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    Walking upright here : countering prevailing discourses through reflexivity and methodological pluralism : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University, Albany, New Zealand
    (Massey University, 2002) DeSouza, Ruth Noreen Argie
    Knowledge development takes place in the context of competing political, social and economic frameworks that often reflect dominant group values, practises and ideologies. Research scholarship needs to include and legitimate knowledge construction from different locations and epistemologies. Where research occurs with minority groups it is suggested that multiple research strategies are incorporated in order to prevent the reproduction of deficiency discourses. Such strategies could include self-reflexivity and the use of methodological pluralism, incorporating appropriate methodologies that can be used to expose and dismantle hegemonic discourses. A research exemplar is used that features the dual transition of migration and motherhood for women from Goa, India who are now living in New Zealand. This is done to illustrate the applicability of reflexivity and methodological pluralism in countering the hegemonic deficiency discourse associated with migrant women. The qualitative approach that was used privileges culture and locates the participants in their historical and cultural contexts. Goan women were interviewed about their migration history, their adjustment to living in New Zealand and experiences of childbirth and motherhood in a new country. The use of alternative creative and innovative conceptions of methodology that allow for the emergence of undetermined discursive spaces between different lines of inquiry, within which the authentic voices of participants might lodge and be heard is advocated. Without such strategies research that purports to represent the experiences of a particular group risks reproducing the processes of subordination that devalue certain groups while holding in place the needs and aspirations of a privileged few. The findings of the exemplar challenge monolithic essentialising representations of migrant women associated with discourses that position them as backward, passive and deficient. This thesis advances the discussion on what it means to construct knowledge of social practices within a multi-ethnic environment in order that the voice of the 'other' can be heard.
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    An exploration of the experiences of cultural safety educators : a thesis presented in partial fulfillment of the requirements for the degree of Master of Philosophy, Massey University
    (Massey University, 2001) Wepa, Dianne T. N
    This thesis is a study of the experiences of four cultural safety lecturers in nursing education in Aotearoa / New Zealand. A review of literature reveals the recent and turbulent evolution of cultural safety. The media which documented this journey in a negative light in the 1990s prompted ministerial inquiries and the publication of the Nursing Council of New Zealand's Guidelines for cultural safety in nursing and midwifery education (1996). Action research methods enabled the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action and reflecting. The findings of the research revealed that the participants not only coped with every day stressors of teaching but they were also required to formulate knowledge of cultural safety. For the Maori participants their stress was confounded with recruiting and retaining Maori students and macro issues such as commitments to iwi. Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that it was organisational in nature and out of their immediate control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations have been made which focus on supporting cultural safety educators to dialogue on a regular basis through attendance at related hui; the introduction of nurse educator programmes; paid leave provisions for cultural safety educators to conduct and publish research so that a body of knowledge can be developed; and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burn out.
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    What is it like to teach cultural safety in a New Zealand nursing education programme? : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Nursing at Massey University
    (Massey University, 2000) Richardson, Frances I
    This thesis explores the experience of teaching cultural safety in a New Zealand nursing education programme. A qualitative approach was used to interview fourteen teachers about their experience of teaching in this area. The teachers were all women and most had taught in cultural safety education programmes for a number of years. Five were Maori and nine were Pakeha. The experience of teaching was different for both groups. The study asked the question "What is it like to teach cultural safety in a nursing education programme?" The participants revealed thoughts, feeling and experiences which together provided a picture of what the experience of teaching is like. Using thematic analysis three themes were generated from the data and analysed against a theoretical framework of power and knowledge derived from critical social theory and feminist influence. The findings of the study demonstrated that the experience of teaching is shaped by a number of factors. These include personal, political and professional factors. These form an integral part of the teaching experience and shapes what happens in the classroom situation. The findings also demonstrate that teachers have developed a high level of teaching skill in teaching a controversial subject. Although the teachers experience times of stress in teaching, this stress is balanced by moments of satisfaction and a sense that they are contributing to change in nursing and health care delivery in a way which reflects the realities of people using the health care system.
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    An ethnography of caring and control in an acute psychiatric unit : a dissertation presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing Studies at Massey University
    (Massey University, 1992) Boddy, Julienne Mary
    The setting for this study was a 19 bed general hospital psychiatric ward serving a heterogeneous population. The objective of the study was to generate thick description of the cultural knowledge patients and nurses used to organise their behaviour and interpret their experience in an acute psychiatric unit. Further aims were to describe the nature of the service provided, and more specifically to identify relationships between caring and controlling in this social context, and the outcomes for patients of caring and controlling interventions by nurses. Over a 10 month period primary data were obtained through participant observation and ethnographic interviews, with analysis of documentation providing secondary data. Thirty patients and 20 nursing staff acted as informants. They were selected on the basis that they had experienced the event being studied, and that they were both willing and able to share the experience. A cyclic research process was adopted, in which initial data analysis followed early data collection resulting in more focussed questions for subsequent data collection. Content analysis was undertaken to inductively derive patterns or themes from the data. Validity of data was achieved through triangulation of multiple data sources. Interpretations of the findings were verified and clarified in collegial dialogue with other psychiatric nurses, and with academic colleagues. The central thesis which emerged from the data is that the nature of caring and controlling acts by nurses is shaped by the social organisation of care, and by the dominant belief system of that setting. A view of mental illness as a life long event for the majority of inpatients, coupled with beliefs about the "outside world" as tough, contributed to nurses' feelings of powerlessness to change situations for, or with patients, and so diminished expectations for change. Caring as a moral obligation was often interpreted by nurses as a moral obligation to provide a safe haven, with nurturance and acceptance of patients viewed as chronically psychiatrically disabled. Additionally, features of the organisational context including nurses' lack of autonomy in their practice, the absence of both appropriate environmental controls and a clearly articulated rule structure, and the competing demands on nurses arising from the provision of the after hours crisis service from the ward, contributed to an organisational context which was not supportive of sustained therapeutic interaction between nurses and patients. There was a culture of chronicity in the ward. Implications of these findings for psychiatric nursing education and practice, and for service development are discussed.
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    A Māori model of primary health care nursing : a thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Massey University, Palmerston North, New Zealand
    (Massey University, 2002) Holdaway, Maureen Ann
    While the philosophy and policy of primary care nursing are consistent with Māori development objectives, the practice can fall short of this ideal. This thesis identifies and examines the shortfall in terms of Māori women's expectations and identifies ways in which traditional nursing practice among Māori communities may be enhanced. The research highlights the need for nursing to broaden our concepts of health, community, and public health nursing, to focus more on issues of capacity building, community needs, and a broader understanding of the social, political, cultural, and economic contexts of the communities we work with. This research used a critical ethnographic method underpinned by a Māori-centered approach to explore health as experienced by Māori women. The primary data collection involved, a period of intensive fieldwork within the community, use of in-depth interviews, attendance at hui, and a review of literature and policy documentation. The findings of this research articulate a model of health that is a dynamic process based on the restoration of, and maintenance of cultural integrity, and is based on the principle of self-determination. Primary health care is a process of enabling Māori to increase control over the determinants of health and strengthen their identity as Māori thereby improving their health and position is society. The findings support a substantive Māori model of Primary Health Care Nursing that provides a framework for theoretical research, which will lead to further conceptual refinement. The model also provides a framework for education curricula and nursing practice that will enhance nursing's ability to meet the needs of Māori.
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    Prejudice, paradox and possibility : nursing people from cultures other than one's own : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy, School of Health Sciences, Massey University, New Zealand
    (Massey University, 1999) Spence, Deborah
    This study explores the experience of nursing a person, or people, from cultures other than the nurse’s own. Informed by the tradition of philosophical hermeneutics, and drawing specifically on some of the notions articulated by Hans-Georg Gadamer and Charles Taylor, it seeks to understand everyday nursing practices within their cultural and historical context. Against a background of Maori resurgence, nurses have been challenged in Aotearoa-New Zealand to recognise and address racism in their practice. Meeting the health needs of all people has long been important in nursing yet the curricular changes implemented in the early 1990s to enhance nursing’s contribution to a more equitable health service created uncertainty and tension both within nursing, and between nursing and the wider community. In this study, I have interpreted the experiences of seventeen nurses practising in an increasingly ethnically diverse region. Personal understandings and those from relevant literature have been used to illuminate further the nature of cross-cultural experience from a nurse’s perspective. The thesis asserts that the notions of prejudice, paradox and possibility can be used to describe the experience of nursing a person from another culture. Prejudice refers to the prior understandings that influence nursing action in both a positive and a negative sense. Paradox relates to the coexistence and necessary interplay of contradictory meanings and positions, while possibility points to the potential for new understandings to surface from the fusion of past with present, and between different interpretations. As New Zealand nurses negotiate the conflicts essential for ongoing development of their practice, the play of prejudice, paradox and possibility is evident at intra-personal and interpersonal levels as well as in relation to professional and other social discourses. This thesis challenges nurses to persist in working with the tensions inherent in cross-cultural practice. It encourages continuation of their efforts to understand and move beyond the prejudices that otherwise preclude the exploration of new possibilities.