Massey Documents by Type

Permanent URI for this communityhttps://mro.massey.ac.nz/handle/10179/294

Browse

Subject: search.filters.subject.Preschool children

Search Results

Now showing 1 - 10 of 13
  • Thumbnail Image
    Item
    The stereotyping of 'old people' : a qualitative exploration of preschool children's constructions of older adults : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Albany, New Zealand
    (Massey University, 2020) Hebenton, Kate
    Despite an ageing population, in Western countries, children and older adults are being provided fewer opportunities to spend time together. Intergenerational (IG) programmes were developed to intentionally bring these two groups together, for the mutual benefit of both parties. However, the voices of children, particularly preschool aged children, are often excluded from the research focussing on these programmes. The aim of the current research was to explore the experiences of the preschool children engaged in a shared-site intergenerational programme, based in New Zealand, and to explore the children’s constructions of older adults. Seventeen children participated in the study, aged between 3 and 5 years old. Methodological choices were ethnographically informed, and included interviews, observations, photographs, and the children’s drawings. Analysis of the data from all four methods produced two key themes. The first revealed that the relationships the children developed with the older adults were with this group as a collective, rather than with particular individuals. Although the children were able to experience individual connections with older adults, these were dependent on the context, and often temporary. The second theme detailed how the children understood what it means to be an older adult, which involved the identification of its group members. The children held a belief that old age was manifested physically, and each child used a singular physical feature of old age to identify older adults as a group. This focus on the physical highlighted the important role that observation played in the children’s developing conceptualisation of older adults. These findings suggest that the children were stereotyping the older adults, but that there was no positive or negative judgement placed on these stereotypes, they just simply existed. They also support a discursive understanding of stereotypes, as opposed to a cognitive one, which is how much of the existing literature conceptualises stereotyping. Finally, the findings demonstrate that very young children are capable of participating in qualitative research, and that they have important and interesting contributions to offer. Future research should prioritise the inclusion of these voices and would benefit from the use of multiple methods to engage children.
  • Thumbnail Image
    Item
    An adaption of the NutriSTEP screening tool to be suitable for nutrition risk factor identification in New Zealand preschool children aged two to five years old; adaptation of NutriSTEP as a parent administered questionnaire : a thesis presented in partial fulfilment of requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand
    (Massey University, 2019) Edge, Breanna Jade
    Background: Risk factors of poor nutrition status in childhood may continue into adulthood and determine development of chronic disease. To reduce likelihood of chronic disease in adulthood, nutrition risk factors should be identified in childhood. Nutrition screening tools (NSTs) have been developed to identify increased nutrition risk and guide appropriate nutrition intervention. There is currently no reliable paediatric NST for use in the community setting in New Zealand (NZ). However, NutriSTEP, a validated parent-administered NST developed in Canada has been shown to identify preschool aged children at increased nutrition risk. Aim: To adapt the Canadian NutriSTEP to be suitable for use in the NZ setting, and to test its reliability, as a means to identify nutrition risk in preschool children aged between two and five years, as a parent administered questionnaire. Methods: New Zealand Registered Dietitians (NZRDs) (n=3) reviewed the wording of the Canadian NutriSTEP and suggested adaptions suitable for the NZ setting. Intercept interviews with parents of preschoolers (n=26) provided non-expert reviews of the Canadian NutriSTEP. NZRDs participated in a second review to evaluate suggested wording adaptions from the parent intercept interviews. Appropriate wording amendments were confirmed and the adapted NutriSTEP was finalised for online reliability testing. Parents of preschoolers (n=79) completed online administrations of the Canadian NutriSTEP and the adapted NutriSTEP four weeks apart in a blinded manner. Intraclass Correlation Coefficient (ICC) was then used to verify test-retest reliability between administrations of the NutriSTEP. Individual questionnaire items were verified for reliability between administrations through Cohen’s Kappa statistic (κ), Pearson’s chi-square value and Fisher’s exact test. Descriptive statistics identified preschoolers at increased (medium to high) nutrition risk and individual questionnaire items with the highest percentage of nutritional risk. Results: The Canadian NutriSTEP and adapted NutriSTEP were reliable between online administrations (ICC=0.91; 95% confidence interval 0.86, 0.94; F=11.4; P<0.000). Most (13 out of 17) questionnaire items had adequate (κ>0.5) agreement between administrations, one item had excellent agreement (κ>0.75). All individual questionnaire items had a p-value p<0.05 indicating a significant relationship between administrations. The Canadian NutriSTEP identified that 20.3% of preschoolers were at increased nutrition risk, whereas the adapted NutriSTEP identified that 31.6% were at increased nutrition risk. Individual questionnaire items with the highest percentage of nutritional risk included; low intake of breads and cereals (58.2%), milk and milk products (51.9%), meat and meat alternatives (40.5%), child sometimes not controlling the amount consumed (35.4%) and low vegetable intake (34.2%). Conclusions: The Canadian NutriSTEP and the adapted NutriSTEP were reliable between online administrations when verified for test-retest reliability in the NZ community setting. The adapted NutriSTEP identified more preschoolers at increased nutrition risk than the Canadian NutriSTEP. This demonstrates the adapted NutriSTEP has increased sensitivity in the NZ setting in comparison to the Canadian NutriSTEP. To identify increased nutrition risk in NZ preschoolers and reduce likelihood of chronic disease, the adapted NutriSTEP should be considered for future use in the community setting and to guide appropriate nutrition intervention by a NZRD.
  • Thumbnail Image
    Item
    Social determinants of preschoolers' sleep health in Aotearoa/New Zealand : a mixed methods study : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Public Health at Massey University, Wellington, New Zealand
    (Massey University, 2019) Muller, Diane Patricia
    Sleep is important for young children’s health and wellbeing. In Aotearoa/New Zealand ethnic and socioeconomic inequities exist in adult sleep, however little is known about the social determinants of young children’s sleep and whether sleep inequities exist in early childhood. A mixed methods study was conducted to address this gap in knowledge. Kaupapa Māori epidemiological principles informed the study design and sleep was viewed through a social determinants of health and complementary socioecological theoretical lens. Sleep and sociodemographic questionnaire data from 340 Māori and 570 non-Māori preschoolers in the Moe Kura: Mother and Child, Sleep and Wellbeing in Aotearoa/New Zealand study (Moe Kura) were analysed. Log-binomial regression models investigated independent associations between ethnicity, socioeconomic position (SEP) and preschoolers’ sleep duration, timing and problems. Ethnicity and socioeconomic deprivation were independently associated with short sleep duration (<10hrs), week/weekend sleep duration difference >1hr, later bedtimes and sleep problems based on a number of maternal-report measures. A sub-sample of Moe Kura mothers (15 Māori and 16 non-Māori with low and high SEP) participated in face-to-face interviews about their preschooler’s sleep. Results from thematic analysis identified four themes relating to mothers’ perceptions of preschooler sleep: ‘child happiness and health’, ‘maternal wellbeing’, ‘comfort and connection’ and ‘family functioning and harmony’. Four additional themes centred around facilitators and barriers to preschoolers sleeping well: ‘health, activity and diet’, ‘sleep promoting physical environments’, ‘consistency’ and ‘doing it our way’. Mothers valued their preschooler having good sleep health, however societal factors influenced the degree of autonomy they had over implementing sleep supporting strategies. Integrated mixed methods findings indicate that ethnic and socioeconomic inequities in preschooler sleep health exist in Aotearoa/New Zealand and that social determinants of preschoolers’ sleep include institutional racism, material and financial resources, employment, housing, social support, early childhood education services and child health services. Results indicate that a victim-blaming approach which does not take into account the broader societal context and places blame and burden on mothers not ‘managing’ their child’s sleep ‘properly’ must be rejected. Action is required to address the socio-political drivers that lead to the inequitable distribution of social determinants of preschoolers’ sleep health.
  • Thumbnail Image
    Item
    Assessing four-year-old children's learning : New Zealand early childhood teachers' purposes, practices and knowledge : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Education at Massey University, Manawatū, New Zealand
    (Massey University, 2018) Cameron, Monica Jane
    Assessment is a core element of quality teaching and learning experiences for all children enrolled in early childhood education settings. This study explored New Zealand early childhood teachers’ purposes, practices and knowledge related to assessing four-year-old children’s learning. Understanding teachers’ beliefs related to the assessment of four-year olds is particularly important for supporting effective transition to school and continuity between early childhood and school contexts. To investigate teachers’ assessment purposes, practices and knowledge, a mixed methods sequential research design was developed. Phase one involved a nationwide survey of early childhood teachers, while phase two involved 14 key informant interviews with teachers representing nine different service types. Interview questions were derived from the survey results. Interviewees were asked to complete the survey and to share three pieces of assessment documentation. Descriptive statistics and thematic coding were utilised to analyse the data gathered. Findings from both phases were used to answer the study’s research questions. Findings demonstrated that teachers recognised the important role of assessment but their assessment knowledge, purposes and practices varied widely. Teachers favoured informal methods and focussed on sharing information with others as a primary purpose for assessment. Teachers’ knowledge of assessment was predominantly developed through their experiences in the sector, thereby conserving established assessment practices. Learning stories were found to dominate teachers’ assessment practices, which focused on specific aspects of children’s learning. Assessing four-year-old children’s learning was considered to be important in relation to transition to school, though challenges associated with sharing assessment information were repeatedly identified. The findings of this study, along with those of extant research, are of concern because New Zealand early childhood teachers’ assessment purposes, practices and knowledge in relation to assessing four-year-olds appear to be constrained relative to international recommendations for quality assessment in early childhood. One implication is that teachers need additional support to develop their knowledge of assessment and understand its multiple purposes. The development of a repertoire of assessment tools would further assist the advancement of teachers’ assessment practices. Early childhood and new entrant teachers need support to develop their understandings of each other’s assessment methods, so that methods with appropriate fit for purpose can be used to promote children’s successful transition to school. Continued research, professional development and initial teacher education need to play a key role in challenging current rhetoric and misunderstandings around assessment.
  • Thumbnail Image
    Item
    Nutrition and physical activity for pre-schoolers : early childhood education teachers' knowledge and perspectives : a thesis presented in partial fulfilment of the requirements for the degree of Masters of Science in Nutrition and Dietetics, Massey University, Albany, New Zealand
    (Massey University, 2017) Rapson, Jeanette
    Background Caregivers’ knowledge of the links between nutrition, diet and physical activity is increasingly being recognised as important for children’s health and body size. Evidence is limited for early childhood education (ECE) teachers’ knowledge about nutrition and physical activity for pre-schoolers, especially in New Zealand. Identifying knowledge gaps amongst teachers may direct professional development, health promotion and obesity prevention strategies in childcare settings. Aims The primary aim was to measure early childhood education (ECE) teachers’ nutrition knowledge for pre-schoolers (2-5-year-olds); and their perspectives towards nutrition and physical activity. In order to achieve this, a secondary aim was to design an ECE teacher nutrition knowledge questionnaire that satisfies psychometric criteria of validity and reliability. Methods Questionnaire items were generated based on New Zealand Ministry of Health nutrition guidelines for pre-schoolers, a literature search and expert advice. Nutrition (n=40) and non-nutrition (n=51) university students completed the questionnaire once; 35 of the nutrition students completed the questionnaire twice. Psychometric tests for construct and test-retest reliability were conducted. The cross-sectional online validated questionnaire of New Zealand ECE teachers’ nutrition knowledge for pre-schoolers was then used to measure ECE teachers’ nutrition knowledge for pre-schoolers. Knowledge was scored and measured against the Ministry of Health Food and Nutrition Guidelines for Healthy Children and Young People (Aged 2-18 years): A background paper (2015c). Teachers’ perspectives towards nutrition and physical activity for pre-schoolers were assessed using Likert scales within the questionnaire. Analysis included descriptive statistics, correlation and linear regression. Results The questionnaire achieved an acceptable level of content and construct validity and test-retest reliability. ECE teachers (n=386) from New Zealand childcare centres completed the validated questionnaire. Teachers’ knowledge of nutrition was lacking; overall score was 22.56 ± 2.83 (mean ± SD), or 61% correct. Age, qualification level, employment role and years of experience did not predict overall nutrition knowledge scores. Teachers’ increased years of experience significantly predicted an increase in knowing that New Zealand nutrition and physical activity guidelines existed (B=0.02 [95% CI, 0.00-0.03], r2=0.13, P=0.033). Teachers’ increased agreement in feeling they were confident talking about nutrition to parents significantly predicted an increase in overall nutrition knowledge scores, (B=0.34 [95% CI, 0.06-0.63], r2=0.15, P=0.019). The belief that ECE teachers play a vital role in promoting pre-schoolers’ healthy eating and physical activity was widespread. Teachers generally held positive perspectives towards feeding practices and perceived themselves to understand key physical activity concepts. Common barriers for ECE teachers’ nutrition and physical activity knowledge included a lack of staff training, confidence and resources. Conclusion The questionnaire achieved an acceptable level of construct validity and test-retest reliability and is suitable to measure ECE teachers’ nutrition knowledge for preschoolers (2-5-year-olds) in New Zealand. ECE teachers may lack nutrition knowledge for pre-schoolers in New Zealand, particularly with regards to basic nutrition recommendations (servings, food/beverage choices and portion sizes). Keywords: childhood obesity, childcare, kindergarten, day care, pre-school, nutrition environment, psychometric validation, nutrition literacy
  • Thumbnail Image
    Item
    New Zealand speech-language therapists' perceptions and experiences of supporting preschool children with complex communication needs : a thesis presented in partial fulfilment of the requirements for the degree of Masters of Speech-Language Therapy at Massey University, Albany, New Zealand
    (Massey University, 2017) Roberts, Claire-Ellen
    Communication allows a person to express their thoughts and feelings and participate fully in life. It is a basic human right. Children with complex communication needs (CCN) also have this right and require early access to augmentative and alternative communication (AAC) to support their development of language and communication skills. This study employed a descriptive cross-sectional survey design to gather insight into the perceptions and experiences of speech-language therapists supporting preschool children with CCN in New Zealand. The survey was completed by 61 speech-language therapists working in early intervention. There were a number of key findings. Only 37% of the participants reported that they used AAC with all of the children with CCN on their caseloads. In terms of their education and competence in AAC, 74% of participants said that their qualification did not include a paper on AAC and 57% rated their competence in AAC as being at the novice level. Team attitudes, lack of specialist support and inconsistent use of the system were the most frequently reported barriers. Whereas, team members’ willingness to try, supportive teams and education of those involved were the most frequently reported facilitators to AAC implementation. This study revealed the need for more education and support for speechlanguage therapists working in early intervention with children with CCN. This support is essential to help these children to develop the language and communication skills needed to participate fully in society, education and work.
  • Thumbnail Image
    Item
    Teachers' perspectives of gender differences in the social behaviours of preschool children : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Education at Massey University, Manawatū, New Zealand
    (Massey University, 2017) Smith, Jessica Anne
    The present research study explored early childhood teachers’ perspectives about social behaviours and gender in young children, in particular the way in which children’s gender related to teachers’ reports of the prevalence of, perspectives about, and strategies used in response to children’s social behaviours. The specific social behaviours examined within this study were prosocial behaviours, social leadership, social dominance, and aggressive behaviours. This study was designed within an interpretivist and pragmatic epistemology, and used a mixed methods online survey to investigate teachers’ perspectives. The online survey was comprised of four sections: demographics; defining social behaviours and their traits; social behaviour scenarios; and gender and Te Whāriki. To allow investigation of differential responses related to gender, two versions of the survey were created where the gender of the child portrayed in the social behaviour scenarios differed across survey versions. The gendered scenarios were used to gather data on whether there was a difference in teachers’ perspectives about and the teaching strategies used for children’s social behaviours based on the gender of the children involved. The majority of the responses to the survey indicated that the teachers identified there to be little difference in the display of social behaviours in young children based on children’s gender. However, the two social behaviours which were reported by the teachers as having the most differences based on gender were social leadership and aggression. The teachers’ strategies identified in the findings showed that there was some difference in teaching strategies used based on the children’s gender, specifically in the areas of social dominance and aggression. The findings provide a snapshot of the way in which teachers define and interpret social behaviours, and suggest that gender plays a limited, but still potentially significant role in the teaching practices they chose to adopt in a variety of scenarios. The teacher’s acknowledged the importance of ensuring gender equity in their practices, but findings suggest that further support may be needed to aid in the delivery of equitable practices.
  • Thumbnail Image
    Item
    Using the Behavioural Paediatric Feeding Assessment Scale to identify fussy eaters, and their adherence to dietary guidelines : a thesis presented in partial fulfilment of the requirements for the degree of Master in Science in Human Nutrition at Massey University, Albany, New Zealand
    (Massey University, 2015) Hashimoto, Sara Sayaka
    Background: Childhood feeding issues range from problems with few immediate health risks to significant problems requiring medical intervention. Fussy eating is implicated in low critical nutrient intake and poor eating habits that could risk later chronic disease. A simple tool to assess fussy eating is not available and it is unknown whether fussy eaters risk subsequent poor adherence to dietary guidelines. The Behavioural Paediatric Feeding Assessment Scale (BPFAS) is a parent-response tool designed to measure feeding issues in children. DICE was developed to measure adherence to NZ Ministry of Health (MoH) food and nutrition guidelines. Aims: Primary aim: To determine whether the BPFAS can be used to identify young children who are fussy eaters and at risk of not adhering to MoH food and nutrition guidelines. Secondary aim: To identify risk factors for poor adherence to MoH food and nutrition guidelines, and higher incidence of problem mealtime behaviours. Objectives were to a) determine whether a higher score on the BPFAS facilitates the identification of young children as fussy eaters, b) to determine whether a higher score on the BPFAS and/or parental perception of their child as a fussy eater relates to poor adherence to MoH food and nutrition guidelines and c) to identify risk factors for poor adherence to MoH food and nutrition guidelines as measured by DICE, and higher incidence of problem mealtime behaviours as measured by the BPFAS. Methods: 1959 parents of New Zealand 2 to 4 year old children were recruited through online- and print-media to complete an online questionnaire about their child’s eating. 570 were excluded based on age, place of residence and lack of consent. Data was collected on: incidence of problem mealtime behaviours using the Total Frequency Score (TFS) from BPFAS; adherence to Ministry of Health (MoH) food and nutrition guidelines using the Dietary Index for a Child's Eating (DICE); parental perceptions of fussiness; and medical history and dietary restrictions related to feeding problems. Pearson’s chi-square tests were used to examine associations between BPFAS and parental perceptions of fussiness and the association of DICE with BPFAS and parental perceptions of fussiness respectively. Children were stratified into those with and without risk factors for feeding issues and independent t-tests and Mann-Whitney U tests were conducted to ascertain if any significant differences between groups existed with regard to DICE and BPFAS scores. Results: 22.7% of children scored 81 or more on the TFS (range: 36-141) and were stratified into the clinical feeding problem group. TFS for normative and problem groups were 62.6±9.98 and 92.4±10.5 respectively. The problem group had poorer DICE (range: 49-114) scores (81.9±12.3) than normative group (91.8±9.23). There were overall moderately strong inverse correlations (r = -0.45, p<0.001) between DICE and TFS, and between DICE and parentally-perceived fussiness score (r = -0.42, p<0.001). A strong positive correlation between TFS and parentally-perceived fussiness score (r = 0.72, p<0.001) was also found. These relationships remained significant when analysis was repeated only on the normative group. TFS was worse in children who had: problems breastfeeding (72.1±16.5 vs 67.8±15.5) and starting solids (77.6±19.2 vs 68.3±15.3); autism (85±25.0 vs 69.2±15.9); medical problems affecting feeding (80.9±18.2 vs 69.2±16.0) and not affecting feeding (75.5±17.0 vs 69.1±15.9); eating difficulties (84.9±19.4 vs 69.1±15.8); parental perception of underweight (77.8±17.9 vs 68.0±15.2 and 67.0±16.2 for average and overweight); and parental concern about weight (82.1±18.1 vs 67.8±15.0), than those who did not. DICE was worse in children who had: problems starting solids (84.9±11.5 vs 90.1±10.7); developmental delay (82.8±12.9 vs 89.7±10.9); eating difficulties (80.9±14.5 vs 89.8±10.8); parental perception of underweight (86.0±11.9 vs 90.12±10.7 and 90.7±10.0 for average and overweight); and parental concern about weight (84.7±12.9 vs 90.2±10.5), than those who did not. Conclusion: These results indicate that children with higher TFS have higher incidences of problem mealtime behaviours and adhere less to MoH food and nutrition guidelines than normative eaters. Children in the higher end of the normative range for TFS are also classed as fussy eaters by their parents, suggesting the BPFAS can be used to identify fussy eaters. Problems with breastfeeding and starting solids, autism, medical problems, eating difficulties, parental perception of underweight, and parental concern about weight appear to be red flags for problem mealtime behaviours. Indicators for poor adherence to guidelines may be: breastfeeding problems, developmental delay, eating difficulties, parental perception of underweight and parental concern about weight.
  • Thumbnail Image
    Item
    Vitamin D and preschool children -- predictors of status and relationship with allergic and respiratory diseases in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nutritional Science at Massey University, Albany, New Zealand
    (Massey University, 2015) Cairncross, Carolyn Tina
    Background The role of vitamin D in allergic and respiratory conditions is increasingly being recognised through an immune-modulatory role. The current evidence is inconsistent, with very limited data in preschool children, a target group with high prevalence of early childhood allergic and respiratory disease. There are little data on the vitamin D status and factors associated with vitamin D deficiency in the preschool age group in New Zealand. Knowledge of these factors can assist prediction of preschool children at risk of vitamin D deficiency, improving health outcomes. Aims and Objectives To describe the vitamin D status of a self-selected sample of preschool children and determine predictors of vitamin D deficiency in order to develop a predictive questionnaire to assess vitamin D deficiency in this age group, and to investigate the relationship of vitamin D status and prevalence of allergic diseases - eczema, food allergy, allergic rhinoconjunctivitis and asthma – and respiratory infections. Method A cross-sectional sample of 1329 preschool children aged 2 to <5 years from throughout New Zealand enrolled during late-winter to early-spring in 2012. 25-hydroxyvitamin D (25[OH]D) was analysed from dried blood spots collected using capillary sampling. Caregivers completed a survey describing their child’s demographics, factors known to affect vitamin D status and medical history of allergic and respiratory diseases. Predictors of vitamin D deficiency (25[OH]D <25nmol/L) were identified using multivariable logistic regression in a randomly selected sub-sample (n=929) for development of a predictive questionnaire, which was then validated by receiver operating characteristics (ROC) analysis (n=400). Results Mean (SD) dried blood spot 25(OH)D concentration was 52 (19)nmol/L. Vitamin D deficiency was present in 86 (7%) and vitamin D insufficiency (25[H]D <50nmol/L) in 642 (48%)children. Factors independently associated with the risk of vitamin D deficiency were female gender (OR=1.92, 95%CI 1.17-3.14), children of other non-European ethnicities (not including Maori or Pacific) (3.51, 1.89-6.50), children whose mothers had less than secondary school qualifications (5.00, 2.44-10.21), who had olive-dark skin colour (4.52, 2.22-9.16), who did not take vitamin D supplements (2.56, 1.06-6.18) and who lived in more deprived households (1.27, 1.06-1.53). There were no children who drank toddler milk with 25(OH)D concentrations <25nmol/L thus these children had a zero risk of vitamin D deficiency. The predictive questionnaire had low sensitivity for the identification of children at risk of vitamin D deficiency (sensitivity 42%, specificity 97%). Children with 25(OH)D concentrations =75nmol/L had a two-fold increased risk for parent reported, doctor diagnosed food allergy (OR=2.21, 95%CI 1.33-3.68). No association was present between 25(OH)D concentration and prevalence of eczema, allergic rhinoconjunctivitis, asthma or respiratory infection. Conclusion Dried blood spot methods facilitated the measurement of 25(OH)D concentrations in a large sample of preschool children from throughout New Zealand. Prevalence of deficiency in winter was low (7%). The predictors of deficiency were consistent with those in previous studies of other age groups in New Zealand. The predictive questionnaire identified less than half of the children with vitamin D deficiency, so has limited diagnostic ability. In this sample of preschool children, vitamin D deficiency was not associated with allergic diseases or respiratory infections. In contrast, high vitamin D concentrations were associated with a two-fold increased risk of food allergy. This relationship between vitamin D status and allergic diseases is complex, and needs to be further investigated in the preschool age group.
  • Thumbnail Image
    Item
    An exploration of nurses' experiences of delivering the before school check : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosphy in Nursing at Massey University, Albany, New Zealand
    (Massey University, 2013) Williams, Sarah Jill
    The New Zealand Well Child/Tamariki Ora (WCTO) programme is a community based well child health service; the programme is supported through the WCTO Framework and an associated National Schedule. The schedule outlines a total of 12 core contacts that every child and their family are entitled to receive from birth to five years. The first four of these are provided by the child’s lead maternity caregiver, with the remainder contracted out to Well Child Providers. The Before School Check (B4SC) is the eighth and final core contact under the WCTO schedule and is performed between 4 and 5 years of age. The B4SC was initiated in September 2008 and utilises not only a developmental screening questionnaire but also a health assessment, behavioural screen, hearing and vision assessment and oral health screen. This check is not necessarily always delivered by the child’s well child provider but can also be done through their family doctor or practice nurse. The purpose of this study was to explore nurse’s experiences of implementing and delivering the B4SC. Since its implementation in 2008 the B4SC has been delivered in a variety of ways by a range of nurses across the country. This study focused on the experiences of nurses working in Auckland and the participants included practice nurses, plunket nurses and public health nurses. Using semi-structured interviewing the participants in this study were given the opportunity to share their experiences and to discuss any issues raised. Based on their experiences participants were also asked if they had any recommendations for the further development of the B4SC. Thematic analysis using a general inductive approach was used to analyse the data and a number of themes emerged. Although the participants were very positive about the potential benefits of the check they expressed a range of challenges in the delivery of it. Five key themes were identified entitled: Construct constraints, Time, Translation & Culture, Child Interaction and Training & Support. Recommendations are made based on the study findings and suggestions for further research are presented.