School of Health and Social Services

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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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    Successful ageing : a critical analysis : a dissertation submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in the School of Sociology, Social Policy, and Social Work at Massey University, Palmerston North, New Zealand
    (Massey University, 2006) Holmes, Jeanne
    The demographics and implications of the growth of the world's population of older people have been well publicised. Frequently, this is linked to concerns about growing demands for social services. In liberal western nations, this rise in the proportion of elderly people is occurring at a period in history when governments are attempting to contain state spending on health care and welfare. Within this context, the gerontological concept of 'successful ageing', which encourages productivity and self-reliance among older people, has emerged. The term 'successful ageing' was coined by R. J. Havighurst in 196l and developed by Rowe and Kahn into a gerontological concept in 1998. Rowe and Kahn's search to identify the factors "that conspire to put one octogenarian on cross-country skis and another in a wheelchair" led them to put forward the view that 'successfully aged' old people are those who remain healthy and socially engaged. The concept of successful aging is widely regarded as promoting well-being in old age. As a result, it has become highly influential in the fields of nursing, social work, and social care. However, the concept has also attracted criticism, mainly for praising the fortunate and privileged elders who have managed to prolong healthy middle age; whilst labelling unwell, disabled, and lonely old people as unsuccessful. In this thesis, my central criticism of the concept of successful ageing is that its definition of 'success' in old age is not based on the views and real life experiences of older people, but instead, on the expertise of scientists and researchers, many of whom have yet to experience the decline and losses normally associated with old age. Consequently, there is a significant difference between the concept of successful ageing and a proportion of elderly people regarding the requirements for the best possible old age. The purpose of this study is to discover the factors which a diverse group of old people regard as essential to optimal old age. It compares and contrasts their self-assessed components of well-being with the externally assessed components of 'successful aging'. The process involved in-depth research with thirty elderly people in New Zealand and the United States. The majority were women. Several ethnic groups were represented. Participants included First Nations people, first generation immigrants, and the descendants of European settlers. Although it was not intentional, my entire sample consisted of people who would have been defined as unsuccessfully aged by the 'successful ageing' paradigm. Yet these people showed resilience, resourcefulness, and often, great satisfaction with their lives. This research demonstrates that there is an incomplete fit between the factors, which older people say produce the best possible old age, and those promoted by the concept of successful ageing. It concludes that in order to promote optimum well-being among older people, it is necessary to take note of the experiences, views, and values of elders themselves.
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    From job creation to training, 1840-1990 : a descriptive analysis of the development and demise of job creation policy as the mainstay of state responses to unemployment in New Zealand : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Social Policy at Massey University, Palmerston North, New Zealand
    (Massey University, 1994) Mulengu, Andrew Punabantu
    New Zealand, for much of the present century has been regarded by other English speaking nations as boldly experimenting in the development of social policy; but is currently taking the dismantling of the welfare state further than most western countries. This thesis provides a historical analysis of job creation for the unemployed, which was provided by the state on a relatively large scale (relative to the size of the New Zealand population), from the earliest days of colonisation in the 1840s until it was virtually phased out inthe mid-1980s. The thesis examines the competing ideas and interests which conditioned the adoption, growth, fluctuations in the eventual demise of job creation as the mainstay of the New Zealand state's responses to unemployment. In particular, it examines the impact of the various sets of ideas about work and human nature which were brought to New Zealand in the course of colonisation by the British; and the extent to which the colonisers were able to recreate patterns of work and dependency from Britain. The study of job creation in New Zealand is a history of conflict based on class interests. One task of the thesis is to show how the state has responded in different periods to demands from working men for the 'right to work'. However, it is also a history of the reinforcing of ancient divisions of labour along lines of gender and ethnicity, and of the relative privileging of 'pakeha' (white, European) men in terms of their access to paid work provided by the state. Job creation for the unemployed has been a site of both conflict and compromise between (mainly male) labour and capital throughout the post-colonisation period in New Zealand. This thesis provides an in-depth study of the ways in which such conflict and compromise contributed to the development, form and eventual demise of job creation in New Zealand.
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    Male breadwinner households and work : alterations in the transition to a liberal welfare regime : a thesis presented in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Social Policy at Massey University, Palmerston North, New Zealand
    (Massey University, 1997) Barrett, Patrick Neville
    This thesis examines how the nexus between households and work in New Zealand has been altered by the transition from a wage earner cum social expenditure welfare regime to a liberal welfare regime. The proposition that welfare regimes are characterised by distinctive institutional arrangements and labour market outcomes is explored at the micro-level through household life and work histories. Life and work history data from a small number of Palmerston North male breadwinner households was used to examine the way individuals' lives have been affected by the institutional context at distinctive historical epochs. The thesis discusses the implications for household labour market activity and experience in each regime. Strong cultural and normative continuities are noted despite the trend towards dual earner households. Variation in the potential for labour market mobility across regimes is observed in terms of changing opportunities for skill acquisition. Change in the experience of unemployment and subsequent labour supply responses is examined. Increasing employment insecurity is found to be an outcome of increasing risk of job loss, declining levels of input into jobs and declining levels of protection from adversity in employment relationship. With fewer employment opportunities in the liberal regime, yet with increasing welfare selectivism, the nexus between households and work is found to be characterised by a greater level of income necessity. Households' responses include the supply of "additional" labour - an added-worker effect - whereby they take whatever work can be found, often lower paid and with poor conditions. The examination at the micro-level of how household labour market activity and experience had been altered by the transition to the liberal regime was found to enhance the understanding of change in the interface between work and welfare.
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    The nature and role of the extended family in New Zealand, and its relationship with the State : based on a study of a provincial city : a thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at School of Social Policy and Social Work, Massey University
    (Massey University, 2000) McPherson, Mervyl J.
    In New Zealand there is a widespread perception that European/Pakeha do not have extended families in the way that Maori and Pacific Islands' cultures do. Yet in recent years social policy has been moving away from reliance on the state towards increasing reliance on one's self and one's family. This study uses survey research, a focus group, demographic analysis and policy analysis to investigate the nature of the extended family in predominantly European/Pakeha New Zealand, and perceptions of the respective roles of the family and the state. Discrepancies are identified between what families are doing, what people think they should be doing, and what policy assumes they will do. The key factors affecting the supply of and demand for extended family support are identified and the trends in these analysed. These issues are then integrated in order to assess the implications for policy and the impact of policies on families and the intergenerational social contract. This thesis found that the predominantly European/Pakeha society of New Zealand does have extended families, in the modified sense rather than the classical sense, as categorised by Litwak (1965). That is, extended families which are based on egalitarianism and choice rather than power and control, and are characterised by a loose, informal set of kin relationships involving an interlocking set of nuclear families which may be geographically dispersed and economically independent, but are bound by a sense of obligation based on affective relationships and the exchange of mutual aid services. These family networks are not large, and little support extends to the wider family beyond parents, adult children and siblings. Also of concern for policymakers is that approximately a quarter to a third of participants in this study did not have extended family living close enough to provide any kind of practical support. This study also found that while people generally believe in helping family members, they believe this help should be given by choice, not obligation, and that nuclear family and labour force commitments take priority over commitments to the extended family. A further finding is that in the future we will face increasing demand for support from both family and the state, and a declining supply of family support, especially if policies make it necessary for the young elderly to stay in the labour force. Families are unable and unlikely to do more than they are already doing, which is already the bulk of social support. Theorists such as Thomson (1981) have proposed that there will be breakdown in the intergenerational social contract at the macro-level of the state as a result of neo-liberal policies of self-reliance, particularly for younger generations, and policies which have favoured the older generation at the expense of the young. It is concluded from this study that the balance of support towards the young rather than the old at the micro-level of the family is preventing this macro-level breakdown. But if more responsibility is put onto families, this will cause breakdown in the micro-level intergenerational contract and upset the balance. Thus there is a need for increased rather than decreased state support to complement what families are able to do and prevent breakdown in the intergenerational contract at both the micro-level of the family and the macro-level of society.
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    Breaking the silence : restorative justice and child sexual abuse : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Social Policy at Massey University, Albany, New Zealand
    (Massey University, 2001) Jülich, Shirley Jean
    This research investigated the relationship between justice and child sexual abuse from the perspective of adult survivors. Utilising participant observation, unstructured interviews and focus groups within a feminist framework, 21 adult survivors of child sexual abuse (18 women and 3 men) were consulted to identify issues that were problematic for them. In addition, 2 jurors, 1 judge and 2 counsellors were interviewed. The findings indicated that child sexual abuse has been shrouded by a conspiracy of silence, caused partly by deeply entrenched structures within society. These forces combined with the complexity of recovery, including the possible impacts of Stockholm Syndrome, and the perceived inability of the criminal justice system to meet their needs, have appeared to silence many survivors of child sexual abuse. A review of the economic consequences and an analysis of the subsequent costs of child sexual abuse have indicated the need to implement programmes that would lessen the burden for victims, offenders, their families and the broader society. Survivors cautiously suggested that restorative justice might be sufficiently flexible to encourage victims of child sexual abuse to criminally report, thereby breaking the silence. A cost benefit analysis of a restorative justice programme indicated that significant savings could be made and highlighted that the prevention of child sexual abuse should be a priority. The findings of this research would have implications for policy makers and all those who provide services to victims and offenders of child sexual abuse. Stockholm Syndrome has highlighted the complexity of the recovery process for victims of child sexual abuse. This syndrome combined with the concerns of adult survivors of child sexual abuse would have implications for practitioners within the traditional criminal justice system and the restorative justice movement. Finally, the costs of child sexual abuse in New Zealand would have implications for justice agencies, health agencies, social welfare organisations and the Accident Compensation Corporation of New Zealand.
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    Safeguarding the practices of nursing : the lived experience of being-as preceptor to undergraduate student nurses in acute care settings : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Albany, New Zealand
    (Massey University, 2001) Rummel, Louise G.
    An Heideggerian Hermeneutic approach has been adopted to explore the experience of being-as preceptor to undergraduate student nurses in the acute care setting. This thesis addresses the question: What is the experience of being a preceptor to undergraduate student nurses in an acute care setting? Fifteen preceptor-participants were interviewed twice, with each interview being approximately one hour. Heideggerian Hermeneutical Analysis was used to reveal the experience of preceptors as they precept undergraduate student nurses. The thesis begins by placing nursing education in an historical, socio-political and professional context that provides the background to current New Zealand nursing practice. Student nurses undergoing their nursing education learn the meaning of being a nurse in many different contexts. This research is situated in the acute care context where both preceptors and student nurses engage in the practice of nursing. The methodological background shapes the way the research is presented to explicate the meaning of being-as preceptor. The four data chapters reveal the preceptors' experience and open with dialogue showing how nurses become preceptors. This is followed by exploration of how preceptors assessed where the student was at, moves to preceptors promoting learning and closes with discussion of how preceptors keep students and patients safe. Many practices were uncovered during the revelations of the preceptors as they disclosed to the researcher narratives of their everyday practice world. Common themes that emerge from the data include: Becoming attuned- the call, The Emerging Identity of 'being-as' Preceptor: Keeping the student in mind, Assessing where the student is at: The Preceptor and Preceptee Working and Growing Together, and The Preceptor as Builder of Nursing Practice: Teaching Reality Nursing. A number of common themes support the relational themes which are of greater complexity. A constitutive pattern, the highest form of interpretation that emerges from the data, was Safeguarding the Practices of Nursing. This constitutive pattern lies within every text either directly or is inferred from each participant's dialogue. It contains the central meaning of the thesis. It is constituted from common and relational themes as they present themselves in the analytical process. In this thesis the experience of being-as preceptor is unveiled through the participants' own words as the researcher takes the reader back to the 'things themselves' as is espoused by hermeneutic phenomenology.
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    A study of medical, nursing, and institutional not-for-resuscitation (NFR) discourses : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Sociology, Social Policy and Social Work at Massey University, Palmerston North, New Zealand
    (Massey University, 2002) Bickley Asher, Joy Lynley
    This study investigates the way that medical, nursing and institutional discourses construct knowledge in the specific context of Not-for-resuscitation (NFR) in a New Zealand general hospital where NFR guidelines are available in the wards and from the regional ethics committee. The thesis argues that there are ranges of techniques that staff use to construct NFR knowledge, enacted through various forms of speech and silence, which result in orderly and disorderly experiences for patients nearing death. The study was conducted through a critical analysis of the talk of health professionals and the Chairperson of the Regional Ethics Committee. Critical discourse analysis, a methodology that is primarily concerned with a critical analysis of the use of language and the reproduction of dominant ideologies or belief systems in discourse, was employed. The researcher examined the transcribed, audiotaped talk of eleven professional staff members of a large metropolitan general hospital, and the Regional Ethics Committee Chairperson. The results of the analysis indicate that medical discourses do not dominate the construction of NFR knowledge within the institution. Nor do the institutional or ethics committee discourses, written as NFR policy documents, dominate by instilling order into NFR practices with patients. Rather, a range of discourse practices within the disciplines of nursing, medicine, management and policy advice work to determine what happens to patients in the context of NFR and, unexpectedly, cardiopulmonary resuscitation. NFR discourses designed by the institution to influence and standardise practice at the bedside are resisted by professional discourses through the techniques of keeping quiet and keeping secrets, forcing others to keep quiet, delays in speaking up, through to speaking up against opposition. These techniques of speech and silence constitute a divergence between institutional discourses and professional discourses, and divergence within nursing and medical discourses. Both medical and nursing discourses underplay the degree of influence their professional power had over NFR events. This research is potentially significant at two levels; firstly because of what it reveals about the way in which health professionals and policy advisors construct NFR knowledge and secondly, because of the relationship between NFR practices in the health sector and societal ideas about control of death at the beginning of the twenty-first century. These findings will have particular relevance for the shaping of future health care policies. The outcomes of this study also point to the need for further research, both into NFR and into cardio-pulmonary resuscitation events particularly with regard to the implications of the policies for patients and their families.
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    Senior citizens? : old age and citizenship in provincial New Zealand communities : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy at School of Sociology, Social Policy and Social Work, Massey University
    (Massey University, 2002) Kerr, Alison Lassie
    This research considers the extent and quality of the citizenship of older New Zealanders in the "Third Age", a stage in the adult life cycle between the second age of careers, partnership and parenting and the fourth and final phase of (usually) increasing dependency. The study questions: whether 'senior citizens' have access to the material and cultural resources to enable them to choose between different courses of action in their daily lives; whether existing intergenerational relations enable them to appropriate substantive rights and responsibilities; and what are the relational practices and processes, the networks and affiliations, through which citizenship may be 'performed' by older people? This research was carried out with six groups of elderly people in a range of communities in the province of Hawke's Bay on the East Coast of the North Island of New Zealand. The purpose of running six different focus groups, each over a six week period, was to generate discussion of the issues for older people as well as individual stories about the lives of elderly people in particular local communities. The aim was to investigate the meaning of old age for elderly New Zealanders by critically analysing the term 'senior citizen'. The study built on contemporary theories of ageing and citizenship, using a narrative collective life history approach in order to focus on older people's personal experience of policy, and the capacity for citizenship that they bring with them into old age. The study also identifies national and local government policies, national and local organisations, media representations of old age, local communities, families and the attitudes of elderly people themselves as important influences on the extent to which they are able to exercise and enjoy their rights and responsibilities as senior citizens. My central thesis is that senior citizenship depends on a civil society which supports autonomy and connectedness for all its citizens. The balance between these two aspects of citizenship is culturally determined and sensitive to outcomes in a range of social domains over the life span. Recommendations focus on self-determination and social inclusion for older people through anti-ageist policies and practices at the national and the local level, and further research into the plans and aspirations of senior citizens.
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    Responding to the call to care : women's experience of breastfeeding in New Zealand : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Wellington, New Zealand
    (Massey University, 2004) McBride-Henry, Karen Sharee
    New Zealand breastfeeding experts have long contended that New Zealand does not have a breastfeeding culture, as demonstrated by anecdotal evidence suggesting that women find breastfeeding difficult to initiate and sustain. A review of the literature indicates that, in New Zealand, breastfeeding knowledge falls within the domain of health care professionals, which marginalises women's own experiential knowledge about breastfeeding. Therefore, this study explores the experience of breastfeeding for women in New Zealand. A reflective lifeworld research methodology underpins this study, allowing the participants' narratives to be explored without the use of pre-existing theoretical frameworks that may close down on aspects of the interpretive analysis. Nineteen women were interviewed for this study, all of whom were New Zealanders who were either breastfeeding at the time of the interviews, or had breastfed within the last two years. Many of the participants had breastfed more than one child. What emerges as the central thesis of this study is that breastfeeding is a priori to unique embodied experiences. A number of sub-themes, which further explicate this central thesis, include: the silencing of the reality of breastfeeding within the public domain, the pervasive influence of society, or 'the they', through the accepted frameworks by which breastfeeding women interpret their individual breastfeeding experiences, and breastfeeding as a means of facilitating close relationships between women and their infants. The findings of this study will assist health care professionals working alongside breastfeeding women, as it offers fresh understandings of what it is to be a breastfeeding woman. It is important that health care professionals lay aside their previously-held perceptions about breastfeeding, and pay careful attention to individual women's experiences prior to planning interventions. If health care professionals value women's embodied breastfeeding narratives, women will be supported to articulate their breastfeeding experiences, thereby increasing women's confidence in their embodied breastfeeding knowledge and capabilities