individual; the availability, competence and expected response of the resource person or health care consultant; the perception of risk associated with a health concern; and the family's culture and life style. The women considered these elements within a structural framework of finite material and personal resources. The women juggled the distribution of these resources in a way that allowed them to select the avenues of health care that provided the best degree of safety and protection of development within the context of their circumstances.
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    Well child care services in New Zealand : an investigation into the provision and receipt of well child care services in a Hawkes Bay sample : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Nursing at Massey University
    (Massey University, 1998) Tilah, Morag S W
    Maternal and child care in New Zealand has traditionally been given by a variety of providers from the private and public sector. The reorganisation of the health services has effected all forms of health delivery including maternal and well child care or well child care services. Contracting of services in a competitive environment has been an important feature of the reorganisation process. Ashton (1995) notes that the system of contracting has facilitated the introduction of new approaches to health from new provider groups, which are not necessarily based on primary health care principles. This has led to confusion for providers and consumers alike. In 1996 a new national schedule which described the services recommended for maternal and child care was introduced called WellChild/Tamariki Ora. A questionnaire based on this schedule was administered to a sample of 125 parents of children under five years of age in Hawkes Bay to investigate issues relating to the provision and receipt of well child care services. Descriptive data showed that the major providers of services in the present study were doctors. There were significant differences found in the number of services received across a number of demographic variables such that generally fewer services were received by the less educated, the unemployed, single parent families, and Maori and Pacific Island people. Perceptions about the helpfulness of services received were not related to ratings of the child's health. Parents who received a greater number of Family/Whanau support services rated their children's health more highly. Findings are discussed in relation to the previous literature and recommendations are presented with particular emphasis on the implications for nursing and the role of nurses in providing well child care services.