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: The intention of this research is, through collaborative discussion and selective conversations, to explore female caregivers' expectations and perceptions of primary health services for some Te Atiawa Maori children. The research process was developed in a partnership between the Maori women participants and the researcher. In addition, two local kuia actively participated in and supported the process. Emancipatory critical social theory underpinned and informed the project. Power relationships between the researcher and the participants can be overtly explored within this theoretical framework. In terms of this particular exploratory study, participatory research appeared to be applicable. The participants are female caregivers of Te Atiawa children. Data collection was done using group interactions and semi-structured interviews in the winter of the year 2000. A thematic analysis of the data was used, in which common themes were identified, compared and discussed. From the analysis of the data of the participants' conversations, key ideas were identified. The major findings have been identified within two main themes. These are: a concept of health is not the same for Pakeha as for Maori, and access issues are still problematic for the participants in this study. Many quotes from the interview participants are included in order to keep the focus of the project on the voices of the women interviewed. In terms of the significant contribution of this research, this study aims to allow voices of female caregivers of Te Atiawa Maori children to be heard. Individual and collaborative interactions offer insights into what is important to them in terms of Maori child health. Clearly, the primary health initiatives promoted by the New Zealand government are not reaching at least some of the people for whom they are intended. The research participants offered their ideas as to how these deficits could be remedied in their community.

Abstract: Plunket nurses are New Zealand child health nurses who work in the community with the families of new babies and preschool children. Their work is called child health surveillance and this is considered to involve routine and unproblematic practices which are generally carried out in homes and clinics in the context of a relationship with the child's mother (Ministry of Health 1996; Royal New Zealand Plunket Society 1997). However, evidence in the literature that surveillance can have implications for power relations throws doubts on official claims that the relationship between the mother and nurse operates as a partnership (Trout and Polaschek 1996). The purpose of this thesis was to explore the way in which surveillance is constituted within the discourses of Plunket nurses and to examine these discourses for any implications of unequal power relations. Foucauldian discourse theory and poststructuralism, which informed this thesis, provided the opportunity to challenge assumptions about power and knowledge in the child health context. Analysis of the discourses generated by interviews with five Plunket nurses revealed that, contrary to the claims in the official literature, the relationship between the Plunket nurse and the mother is not that of an equal partnership but is constituted in various and unexpected ways. It was through the nurses' discourses of surveillance that the power relations underpinning this relationship were surfaced. While these discourses suggested that many mothers who use the nursing service are actively involved on their own terms, there are a number of women for whom the surveillance activities of the nurse have been shown to be particularly intrusive (Mayall 1986; Clinton 1988; Bloor and McIntosh 1990; Knott and Latter 1999). It may be primarily this unwelcome surveillance which accounts for the considerable number of women who, the statistics show, cease using Plunket services particularly in the early months. It is perhaps for this reason that the nurses in this study locate themselves as being caught between divergent discourses of support and surveillance. Findings indicate that the resolution of this dilemma by abandoning surveillance practices might improve maternal satisfaction with the Plunket nursing service. The author concludes that a child health service responsive to mothers' stated needs rather than institutional requirements or the nurse's own agenda could lead to a more open and equal relationship between mother and nurse. This relationship would be likely to benefit mothers and babies and, at the same time, enhance both nursing practice and nurses' satisfaction with their work.

Abstract: Reports the findings of health professional's perceptions of beneficial care for seriously ill children and their families. Represents one component of a PhD qualitative evaluation study investigating care provided by a child health trust in NZ. Uses a focus group to identify key aspects of beneficial care and subsequent themes, including: collaboration between health providers, effective communication, expert skills, support for colleagues and after-hours care. availability.

Abstract: This research aimed to assess the evidence for benefits and risks of positive pressure mechanical valve (PPMV) intravenous access ports on central nervous system devices (CVADs) in children. PPMVs on CVADs have been promoted as preventing occlusion and the need for heparin flushing. A search for primary research to March 2010 was conducted using MEDLINE, EMBASE and CINAHL. There is sufficient evidence that some models of PPMV intravenous access ports on CVADs, when flushed with normal saline, are associated with increased bloodstream infections in children. Further research is required.