School of Health and Social Services

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    Bewhoherenow : philosophy of existing sense : a thesis presented in partial fulfilment of the requirements for the degree of Ph. D. in Social Policy and Social Work at Massey University
    (Massey University, 1995) Goodwillie, Craig
    body is[born and sustained through] sacrifice. i see mind seek immortalityandomnipotence through sacrifice. i see mind over body - mind rooting divide in subtraction of orgasmic from being[beingintheworld] to body to part[orgasm] to non i see mind rage [Laing] - where there was once here - rapeing here. seeyouhere [appealing]. argument [syllogism]. i, bodimentofbeing [eg Laing] iam bewhoherenow lookdown. iambody in Pain. The mutual repulsion of profane and sacred [Gould on sacred Hindu law]. profanity [of body] is polluted in embodying [pollution in her] and the sacrifice [decay and death - of zeroing body] - purifies sacred. Based on Gould's summary of the underlying assumptions of Hindu sacred law in chapter four "Priests and Conrapriests" (1967) In Gould, Harold A. (1987) The Hindu Caste System: The Sacralization of a Social Order. Chanakya: Delhi. p. 111. Reprinted from Contributions to Indian Sociology. New Series, No. 1, pp 28-57. pain embodimentofbeing [eg Kierkegaard guilts] therefore pain splacematterenergytime [Zeno on splacematterenergytime] splacematterenergytime therefore physics [physics - enlightenment testing ground for cause and effect. Einstein is the light speed observer - observing as fast as impossible with all else in train[slaved]. Newton masters gravity. Chaos is unpredictable slave. Second law of thermodynamics is mastery of slavery. Determinism - master[cause] and slave[effect] - exposed.] physics therefore chemistry [cell bodies], biology [organic bodies], psychology [human body], sociology [human bodies] physics therefore economy [shop - supply of body mastered and demand of body slaved], therefore law [keep shop] and policy [shop front] physics therefore mathematics [dominating human language. the right angle [triangle, hypotenuse, point of view] from Pythagorus and the zeroing of infinity from Indian grammar as void shape [the view of] mind.] physics of mathematics therefore philosophy of mathematics [the form of Plato called first cause by Aristotle and named one by Parmenides and Ptolemy mythologise shape as truth.] mathematics therefore logic [proofing the dominance of mathematics as dominant perspective. Leibniz puts one[everything] and zero[nothing] in Aristotle's syllogism and Boole starts crunching medium of english.] language therefore body [language is metaphor - the naming of] therefore is am i [who] was seen before [then] and therefore pain is becoming in between being inbetweenbeing - etheranderos - heavenandearth and [therefore] creation becomes kill[determined] [sacrifice]. sense [evidence]. inaffinity i body being in words [sound] in paper [light] in hand [body] and water [blood] and inaffinity [analogy] i syllogism. i syllogism to immortality [aim of mind] and syllogism immortality to death [target]. i deal summarily with logic [Aristotle, Leibniz, Boole, Russell and others] language [Panini, Itkonen, Laing, Burke and others] law [Williams, Waddams and others] mathematics [Sarton, Kline, Weyl and others] physics [Zeno, Pythagorus, Newton, Einstein] chemistry [Van Helmont, Brock, Hoagland] biology [Malthus, Darwin, Carson] sociology [Milgram] psychology [Skinner] economy [Smith, Marx, Stigler, Mumford] policy [Machiavelli, Orwell] and mythology [Upanishads, Plato, da Vinci, Galileo, Kant]. i quote directly or quote quote from recognised source. i use subheadings. i sound wordsounds [eg bodyandsoul] i emotion for sound [errors abound]. conclusion [assumptions]. beingintheworld is[the way of the world]. body is mind is being. mind is grasping[knots] itself. mind is lost[without body]. presumption [prediction]. beingwhole [therefore] letgoofyourself [advice given] and shebehere. [500 words]
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    The restructuring of the Department of Social Welfare and implications for social work practice, 1986-1988 : a dissertation presented in partial fulfillment for the requirements of a Doctorate in Philosophy at Massey University
    (Massey University, 1990) Barretta-Herman, Angeline
    This exploratory study analysed changes in the practice of social work in the Department of Social Welfare which occurred as a consequence of the Department's restructuring in 1986. This restructuring introduced major changes in management, service delivery, and the provision of culturally appropriate social services. It was proposed that changes in the practice of social work were related to wider economic, political and social debates regarding the viability and effectiveness of New Zealand's social services. These debates were interpreted as indicating a significant shift from policies derived from a welfare state model of provision to a welfare society model of social service delivery. A multi-leveled analytical framework was used to examine issues of policy, organization and professional practice. Three qualitative techniques were used to generate the data reported in the dissertation: documents published during the period 1969 - 1988; a structured interview schedule completed with both managers and social workers; and, finally, participant observation in two District Offices of the Department. Findings from this exploratory study provided general support for the shift in policy from a state funded, centrally directed model of service provision, to a pluralistic model that altered the role of the state and was intended to increase the involvement of community - based voluntary services. Within this shift, it was shown that during the 1986 - 1988 period, the Department's role became increasingly concerned with funding, monitoring and evaluating services. Biculturalism and the needs of Maori were shown to be critical factors in these shifts. The practice of social work within the Department of Social Welfare also became more limited and more specialised and its professional identity was altered by the changed organizational emphasis and the requirements of the Department. Several avenues for further research were delineated. Prospects for the future practice of social work sketched in the context of ongoing change within the Department were identified.
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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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    The nursed passage : a theoretical framework for the nurse-patient partnership : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University
    (Massey University, 1988) Christensen, Judith C.
    This study focused on nursing in action. The research goal was to identify nursing-relevant dimensions within a person's experience of being a hospital patient undergoing elective surgery. In order to discover and conceptualise the underlying processes which are present as patients are nursed through this experience, an open question was posed - What is happening here? A qualitative research method was the most appropriate means of discovering an answer to this question. The particular method chosen was the grounded theory approach developed by Glaser and Strauss. Data were collected in five surgical wards of a large city hospital over a period of five months. The research participants were twenty-one patients and the nurses involved in their care. Primary sources of data were interviews and the nursing records. These were augmented by field notes and accounts of observed incidents relating to the care of each patient. Using the inductive strategies of the grounded theory method, numerous descriptive concepts were generated during data analysis. These were ordered within an integrating social process derived from anthropology. By this means a grounded theory in the form of a theoretical framework - the Nursed Passage - was developed. Within this passage the patient is the passagee and nursing is translated into action through the agency of the nurse. The Nursed Passage is a patterned partnership with three key elements. Firstly, the temporal element, characterised by ongoing movement and constant change, is conveyed in the sequence of phases or stages. Secondly, the participative element is portrayed as a patterned relationship in which both nurse and patient are actively involved in progressing the patient through the passage. Finally, the contextual element recognises complex factors within the nursing environment which have an impact on the shape of the relationship between patient and nurse. This theoretical framework, generated from the reality of nursing as it occurs in one setting, assigns a specific shape to the encounter between nurse and patient. It identifies the contribution nursing alone can make to optimise each patient's hospital experience. In this way it both complements and facilitates the work of medical and other colleagues with whom nurses work. Thus, it serves to revalue nursing in terms that can maximally utilise the registered nurse's knowledge and skill for the benefit of all concerned, but particularly the patient and the nurse. Consequently, it has potential value for nursing practice, education and research.
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    Reclaiming the last rites (rights) : women and after-death policy, practices and beliefs in Aotearoa/New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Social Policy and Social Work at Massey University
    (Massey University, 1995) Hera, Jean
    This thesis develops an ecofeminist analysis of women's roles in after-death work and ritual in Aotearoa/New Zealand. The thesis describes and analyses the male takeover, and accompanying professionalization of death which has removed death out of the hands of the lay women in the family and community who previously held this role, and which has removed dying, death and after-death practices and ritual out of the home and into the institution. A bicultural emphasis has been adopted for this research into death which involves Maori, the first nation tribal peoples of Aotearoa/New Zealand and Pakeha, people of European (particularly British) descent who have colonized Aotearoa. The thesis examines both the differing and related experiences of Maori and Pakeha in relation to changing and evolving after-death policy, practices and beliefs in Aotearoa/New Zealand. It also considers the value of after-death experiences in the home and in the community and the choices and restrictions of today that relate to this. A triangulation of research methods is used: public records research to produce an historical social policy analysis of death, the action research of the Palmerston North Women's Homedeath Support Group which is an initiative to demystify and reclaim after-death knowledge and choices, and eighteen in-depth interviews which provide women's stories of their after-death experiences. The research aims to contribute to a process which seeks to demystify death and assist women and the wider community to reclaim control over the last rites (rights).
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    From rocking the cradle to rocking the system : women, community work and social change in Aotearoa : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy, Department of Social Policy and Social Work, Massey University
    (Massey University, 1991) Craig, Wendy
    This dissertation explores women's involvement in community work in Aotearoa. It is argued that women's significant contributions to community work have been hidden, devalued or ignored in mainstream writing and teaching. This study documents women's experiences and their perceptions of these experiences; such stories which are very seldom told. It also focusses on an explanation of social change from the perspective of women community workers. These women view community work as a site of struggle for change, through the processes of empowerment, self-determination and working collectively. Sixteen women, eight Maori and eight pakeha, participated in this study. These women have been identified as change agents and throughout their stories they constantly link their daily experiences to national, global and structural issues. All of the women have made a commitment to working towards change. This commitment has not always been been without cost to themselves and to their families. Although the changes that the women have achieved can, at times, be seen as reformist in nature, it is argued that as women's community work challenges the practices of the state, it contributes to social change processes. The approach taken is informed by my socialist feminist perspective. Issues pertaining to gender, race and, to some extent, class are considered in this thesis.. The study concludes that future theorising about community work in Aotearoa, must, of necessity show, more effectively how gender, race and class are interrelated. The differences between the Maori and pakeha women's stories indicate that gender cannot be examined in isolation from race. The existence of gender, as a category, is shaped also by other relations such as race and class. In articulating their struggles for change, the women reveal that there is much to be learned about the politics of caring. The women recognise that they have been trained to be the caregivers in society. For these women, however, caring plays an important role in the social change process. Their approach is based on an empowering model rather than a dependency one. Yet, whilst the women celebrate their own capacities related to caring, they are also concerned that men stand back from, and even devalue, this essential role which enables society to function. Thus community work is frequently conceptualised as women's work, and the women have to struggle to be recognised and paid for it. This thesis also shows that, despite the differences between the Maori and pakeha women, their relationship is generally co-operative and the potential for them to learn from one another exists. Through their collective involvement in the Aotearoa Community Workers Association the women have found ways to work towards a partnership which is based on an understanding of the rights of Maori as the indigenous people of Aotearoa. This research serves as a celebration of the women's experiences and knowledge of community work in Aotearoa. It is documented in a way that other women community workers can use to reflect on their own work. The challenge of any research and action is to not only record people's experiences, but also to use our knowledge, both written and oral, to provide an explanation of our current reality in order to , if necessary, change this reality. This dissertation, as part of a social process, has attempted to achieve this aim.
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    Food choices and feeding patterns for women and infants in rural northern Thailand : an ethnographic study : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University
    (Massey University, 1992) Ratanawadee Boonyaprapa
    The question for this study arose from the situation that malnutrition remains one of the major health problems among Thai children, particularly the under-fives. The purpose of it was to develop better understanding as to what sustains beliefs and practices associated with infant nutrition. An ethnographic approach was chosen as the research method. One rural village in northern Thailand was selected as the site of fieldwork for a period of 10 months. Data were collected through participant observation, interview, and ethnographic records. Key informants were 18 pregnant women and mothers of the under-twos. General informants were elderly kinswomen, fathers of the under-twos, volunteer health workers and community health workers. From the data it can be argued that what each woman does with regard to her own nutrition during pregnancy and following childbirth and the feeding pattern that she adopts for her infant are the outcomes of interplay between a complex network of cultural, social, personal and situational factors. These act and interact as pushes and pulls in a woman's decision making, frequently conflicting. Four main sources of pushes and pulls are: traditional beliefs; personal factors including attitudes, feelings, needs and experiences; sociocultural situations and changes; and government health services. If nursing interventions aimed at promoting a well nourished woman and a well nourished child are to be effective, nurses must be aware of these multiple influences. The conceptual account generated from the findings of this study has potential value for nursing practice, education and research. It identifies the aspects amenable to change by nurses and other health workers in their work to counter malnutrition situation, and so to improve the health of mothers and children.
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    The actualized caring moment : a grounded theory of caring in nursing practice : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University
    (Massey University, 1991) Euswas, Payom Wiriya
    The purpose of this study was to provide a partial theoretical description of the phenomenon of caring in nursing practice. Three practice settings involving cancer patients were selected: hospital, hospice, and community with thirty patients and thirty-two nurses participating in the study. A research design combining a phenomenological perspective and grounded theory strategies was implemented. Data were collected by indepth interview, participant observation, and records. The data were analysed by the method of constant comparative analysis. A number of concepts were developed from the data and the theoretical framework of "The Actualized Caring Moment" was formulated to explain how the actual caring process occurs in nursing practice. This caring moment is the moment at which the nurse and the patient realise their intersubjective connectedness in transforming healing-growing as human beings in a specific-dynamic changing situation. The actualized caring moment is a gestalt configuration of three main caring components: The preconditions, The ongoing interaction, and The situated context. The Preconditions, which consist of the nurse, personally and professionally prepared to care, and the patient, a person with compromised health and wellbeing, are prerequisites for the occurrence of the caring process. The nurse has the qualities of benevolence, commitment, and clinical competency to be ready to care. The patient is a unique person in a vulnerable state and requires assistance from the nurse to meet personal health needs. The Ongoing Interaction, the actual caring process, is the continuity of the nurse-patient interaction moment-by-moment which brings together six caring elements: Being there, Being mindfully present, A relationship of trust, Participation in meeting needs, Empathetic communication, and Balancing knowledge-energy-time. The Situated Context is the situation and environment where the actual caring process is taking place, and this is comprised of circumstances of the nurse-patient meeting and care-facilitating working conditions The conceptual framework of "The Actualized Caring Moment" offers nurses an opportunity to understand their practice more fully in providing effective nursing service. Consequently, its implications are valuable for education, research, and the development of knowledge focused on the discipline of nursing.
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    Schizophrenia, a way of being-in-the-world : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University
    (Massey University, 1995) Walton, Jo Ann; Walton, Jo Ann
    This phenomenological study describes what it is like to live with a schizophrenic illness and relates the understanding gained from this descripton to implications for nursing practice. The participants in the study were ten adults who have been diagnosed with schizophrenia, who take regular medication and who are living independent lives in the community. Over a period of sixteen months they were interviewed about the effects of the illness on their everyday lives. During this time they explained the challenges and difficulties which have faced them, both during and long after the resolution of acute illness. As they describe it, schizophrenia is a part of who they are. The narrative contained in this thesis presents the participants' stories in aggregated form, setting their experiences alongside ideas from the early work of Martin Heidegger, whose phenomenological writing informed the analysis and interpretation of the data. As the participants explain, schizophrenia has touched every aspect of their lives. Living with schizophrenia is shown to affect their whole Being-in-the-world. It incorporates Being-with-others, living carefully and taking a stand on life. While hoping for a cure, their reality is of living with a chronic illness which has major effects on their lives. At the same time the participants are shown to define themselves not in terms of their illness and treatment, but in respect of their hopes and dreams and the stance each is taking on his or her own life. In this way their existential predicament is highlighted in the study. Participants are on the one hand very much like all other people, while on the other hand they have to contend with very different concerns than do most others. In itself the description of the experience of schizophrenia contained in the thesis is useful for its potential to increase understanding of the illness by nurses and other health professionals. Further than this, however, the study is shown to have implications in terms of nursing practice and the provision of health care. With regard to the seriously mentally ill the data bring into question some of the theoretical positions which have held sway in nursing for many years. The research demonstrates that it is practicable to attend to the subjective experiences of people who suffer from schizophrenia and to understand their needs and desires from the position of fellow human being, without the need for a guiding theory from which to interpret what they are saying or what their words "really mean." It is argued that relationships between nurses and clients which are based on understanding and trust rather than distance hold promise in the care of those with schizophrenia. Heidegger's concept of solicitude as care for others is addressed in this regard, and is shown to be most appropriate as a basis for nursing care in the mental health arena.
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    Cultural perceptions of illness in rural northeastern Thailand : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University
    (Massey University, 1994) Nuntaboot, Khanitta; Khanitta Nuntaboot
    In a transitional society like Northeastern Thailand, alternative and often competing therapeutic methods have been widely used by local people. Most illnesses are managed without recourse to the Government health care services. In Thailand there is a paucity of studies which explore and develop an understanding of how rural people regard illness in terms of causes and classification and how this knowledge influences what actions they take to deal with it. The impact of medical pluralism on illness management has rarely been studied in this country. The purpose of this study is to provide an understanding of the cultural meanings of illness for people in rural Northeast Thailand and their behaviour regarding health and illness care. An ethnographic approach, employing participant observation, interviews and ethnographic records, was selected as the research method, with fieldwork carried out in one rural village in Northeast Thailand where the researcher lived for 12 months. The findings suggest that what people do during an illness is guided by their healing knowledge which is experiential in nature. Mutual influences exist between people's beliefs about illness and their experiences of illness and healing methods. The experiential healing knowledge encompasses broad illness categories and beliefs in multiple causes of an illness. Multiple healing methods including both Western medicine and village curing methods are applied in any illness situation. Western medicine is believed to be effective to treat disease which is viewed as one part of illness, while village curing is believed to effectively treat other causes of illness as well as disease. Kin and neighbours actively participate in the articulation of illness situations, being involved in diagnosing the illness and identifying and prioritising multiple therapeutic management options. This description of people's perceptions of illness and its management, generated from the data, is crucial to increasing the knowledge base of members of nursing and other health professions. Such knowledge identifies critical aspects and possibilities for change in the practice of health professionals when working with rural people in Northeast Thailand. The study concludes with a discussion of strategies for practice and education which might be applied by nurses and other health professionals to improve the utilisation of available health care services.