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    Understanding as coping : a grounded theory of women's experiences of premenstrual changes : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 1995) Carvell, Julie
    Previous psychological research into premenstrual changes has tended to operate from a biomedical perspective and employ a positivist (or scientific) approach. The present study utilises a qualitative approach, the grounded theory method, as a means of collecting and analysing data. Ten women were interviewed using a semi-structured interview guide approach. These women were asked questions centred around four areas; (1) What sorts of premenstrual changes do you experience?, (2) In what ways do you think your life is influenced by these changes?, (3) How do you cope with and manage these changes?, and (4) What changes would you like to see that would help you and/or other women cope with these changes? The interviews were transcribed verbatim and analysed using grounded theory techniques. A grounded theory of the women's premenstrual experiences - experiential learning and perceived control - is presented and the implications of this theory for future research and as a therapeutic tool are outlined.
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    Igniting the diabetes self-care pilot light : understanding influences on health activation : a thesis presented in fulfillment of the requirements for the degree of Doctor of Philosophy, Massey University, Palmerston North, New Zealand
    (Massey University, 2011) Snell, Helen Julia
    Diabetes presents a serious health challenge for New Zealand because it is a significant cause of ill health and premature death. It is well recognised that self-care in diabetes, can be demanding and is influenced by numerous factors. Health activation is a composite notion focusing on four major elements believed to influence active engagement in self-care: these are beliefs, knowledge, skills and confidence, and behaviours. In this study I set out to elicit an understanding of influences on diabetes-related health activation in general, and specifically to provide explanations for how diabetes-related distress and/or health professional communication and decision-making styles impact on health activation. An additional aim was to generate new ideas on how diabetes care can be structured to maximise personal resourcefulness and promote health activation. Mixed methods methodology allowed for a pragmatically structured research approach. In particular the use of both quantitative and qualitative methods ensured that participants’ perceptions were comprehensively explored. Two hundred and twenty participants completed a semi-structured questionnaire and eighteen participated in a subsequent interview. Health activation was found to be dynamic and influenced by many factors. Diabetes-related distress and health professional communication and decision-making styles explored in this study were important contributors to health activation. This information has complemented and expanded knowledge of these constructs and has extended understanding on relationships between them. In particular it has generated knowledge about health activation, diabetes-related distress and health professional communication and decision-making styles specific to the New Zealand context.
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    From experiencing social disgust to passing as normal : self-care processes among Thai people suffering from AIDS : a thesis presented in fulfillment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand
    (Massey University, 2008) Siriwatanamethanon, Jirapa
    AIDS is a chronic disease that seriously affects health, emotions, social relations and household economy. People living with HIV/AIDS experience great suffering, stigmatisation and discrimination from other people around them because they know that it is incurable, contagious, evokes social disgust and is a complex disease requiring life-long self-care. This researcher explored ways people with HIV/AIDS take care of their health and manage their lives in the context of stigma and discrimination. A grounded theory study was conducted with 30 participants with HIV/AIDS, in Mahasarakham Province, Thailand. Participants were recruited from an HIV/AIDS day care clinic and by snowball sampling. Data were gathered through in-depth interviews, participant observations and field notes made during home visits. Interviews were tape recorded, then transcribed verbatim. “From experiencing social disgust to passing as normal” was generated inductively from the data as the basic social psychological process of Thai people living with HIV/AIDS. From experiencing social disgust to passing as normal comprised four categories: being HIV/AIDS, making choices, keeping well and feeling empowered. The category “being HIV/AIDS”- discovering the meaning of having HIV/AIDS, comprises four concepts: being diagnosed with HIV/AIDS, being stigmatised, suffering, and learning about HIV/AIDS. The category “making choices”- to live a normal life, involves three concepts: avoiding unhappy situations, getting remarried and seeking support. The category “keeping well”- maintaining emotional and physical health, includes eight concepts: religious practices, keeping a cheerful mind, self-treatment, taking care of the body, keeping the environment clean to prevent getting germs, healthy behaviours, getting healthcare services, and attention to, and concern about, medication. The last category “feeling empowered”- personal and social acceptance of illness, includes eight concepts: being encouraged, acknowledging the disease, social acceptance, tamjai, feeling proud of self, feeling good about life, feeling lucky and having hope. In the context of northeastern Thailand, successful management of HIV/AIDS was underpinned by participants making a transition from “experiencing social disgust” to “passing as normal” within their communities. The desire to live a normal life despite having HIV/AIDS motivated participants to undertake effective self-care in order to remain symptom free (thus avoiding visible signs of the disease), and to selectively disclose their illness to avoid the ongoing risk of stigma and discrimination. The findings of this study are useful in that they will provide Thai health professionals with a clearer conceptualisation of self-care among the Thai population. An inductively derived theory of self-care among Thai with HIV/AIDS can be applied and integrated by health professionals into the self-care models for people living with HIV/AIDS including models used in nursing education, research and practice.