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    Consumer value and value co-creation in complementary and alternative medicine (CAM) health services : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Marketing at Massey University, Albany, New Zealand
    (Massey University, 2015) Dodds, Sarah Louise
    This thesis contributes to an emergent area on consumer value co-creation in a rapidly growing and exciting ‘new’ service market, Complementary and Alternative Medicine (CAM) health services. The market for CAM health services is experiencing strong growth as consumers look for greater value, choice and control in managing their health. Despite the growth in this large health service market there is a paucity of research from a service marketing and consumer behaviour perspective. Yet, understanding what CAM consumers’ value and how they co-create value with CAM health services has important managerial implications. The purpose of this research is to explore what value CAM consumers’ gain and how they co-create value from their consumption experiences with CAM health services. The research adopts an interpretive approach employing an exploratory case study research strategy, using qualitative methods and an adapted version of the visual elicitation technique ZMET. The research process is semi-longitudinal and is conducted in three phases over a 12 month period. Sixteen CAM consumers with ‘lifestyle’ health complaints who use CAM health services participated in the study. The findings reveal eight consumer value components including: quality of care, treatment efficiency, physical environment, esteem value, social value, spiritual value, ethics and play. A consumer value model for CAM health services and potentially all health care services is proposed. Significantly this research found that CAM consumers co-create value on three levels according to their: approach to health care, preferred ‘consumer value co-creation relationship styles’ and engagement in ‘consumer value co-creation activities’. Consequently this thesis presents a typology of consumer value co-creation in CAM health services and develops a consumer value co-creation framework that can potentially be used for all health services. This research contributes to service marketing and consumer behaviour theory by extending the concepts of ‘consumer value’ and ‘value co-creation’ to incorporate findings from the CAM health service sector. The managerial implications of this research could help guide both CAM health care and mainstream medical practices to provide better health services and ultimately improved health outcomes for health care consumers. Future research could implement the unique three phase semi-longitudinal process and visual methods developed in this research, in various health care and service settings.
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    Spiritual healing and its contribution to contemporary religious life and alternative medicine in Aotearoa-New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Religious Studies at Massey University
    (Massey University, 1996) Martin, Melva May
    Spiritual healing spans many centuries, cultures, and health professions, yet the scientific study of spiritual healing is lacking from the literature of religious studies. There is no doubt that spiritual healing is very much a part of many religions; healing was in fact a practical foundation for the Christian religion as taught by Jesus Christ and his disciples. As a result of breakdown in religious organisations spiritual healing has become the foundation from which many movements away from conventional religions has occurred and consequently sects, cults, and practitioners of alternative medicine have gathered followers and flourished as they practise their mode of spiritual healing. The ultimate purpose of this study was to discover new knowledge about the phenomenon of spiritual healing from the viewpoint of both healer and healee, i.e., those who recognise or have experienced spiritual healing as a distinct process of healing. Phenomenology provided the philosophy and the basis for the overall design of the study which sought to discover the contribution of spiritual healing to contemporary religious life and alternative medicine in Aotearoa-New Zealand. Triangulation was the method of choice to explore the essence of spiritual healing in a primary research survey carried out in the Manawatu region of Aotearoa-New Zealand. The strength of phenomenology lies in the lived experience and understandings of people, therefore a more accurate account of the phenomenon of spiritual healing was established from experiential data acquired from the primary research study. The results from the primary research study enabled the researcher to demonstrate knowledge which was context specific and relevant to the literature about spiritual healing within the domain of religious studies. It also described the contemporary position of spiritual healing in religious life, and alternative medicine in Aotearoa-New Zealand today. One of the major procedures many healers use to effectively heal the physical, energetic or etheric levels is a hands-on approach to the patient (healee) in treatment, either through actually touching the body or holding the hands a short distance off the body. The results of my primary research demonstrates that these methods of healing confirm the literature and are practised today. Illustrated experiences of healers and healees during spiritual healing interactions, as described in chapter four, indicate that through spiritual healing physical changes occur during healing interactions. Results of biophysical changes in pulse rate, blood pressure, and cranial rhythm, as well as experiential findings, show evidence for an energy ('e') exchange between the healer ('s') and healee ('s') during the act of healing with both people being affected and indications of a higher spiritual source ('S') at work during the interaction. From this study an equation for spiritual healing is proposed as follows: 's' + 's' + 'e' = 'H'(spirit of healer) (higher Spiritual source) (energy) (healing) ln Aotearoa-New Zealand, conventional medicine, nursing and religion have failed to treat the whole person, i.e., body, mind and spirit. Although their philosophies encourage the holistic approach evidence indicates that there is limited knowledge available within the professions and some role confusion for the provision of spiritual healing. However, a 'holistic'philosophy has always been part of alternative medicine and in both Britain and America alternatives are becoming an accepted and established part of their health care systems. There is currently a growing interest in alternative medicine and natural therapies within the health professions in Aotearoa-New Zealand and units of learning are being developed for the New Zealand Qualifications 'Framework'. Indications are that spiritual healing will become a major aspect of religious life and alternative medicine over the next decade in Aotearoa-New Zealand.
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    Midwives' use of unorthodox therapies : a feminist perspective : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Midwifery at Massey University
    (Massey University, 1996) Hotchin, Claire Lucille
    In New Zealand independent midwives are increasingly incorporating unorthodox therapies into their practice. This research studied the experience of metropolitan midwives using unorthodox therapies within the existing edically dominated maternity care system. It also explored the forces that facilitated and constrained midwives in their use of unorthodox therapies. Feminist case study method was used to research the experience of five independent midwives who had integrated unorthodox therapies and practices into their midwifery practice. Their individual stories are related in separate chapters. Semi-structured interviews were used to gather the data which was analysed using the feminist concepts of power and gender. Three key points emerged from the analysis. The midwives strongly believed that the way in which they used unorthodox therapies in their practice benefited and empowered women. Secondly, they had some concerns regarding knowledge of unorthodox therapies. Thirdly, the midwives who used unorthodox therapies felt professionally vulnerable within the bio-medical orthodoxy. Feminist theory was used to analyse the data and enabled the researcher to place midwives' use of unorthodox therapies within a broader socio-political context. It is hoped that this may stimulate midwives to examine their own use of unorthodox therapies as well as provide the impetus to initiate change within both the bio-medical orthodox maternity system and alternative heath movement.
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    Integrative medicine : a contested practice : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Albany, New Zealand
    (Massey University, 2012) Madden, Helen
    In contemporary Western society, the healthcare arena has become increasingly technology-based, rationalised and specialised with alternative forms of medicine being taken up alongside orthodox medicine. This shifting healthcare terrain has brought forth challenges to practitioners' and patients' identity and to the practitioner-patient relationship. Today, the expertise and autonomy underpinning general practitioners' professional identity has been challenged. In parallel, patients have become reconceptualised from subjects in need of medical expertise, to 'informed' and 'active' health consumers. Within this fluid healthcare arena integrative medicine (IM) is emerging, a practice which amalgamates orthodox medicine with forms of alternative medicine. This emerging form of healthcare produces a number of paradoxes. These occur around the paradigm clash between treatment philosophies, issues of professionalism and the standardisation of treatments, power relationships and debates around dominance and subordination, and issues relating to patient autonomy and treatment responsibility. A discursive analysis of IM practitioners' and patients' talk reveals that the practice of IM gives rise to a number of contradictions and challenges for both IM practitioners and patients. Practitioners draw on discourses of holism, liberal humanism, spirituality and empowerment to construct IM as a healthcare model which maintains elements of both allopathic and alternative medicine in place, but also to legitimate practices inherent in IM. Through doing so, they reconstruct their medical professional identity. In conjunction, patients' draw on practitioners' extended knowledge-base and open-mindedness to construct IM practitioners as trustworthy professionals and to legitimate their own engagement in exploratory forms of treatment. This has implications for patients' and practitioners' subjectivity. Patients become individuals who deserve to be understood on a multitude of levels: psychologically, spiritually, emotionally and physically through which they gain recognition. Concurrently, practitioners' become placed in a paradoxical position with respect to their practice. They resolve this by resisting the position of biomedical expert and by incorporating a range of alternative medicine treatments to extend the healthcare they offer to patients. In conclusion, the practice of IM is shown to legitimate patients' engagement in self-reflexivity practices and to reproduce Cartesian dualism. Further, the research reveals how discourses of holism and empowerment, that are held to represent the fundamental difference between allopathic and alternative medicine, are drawn on by practitioners to legitimate a more in depth practice and a deeper level of engagement with patients. Finally, the research questions whether IM constitutes a truly 'integrative' medicine.
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    Taking the spirits seriously: neo-shamanism and contemporary shamanic healing in New Zealand : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Social Anthropology at Massey University, Auckland, New Zealand
    (Massey University, 2011) Sanson, Irene Dawne
    This thesis is a phenomenological and comparative study of contemporary shamanic healing and neo-Shamans in New Zealand. It considers neo-Shamanism as a complex of spiritual practices situated within a broad but identifiable cosmological sensibility, and as variable systems of healing. The relationships between neo-Shamans and some other new religious movements in New Zealand, and the similarities or differences between the practices of other neo- and indigenous shamans within a global context are examined. The discussion sits within a larger health and healing discourse about the relationships between neo-Shamanism, complementary and alternative medicine, and biomedicine amongst the medically pluralistic culture of New Zealand. It describes contemporary Māori healing as a possible variant of shamanism within local and global contexts; in particular, it examines the relationships between (some) neo- Shamans in New Zealand and (some) Māori healers. I argue that modern Western shamans are synthesising and creating multiple 21st century forms of neo-Shamanisms, and that neo-Shamans in New Zealand are part of this emerging (re)construction process. However, neo-Shamans in New Zealand are also unique in that they live and practise in this land, which has led to them creating new spiritual identities as neo-Shamanic practitioners in New Zealand. I suggest that neo-Shamans in New Zealand do many of the things that indigenous shamans have always done and continue to do (such as entering altered states of consciousness), albeit within a particular modern Western cultural context. Moreover, I contend that neo-Shamans are challenging orthodox Western science as they engage in a sacred science that ‘takes the spirits seriously’ (Blain, 2002:74). Secondly, I argue that many practitioners of complementary and alternative medicine consciously or unconsciously incorporate what might be regarded as shamanistic techniques and tools into their work, creating fusion models of healing. My observation is that the importation of shamanic healing practices into the West has contributed to these processes. I suggest that while at least some contemporary healers might be considered ‘shamans’ in disguise, nomenclature issues around whether or not they should be defined as shamans are less important than the fact that their healing practices have widened to include implicitly or explicitly a spiritual dimension.
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    Crossing the sea : narratives of exile and illness among Cambodian refugees in New Zealand : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Social Anthropology at Massey University
    (Massey University, 1995) North, Nicola H.; North, Nicola H.
    Cambodian refugees have settled in many countries of the West, including New Zealand. Cambodian refugees are consistently described as the most traumatised of Southeast Asian refugees; hence they are expected upon resettlement to be in special need of health care, which host countries must provide. Most Cambodians from rural areas have had little prior experience with Western-type health care, having employed mainly local (rural Cambodian) healing techniques, supplemented with a range of available Western and Asian medicines, in an environment of medical pluralism. Using the ethnographic method, this three year study set out to determine illness experiences of resettled Cambodian refugees, and to interpret experiences in the contexts of the events that led to their fleeing Cambodia, the trauma of the flight itself, and the process of resettlement in an unfamiliar nation, geographically and culturally far distant from home. Theories that Cambodians hold regarding the origins, progress, and preferred treatments of illness are described. Experiences of seeking health care from New Zealand's biomedically based health services are presented, and complementary health-care practices such as Cambodian self-care and alternative medicines are identified. Adult Cambodian who have survived severe deprivation, atrocities and profound loss often suffer serious ill health. Ill health is both cause and consequence of inability to acquire new skills and education, low facility in English, unemployment and poverty. For adults caught in the cycle of illness and poverty, social interaction is primarily with other Cambodians. A Cambodian sub-society on the margins of mainstream society has emerged, in which, among other things, healing practices are carried out. Cambodian refugees show no reluctance to use Western medicine, and little desire to employ Cambodian medicine, which in any case is now largely unavailable. While some Cambodians suffer from diseases that appear amenable to Western medical diagnoses and treatments, others have been found to suffer intractable, often painful illnesses for which no biomedical explanation could be found. In such cases, the sufferers themselves offered explanations for their illnesses, drawing from Cambodian theories of illness, and personal life experiences, in doing so. However, some serious illnesses experienced by Cambodian refugees fit neither Cambodian nor Western biomedical disease categories. A result of exile is that familiar Cambodian systems of healing are no longer relevant, and at the same time, conditions of exile and transition cast doubt on former theories of illness, leading to a search both for understanding and for healing. Employing Cambodian self-care techniques together with Western and Asian medicines, resettled Cambodians are actively creating a transitional system of healing appropriate to their transitional status. Hard, solitary intellectual labour ("thinking too much") is a central process by means of which exiled Cambodians struggle to regain control of their shattered lives. The development of a new system of healing is part of the global process of hybridization of cultures, accelerated by massive transnational migration. To depict both the danger and the generativity of the transformations of which Cambodian refugees are both agents and subjects, the study concludes by borrowing a Cambodian metaphor for giving birth: "crossing the river." Cambodians consider women post-childbirth to be weakened and vulnerable to illness, cold and wind; while the child is newly born into humanity, the mother too is reborn into a new social status. Refugees who have literally crossed the sea to settle in a new country are undergoing a similar rebirth.