Abstract: The aim of this thesis is to present a phenomenological exploration of the experiences of four woman who have had an adolescent child die of cancer. Using the method of hermeneutic phenomenology, as described by van Mann (1984,1990) the study drew on the stories of four woman. From their stories eight emerging themes became apparent.The analysis of the themes is described under the following headings:- wanting to protect; wanting to be with; maintaining normality; feeling positive and hopeful; facing finality; realizing that death was imminent; coping with the common reality; and interacting with health professionals.Further interpretation of the emerging themes revealed “hope expectations” as the phenomenon of concern that captures these mothers' experiences. The hope expectation phenomenon reveals how the mothers coped with adversity, differing hope expectations in the common reality, oscillating hope expectations throughout the journey and hope expectations inspired by the health professionals.The outcome of this work is to provide professional, especially nurses, with insight and knowledge of the maternal experience of caring for the dying adolescent. It is hoped this research will contribute to the body of nursing knowledge and influence the care of parents who experience the trauma of caring for their dying adolescent child

Abstract: This research utilized a focus group methodology to discover what nurses in clinical practice considered 'caring' care meant for them. Six registered nurses volunteered to participate in the project. They practiced over a wide variety of real settings within the public hospital, which provided both acute and elective surgical and medical services, including an extensive elderly population. Taking these important 'caring' statements, I then explored with the group what factors in their work environment hindered of enhanced their identified 'caring' care in clinical practice as did their overseas counterparts. This study also highlighted the impact the health reforms had on the individual clinical practice at this hospital. The effects of the institutional changes in response to the health reforms were far reaching at both the personal and professional level. Caring is an important concept found in nursing practice. It has been widely documented By nurse scholars, researchers and nurse authors that care is at the core of nursing practice.Some have even referred to care as being the heart of nursing. The finding from the present research indicates the importance nurses place on caring in their day to day encounters with patients. It also demonstrates how nurses express their care and their perceptions of the importance of care has in the clinical practice

Abstract: This text begins with a discourse analysis of the Diagnostic and Statistical Manual of Mental Disorders (fourth edition, 1994 – DSM -IV- to illustrate the discursive construction of mental disorder. The analysis identifies how productivity, moderation, entariness and rationality are constructed by this psychiatric discourse as the fundamental attributes of normality. It is argued that this discursive construction of normality has particular implications for the subject positions available to women.The text explores how those subject positions are constituted by analysing the narratives of women who have been diagnosed as having a mental disorder. Its object is to explore how the categories 'mental disorder' and 'women' are constituted; the effect this has on some women's experiences; and to offer a feminist interpretation of those experiences. The text explores the meaning of these women's experiences and proposes that their responses can be regarded as tactical responses to the non-recognition, or disconfirming recognition, accorded to the subject positions available to them.The women's tactical responses although taking different forms, reveal some commonalities in their responses to a lack of recognition for their performances: shame regarding the body which marks them as women; a sense of meaningless and emptiness in the available performances; a sense of themselves as objects for the use of others; passive performances as self-protective tactics; a need to suppress anger; and a tension between cultural expectations of normality and their own subjective experiences. The tactical responses that these women had employed take the form of over-conformity, withdrawal and resistance. They reflect that Sass (1992:58) describes as attempts to escape the 'form of the real'. It is the women's body which establishes her engendered subjectivity and it is through the body that the tensions related to her expected performances emerge. Each women's tactical response is imbued with multiple and sometimes contradictory meanings that may represent their ambivalence in relational to the cultural expectations for productive, moderate, unitary and rational performances. To enable the meaning of the women's distress to emerge it is necessary that it be recognised by interpretations that reflect their multiple and contradictory form.Alternative readings of these women's tactical responses position the desire for recognition as central. It proposes that it is necessary to pay attention to both the literal and figurative functions of language. The possibility of 'advancing our understanding of social life' (Gergen, women constructed as mentally disordered. These readings of the narratives require an understanding of the context and construction of the narrator's life and opens up the possibility for multiple understandings that do not necessarily privilege productivity, moderation, unitariness and rationality.By attending to the significance of the women's narratives this text proposes that the DSM-IV's (1994) construction of mental disorder of effectively marginalises women's experiences of their culturally determined subject positions. It acknowledges the need to understand how women symbolize their distress in a way that creates and communicates meaning

Abstract: Objective; The objective of this study is to determine if attending a nursing education session on menopause has an impact on women's management of their menopausal symptoms and consequently their quality of life for women aged 40 to 60 years. The hypothesis is that women attending education sessions will start or increase health promotion activities which will reduce menopausal symptoms and thus improve their quality of life.Design and method; Two questionaires were given to the women on the day of the education sessions and another questionnaire was sent to the participant three months later. The sample of 30 completed questionnaires includes feedback from Pacific Island women. A combination of quantitative and qualitative methods were used. The measure of quality of life has been based on the level of impact of menopausal on each women's life before the education session and three months later.Results; Initial analysis indicates that diet, exercise and time out were most commonly reported health activities utilized for relief of symptoms with HRT and herbal remedies used less often. Three months after the education session there was a significant reduction in the impact of symptoms in most categories with 140 incidences of total disappearance of symptoms, 24 incidences of reduction of symptoms, 17 incidences of symptoms increasing while 36 symptoms remained unchanged. Only one woman reported that she continued to have no control over her symptoms while the rest of the sample indicated that they had some or total control. The most common changes in health promotion activities were reduction in caffeine, exercise, relaxation and lubrication with sex. Herbal, homeopathy, dietary and hormone treatment rated low in health activities after the three months.Conclusion; Initial analysis indicates that menopausal symptoms has significantly improved for the majority of women who attended the nursing education session

Abstract: This thesis presents a grounded theory study following Glaser's methodological stance. It explores nursing of the 10-24 year old client through interviews with thirteen registered nurses. The participants worked in a variety of clinical settings including community, hospital and specific adolescent services. From the analysis of the data emerged the complexity of the nurses work with the chosen age group. The study identifies that the quality of the nurse/client encounter may enable the young person to feel accepted and to be empowered to make their own health choices.This thesis identifies how Having Attitude is seen by the nurse participants as critical in the care of the young person. Having Attitude is about the nurse balancing the dependence/independence needs of the young person with their family and peers, and about being acceptable to the client. This results from the work of the nurse which is characterised by the nurse being competent' and 'being supportive whilst taking into account all of the socio-political factors that effect the nurses working situation. The socio-political context impacts upon the young persons life in terms of the types of health issues they have, and the availability and affordability of appropriate health services. It also impacts on the environment in which the nurse works, in terms of the complexity of the concerns with which young people present, current health reforms and funding issues. The nurse needs to have a broad knowledge base and ability to work within a complex situation. Nurses believe they can make a difference to the young persons health experience when they are supportive, competent and have attitude

Abstract: The aim of this study is to investigate whether clinicians consider women have different needs to men. To identify what specific treatment clinicians provided for women with alcohol and drug problems and ascertain whether various clinician variable, are elated to differences in beliefs and treatment provision.The questionnaire items for this study were included in the National Centre for Treatment Development (Alcohol, Drug & Addiction) New Zealand wide telephone survey of alcohol and drug clinicians. Independent interviewers surveyed 217 clinicians. Clinicians were first asked whether they believed women with alcohol and drug problems have differing treatment needs to men. Clinicians responses were compared with various clinician Socio-demographic characteristics (gender, age, ethnicity, professional group, years working in the alcohol and drug treatment field, work setting, qualifications/courses attended, location, and personal alcohol use).Key findings are that almost a quarter (24%) of the clinicians surveyed did not believe that women have different treatment needs to men. However the majority (76%) of clinicians do believe that women have different treatment needs to men. Furthermore findings from this study suggest that significant differences exist in relation to clinicians' practice in new Zealand in relation to clinician, gender, work setting (Crown Health Enterprise, outpatient and residential), and gender mix of caseload

Abstract: This thesis investigates the relationship between language, 'discourse' and professional knowledge and power in a specific context; that of surgical nurses' “talk” about their work managing pain in hospitalised patients. This thesis argues that the work of 'caring for' hospitalised surgical patients who report pain is influenced by discourses which are predicated on different readings/understandings of the body/patient, and from which different knowledge is constructed. Of interest to this thesis are the discourses of biomedicine and nursing, and their role in constructing a particular reality/ies which determine the ways in which surgical nurses talk about their work managing pain. Using the method of critical discourse analysis, the “texts” of transcribed audio-taped conversations with four registered nurses working in surgical specialties were analysed to uncover 'discourses of pain management'. The results of the analysis indicate that the biomedical construction of pain, and approaches to pain management, remain the dominant influence over surgical nurses' practice. There was evidence of nursing discourses with an emphasis on nurse-patient relationships also playing a role. These discourses were critically examined for what they reveal about relations of professional knowledge and power in this specific context of the nurses' practice. The implications for nursing and nursing research are considered significant because the study critically (re)presents a different perspective on, and reality for surgical nurses' pain management practices. In so doing, it elucidates an explanation for, and understanding of, why surgical nurses take care of patients reporting pain in particular ways.