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

Abstract: The purpose of this thesis has been to explore the discursive production of delirium in people over the age of 65 years. The philosophical approaches underpinning the study were derived from the field of critical gerontology, postmodernism and the utilisation of a Foucauldian understanding of discourse and power/knowledge. Data sources included published documents on delirium, interviews with people over the age of 65 years who had been delirious (as well as their clinical notes), family members, registered nurses and a doctor. Textual analysis revealed the presence of two contesting and contradictory discourses that impacted on being an older person who had delirium. These were identified as the discourse of delirium as a syndrome and a personal discourse of delirium. The discourse of delirium as a syndrome is underpinned by the biomedicalisation of the ageing process. This process utilises scientific methods as the foundation from which to understand, research and provide a health service to older people with delirium. Any personal perspectives on delirium are rendered unimportant and relegated to marginalised positions. Nursing through its vicarious relationship to medicine is interpellated into deploying the discourse of delirium as a syndrome and has largely ignored the personal dimensions associated with this phenomenon. Consequently, the older delirious 'body' is known and inscribed as unruly, problematic, physically unwell, cognitively impaired and at risk. Conversely, a personal discourse of delirium privileges the individual narratives of people who have been delirious and provides a different perspective of delirium. The deployment of a personal discourse of delirium offers another position that views this group of older people as bringing to the health care setting a rich tapestry of life experiences that are more than a cluster of signs and symptoms. It is these varied life experiences that need to be included as a legitimate source of knowledge about delirium. This thesis demonstrates how nursing needs to espouse a critical gerontological position when working with older people who have delirium. Critical gerontology provides nurses with the theoretical tools to challenge the status quo and uncover the multiple, varied, contradictory and complex representations of delirium in older people.