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Item Paediatric hospital visiting policies in Cameroon : the experiences of nurses and parents : a thesis presented in partial fulfillment of the requirements for the degree of Masters of Arts in Nursing at Massey University, Palmerston North, New Zealand(Massey University, 2001) Njeba, Patience YensehThis study explored the experiences of parents and nurses caring for hospitalised children with the parents either living-in or having only visiting rights. The participants were parents with children hospitalised for a minimum of three days and nurses working in the paediatric ward for a minimum of six months. A qualitative approach using semi-structured interviews and participant observation was used to collect the data and Burnard's (1991) thematic content analysis to analyse the data. Six themes were identified of which two (one from the nurses and one from the parents) are main themes. The main theme from the nurses relates the nurses' aim of meeting the children's need and getting them ready for discharge home. The main theme from the parents relates the parents' satisfaction with the care they receive and the difficulties they have as parents not always being able to be with their child at will. The roles of parents and the nurses with regards the cares of children are relatively distinct in the hospital. The parents' role seemed quite limited due to the poor information received from the nurses although they (nurses) had a better understanding of what these roles could be. It could be noted that attitudes and opinions of nurses and parents about the way children are cared for in hospitals are different. For some parents, living-in and carrying out basic cares such as bathing, changing, feeding and comforting the child is just normal. Others felt it is the nurses' responsibilities, hence were reluctant to do it. Nurses also had divided views with regards to providing this basic care for the children added to their nursing/medical cares. As well there were few nurses to provide the care. Despite the differences, the nurses and parents have a common goal of getting the child ready for discharge home. On the whole the nurses are happy to have parents live-in and parents are happy to stay, although some parents feel living-in is an obligation not a choice. Unlike the parents of the older children that are happy to live-in, the neonatal parents are not given that privilege to live-in and that is distressing to them. The different concepts of care in paediatric wards are examined and not all of the concepts can be applicable in the Cameroon context. The study suggests a possible concept of care to be used in the hospital after a review by the authorities. This study provides a base for future research in this domain.Item 'On the path, off the trail' : the relational work of nurses in outreach health : a thesis presented in partial fulfilment of the degree of Masters of Philosophy in Nursing at Massey University, Wellington, Aotearoa New Zealand(Massey University, 2017) Martin, GarrickThis research study draws on the practice reflections of nurses working with people who are homeless and experiencing mental health problems to explore engagement as a core nursing practice in this setting. Therapeutic relationships and engagement are at the heart of nursing practice, and this is especially so in mental health nursing. Homeless and hard-‐ to-‐reach clients are an underserved population for mental health services. This research seeks to ‘make visible’ the ways in which mental health nurses uniquely and successfully engage with people experiencing homelessness and marginalisation, which in turn contributes to improved health and social outcomes for those people. Eight New Zealand registered nurses were interviewed and critical thematic analysis used to interpret the resulting data. The research findings were that nurses practicing in this specific homeless health context value relationships as a core nursing intervention. The work of engagement was described as uncertain. The research participants echoed the nursing theory and literature that argues nurses’ relational work is often unseen and undervalued within health systems. Relational work is described as a defining concept for mental health nursing yet the lack of visibility of this skilled work adds to nurses’ experience of uncertainty. The recommendations suggest ways to render visible and hold central the nursing work of engagement.Item Development of a model of practice related to sexuality in nursing education : a study exploring nurse educators' perceptions and experiences of practice related to sexuality : a thesis presented in partial fulfilment of the requirements for the degree of a Master of Education in Adult Education at Massey University(Massey University, 2004) Ashcroft, CarolNursing literature identifies that sexuality is an integral part of holistic client care. However, research continues to indicate that nurses generally, do not address issues of sexuality with clients. While there is no absolute reason attributed to this deficit in client care, issues within undergraduate nursing education and the nurse educators have been implicated. While most of the literature is written by nurse educators, it appears to be their own views and/or anecdotal views of other nurse educators from reviews of the literature. I was unable to find research that is specifically focused on the perceptions and experiences of nurse educators in regard to practice related to sexuality in nursing education. Coupled with this, the literature is from overseas and is not necessarily the perceptions or experiences of lecturers within the New Zealand nursing curricula, and the literature is now somewhat dated. Before assumptions about sexuality-related practice in New Zealand undergraduate nursing education and nurse educators can be made, the current situation within the New Zealand nursing curricula needs to be explored. To my knowledge, a study of this nature has not been undertaken. A descriptive qualitative research study was undertaken where six nurse educators from an undergraduate nursing programme in New Zealand were interviewed. From the analysis of the collected data, nursing lecturer's experiences and perceptions of practice related to sexuality were described. The analysis clearly suggests that further research and improvement is required in undergraduate nursing education, particularly sexuality assessment of the client in order to provide holistic care. A model for practice related to sexuality in nursing education has been developed and described.Item Conditional expertise in chronic illness : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Social Sciences at Massey University(Massey University, 2000) Casey, GeorginaThe incidence of chronic illness is increasing in the developed world. This means that there is an increased utilisation of acute health care services by people with chronic illnesses, either for treatment of exacerbations or for unrelated health problems. Acute health care services are based on the notion of finite, curable episodes of ill-health, and as such they do not always meet the needs of people with chronic illnesses. This study uses a grounded theory approach to examine the issues surrounding hospitalisation in acute care facilities for a group of eight people with chronic illness. Participants were interviewed within two months of an admission to hospital. Analysis of data, further interviews and other data collection, and generation of theoretical concepts were performed in accordance with the grounded theory method. The key finding from the research was a state of conditional expertise for the chronically ill. While living at home, and in a state of relative well-being, participants were acting as experts in the management of their illnesses. During encounters with health providers in the primary care setting, particularly those whom participants knew, a process of negotiation occurred, engendered by mutual trust in each other's expertise. However, once the acute care setting was entered, participants discovered that their expertise was neither valued nor acknowledged. In response, they went through the processes of informing health carers, by repeatedly telling their stories to different health professionals they encountered, and finally withdrawing from participation in care. This withdrawal could be either physical, where the participants sought early discharge, or emotional in terms of becoming passive recipients of care. The implications of this study, given its limitations, are numerous. In order to provide satisfactory care for people with chronic illnesses, health professionals working in acute care settings must move beyond the dominant model and seek to establish trust relationships which acknowledge and value patient expertise. This requires, first, that education programmes for health carers encourage the recognition of important data patients that do not relate to biological and disease states. Second, a system of care needs to be developed within the acute care setting that allows ongoing relationships to be established between individual patients and carers. This in turn would generate trust between patient and carer, which would enhance the abilities of each to acknowledge expertise. The Partnership model of nursing care is proposed as a possible solution to this problem.Item The experience of hospitalization first time for an acute medical illness : a thesis submitted to Massey University of Palmerston North in partial fulfillment of the requirements for the degree of Master of Arts in Nursing(Massey University, 2000) Blockley, Colette EvonneThis research focused on exploring and describing patients' experience of their first hospitalization for an acute medical illness. Twelve participants who had experienced their first hospitalization within the last two years were involved. Unstructured, open-ended interviews were employed to obtain data. Thematic analysis (Burnard, 1991) was used to provide a detailed systematic description of issues addressed in the interviews. Six main themes emerged from the participants' stories. Waiting was the predominant theme that emerged from the participants' experiences in the accident and emergency department. Once admitted to the ward, the need to know, support, environmental issues (which included the physical environment, privacy and safety issues) are the themes that emerged from the data. On discharge and post discharge, lack of information was a theme that had significance for the majority of the participants. The implications of these findings for practitioners who work in an acute hospital setting, especially with patients who have not previously experienced an acute hospitalization, are explored.Item "Having attitude" : nurses' perceptions of the qualities and skills needed to successfully nurse the 10-24 year old client : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University(Massey University, 1998) MacDonald, SusanThis thesis presents a grounded theory study following Glaser's methodological stance. It explores nursing of the 10-24 year old client through interviews with thirteen registered nurses. The participants worked in a variety of clinical settings including community, hospital and specific adolescent services. From the analysis of the data emerged the complexity of the nurses' work with the chosen age group. The study identifies that the quality of the nurse/client encounter may enable the young person to feel accepted and to be empowered to make their own health choices. This thesis identifies how 'Having Attitude' is seen by the nurse participants as critical in the care of the young person. 'Having Attitude' is about the nurse balancing the dependence/independence needs of the young person with their family and peers, and about being acceptable to the client. This results from the work of the nurse which is characterised by the nurse 'being competent' and 'being supportive' whilst taking into account all of the socio-political factors that effect the nurse's working situation. The socio-political context impacts upon the young person's life in terms of the types of health issues they have, and the availability and affordability of appropriate health services. It also impacts on the environment in which the nurse works, in terms of the complexity of the concerns with which young people present, current health reforms and funding issues. The nurse needs to have a broad knowledge base and ability to work within a complex situation. Nurses believe they can make a difference to the young person's health experience when they are supportive, competent and 'have attitude'.Item An exploration of nurses' understanding of parenting in hospital : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy (Nursing) at Massey University(Massey University, 2000) Crawford, RuthParental involvement in their child's care in hospital is common place. Research indicates that parents want to actively participate in the care ot their child. Nurses' responses to parental presence in hospital have been examined in previous research, especially with regard to attitudes, perspectives and role division. There was however a gap In the literature with regard to nurses' understanding of parenting in hospital. Within New Zealand there was no research examining nurses' understanding of parenting. The research described in this 75 point thesis explored the nurses' understanding of parenting in hospital. Using focus groups as the research method, eight nurses were invited to share their understanding of parenting in a New Zealand hospital. The data was analysed using thematic analysis informed by Stevens (1996). Although the size of the study was limited, this research has been able to raise some important issues about nurses' understanding of parenting in hospital, including the conflict perceived between parents and nurses, and the participants 'ideal' parent-nurse relationship.Item Practice nurses' perceptions of their contribution to the care of individuals with chronic health conditions : an exploratory descriptive study : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Philosophy in Nursing at Massey University(Massey University, 2006) Davies, Deborah CThe release of the New Zealand Primary Health Care (PHC) Strategy (King, 2001), placed an increased emphasis on the provision of healthcare in the community or primary health care setting, and in particular on the role of PHC nursing. Alongside this, new roles are being created which practice nurses are expected to fulfil such as 'Care Plus', which is an initiative of the PHC strategy providing funding for increased care of people with high needs due to chronic conditions or terminal illness. Practice nurses are health care providers in general practice settings, and it is assumed that they make a significant contribution to the health of individuals with chronic conditions. In this study an exploratory descriptive approach was used to explore practice nurses' perceptions of their contribution to the care of individuals with chronic conditions. The total number of participants was eleven. Thematic content analysis was used to develop themes from the data. Overall practice nurses described three key areas of contribution: The preparation of the individual for an appointment at the general practice, care provided by the practice nurse at the general practice, and the giving of information. Each theme consisted of a considerable level of complex processes employed by the practice nurses, with all being inextricably interwoven within the care. A number of dualities were apparent that impact on the contribution practice nurses perceive they make to individuals with chronic conditions, within the reality of their practice contexts. The systems within which the practice nurse participants described working posed certain challenges to the fulfilment of the role of registered nurse. Recommendations include the significance of the development and maintenance of nurse-client relationships, achieving a balance between the organisation provided by computerised systems and client centred care, and the concept of adequate time for interactions with individuals. Recommendations regarding nursing's role in acknowledgment of the individual as an active participant in care, the recognition of an individual's right of choice regarding ongoing contact with the general practice, and a need to recognise a focus of care as support of client self-management also arise from this study.Item Optimising the human experience : the lived world of nursing the families of people who die in intensive care : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University(Massey University, 1997) Andrew, CatherineIntensive Care nurses share some of the most precious and poignant moments with people who have family members dying in ICU. This study explores the lifeworld of seven ICU nurses who describe their experiences working with these families. Data was gathered using unstructured, indepth, face-to-face interviews. These were tape-recorded and transcribed. The study uses a phenomenological approach informed by Heidegger and hermeneutics. Van Manen's methodological suggestions are followed to shape and focus the study, and provide guidelines for analysis of the data and the writing of the report. The findings reveal that ICU nurses recognise that this is a particularly tragic and difficult time in peoples' lives. The nurses are aware that the last hours or days with a dying relative may be vividly remembered for years to come. During this time nurses seek to optimise the human experience of the family members by making the time as positive, or best, as possible. This is achieved through strategies such as Being There, Supporting, Sharing, Involving, Interpreting and Advocating. These strategies are enabled by three domains: Nurse as Person, Nurse as Practitioner and Nurse as Colleague which describe a wider context to working effectively with families rather than merely looking at direct interactions between the nurse and the family. Optimising the Human Experience is proposed as the central essence or phenomenon of nursing the families of people who die in ICU.Item An exploration of the nature of therapeutic nursing in a general rehabilitation team : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University(Massey University, 1997) Price, EileenThe role of the nurse in the rehabilitation specialty has been defined in terms of the tasks and functions which nurses perform. Whilst the therapeutic contribution of other disciplines is more clearly understood, the extent to which nursing activities are therapeutic is not clear. Therapy is defined as activity which brings about healing or an improved outcome for the customer and is arguably the raison d'être of the rehabilitation specialty. The purpose of this study was to explore the concept of therapeutic nursing in a rehabilitation context from the perspective of the nurse and the customer. The purpose was not to explore all aspects of nursing activity. This was neither within the scope of the study nor necessarily consistent with the research question. The aim was to make more transparent to nurses and to their colleagues just what constitutes the therapeutic work of nursing in rehabilitation, enabling nurses to focus specifically on activity which is of a therapeutic nature and consequently offer nursing which is specifically rehabilitative. The investigator was the Team Leader of a General Rehabilitation Team in a rehabilitation unit located in a major city in New Zealand. The study design used the Focus Group method to collect data from nurse participants in the team. Thematic analysis applied to the data generated nurse-validated categories of therapeutic activity. Also, during the study discharged customer participants were invited to answer a questionnaire about their perceptions of the nature of therapeutic nursing activity. The responses facilitated a comparison between nurse and customer perceptions of therapeutic nursing. Major themes were extracted from the data and there was congruency between nurse and customer data. Together these themes created a profile of the nurse as a coach. This role constitutes a leadership role in the team, with the customer and with the family. Coaching activity supports the customer through the rehabilitation programme, assists in overcoming barriers to progress and creates opportunities to develop independence. A new model for rehabilitation nursing practice is proposed, and recommendations for practice, research and education are described.