Abstract: This paper explores the creative opportunities children might have to attend to their emotions and feelings following the death of a parent, grandparent or close friend. It presents the position that often children are left out of the process of caring for an adult when they are terminally ill and that has long term psychological implications. It also suggests that this has antecedents for the white New Zealand culture that were noted historically. In this research the author describes a personal journey that has shaped her current work as a hospice practice manager. The writer explores literature in psychological aspects of removing children from the dying room, creative therapies and the importance of sacred memories for the living child. The need to create memory that will embrace the child as a cloak enfolds them in their crisis stimulated the writer to offer a text in the personal narrative form. This text is presented in this form to enable other clinicians to access their own memories as survivors of grief in their own families. It is suggested that by enabling children and family to explore the importance of relating in the palliative phase of a person's life journey, good memories are created for the survivors.

Abstract: This study investigated issues surrounding the high numbers of preventable admissions of young children with acute illnesses, particularly amongst Maori and Pacific children. It focuses on what happens once these children are discharged. Its aims were to find out what the expressed needs of parents were, as they cared for their child, once home. Whilst there has been a small amount of international research undertaken in this area, there is little known about expressed parent need in the New Zealand context. This exploratory descriptive study involved parents of under five year old children, who had been admitted to a hospital, with one of five acute illnesses. Eighteen parents were surveyed over the telephone. This study found the parents expressed a need for reassurance and advice once home, and that they worried about their child getting sick again. It highlighted gaps in discharge planning and support. None of the parents had received a written discharge plan for their child. Only five parents had received either a contact number for advice or a referral back to their primary care provider. This study found that whilst some parents considered their discharge needs had been met, others considered that they had not. Four local discharge practice opportunities to support these families were recommended, these included, providing parents and caregivers with an individualised written discharge plan, giving a contact number for advice after discharge, offering a follow-up phone call in the first 48 hours, and ensuring that all children have a referral back to their primary health care provider. Areas for further research were highlighted, including the need for a larger study to explore and compare the needs of rural and urban parents, and Maori and Pacific parents.

Abstract: This study explores the phenomenon of a personal exploratory field visit to HIV programmes in Malawi and how that informs the author's future plans to work cross-culturally with HIV. He uses hermeneutic phenomenology with the guidance of Heidegger and Gadamer, and draw on Ackermann, Hill, Maluleke, Moltmann, and Thielicke for theological direction. This study analyses how personal formation takes place and how the meaning of that experience can inform future cross-cultural interaction. The data of this study is drawn from a range of people interviewing 'me'. This includes a pre and post interview in relation to the author's three week exploratory visit to Malawi, and recorded daily reflections during the visit. Upon return he was interviewed about the experience by ten people from the following areas: nursing, counselling, development, theology, business, medicine, clergy, an Expatriate Malawian, and a women working from a Maori paradigm. These interviews focused on the author's experience with questions framed from the interviewer's specialty area. The transcripts become further data for this study. The findings of this thesis suggest that people wishing to work cross-culturally need to understand their motivation for their work, and understand who they are before entering a foreign land. This transformative journey also needs to continue as part of the process of working with people because we can only be effective with change if we are listening and hearing the other's perspective. It is in being open to this difference between persons that we continue to find ourselves. While perhaps we have a tendency to want to make everybody like us, we can only grow into our full potential in relationship with truly different others. Tensions experienced demonstrate that there is a complex need to understand how the context controls how HIV is perceived. This requires uncovering some of the deeper issues of HIV and culture, and knowing how to conceptualise these in both positive and informative ways. This thesis asks four key questions for the global-co-worker to work through before embarking on cross-cultural mission: 1. How do you know you should go?; 2. How are you going to make a difference?; 3. Who are you going to be?; and 4. What will sustain your involvement? The author's own experience has drawn me into a deeper awareness of the need for a vital connectedness of faith, hope and love underpinning the everydayness of such an experience.

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.

Abstract: The Plunket orientation programme, first implemented in 1994, aims to prepare new Plunket Nurses for autonomous practice within the complexity of community based nursing. This study seeks to identify what new Plunket Nurses feel are their orientation needs. An evaluation research approach was used. An examination of the literature explored how orientation is conducted and the needs of nurses in orientation. Key aspects in relation to orientation were identified as including socialisation, job change, new graduates, preceptorship, orientation frameworks and retention. A focus group followed by a postal survey were utilised to collect data from new Plunket Nurses nationwide to ascertain what they thought their orientation needs were. Data analysis was completed using descriptive statistics and thematic analysis. The results of the study identified key orientation needs for new Plunket Nurses. These were an orientation programme, preceptorship, clinical skills teaching, time in own area and beginning autonomous practice, administration needs and support needs. The participants recommended quality preceptorship and early clinical teaching from the Clinical Educator. There was a general dissatisfaction with orientation as it stands in preparing them for their role as a Plunket Nurse. Recommendations to the Plunket Management Team were made based on the results of this study.

Abstract: This research draws on the experiences of four women whilst they were inpatients at the Mental Health Unit in Southland. The Husserlian path of phenomenology was followed and in-depth interviewing used to collect data. Colaizzi's method of analysis enabled accurate interpretation of transcripts. The overall goal of this research was to provide health professionals with an opportunity to inform their practice, based on what consumers were saying about their experience of hospitalisation. Themes emerged through participants relating their experience by using comparisons with either their outside world or previous episodes of hospitalisation. Through analysis, two fundamental structures became evident within the findings. These were 'the environment as containment' and 'the road to recovery'. The author concludes that this study raises significant issues surrounding the experience of hospitalisation at the Mental Health Unit that have implications for future research and for future service delivery.