Woods, M. (2008). Parental resistance. Mobile and transitory discourses: A discursive analysis of parental resistance towards medical treatment for a seriously ill child. Ph.D. thesis, , .
Abstract: This qualitative thesis uses discourse analysis to examine parental resistance towards medical treatment of critically ill children. It is an investigation of the 'mobile and transitory' discourses at play in instances of resistance between parents, physicians and nurses within health care institutions, and an examination of the consequences of resistance through providing alternative ways of perceiving and therefore understanding these disagreements. The philosophical perspectives, methodology and methods used in this thesis are underpinned by selected ideas taken from the works of Michel Foucault and Pierre Bourdieu and supported by relevant literature in the fields of media, law, children, parenting, caring, serious childhood illness, medicine and nursing. It is argued that from an examination of interview based texts, parental resistance is an omnipresent but transitory occurrence that affects many of the interactions between the parents of seriously ill children and clinical staff. It is maintained that within these interactions, the seeds of this resistance are sown in both critical decision making situations and in everyday occurrences between doctors, nurses and parents within healthcare institutions. Contributing factors to parental resistance include the use of power games by staff, the language of medicine, forms of symbolic violence, the presence or absence of trust between parents and medical staff, the effects of medical habitus, and challenges to the parental role and identity. Overall, it is proposed in this thesis that parents who resist treatment for their seriously ill child are not exceptions to the normative patient-physician relationship.
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Litchfield, M., & Laws, M. (1999). Achieving family health and cost-containment outcomes: Innovation in the New Zealand Health Sector Reforms. In Cohen,E. & De Back,V. (Eds.), The outcomes mandate: New roles, rules and relationships. Case management in health care today (pp. 306-316). St Louis: Mosby.
Abstract: The chapter presents the research findings of the 1992-1993 Wellington Nurse Case Management Scheme Project as a distinct model of nurse case management, which introduced a role and form of practice of a family nurse and a diagram of the service delivery structure required for support and relevant for the New Zealand health system reforms.
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Litchfield, M. (2005). The nursing praxis of family health. In Picard, C & Jones, D., Giving voice to what we know (pp.73-82). Boston, Massachusetts, USA: Jones & Bartlett.
Abstract: The chapter explores the process of nursing practice and how it contributes to health, derived from research undertaken in New Zealand. It presents the nature of nursing research as if practice – the researcher as if practitioner – establishing a foundation for the development of nursing knowledge that would make a distinct contribution to health and health care. It includes the philosophy and practicalities of nursing through the use of a case study of nursing a family with complex health circumstances.
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Stewart, A. (2000). When an infant grandchild dies: Family matters. Ph.D. thesis, , .
Abstract: This research undertaken by a nurse working with bereaved families, aimed to explore how grandparents, parents and health/bereavement professionals constructed grandparent bereavement when an infant grandchild died unexpectedly. The 26 participants, living in New Zealand and the United Kingdom, included 16 grandparents and 6 parents from 11 families, in addition to three health/bereavement professionals. A constructivist inquiry informed by writings on nursing, storying and postmodernism was used. Through an exploration of the methodological and ethical issues that arose and were addressed during the study, this work adds to knowledge of how constructivist inquiry can be used in nursing and bereavement research. In addition, the context of this research as a partnership with multiple family members contributes to the ongoing debate about whether participation in bereavement research may be harmful or therapeutic. Conversations in this research formed a series of interviews and letters, which led to the development of a joint construction and each individual's story. A grandchild's death was constructed as a challenge which grandparents faced, responded to and then managed the changes that arose from the challenge. The context of their bereavement was seen as underpinned by their relationship as “parents of the adult parents” of the grandchild who died. This meant that grandparents placed their own pain second to their wish to support and “be with” the parents. Outside the family was where many grandparents found friends, colleagues or their community forgot, or chose not to acknowledge, their bereavement. This work shows how some grandparents help to create a space within the family which maintains a continuing relationship with the grandchild who died.
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Chenery, K. (2001). 'Can mummy come too?' Rhetoric and realities of 'family-centred care' in one New Zealand hospital, 1960-1990. Ph.D. thesis, , .
Abstract: This study explores the development of 'family-centred care' in New Zealand as part of an international movement advanced by 'experts' in the 1950s concerned with the psychological effects of mother-child separation. It positions the development of 'family-centred care' within the broader context of ideas and beliefs about mothering and children that emerged in New Zealand society between 1960 and 1980 as a response to these new concerns for children's emotional health. It examines New Zealand nursing, medical and related literature between 1960 and 1990 and considers both professional and public response to these concerns. The experiences of some mothers and nurses caring for children in one New Zealand hospital between 1960 and 1990 illustrate the significance of these responses in the context of one hospital children's ward and the subsequent implications for the practice of 'family-centred care'. This study demonstrates the difference between the professional rhetoric and the parental reality of 'family-centred care' in the context of one hospital children's ward between 1960 and 1990. The practice of 'family-centred care' placed mothers and nurses in contradictory positions within the ward environment. These contradictory positions were historically enduring, although they varied in their enactment.
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Dickinson, A. R. (2004). Within the web: The family/practitioner relationship in the context of chronic childhood illness. Ph.D. thesis, , .
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.
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Litchfield, M. (1992). The nation's health and our response. (Vol. Keynote address at the 1992 NERF/NZNZ National Nur).
Abstract: An analysis of the challenges for the nursing profession of the Government's health reforms. The findings of the 10-month Wellington Nurse Case Management Project 1991-1992, including the description of family nursing practice, what it achieved for health and the service delivery model that would position family nurses in the health reforms were used to provide an exemplar for the nuyrising contribution to health policy for the health reforms. The paper identified a vacum for the reorientating of health care provision to patients/clients and health need and the call to nursesw to take leadership in goving direction to the reorientation.
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Davidson, L. (2000). Family-centred care perceptions and practice: A pilot study.
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McNamara, N. (2007). The meaning of the experience for ICU nurses when a family member is critically ill: A hermeneutic phenomenologcial study. Ph.D. thesis, , .
Abstract: This study provides insight into the experience of being an ICU nurse and relative of a critically ill patient. Analysis of data from interviews of four ICU nurses who had experienced having a family member admitted to ICU brought up several themes. These included: a nurses' nightmare, knowing and not knowing, feeling torn, and gaining deeper insight and new meaning. Recommendations for organisational support for ICU nurse/relatives, and education for staff are made, based on the findings.
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Lichfield, M. (1974). The paediatric nurse and the child in hospital. New Zealand Nursing Journal, 67(11).
Abstract: A paper intended to inform paediatric nurses and influence service policy and management, adapted from a presentation at an inservice education study day for nurses at Wellington Hospital. The paper grew out of the findings of a small research project undertaken by the author as part of nursing practice in a paediatric ward of Wellington Hospital. The observations of the stress in the experience of infants and parents and the ambiguities inherent in the relationships between parents and nurses were the basis for arguing for changes in nursing practice and ward management.
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Chenery, K. (2004). Family-centred care: Understanding our past (Vol. 20).
Abstract: Oral history accounts of the care of the hospitalised child in the context of family are used to argue that current practice paradoxes in family-centred care are historically ingrained. The article looks at the post-war period, the intervening years, and current practice, centred on the changing concept of motherhood throughout that time. The conflict between clinical expediency versus family and child needs is explored.
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Chadwick, A., & Hope, A. (2000). In pursuit of the named nurse. Australasian Journal of Neuroscience, 13(4), 6–9.
Abstract: This paper outlines the project outcomes, benefits, impact and constraints of introducing the named nurse concept to a neuro-services department. The concept of the named nurse was first introduced in the UK, in 1992, with the aim of supporting the partnership in care between the patient and the nurse. The evidence for the effectiveness of introducing the named nurse concept is largely anecdotal. In line with the hospital wide policy of implementing the named nurse concept at Auckland Hospital, a six-month pilot study was undertaken within the Neuro-services Department. The aims of the study were to foster a partnership in care with patients / whanau and the multidisciplinary team, to improve the efficiency and effectiveness of delivery of nursing care, and to contribute to continuous quality improvement. The results highlighted that, in theory, the named nurse concept would be effective in providing quality co-ordinated care, however factors were identified that hindered the effectiveness of its implementation. Therefore, further development of the concept was required.
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Crawford, R. (2001). Nutrition: Is there a need for nurses working with children and families to offer nutrition advice? Vision: A Journal of Nursing, 7(13), 10–15.
Abstract: Using nursing and associated literature, the relevance of nutrition in the care of children and families is highlighted in this article. The role of a nurse in providing nutrition advice and interventions is examined, in the context of social and economic pressures on the provision of a healthy diet. Relevant examples of the provision of such advice is provided, along with competencies required to achieve this in practice.
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Wright, R. (2001). Linking theory with practice. Kai Tiaki: Nursing New Zealand, 7(2), 14–15.
Abstract: This article describes the care of a brain-dead intensive care unit patient. The human caring theory of Jean Watson is used to interpret the interactions between family, patient and nurse in this case study. Watson's concepts of care are examined as they relate to each stage of caring for the patient and his family.
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Ward, J. (2001). High acuity nursing. Vision: A Journal of Nursing, 7(12), 15–19.
Abstract: This article looks at the role of technology in nursing, and the interaction between it and human compassion and caring. The interface between critical care technologies and caring is explored, along with the social and political issues facing critical care areas.
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