Massey University Departments

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    Living large : the experiences of large-bodied women when accessing general practice services : a thesis presented in partial fulfillment of the requirements for the degree of Master of Philosophy (Nursing) at Massey University, Palmerston North, New Zealand
    (Massey University, 2011) Russell, Nicola
    The ‘obesity epidemic’ of the past two decades has resulted in numerous studies reporting higher levels of stigma and discrimination experienced by obese/overweight women, both within the health care system and society in the main. Despite general practice being the most utilised point of access for health care services, there has been very little international or national exploration of the experiences of large-bodied women accessing these services. Utilising a qualitative, descriptive research design, this post-structuralist feminist study has enabled a group of large-bodied women to express their stories of accessing general practice services. Eight self identified large-bodied women volunteered to participate in semi-structured face-to-face interviews. Thematic analysis identified seven themes: Early experiences of body perception, Confronting social stereotypes, Contending with feminine beauty ideals, Perceptions of health, Pursuing health, Respecting the whole person and Feeling safe to access care. The women in this study articulated broader interpretations of health and well-being than those teachings reproduced within dominant bio-medical and social discourses of obesity. When these women’s personal context, beliefs and values are silenced by the health care provider, the rhetoric of health care professional claims of patient-centred care has given way to these women experiencing stigmatisation and a sense of ambiguity about general practice services. However, when space is given for multiple interpretations of obesity to exist within the patient-health care provider relationship, these women feel respected, their health needs are satisfied and they are more comfortable to engage in health screening services. Resisting the powerful socio-cultural milieu which supports the superiority of a slim female body as a signifier of both health and beauty presents a challenge for health care professionals to negotiate. I contend however, that giving consideration to the perspectives of large-bodied women and critically reflecting upon one’s own personal beliefs and attitudes about the overweight/obese, presents an opportunity to ensure clinical practice for this population is truly patient-centred.
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    An exploration of the role of short term medical missions in health care provision in Honduras : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Development Studies at Massey University, Turitea, Palmerston North, New Zealand
    (Massey University, 2005) McLennan, Sharon Joy; McLennan, Sharon Joy
    Short term medical missions, or medical brigades are teams of expatriate health professionals and lay people, who travel to Latin America and other parts of the world for a week or two to provide health care to the poor. While the number and popularity of these teams appears to be increasing, to date there has been little literature or critical research addressing their role. This thesis addresses the role of Short Term Medical Missions (STMMs), who they are, what they do and how they fit into health service provision in developing nations. In particular it outlines the services provided by STMMs, including clinical services, resource provision and preventative services, it discusses the motivation for using STMMs as service providers and it also begins to explore the impact they have on the populations and on local health care services in the areas they operate. This is done within the context of Honduras, a nation that has seen an influx of these teams in recent years, particularly since Hurricane Mitch in 1998. Honduras faces many challenges in health and health care and STMMs have been seen by some as a means of “filling gaps”. This study questions whether STMMs are indeed actually filling real gaps, and if they are, whether they most appropriate means of doing so, as there are many limitations to the ability of short term, outside volunteers to provide quality services. While not directly measuring the impact of STMMs on the health status of the population, this study discusses the actual and potential impact of STMMs on local health services, and argues that there are potential long-term consequences to their use. These consequences include an increasing dependency on outside assistance that may be detrimental to the long-term development of National health services.
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    Exploring the health care experiences of rural Thai people living with acquired valvular heart disease : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Wellington, New Zealand
    (Massey University, 2010) Buatee, Supatra
    Valvular heart disease (VHD) is a preventable disease but it is one of the major causes of chronic illness in developing countries. As this disease is curable by surgery, access to appropriate and effective health care is necessary to prevent people from developing this disease and to treat people with VHD. The voices of people living with this condition will provide direction for health professionals in the development of better health care services for those living with VHD. This qualitative narrative study aimed to explore the experiences of individuals living with VHD. Thirty individuals diagnosed with VHD participated in this study drawn from a population of individuals attending a Thailand provincial hospital. They participated in (open and honest conversation) which was supported by a Thai cultural stance to build the trust necessary for the conversations. Conversations aimed at eliciting information about personal health care experiences were undertaken and lasted from 30 to 90 minutes, all were audio-taped and transcribed verbatim. Multistage narrative analysis methodology was used to identify emerging themes and three major themes emerged: autonomy and life with VHD, the effort of learning for life with VHD, and the maximisation of resources for the management of life with VHD. All of these themes indicated difficulty of access of acceptable and affordable care and difficulty in involvement in health care and illness management. These findings suggest that health care structures, resource distribution and the way professionals interact and communicate are important factors in the health care experiences of individuals living with VHD. Health care services that are based on the principles of equity and balance of power between institutions and clients may support the development of appropriate health care services for all individuals. Culturally-based narrative research is recommended to increase the possibility of expanding ways of knowing with the inclusion of a range of points of views for understanding health care provision. This knowledge is necessary for the development of client-centred and community-based health care services to improve health care outcomes for the rural population in Thailand.