Abstract: An exploration of the nature of nursing knowledge in practice. The praxis methodology was inspired by the Newman's theory of health as expanding consciousness and evolved through the process of the research. The methodology was eventually presented as both the process of research and practice. Five families were visited in their homes five times to talk about what was going on for them. All were experiencing a time of great upheaval in family life. After three visits a summary text was constructed merging researcher statements and parent quotes and given to the families. Through the subsequent reflective discussion significant insights into family pattern were shown in statements of intended action to change how health matters were managed with greater facility in family living. The process was presented as five themes with descriptors representing a non-linear, discontinuous progression: A moment of partnership: parameters of entry and closure, a timing of upheaval in family life, and an in-forming capacity through the bringing together of family story-telling and researcher's theory. An evolving dialogue: a progressive flow of enfolding and unfolding, and its embeddedness in contexts of socio-economic status, gender and health care culture. Recognising pattern: incidental revelations and an all-encompassing insight as the potential for action. Expanding horizon: moving from being on a treadmill trapped in the present without vision to having a view to a future, the presence of past and future. Increasing connectedness: a sense of inclusion, inter-dependence and generally, transformation in family life. This was a framework for personal practice

Abstract: This study explores the phenomenon of the relationships between practitioners and families who have a child with a chronic illness. Using a heremeneutic phenomenological method informed by the writings of Martin Heidegger [1889-1976] and Hans-Georg Gadamer [1900-2002], this study provides an understanding of the meaning of 'being in relationship' from the perspective of both families and practitioners. Study participants include ten family groups who have a child with a chronic illness and twelve practitioners from the disciplines of nursing, medicine, dietetics, physiotherapy and speech therapy who work with children with chronic illness. Narrative audio-taped interviewing was the means by which the participants told their stories about times that relationships worked well and when they did not. These stories uncover the every day realities of 'being in relationship' and provide another understanding of the relationship between family and practitioner.The findings of this thesis suggest that chronic childhood illness 'throws' families and practitioners together into a web of relationships that must work for the sake of the child. The relationship is primarily conducted between adults. Children are usually excluded. In order to understand and manage the child's illness, practitioners and families 'go around' and act 'in-between' relationships. While the quality of the relationship from the family perspective is not essential to the chronic illness journey, relationships are more successful when practitioners recognise the uniqueness of each family web. The nature of the relationship is often simple, yet it co-exists with complexity. This thesis proposes that a 'companion relationship' between practitioners and family may offer a more effective and satisfying way of working. It also challenges practitioners to consider the voice of children within health care relationships.