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    Nursing care for people living with diabetes and associated conditions in Fiji : an iTaukei community context : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy, Massey University, Palmerston North, New Zealand
    (Massey University, 2021) Ravono, Akisi Nailaba
    This research examined the experiences of iTaukei (indigenous people of Fiji) patients and nurses in the context of the diabetes epidemic in Fiji. Vanua theory, which has some influence on iTaukei health beliefs and practices through its physical, social and cultural elements informed the design and conduct of the research. Despite the voluminous global literature on diabetes and non-communicable diseases (NCD), there was little written about the topic for Fiji and the Pacific. Fiji was among the first few countries to adopt public health initiatives that were developed to curb the incidence of NCD. However, such initiatives have faced a perpetual challenge in terms of implementation, monitoring and evaluation. The research used the Fijian Vanua Research Framework and veitalanoa, a data collection method, to gather information from twelve patients and eleven nurses from four medical areas in Fiji. The veitalanoa groups were complemented by four veitalanoa individual sessions and field observations. Findings revealed that patients struggled to cope with diabetes and associated complications while nurses were challenged to deliver best practice in inadequate nursing practice environments. Specifically, patients had difficulties both living with diabetes and accessing planned care and were culturally unlikely to question or challenge medical decisions, simply expecting safe and trustful care. Nurses were not able to nurse in the way they know is needed; they provided rudimentary and sometimes inappropriate care, and experienced extreme frustration while attempting to provide holistic care in a highly medicalised model of care. The nurses were aware of vanua etiquette and their connections with iTaukei patients, however, they could not apply such protocol. Despite study findings revealing significant challenges for patients and nurses, the participants suggested a way forward for the improvement of nursing care and primary health care in Fiji. Such changes may represent considerable challenge to the accepted hierarchies of power and decision making and will need to be strongly supported by a focus on patient centered care. 
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    Fostering a new approach : how alternative care models in Greece are meeting unaccompanied minors' rights : a thesis presented in partial fulfillment of the requirements for the degree of Master of International Development at Massey University, Palmerston North, New Zealand
    (Massey University, 2019) Finlay, Liselle
    Unaccompanied minors seeking refuge in Greece are met with woefully inadequate care structures for meeting their needs. Despite the United Nation’s Convention on the Rights of the Child [CRC] stipulating children’s entitlement to appropriate care arrangements, there is a gap between this rhetoric and the reality of alternative care provision for minor refugees. Significantly, institutions are prioritised over familybased solutions. There is also a lack of research addressing the processes of power and exclusion in refugee hosting countries, and how these structural conditions influence unaccompanied minors’ situations and their wellbeing. To address these issues, this study adopts a socio-political construction of children’s rights to understand both how different care models are meeting unaccompanied minors rights, and why these models were selected. In conceiving rights as a socio-political process, this thesis addresses issues of power and agency in the navigation of rights. Tensions between restrictive migration policy and commitment to the CRC will be shown to compromise care provision for unaccompanied minors through conscription to control over care. Despite the overarching structural limitations, young people in this study find avenues for exercising their agency, albeit often risky ones. What emerges is a need to understand both young people’s vulnerabilities and strength, and how they are both these things in different parts of their lives. This thesis presents results of fieldwork largely undertaken in Athens over a six-week period in 2018. A cross-section of care providers engaged in the welfare of unaccompanied minors participated in the study. Also interviewed were the foremost experts in Greece’s child protection system: young people who themselves have experienced these care models. Findings reveal the impact migration policy has had in undermining care provision for unaccompanied minors, and the corresponding tensions that emerge for NGOs looking to address urgent needs and find sustainable solutions. This study recorded that rights violations and risks are occurring. It also explored the barriers and opportunities to expand the spectrum of care options and strengthen optimal care, which were identified as family and community-based alternative care initiatives.
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    The implementation of trauma informed care in acute mental health inpatient units : a comparative study : a thesis presented in fulfilment of the requirements for the degree of Master of Public Health at Massey University, Wellington, New Zealand
    (Massey University, 2013) Ashmore, Toni Rae
    Trauma informed care (TIC); particularly related to interpersonal violence, is a burgeoning topic for mental health services in both New Zealand and Australia. This thesis compares the implementation of trauma informed care, particularly in relation to interpersonal violence, in an acute mental health inpatient unit in New Zealand and a similar unit in New South Wales, Australia. A policy analysis was undertaken of current policy documents that guide each unit, along with semistructured interviews with ten senior staff, five from each unit to investigate implementation of key features of trauma informed care, particularly in relation to interpersonal violence. Results showed a difference in overall implementation between the two units. Single interventions rather than a whole of service change of philosophy were evident. Differences were identified in relation to policies referring to interpersonal violence, staff knowledge and understanding of trauma informed care, access to training and resources, how safety was provided for, collaborative care arrangements and workplace power dynamics for both clients and staff. Across both units were identified a lack of guidance to inform implementation of TIC, consumer involvement and practice around diversity. Contributing factors for TIC implementation include having a clear definition of TIC, commitment at all governance levels, access to TIC training for all staff, and policies underpinned by TIC. Further research investigating these results may enhance service delivery, resulting in better outcomes for the promotion of recovery and healing of those with histories of interpersonal violence.
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    Care as a Contemporary Paradox in a Global Market
    (Massey University, 2011) Rogerson, Ann; Morgan, Mandy; Coombes, Leigh
    The contemporary mother faces difficult choices when deciding whether to be either a ‘stay at home’ or a ‘working mother’. Conflicting discourses of good and bad mothering revolve around a political divide under pressure, one that territorialises the public and private domains. Gilligan (1982) famously highlighted the existence of these domains by challenging Kohlberg’s findings that men were endowed with higher moral reasoning powers than women. Disappointed by what she identified as the masculinist bias of Kohlberg’s work, Gilligan conducted her own research, finding that men and women reasoned differently but equitably. Gilligan’s thesis now theoretically informs a feminist ethics of care that has reputedly transformed political spatial boundaries of the public and private domains, domains traditionally gendered as masculine and feminine. Yet the ‘care’ that Gilligan has drawn our attention to is seemingly a new phenomenon. Appearing in language around the same time as the birth of Gilligan’s feminist ethics and indeed amidst the growing dilemma of the working mother, this care shows no visible sign of its maternal origins. In this paper, I attempt to define and locate care amidst the dismantling of the spatial divide that separates the public and private, a dismantling that coincides with the commodification of care within a global market.