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    Hearing voices : the gendered nature of mental health practices in New Zealand in the 1920s and 1940s : a thesis presented in partial fulfilment of the requirements of Master of Arts in Women's Studies at Massey University
    (Massey University, 2007) Adams, Glennys Elaine
    This thesis asks what insights can be gained from the oral histories of mental nurses and attendants about the gendered nature of mental health practices in New Zealand in the 1920s - 1940s. Previously recorded interviews provided the primary texts for analysis. In considering both their oral accounts and memories as constructions, feminist poststructuralist models are used to study the nurses' and attendants' experiences. Utilising gender as an analytical tool meant that the narrators' memories were understood as the gendered products of the interconnections between the practices and discourses of culture and individual subjectivity, and that gender was implicated in the practices and production of power in mental institutions. Discourse theory and practices provided the conceptual framework and methodology for an analysis that regarded knowledge as residing in and produced by discourses. By studying the different constructions of female nurses and male attendants in discourses of mental nursing it was possible to recognise how these representations legitimised and privileged particular kinds of knowledge and power. Contextualising the narratives socially and culturally enabled consideration of how the nurses and attendants reproduced dominant discourses of femininity and masculinity in circulation at the time they were working. The findings point to the way in which powerful discourses of gender predicated on the separation of women and men respectively into private and public spheres, intersected with gendered assumptions of mental illness and mental nursing. The oral testimonies show that the female nurses were situated between the paradigms of these discourses, but because subjectivities are not fixed and immutable, they adopted different and changing positions in relation to them at different times. Although it is argued that discourses of gender did shape the subjectivities of the nurses and attendants and were employed to support gendered institutional practices this was more complex than first appears. The voices of the female nurses can be heard sometimes embracing, sometimes resisting and sometimes transgressing gender norms.
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    A thematic analysis of factors influencing decisions to use physical restraint in acute mental health settings : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Philosophy in Nursing, Massey University
    (Massey University, 2007) Edgar, Murray James
    This study investigates the factors that influence nurses' decisions to use physical restraint or to attempt alternative interventions within acute mental health inpatient settings. The objective was to better understand the background to these decisions in the hope that this will lead to the development of more consistent and justifiable approaches to challenging behaviour displayed by some mental health patients. Eight nurses working or recently working in acute mental health services in two different District Health Boards were interviewed using a semi-structured interview technique. The sample was purposive, with participants being asked about their experiences with physical restraint, using specific events from their clinical practice. These interviews were then reviewed by the researcher and note taken of areas for further exploration or clarification. A second interview focussed on the areas identified as of particular interest to this research. 32 events of restraint use or near-use were related to the researcher, giving a significant amount of data for analysis. A thematic analysis approach was used to identify and examine themes within the data. The central thesis emerging from the data and its analysis is that much of what influences nurses' decisions relates to intrinsic factors such as their attitudes towards the patients in their care, whether the patients are appropriately domiciled in mental health services, and assessments of the causes of the challenging behaviour. The importance of working as a team and trusting colleagues emerged as a strong yet previously under-researched theme. Implications for nursing practice are discussed. Particular emphasis is placed on the further development of Calming and Restraint programmes for nurses working in acute mental health settings. The need to address the background attitudinal factors from both a training and service delivery perspective is strongly evident.