Abstract: The study reconceptualises the process of nursing practice where health is expanding consciousness. The praxis methodology and design derive from the findings of the previous study (Litchfield, 1993) through which a framework for personal practice was articulated. The philosophical premises were hermeneutic and dialogic reflecting a narrative orientation within a participatory paradigm. Ontology and epistemology merge and language is fundamental. The findings from this subsequent study depict the process of modeling practice as a tetrahedron to show inter-relatedness of four facets, each defined completely by the others: partnership, dialogue, pattern recognition and health as dialectic. Five young families with complex health circumstances were preferred by Plunket Nurses and visited at hole to talk about health and the family. Th e process of health patterning ended with indication of insight as the potential for action; the partnership ended as the closure of the initial contract to provide a summary text to the family. Transformative change in family living was identified. The continuous analysis of the scripts of the evolving conversations and summary text showed the relational, dialogic processes were identified as vision – finding purpose to act in the here-and-now against the backdrop of past and potential of the future; and community – a sense of being connected, participant and relevant in society. This process of research, as if practice, presented health and caring as synonymous and core of the discipline of nursing

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.

Abstract: A review of the current status of midwifery in NZ and potential for its' development

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: It is evident from the prevalence of items in the popular press and incased research by health professional that, over the last two decades, menopause as been discussed more openly. However, medical information is still largely oriented toward menopause as a disease with emphasis on the pharmacological interventions needed to correct the disease. Literature in medical and nursing journals is also predominantly oriented towards menopause as a state of oestrogen, nurse researchers and feminists writers are challenging this viewsThe aim of the research was to discover how women gain knowledge about menopause, and how they make decisions about “managing” their menopause. In the study knowledge was defined as being more than information. It is seen as being more than information. It is seen as understanding derived from synthesis of data about menopause collected from various sources. Eleven women aged 46-55 recruited through a letter in the researcher's local newspaper, were interviewed. The resulting data was analysed by the constant comparison method as used in grounded theory.A descriptive model was developed including the basic social process of “integrating menopause into midlife”. A tertiary level of education and good social support were found to be associated with the women being seekers of knowledge about their menopause. These women, the majority of the participants, revealed themselves as being self-controlling with respect to their menopause. Among the few who had allowed their menopause to be managed by others, if they experienced adverse effects of the treatment, then there was a move toward greater self management.,Generally, nurses were not seen by the participants as possible sources of information. That finding highlights menopause as an area of health education in which nurses have the potential to play a more active role

Abstract: This research project was undertaken with the aim of making teaching and learning processes in the first year of the programme explicit to ensure successful strategies could be replicated and limitations addressed. Action research methodology was utilized to explore which tutors and students the philosophy of teaching, the student/tutor relationship, preferred learning styles and teaching methods, and influences on student learning. Findings elucidated that the philosophy and teaching methods used in the programme were congruent with the goals of the Polytechnic,, the curriculum aims, and current nursing ideologies. Students preferred small group, interactive teaching, did not always rate their ability accurately, and tended to downgrade their ability and did progressively less preparatory work for classes as the year progressed. Factors that impacted on the learning of this mainly mature group were external to the programme and included paid employment, family responsibilities, unexpected life events, lack of time and/or space to study, and financial problems. The research was used to determine the structure of the first year of the 1994 Bachelor of Nursing programme which articulated more clearly the process and pathway for students to become self directed learners. The research process was challenging and provided many useful insights for tutors and students