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Blanchard, D. L. (2006). Developing the place and role of family within the culture of critical care nursing: An action research approach. Ph.D. thesis, , .
Abstract: This research examines how nurses negotiate the context of the Intensive Care Unit (ICU) while working with families. The action research described in this thesis developed through a series of meetings and conversations where the conversations supported the reflexive intent of the research. In commissioning the research, the design of the meetings and conversations were as a series of overlapping actions. Data collection and data analysis occurred in the action research by meetings, reflective conversations, ad libitum observations, and in a research journal. Conceptual maps explain the progress and findings of the research in this thesis while categories distilled from the conversations also support the findings in the research. The Family Action Research Group that was established within this project proposed a Family Assessment Form for the family to provide an assessment of themselves and the patient. Implementing this assessment tool demonstrated that clear information was needed for the family in the ICU. Findings in this research focus on developing action research and family care in ICU. Findings also focused on the role of the researcher being of and not being of the context where action research is undertaken. Recommendations include staff examining relationships for potential asymmetries and seeking ways to address these to support families and staff. Suggested strategies for developing action research in a clinical context include detailed planning, clear focusing, transparency of data, and working to explain change initiatives through the research are also included.
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Desmond, N. (2007). Aspects of nursing in the general practice setting and the impact on immunisation coverage. Ph.D. thesis, , .
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Garlick, A. (2006). Determined to make a difference: A study of public health nursing practice with vulnerable families. Ph.D. thesis, , .
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Crawford, R. (2000). An exploration of nurses' understanding of parenting in hospital. Ph.D. thesis, , .
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Connor, M. (2004). Courage and complexity in chronic illness: Reflective practice in nursing. Wellington: Daphne Brasell & Whitireia Publishing.
Abstract: This book presents the reflective account of an actual nursing practice situation (a woman living with chronic asthma).The author provides a descriptive narrative and then delves deeper into the narrative to obtain greater understanding of what she calls “strife” in chronic illness and the best nursing practice to assist its resolution.
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Marlow, S. A. (2007). A voyage of grief and beauty: A phenomenological study of the experience of supporting a family member with an intellectual disability who is dying in a community setting. Ph.D. thesis, , .
Abstract: This thesis reports on a research project which explored the phenomenon of supporting a family member with an intellectual disability who is dying in a community setting. The research purpose was to enhance professional understanding of what it is like to encounter this lived experience. Literature back-grounding the phenomenon and philosophical and theoretical constructs embraced by the researcher are outlined. An explanation is given of the hermeneutic phenomenological methodology which was utilised. The main method of collecting research data was through conducting five open-ended interviews with participants who had supported a dying child or sibling. The participants' family members were aged between 3 and 52 years old at the time of their deaths. Their specific intellectual disabilities included Down syndrome, a metabolically induced disorder and a non-identified syndrome. The family members had died from a variety of terminal illnesses and in a range of community settings. Interpretive analysis was achieved through reflexive journaling and hermeneutic intuiting of interview transcripts and field notes. The research findings have been subjected to rhetorical consideration in the light of further literature and poetic texts. Research findings are expressed metaphorically as groups of boulders representing themes and sub-themes. Three major themes were revealed as having impacted on the river voyage shared by participants and their dying family members. These were Interlocked Companionship, Search for New Balance and Permeable Interaction. An assessment is offered of the strengths and weaknesses of the research project. The thesis concludes with recommendations for reflective practice, evidence based practice, service development and areas of future research.
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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.
Keywords: Nurse-family relations; Chronically ill; Children
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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.
Keywords: Intensive care nursing; Nurse-family relations
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Moke, K. (2019). Finding the balance: Family inclusive practice in adult community mental health. Master's thesis, University of Otago, Dunedin.
Abstract: Explores family-inclusive practice in Adult Community Mental Health in a District Health Board. Focuses on what adult community mental health nurses and clinical managers consider to be barriers and facilitators to family-inclusive practice. Explores community mental health nurses' and clinical managers' perspectives of family-inclusive practice through semi-structured interviews using a descriptive qualitative design.
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Roberts, C. (2007). The influence of nursing culture on family visiting in adult intensive care units. Ph.D. thesis, , .
Abstract: This dissertation considers the implications of the relationship between nurses and the patient's family, when family members visit intensive care units (ICUs) following the acute admission of a relative there. In particular it explores the issues of power and control, nurses might have in this setting, the culture that supports that, and the implications this has for practice in the New Zealand context. A comprehensive literature review on the perspective of nurses in relation to relatives visiting adult intensive care units was conducted. The author concludes that nurses modify policies related to visiting access for family members to suit themselves, and the needs of their patient. Nurses use a variety of tactics to maintain a position of power and control by looking out for themselves first, their patient second, and relatives third. The need of the patient and their families is not well understood by nurses, and nurses feel they have inadequate skills to cope with the needs and stresses of visiting relatives. The author suggests that for nurses to provide family focused care in ICU they must develop a therapeutic relationship with all concerned. ICU nursing culture affects nurses ability to focus on caring for their patients and their families. Nurses in ICU appear to need to maintain power and control over their environment but further research is needed to identify the current situation in New Zealand ICUs.
Keywords: Intensive care nursing; Nurse-family relations; Culture; Nursing
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Cleaver, H. (2005). Reflections on knowing, not knowing and being in palliative care nursing. Ph.D. thesis, , .
Abstract: The author notes that responses to questions from dying people and their families are as individual as each nurse, patient, family member, or situation. This is well recognised and an unspoken truth in palliative care practice. This paper explores the subjective nature of knowledge in palliative care generated through capturing moments of practice and subsequent reflections. This demonstrates how the author uses her model of care to open a space that enables the person and their family to find meaning from their experience and articulate what they need at the time. The author identifies her interest in the paradoxical reality of knowing and not knowing and describes how that paradox contributes to her role in supporting individuals' needs within their realities.
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Fahey, M. (2003). Family centred care in the newborn intensive care unit: Creating a supportive environment. Ph.D. thesis, , .
Abstract: The environment of the Newborn Intensive Care Unit (NICU) is a stressful one for families and is often designed to provide technical care for the infant rather than facilities that would enable and support parental and family participation in infant care. Furthermore, the author notes that the environment of the NICU emerged in literature as an obstacle to meaningful family involvement in care. However, she goes on to say that a philosophy of Family Centred Care in the NICU can offer a framework of care that supports family involvement in the infant's care and family presence in the NICU. It also promotes parental participation in decision-making for the infant and gives recognition to the importance of perspectives provided by the family. This dissertation explores the difficulties associated with the practice of Family Centred Care in the environment of the NICU. It offers recommendations for features of unit design that can promote Family Centred Care by supporting and sustaining the presence of families in the NICU and therefore facilitating their involvement in the care of their infant.
Keywords: Intensive care nursing; Infants; Nurse-family relations
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Hall, J. (2004). Building trust to work with a grounded theory study of paediatric acute care nurses work. Ph.D. thesis, , .
Abstract: Grounded theory methodology has guided the grounded theory methods used to explore the acute care paediatric nurses' perspective of what they do when a child has had a severe accident. The research was initiated from the experience of nursing children in the context of a rehabilitation centre and wondering how acute care nurses promoted a child's recovery after a severe unintentional injury. Many avenues were used to search international and New Zealand literature but the scarcity of literature related to what acute care paediatric nurses do was evident. Nursing children in the acute care ward after a severe accident is complex. It encompasses nursing the family when they are experiencing a crisis. It is critical that the acute care nurse monitors and ensures the child's physiological needs are met, and the nurse “works with” the child to maintain and advance medical stability. Nursing interactions are an important part of “working with”, communication is the essence of nursing. This research has focussed on the nurses' social processes whilst caring for the physical needs of the child and interacting with the family and multidisciplinary team when appropriate. An effective working-relationship with a nurse and family is founded on trust. Grounded theory methods supported the process of exploring the social processes of “building trust” whilst “working with” families in a vulnerable position. Nurses rely on rapport to be invited into a family's space to “work with” and support the re-establishment of the parenting role. The “stepping in and out” of an effective working-relationship with a family is reliant on trust. Nurses build trust by spending time to “be with”, using chat to get to know each other, involving and supporting the family to parent a “different” child and reassuring and giving realistic hope to help the child and parents cope with their changed future. A substantive theory of the concept of “building trust to work with” has been developed using grounded theory methods. The theory has been conceptualised using the perspective of seven registered nurses working in paediatric acute care wards that admit children who have had a severe traumatic accident.
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McClunie-Trust, P. (2000). Body boundaries and discursive practices in life threatening illness: Narratives of the self. Ph.D. thesis, , .
Abstract: This thesis tells a story from within and between the boundaries of my professional work as a nurse and my private life as the wife of a patient with life threatening illness. The events related in the thesis are told using a technique I have called writing back to myself, where my own journals and stories of the experience of living with life threatening illness provide data for analysis. The reader is invited to participate in these representations and to consider the potential for the skilful practice of nursing which may be read in the stories, and the analysis I have developed from them. I have developed the theoretical and methodological positionings for the thesis from the work of Foucault (1975,1979,1982,1988), Deleuze (1988), Ellis (1995), Richardson (1998) and other writers who utilise genealogical or narrative approaches. The analysis of my own stories in the thesis explores the philosophical and contextual positionings of the nurse as a knowledge worker through genealogies of practice and the specific intellectual work of the nurse. Local and contextual epistemologies are considered as ways of theorising nursing practice through personal knowledge, which is surfaced through the critical analysis of contextual positionings and the process of writing as inquiry.
Keywords: Nurse-family relations; Nursing; Ethics
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