Ethical decision-making is an integral aspect of gerontic nurses' experiences of caring for nursing home residents and their families. This thesis examines the author's journey into the life-worlds of nine registered nurses working in an Australian nursing home to explore how they manage the ethical problems they encounter in their everyday experience of nursing home life. As a result of interviews, the study revealed that nurses utilized an approach to ethical decision-making not previously described.This approach was identified as being professional, familial, collegial and reciprocal in nature. As an approach to ethical decision-making, respectful relationships is a potential tool for nurses coping with the ethical problems that are an every-day aspect of their professional lives in a nursing home. Respectful relationships can guide nurses' ethical decision-making as they strive to do the right thing / Doctor of Philosophy (PhD)

Job-seeking research has been implicitly an examination of the job-seeking activities of youth. Even at the broader level of the labour market there continues an underlying association of youth with employment while the experiences of mature workers have been largely minimised, especially in New Zealand. This study examines the job-seeking activities and experiences of mature job-seekers in the New Zealand labour market from a political economy perspective.Issues surrounding mature workers have lacked a theoretical and disciplinary "base" with the issues of retirement and health consistently overwhelming any discussion about mature people and employment. The political economy theory of aging does provide a useful explanatory framework given the struggle for recognition and resources of mature workers. The persistent exclusion of mature workers from any discussion about the labour market in New Zealand is a common theme throughout the present study.As mature workers become increasingly "problematised" by economists as a threat to future economic productivity; issues surrounding mature employment need to be better understood because there will be greater proportions of mature workers and mature job-seekers. Through a sample of 947 mature jobs-seekers collected by MESA offices throughout New Zealand, issues surrounding mature job-seekers in particular were examined.The results highlight both the different and similar experiences of men and women in the New Zealand labour market. Women respondents were more likely to present themselves as younger than men, and to be returning to the labour market after family responsibilities with lesser confidence in their job-seeking skills and occupational abilities. Men by contrast presented themselves at MESA as older and more likely to have been made redundant; they also appeared to have more confidence in their job-seeking and occupational skills. Gender, however, did little to explain the primarily formal job-seeking methods used and the effort expended job-seeking. There is little to suggest that job-seeking efforts diminish significantly with age. Only with the final cohort of age 61 years and over, was mean job-search effort significantly less than for other age-cohorts. By contrast the variable time out of work explained much of the variance with job-search peaking at six months out of work. Subsequent analysis strongly supports the suggestion that any policy intervention will have the greatest impact within the first four to six months of unemployment.There is also some evidence to suggest that the reason for becoming a mature job-seeker and the attributions these mature job-seekers make for their unemployment is associated with their job-search efforts. In the present study those mature job-seekers made compulsorily redundant, regardless of age or gender, clearly tried harder than other job-seekers. By contrast those job-seekers who indicated they had been dismissed gave less effort to their job-search.The primary barrier identified by mature job-seekers is silence, silence from employers or employment agencies about why they have not been considered or rejected for work. As a consequence many mature job-seekers interpreted this silence as age discrimination. Understandably mature job-seekers are reluctant to see their lack of skills or experience as contributing to their circumstance and feel disappointed that their skills are not appreciated: a point well highlighted by the qualitative analysis "Trajectory of emotion" that captures the voice of participants in the present study. Finally, paid employment does matter to mature people and future research and policy would do well to examine the full picture of the labour market and give attention to where real needs exist. Mature job-seekers in the present study did not necessarily seek "special" treatment but rather the same opportunities as their chronologically younger colleagues to make a contribution to New Zealand society through paid work.

The residential aged care industry in Australia has been undergoing change on multiple fronts since the introduction of the Aged Care Act 1997. Some of the sources of this change have been new regulatory systems such as accreditation and certification, concerns about financial viability, problems with recruitment and retention of staff, new models of care and increasing acuity of care provided. Facility Managers of aged care homes are at the forefront of managing these changes. In spite of their central position within the industry, there has been almost no research on the general role and functions of Facility Managers and even less that focuses on their role in the management of change. Using a constructivist methodology, this study set out to address this lack of research and to develop a range of practical proposals concerning the management of change in the sector. The research questions the study sought to answer were: 1. How is the role of managing change perceived and understood within the overall role of Facility Managers? 2. How is the role of managing change approached by Facility Managers? 3. How do Facility Managers learn to manage change? 4. Do Facility Managers need to be supported in their efforts to manage change and, if so, how should that support be provided, and by whom? Data for the project came from one-to-one interviews with two groups: a randomly chosen cross-section of Facility Managers and a purposive sample of senior stakeholders within the sector. Thematic analysis was used to draw out patterns and themes in the interview transcripts, and to develop interpretations and connections to the literature. The study found that there is not a clear understanding of how the management of change fits into the role of Facility Managers, and that the management of change is an issue that is in the background of management thinking and practice in the sector. The change management aspects of the Facility Manager's role have been largely ignored or taken for granted. This can lead to stress on the individual manager as well as reducing the effectiveness of the change process. There are many ways that Facility Managers can be better supported in the management of change, and the study presents a number of proposals to help achieve this. These focus on general principles and competencies underlying the management of change, an analytical model of change management, and management development practices supporting the management of change.

This thesis examines how rapid demographic, social and economic changes are impacting on traditional care for the urban aged in China and Japan as both experience world record rates of ageing caused by greater longevity and lower birth rates. The challenge for their governments is to foster active contribution by the healthy aged to society and protection for the frail aged. China lags behind Japan in special treatment for senior citizens. The manner in which these two countries handle the ageing of their populations could provide valuable lessons for Australia in the future.

This thesis examines the menopausal experiences of a non-clinical sample of lesbians living in Australia. Research on menopause to date has largely been conducted from a medicalised and heterosexual perspective: thus lesbians’ experiences remain unknown and invisible. Using a qualitative feminist multiple method research methodology combining content analysis and questionnaire/interview research, two hundred questionnaires were posted upon request to self-identified lesbians living in every Australian state and territory. Follow up in-depth interviews were conducted with twenty lesbians. Responses were grouped into four major themes: body image, sex and sexuality, hormone replacement therapy and health services and homophobia. The findings show that lesbians at menopause face some different and additional issues from those experienced by heterosexual midlife women. For many of the study participants, commonly discussed concerns at menopause such as weight gain and other physical signs of ageing, decreased fertility, lack of libido, sexual difficulties and hormone replacement therapy were of little relevance and importance. Lesbians in this study frequently raised other issues such as the universal assumption of heterosexuality and homophobia experienced when interacting with health professionals, which led to less than satisfactory health care and reinforced feelings of invisibility. In the Conclusion I argue that the study participants' views and experiences challenge negative, stereotypical views of both lesbians and menopause. The data thus add a new dimension to the presently narrow, heterosexist and medicalised view of women at midlife and contribute new knowledge to the body of literature on menopause. This thesis is a first important step in recording the experiences of lesbians regarding menopause in Australia. I include recommendations for further research in the area of lesbian health and improved practice, and discuss old and new obstacles lesbians face in a heteropatriarchal society in which lesbians continue to be invisible.

老年期是人生歷程中的最後一個階段，不但收入減少、開支增多，而且精 神及物質生活皆易成問題。以往在農業社會中，社會變遷遲緩，尚傳統， 重經驗，對老人非常敬重，所以，當時老年人尚沒有太多的問題。可是， 到了今日由於工商業的高度發展與社會各層次的顯著變遷，不僅老年人口 快速的增加，而且其生活素質亦受影響，以致老人問題已演變為世界各國 普遍的問題。中韓兩國近四十年來的社會變遷是相當急遽的，都市化和工 業化的結果使兩國社會中的老人開始體驗地位上的變遷。雖然，老年人在 社會上所享有的地位仍然崇高，而且家庭也還未完全放棄對老年人的照顧 ，但是老年人受社會變遷衝擊的情形已逐漸明顯。因此，中韓兩國老人問 題的嚴重性亦將日益明顯。而欲改善此現象所帶來的問題，並協助老人能 成功地調適其晚年生活，一個追求社會正義與經濟利益均衡發展的老人福 利政策之推動與落實，實屬當務之急。中韓兩國具有相類似的社會條件和 情況以及相同的文化，因此在推行老人福利政策的過程上，若全盤接受西 方國家，似乎不妥，倒是中韓兩國相互參照比較乃最為可行。正因如此， 中韓兩國老人福利政策之比較實在比與其他任何國家的比較更具意義。故 本研究是藉著分析、比較兩國老人福利政策之過去歷史與發展過程及目前 實施的現況，發掘其優點與缺點，並且試著尋覓較合適的未來老人福利政 策之方向。本篇論文共分六章，茲將各章要點分述如下：第一章：緒論， 略述本文研究的目的、研究方法及其範圍。第二章：老人福利政策的理論 基礎，探討對老人問題的基本認識、老人福利政策的意義與基本原則。第 三章：中華民國的老人福利政策，先說明老人福利政策的歷史與其發展過 程，觀察並分析中華民國現行老人福利政策的現況，並找出問題及提示之 。第四章：韓國的老人福利政策，先說明老人福利政策的歷史與其發展過 程，觀察並分析韓國現行老人福利政策的現況，並找出問題，提示之。第 五章：針對第三、四章所分析提示之中韓兩國老人福利政策的現況及問題 ，相互參酌比較，並探討未來老人福利政策的改善方向。第六章：結論及 建義。

Graduation date: 1998

Given the high risk of relapse during the first year of exercise involvement, it is important to determine the processes of self-motivation which enable novice exercisers to become long-term maintainers. This study was designed to extend previous Stages of Change (Prochaska & DiClemente, 1983) research by comparing the Possible Selves (Markus & Nurius, 1986) of individuals at different points within the Maintenance stage of exercise. Participants consisted of female university employees, spouses, and dependents age 35-59 years who volunteered for the study. Participants completed the Stage of Exercise Scale (SOES; Cardinal, 1995) and a self-administered form of the Possible Selves Inventory (Cross & Markus, 1991) which was adapted to address the exercise domain. Women classified by the SOES as being in the Maintenance stage of exercise V=92) were assigned to one of three groups based on the duration of their exercise maintenance (6 months-5 years, 6-10 years, and 11-20 years). The three maintenance groups were compared with regard to the number and category of open-ended and exercise-related possible selves and the self-efficacy and outcome expectancy associated with three focused selves (most important, exercise-related, and exercise-specific). The results indicated that the three maintenance groups did not differ significantly in their possible selves. These findings provide support for the current conceptualization of the Stages of Change Model (Prochaska & Di Clemente, 1983) and suggest that differences between novice and expert maintainers may be behavioral, rather than cognitive, in nature. Several implications for intervention design and suggestions for future research are discussed. / Graduation date: 1998

Although research evidence clearly indicates support surface properties are a major factor contributing to fall risk among the elderly, investigations examining the influence of variations in surface conditions on the postural control of older adults during task performance have been limited. Thus, the primary purpose of the present studies was to determine whether the coordination and control of body kinematics exhibited by older adults during upright leaning (i.e., leaning forward through the region of stability) and gait would be different across variations in support surface properties. Secondary objectives of these studies included, examining if coordination and control measures of body kinematics differed as a function of the participants' level of postural stability and/or repeated exposure to the support surface properties. Three support surface conditions were selected for inclusion based on resistance properties to applied forces (i.e., normal and shear): rigid, high friction; compliant; and rigid, low friction. For both tasks performed, body kinematics for trials 1-3 (T1) and 10-12 (T2) from 12 completed trials on each support surface were analyzed using three-dimensional (3-D) video analyses. Results of separate univariate repeated measures analyses of variance yielded significant surface condition main effects for lower extremity coordination patterns and postural control strategies in the gait and leaning task, respectively. Additionally, a significant surface condition main effect and an interaction effect of surface condition by trial block were identified for the measure of head stability in the gait and leaning tasks, respectively. Differences in head stability and the control of lower extremity joint motions as a function of level of postural stability (i.e., group differences) were observed only during the walking task. Present findings indicate that during goal-directed behavior, the coordinated movements of the body and its segments emerge from constraints imposed by the interaction of the support surface, the task and the individual. The observed adaptations in the coordination and control of posture in response to support surface constraints evidenced in the present studies provide support for the theory of perception and the control of bodily orientation (Riccio & Stoffregen, 1988). / Graduation date: 1998

The purpose of this study was to determine whether women aged 65 and older are wearing sweatshirts and sweatpants for activewear, and, if so, to investigate the types of activities they are worn for, reasons for wearing, feature preferences, and fitting problems. While sweatshirts and sweatpants have been popularly worn by younger generations, there is little published research on their wear by the elderly. A convenience sample of 222 female members aged 65 and older taken from 34 Family and Community Education (FCE) extension study groups within four counties in the Willamette Valley of western Oregon was used in the research. A questionnaire-survey was administered at FCE meetings to provide quantitative and qualitative data. Eighty-three percent or 185 participants affirmatively answered to wearing either sweatshirts, sweatpants, or both garments of sweats attire. The largest percentage of respondents (43%) reported they "Usually wear sweatshirts and sometimes wear sweatpants". Activities with the highest frequency cited by respondents for wearing sweats attire included (in descending order): (a) exercise, (b) home-based indoor activities and situations, and (c) outdoor activities and situations. During the winter, 79% of the participants wore sweats attire frequently (a minimum of 2-3 times per week). Extremely important reasons cited for wearing sweats attire were "Warmth" and "Easy to care for or launder". The most highly desired features in sweats attire included: pullover sweatshirts with raglan sleeves, sweatpants with an elastic waistband and pockets, medium thick/medium weight, cotton/manufactured fiber blends, fleece interior, and muted colors that hide soil. Clothing size was more frequently related to these preferences than health status or age. Excess lengths of sleeves and pant legs, and tight, high necklines were the most frequent fitting problems cited. ANOVA and Newman-Keuls Multiple Comparison Procedure were used to analyze relationships. Poor health status and increased fitting problems showed a statistically significant relationship at p���.01. Sweats attire provoked either very positive or very negative written comments. Non-wearing participants reacted negatively to the appearance and warmth of sweats attire, whereas, wearing-participants reacted strongly to benefits of comfort and warmth. Practical for lifestyle and easy manageability when dressing and undressing were also high considerations for positive respondents. Additional uses cited by respondents for sweats attire included sleepwear. The findings imply that sweats attire is frequently worn by active, older Oregon women for casual, familiar activities, situations, and environments. Also implied is the need for manufacturers and retailers to recognize the diversity of this heterogeneous population. Stereotypical images and clothing styles can be challenged to address the elderly population's needs for clothing comfort and current style, while offering functionality with such special features as extra pockets; shorter lengths with adequate torso ease; wider, lower necklines for postural changes; light weight fabrics with warmth; and easy-care finishes. / Graduation date: 1995