Massey Documents by Type

Permanent URI for this communityhttps://mro.massey.ac.nz/handle/10179/294

Browse

Has files: YesSubject: search.filters.subject.Medical screening

Search Results

Now showing 1 - 5 of 5
  • Thumbnail Image
    Item
    Community participation in policy development : a case study of the National Cervical Screening Programme : a thesis presented in partial fulfilment of the requirements for the degree of Master of Educational Administration at Massey University
    (Massey University, 1992) Grew, Gillain Dorothy Anne
    This thesis is a case study of the development of the National Cervical Screening Programme policy. The aim of the study was to identify and describe the political, social and ideological factors which may have influenced the National Cervical Screening Programme policy. The policy-makers included community or consumer participants as well as professionals. This relatively unique feature of community involvement was also a focus of study. The study involved a literature search and review as well as interviews with key informants. Cervical screening on a population basis was trialled as far back as the 1960s at the same time that Professor Green was questioning the efficacy of early treatment of cervical abnormalities. Green's controversial research resulted in a Royal Commission of Inquiry which recommended the establishment of a population based national cervical screening programme. The political, social and ideological context in which the National Cervical Screening programme policy was developed is described and interpreted. It is concluded that the National Cervical Screening Programme policy was adopted by the Government as a means to ameliorate the crisis of legitimation which was evident during the 1980s. It is further concluded that community or consumer participation in policy development is a highly complex issue requiring further study. Consumer representation is particularly problematic as consumer policy-makers require considerable skills, the acquisition of which may cause them to become less representative of the public whose voice they are intended to be.
  • Thumbnail Image
    Item
    Implementing a newborn hearing screening programme : a feasibility study : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts at Massey University
    (Massey University, 2004) Anderson-Hawke, Karen
    Aim. To determine the feasibility of implementing a universal newborn hearing screening programme at National Women's Hospital (NWH), Auckland, New Zealand. Method. This feasibility study evaluates the potential for success of a Universal Newborn Hearing Screening (UNHS) Programme in a tertiary hospital setting. A review of the present provision of care for infants with congenital hearing loss and a clear description of the current environment and resources at National Women's Hospital was undertaken. By utilising the four key determinants of a feasibility study as described by Whitten, Bently & Dittman (2001) I was able to provide a clear description of the current position and explore the alternative solutions, ensuring an accurate and comprehensive study approach was undertaken. Results. A detailed analysis of the environmental setting and population at NWH identified the support required for implementing a UNHS programme. Findings also identified the acceptance by both staff and consumers in providing improved congenital hearing loss detection and intervention early in the newborn period. The evidence supported recommendations for two possible hearing screening protocols that are both practical and feasible in the National Women's Hospital setting for the detection of congenital hearing loss in the newborn population. Conclusion. Overall findings indicated that the implementation of UNHS at National Women's Hospital is feasible. The current method of detecting hearing loss in the newborn population is inadequate with unacceptable delays for diagnosis and appropriate intervention to improve outcomes for those identified with a congenital hearing loss. The protocols supported by this study are based on the research findings and are unique to the NWH environment and target population. They will ensure the infants with congenital hearing loss are detected and referred early (soon after birth) so formal audiological diagnosis and strategies for intervention can occur with treatment implemented by six months of age. This will improve the child's communication and learning skills, improving their level of education and long term learning ability. Further and regular audit of the programme, screeners and outcomes will be required to ensure its efficiency as a screening service for congenital hearing loss.
  • Thumbnail Image
    Item
    Choice, morality and vulnerability : young women's discourses of cervical screening : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology (endorsement in Health Psychology) at Massey University, Albany, New Zealand
    (Massey University, 2016) Coulter, Holly
    Cervical screening is a health surveillance tool used to prevent cervical cancer. In New Zealand, research into cervical screening has largely focused on barriers to participation. This type of research implicitly assumes that cervical screening is a desirable health behaviour for women to engage in, and does not explore how social and political factors are implicated in cervical screening behaviour. This research sought to explore women’s understandings and experiences of cervical screening. Ten women aged 20 to 30 were interviewed, their responses recorded and transcribed, and an interpretive analysis conducted. From the analysis, three broad webs of discourse surrounding cervical screening – choice, morality and vulnerability – were identified and discussed. Each web of discourse was used to construct cervical screening in different ways. For choice, participants constructed cervical screening as an autonomous choice, routine, or an obligation. Morality was drawn upon for its role in cervical screening around ideas of individual and social responsibility, and sexual activity. Finally, vulnerability was explored through the fear of getting cervical cancer, the vulnerability experienced as part of screening, and the protection it was seen to offer. Choice, morality and vulnerability worked together to limit the available ways of experiencing and acting in relation to cervical screening, constructing compliance as the only option for women. Those who do not comply are positioned as problematic, irresponsible and immoral by women, their friends and families, and health professionals. This research highlighted the ways in which discourses produce realities which create and maintain power imbalances which govern and control women’s bodies. Rather than viewing cervical screening as a desirable yet morally neutral act which all women ought to participate in, it is a site where women may choose to comply or resist dominant discourses which exert power over women’s bodies.
  • Thumbnail Image
    Item
    An exploration of nurses' experiences of delivering the before school check : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosphy in Nursing at Massey University, Albany, New Zealand
    (Massey University, 2013) Williams, Sarah Jill
    The New Zealand Well Child/Tamariki Ora (WCTO) programme is a community based well child health service; the programme is supported through the WCTO Framework and an associated National Schedule. The schedule outlines a total of 12 core contacts that every child and their family are entitled to receive from birth to five years. The first four of these are provided by the child’s lead maternity caregiver, with the remainder contracted out to Well Child Providers. The Before School Check (B4SC) is the eighth and final core contact under the WCTO schedule and is performed between 4 and 5 years of age. The B4SC was initiated in September 2008 and utilises not only a developmental screening questionnaire but also a health assessment, behavioural screen, hearing and vision assessment and oral health screen. This check is not necessarily always delivered by the child’s well child provider but can also be done through their family doctor or practice nurse. The purpose of this study was to explore nurse’s experiences of implementing and delivering the B4SC. Since its implementation in 2008 the B4SC has been delivered in a variety of ways by a range of nurses across the country. This study focused on the experiences of nurses working in Auckland and the participants included practice nurses, plunket nurses and public health nurses. Using semi-structured interviewing the participants in this study were given the opportunity to share their experiences and to discuss any issues raised. Based on their experiences participants were also asked if they had any recommendations for the further development of the B4SC. Thematic analysis using a general inductive approach was used to analyse the data and a number of themes emerged. Although the participants were very positive about the potential benefits of the check they expressed a range of challenges in the delivery of it. Five key themes were identified entitled: Construct constraints, Time, Translation & Culture, Child Interaction and Training & Support. Recommendations are made based on the study findings and suggestions for further research are presented.
  • Thumbnail Image
    Item
    Progression to diabetes : 5 year follow-up of the Northland Diabetes Screening and Cardiovascular risk assessment pilot : a thesis presented to fulfil requirements for the degree of Master of Public Health at Massey University, Wellington, New Zealand
    (Massey University, 2014) White, Bronwyn Kaye
    Aim: The primary aim was to determine the effect the Northland Diabetes Screening and Cardiovascular risk assessment pilot had on the progression from a normal glucose test (NGT) at baseline to diabetes. Method: Patients from a single practice (Maori = 1509, Non-Maori = 619) who were invited onto the pilot with NGT at baseline were retrospectively followed up for 7 years. Results for Pilot (PG) (Maori = 336, Non-Maori 255) and Non-Pilot (NPG) groups (Maori = 537, Non-Maori = 204) were compared on progression to diabetes, impaired glucose tolerance (IGT), all-cause mortality. Results for Maori: There were 10 incidence cases of diabetes, 20 IGT and 18 deaths from any-cause during a median duration of follow-up of 6.4 years in the PG compared with 22 incidence cases of diabetes, 23 IGT and 30 deaths from any-cause in the NPG followed for a median duration of 4.3 years. Participation in the pilot was associated with a statistically significant protective effect on progression to diabetes (Age-adjusted rate ratio 0.44(95% CI 0.2156, 0.912) and all-cause mortality (Age-adjusted rate ratio 0.49 (95% CI 0.2771, 0.8626). Results for Non-Maori: There were 12 incidence cases of diabetes, 13 IGT diagnoses and 19 deaths from any-cause during a median duration of follow-up of 6.2 years in the PG compared with 9/204 diabetes incidence cases, 11 IGT and 13 deaths from any-cause in the NPG followed for a median duration of 4.7 years. There was no statistically significant association with participation in the pilot on progression to diabetes, IGT or all-cause mortality. Conclusion: The protective effect for Maori patients in the pilot on progression to diabetes was either because they had inherently lower risk than the non-pilot group or potentially because their baseline results were interpreted in the context of their CVD risk. The effectiveness of CVDRA programmes on reducing incidence diabetes should be formally assessed. Research focusing on risk reduction for Maori aged 35-49 years is recommended.