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    Older women's experiences of menopause : a feminist descriptive study of older women's knowledge and attitudes toward menopause : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Nursing, Massey University
    (Massey University, 2003) Gracez, Teresa
    As a result of improved health breakthroughs, most women can expect to live into their ninth decade. Consequently they will experience several stages of growth and development through which most women from previous centuries never had the opportunity to pass. Maturational changes often bring satisfaction, but the physical and social changes that accompany ageing may encourage some women to seek support and information from nurses. Although women today have more awareness of menopause and access to information and resource than women 30 years ago, it remains difficult for women to understand menopause in a non-contaminated manner. This study brings together the two divergent perspectives on menopause: feminist and biomedical discourses. Feminist discourses most commonly regard menopause as a normal life transition whilst, biomedical models construct menopause as an illness requiring medical treatment. This qualitative descriptive study underpinned by feminist epistemology explores older women's experiences of menopause before menopause came to be perceived to be a problem requiring medical treatment. Semi-structured interviews were conducted with ten women, aged 70 years and over. Qualitative content analysis in this study resulted in two categories and eight themes of older women's experiences of menopause. The findings in this study indicate that older women perceived menopause to be a 'natural' and 'normal' life developmental stage. Although the women viewed menopause to be a 'normal' passage in life and something that did not require much attention or medical intervention, the majority of women were quick to recommend that today's woman should seek help from menopausal symptoms from medical practitioners. This surprising variation of menopause being accepted as an illness for today's woman but not an illness 30 years ago suggests that the women's thinking has evolved in keeping with the social context they now occupy.
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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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    The measurement and correlates of women's health care utilization : a thesis presented in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Palmerston North, New Zealand
    (Massey University, 1998) Madison-Smith, Gillian L.; Madison-Smith, Gillian L.
    Andersen's Behavioural Model of Health Care Utilization was used to examine New Zealand women's use of six health care services. The model conceptualises health care utilization as a function of predisposing, enabling and need variables. Predisposing variables encompass the individual's characteristics which are present prior to the onset of illness that represents their propensity to use health services, for example, age. Enabling variables represent features affecting the means to obtain services, for example, income. Need variables represent the presence of illness, either self perceived or professionally diagnosed. Of the six services investigated in the present study, two were non-medical (use of disability and bed days) and four were medical (use of General Practitioners (Gps), health professionals, hospitals and prescription items). The study examined a geographically stratified sample of 964 women between the ages of 19 and 90 drawn from a range of New Zealand households. Five hypotheses were tested for each of the six health services. Incorporating new measures to capture the model's components, the first two hypotheses replicated the model by examining use of health services in terms of 'contact' and 'volume'. Contact focused on whether or not a service had been accessed, while volume focused on the amount of consumption that occurred over a defined catchment period. Predisposing and enabling characteristics were important predictors of contact; but need became more important when predicting ongoing service use. The last three hypotheses expanded the model by examining the effects of trauma and Post-Traumatic Stress Disorder (PTSD) on health care utilization. Traumatic events were associated with ongoing use of bed days and hospitals. PTSD was associated with use of bed days, hospitals, and GPs. Suggestions are made regarding future research in terms of overcoming research limitations and expanding the field. These included improving measures to capture needs for women of all ages as opposed to focusing on measures capturing chronic conditions best suited for the elderly, examination of service use in terms of episode events and suggested developments for the model incorporating reciprocal and feedback loops to account for traumatic events, PTSD, personal health habits and satisfaction with use of health services.