Abstract: The diagnosis of childhood cancer has a profound impact on the family. How nurses understand family affects their practice with families facing the diagnosis of childhood cancerShaped by Heideggerian phenomenology, van Manens methodology for hermeneutic phenomenology was used to construct an understanding of family from the experiences of family members facing the diagnosis of childhood cancer. Seven family members from two families, one mother, two fathers, two siblings, and two grandparents were interviewed about their experience of facing the diagnosis of childhood cancer.From the participants experience the meaning of family was interpreted as being-with-others, for-the-sake-of-others, who one might not distinguish from oneself. This understanding of family is recognisable, yet different from traditional definitions of family and may help nurses and family members to act more thoughtfully and tactfully with each other

Abstract: The focus of this thesis is the practice of the nurses employed in the Native Health Nursing Scheme in New Zealand from 1911 to 1930. These nurses were a vanguard movement for change in community nursing services as they established a new role and developed innovative ways of practicing nursing while claiming greater autonomy and accountability for nurses who worked in community settings. Consequently they contributed to an increase in status for nurses in New Zealand.The Native Health Nursing Scheme was established by the Health Department to replace the Maori Health Nursing Scheme, an initiative by Maori leaders for Maori nurses to provide nursing care for their own people. The original scheme had foundered amid under-resourcing, a lack of support from hospital boards and administrative chaos. Government policy for Maori health was openly assimilationist and the mainly non-Maori Native Health nurses carried out this policy, yet paradoxically adapting their practice in order to be culturally acceptable to Maori.Their work with the Maori people placed the Native Health nurses in a unique position to claim professional territory in a new area of practice. As they took up the opportunities for an expanded nursing role, they practiced in a manner which would develop the scope and status of nursing. The geographical isolation of their practice setting provided the nurses with the challenge of practicing in an environment of minimal administrative and professional support, while also offering them the opportunity for independence and relative autonomy. Obedience, duty and virtue, qualities highly valued in women of the day, were expected especially in nurses. These expectations were in direct contrast to the qualities necessary to perform the duties of the Native Health nurse. The conditions under which these nurses worked and lived, the decisions they were required to make, and the partnerships they needed to establish to be effective in the communities in which they worked, required courage, strength, organizational ability and commitment

Abstract: The Nightingale ethos with its allegiance to the traditional belief in women's responsibility for nurturance, cleanliness and order, aided in the shaping of early formal nursing education in New Zealand

Abstract: The purpose of this research has been to trace the development of the nurse practitioner role in New Zealand. Using a discourse analytical approach informed by the work of Michel Foucault, the study foregrounds the discourses that have constructed the nurse practitioner role within the New Zealand social and political context. The author suggests that discourses of nursing and of medicine have established systems of disciplinary practices that produce nurses and physicians within defined role boundaries, not because of legislation, but because discourse has constructed certain rules. The nurse practitioner role transcends those boundaries and offers the possibility of a new and potentially more liberating identity for nurses and nursing. A plural approach of both textuality and discursivity was used to guide the analysis of texts chosen from published literature and from nine interviews conducted with individuals who have been influential in the unfolding of the nurse practitioner role. Both professionally and industrially and in academic and regulatory terms dating back to the Nurses Registration Act, 1901, the political discourses and disciplinary practices serving to position nurses in the health care sector and to represent nursing are examined. The play of these forces has created an interstice from which the nurse practitioner role in New Zealand could emerge. In combination with a new state regime of primary health care, the notion of an autonomous nursing profession in both practice and regulation has challenged medicine's traditional right to surveillance of nursing practice. Through a kind of regulated freedom, the availability of assessment, diagnostic and prescribing practices within a nursing discourse signals a radical shift in how nursing can be represented. The author concludes that the nurse practitioner polemic has revolutionised the nursing subject, and may in turn lead to a qualitatively different health service.

Abstract: 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 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 carting moments. The pre-conditions, The on-going interaction, and The situated context.The Pre-conditions, which consist of the nurse, personally and professionally prepared to care, and the patient, a person with compromised health and wellbeing, are pre-requisites for the occurrence of the caring process. The nurses 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 on-going 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 Actualised 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 focussed on the discipline of nursing

Abstract: The question for this study arose from the observation that health care often does not match the client's self-determined needs and desires, and hence is wasted care. As a result, the study proposed to discover what elements are involved when women with dependent children make health care choices and what they want in the way of health care.The exploratory study was conducted using strategies of grounded theory. Fourteen in-depth interviews, involving eleven women, were conducted. The selection of participants and of the questions for the interviews was basef on theoretical sampling. Constant comparative analysis and integrative diagramming were used to analyse the data.The theory that emerged from the data was Bonded Caring and its two essential categories; Interconnectedness and Caring. Bonded Caring requires an intimate and ongoing relationship in which there is development of in-depth knowledge of the unique characteristics of the person(s) involved. It is characterised by a strong and enduring effective quality, and by a concern, worry and serious attention to the needs of the person(s) involved. This concern necessitates the gathering of information about the nature of the needs, and making the best possible choices concerning their management.During this research for knowledge and skills needed to carry out health care, women assess their own knowledge and experience; the level(s) of health care needed by each individual; the availability, competence and expected response of the resource person or health care consultant; the perception of risk associated with a health concern; and the family's culture and life style. The women considered these elements within a structural framework of finite material and personal resources. The women juggled the distribution of these resources in a way that allowed them to select the avenues of health care that provided the best degree of safety and protection of development within the context of their circumstances

Abstract: The study explored the basis of the relatively low uptake of cervical screening and practice of breast self-examination among New Zealand women. Consistent with an interpretive approach to social phenomena it was anticipated that part of the explanation would lie in the meanings which women attach in general and to these specific health-protection practices.Theoretical sampling was effected by semi-structured interviews with 45 women. Transcripts of these interviews provided the substance data which were then analysed by the process of constant comparative analysis and other grounded theory strategies for analysis.The concept of a health-protective paradox centered around the core-variable 'vigilance-harmonizing which was generated to reconcile the seeming inconsistencies within, and between, individual women and their health practices. This conceptualisation was developed from the substantive date in order to provide a model designed to increase the effectiveness of nursing interventions for this area. The model, by illuminating processes from the client's perspective then can indicate those processes most suitable for incorporation in effective health education measures designed to promote the uptake of cervical screening and breast self-examination by women.As an adjunct to the study, a breast cancer case history is presented which shows the theory-in-use. The use of this case-history lies in the fact that it shares the substantive area of inquiry which serves to accentuate the viability, relevance and applicability of the grounded theory