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    The psychosocial interactions of adolescent and young adult (AYA) cancer survivors and the possible relationship with their development : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Palmerston North, New Zealand
    (Massey University, 2019) Cameron, Nicole
    Adolescents and Young Adults (AYAs) with cancer may be particularly affected by social interactions, as they can be grappling with both a serious illness and normal developmental challenges. The present research aims to increase the understanding of the psychosocial interactions of AYAs with cancer and how these interactions can be grouped and organised in relation to each other. Furthermore, this research hopes to examine the relationship that cancer has with the developmental trajectory of this population, and how social interactions influence this relationship. As development is an important aspect of this age group, it is appropriate to consider both psychosocial interactions and the development of AYA survivors. Qualitative interviews asked ten participants (aged 16-25 years) to describe their psychosocial interactions and examined how these might affect their development. Thematic analysis identified a range of themes including: the importance of personal privacy and controlled sharing of information, independence, identity formation, positivity, acknowledgement of cancer vs. being treated normally, and receiving support instead of supporting others. In the one year follow-up interviews with five participants, half of these themes remained constant; however the personal privacy, independence and supporting others themes changed. Development appeared to be impacted by cancer for both adolescents and young adults, but this impact lessened over a one-year period. A quantitative study followed, which involved asking thirty AYAs to sort psychosocial interactions using a GOPA card-sort process, resulting in a multidimensional model of interactions. Interactions were derived from a combination of the aforementioned interviews, and a similar model completed for an Honours thesis. This model showed that AYAs conceptualise interactions in two main ways: through their perception of emotional response (avoidance/discomfort interactions opposed support interactions) and empathy (empathic actions/encouragement interactions opposed thoughtlessness interactions). Unfortunately the sample size was too small to complete two separate models comparing age differences, and therefore an understanding of developmental disparities in conceptualising interactions was unable to occur. Overall, social interactions and developmental stage appear to influence AYAs’ experience of cancer. Together, these two studies provide an understanding of how AYAs in New Zealand experience and perceive psychosocial interactions. Furthermore, there is an enhanced understanding of the developmental impact that cancer has on AYAs’ interactions. This research proudly contributes to the body of knowledge on AYAs in New Zealand, their psychosocial needs and the way cancer impacts on their development.
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    Perceived insufficient milk supply in New Zealand mothers during the first-year postpartum : this thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand
    (Massey University, 2019) Hintz, Micah
    Background:  Mothers  rarely  achieve  breastfeeding  (BF)  recommendations  and  there  are  numerous reasons that may lead to early cessation. However, insufficient milk supply is a frequently reported cause. Current research on perceived insufficient milk supply (PIM) itself is limited.  Numerous  factors  are  suggested  to  play  a  part  in  the  occurrence  of  PIM,  including:  demographic, psychological as well as feeding practices and management factors. Aim. To determine  the  factors  associated  with  PIM  and  the  impact  that  this  has  on  BF  practices.  Methods: Secondary analysis of the data collected from Manawatu Mother and Baby Study. Sixty-­one  women  were  included.  Interviews  about  maternal  demographics,  obstetric  characteristics and BF practices were conducted on women approximately 2 weeks postpartum, then at 2 weekly intervals throughout the first three months, and finally once per month until the infants first birthday. Bivariate associations and logistic regression analyses were conducted to determine the relation of PIM with variables, as well as with BF duration. Results: PIM was reported by 44% of the participants and was the main reason for introduction of infant formula. Formula use was a significant predictor for PIM (R2=0.22) and was explained by formula being used in response to PIM. We found that PIM was a significant predictor of BF duration (any BF 5 months R2=0.44, full BF 5 months R2=0.13, any BF 12 months R2=0.32). Additionally, maternal importance  of  BF  at  4  weeks  can  also  predict  the  duration  of  BF.  Conclusion:  PIM  plays  a  significant role in the introduction of infant formula and BF cessation. However, the absence of a significant relationship between PIM and demographic variables makes it difficult to identify mothers who may be at risk of PIM. Further research is required to try identify mothers at risk of PIM, in order to help prevent or resolve it.
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    The psychosocial consequences of severe head injury from the perspective of relatives who care for head-injured persons in the community : a cross-sectional case study approach : a thesis presented in partial fulfilment of the requirements for the degree or Master of Arts in Psychology at Massey University
    (Massey University, 1989) Cannon, Margaret Ann
    The primary aim of this research was to gain insight into the "world" of carers of head-injured persons in the community, identify their major areas of stress, and explore support needs. A cross-sectional multiple case study design was chosen. The patient sample had all experienced severe to extremely severe head injuries. They were not interviewed. Semi-structured interviews were conducted with eleven carers of the head-injured persons, all but one being a relative of the patient. A verbally-administered questionnaire was used during the interviews to ensure that standardised questions were asked of all respondents. Many of the questionnaire items were closed, but others were partially or fully open-ended. The questions addressed: historical information, changes in the patient, changes in overall life-style, changes in relationships, carers' personal and practical support needs, and their perceptions of the future. A single quantitative analogue rating scale was used to measure levels of respondents' reported distress. Respondents were encouraged to provide comments freely during the interviews. The obtained data was systematically presented in the form of group frequencies and occasional measures of central tendency. This data was supplemented by eleven individual case studies. The main patterns and themes were apparent in the grouped data, but the individual case studies permitted examination of both common and unique responses within a "real life" context. There was thus across-study and within-study investigation. The approach to the research was exploratory and descriptive. No hypotheses were held but some expectations were indicated in the existing literature. The present study found similarities with previous research in that psychosocial changes in the patient were reported more frequently by carers than broadly physical changes, reported stress levels were generally high, and there were complaints by respondents about lack of head injury information, and lack of family counselling. The most notable differences were that respondents in this study considered that (in terms of reported frequencies) communication, conversation and interactional changes in the patients, together with patients' social restrictions/isolation, were the most distressing changes for the carers. A major area of reported distress by respondents in this study related to insensitivity by others towards the patient. However, a number of positive, optimistic comments were made by respondents. Practical support needs were generally met, as were personal support needs in the form of confidantes and friends. The methodological limitations of the present study were discussed, and theoretical and practical implications examined. Suggestions were made for further research.
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    The experience of pain in surgical patients : a cross-cultural study : a thesis...for the degree of Master of Arts in Nursing Studies at Massey University
    (Massey University, 1981) Madjar, Irena
    The purpose of this study was to describe and compare the experience of pain in surgical patients from two cultural groups, and to identify similarities and differences in their conceptualizations of pain, and attitudes and behavioural responses to pain. An integral part of the study was to generate hypotheses and concepts which may contribute to the formulation of substantive theory in the area of care of patients in acute pain. The design of the study was influenced by a qualitative approach to research, with the basic expectation that explanation would emerge from the data collected. The methodology used was that of supplemented participant-observation. Thirty three adults (20 Anglo-Australians and 13 Yugoslavs), admitted for abdominal surgery to one of three hospitals in Sydney and Wollongong, Australia, were observed throughout their period of hospitalization. In addition, non-structured interviews were conducted with each patient prior to surgery, and prior to discharge from hospital; verbal self-reports, visual analogue scales, and behavioural observation check lists were used; and information about peri-operative interventions (including analgesic drugs) was collected. The findings relate primarily to: (a) the experience of pain in terms of the intensity, duration, and quality of pain, and pain-related behaviours; (b) the relief of pain in terms of the use and perceived effectiveness of analgesic drugs and other pain-relieving measures, with special reference to patient preferences for social company during the experience of pain; and (c) the prospective and retrospective evaluation of the experience in terms of pre-operative fears, fulfilment of expectations, and positive and negative aspects of the experience. The findings support the hypothesis that while some behavioural differences exist between Anglo-Australian and Yugoslav patients, the greatest degree of difference between the two groups is found in their underlying attitudes to pain. In addition, a number of more specific conclusions are presented, followed by a discussion of implications for clinical practice and for further research.