Shoulder dystocia is an obstetric emergency which can result in significant maternal and neonatal morbidity, and in some cases perinatal death. It is an unpredictable event which causes stress and trauma for all concerned. Widely accepted and current management of shoulder dystocia involves performing a set of manoeuvres described in the HELPERR mnemonic, which are taught in emergency obstetric training sessions. This qualitative interpretive study presents a descriptive and hermeneutic analysis of the narratives of five clinicians who have significant experience in the management of shoulder dystocia. The qualitative descriptive approach is informed by the work of Sandelowski and it incorporates a hermeneutic ‘hue’ influenced by the work of Heidegger. This approach allowed themes to be identified from straight description. The data was then further analysed using the hermeneutic approach, to bring forth the richness and meaning of the participants’ experiences. This research approach facilitated a comprehensive analysis of the data. The findings of this research are that the management of shoulder dystocia has been influenced by HELPERR, so that practitioners most commonly follow the sequence of the mnemonic, despite the fact that some of the manoeuvres are difficult to perform or remember. Alongside this, the research shows that through their experiences, practitioners have discovered by ‘accident’ the manoeuvre of axillary traction. They find this manoeuvre not only more effective, but easier to perform in any circumstance. Another important finding of this research is that there are improved neonatal outcomes when axillary traction is the method of choice for resolving shoulder dystocia. In addition, the research highlights that practitioners who are involved with shoulder dystocia, particularly when the outcome is poor, are at risk of suffering post-traumatic stress and psychological damage, which can result in loss of the practitioner from the profession. In these ways, this research has contributed to the body of knowledge of shoulder dystocia, and more importantly, provides an alternative and effective strategy for managing shoulder dystocia.

Shoulder dystocia is an obstetric emergency which can result in significant maternal and neonatal morbidity, and in some cases perinatal death. It is an unpredictable event which causes stress and trauma for all concerned. Widely accepted and current management of shoulder dystocia involves performing a set of manoeuvres described in the HELPERR mnemonic, which are taught in emergency obstetric training sessions. This qualitative interpretive study presents a descriptive and hermeneutic analysis of the narratives of five clinicians who have significant experience in the management of shoulder dystocia. The qualitative descriptive approach is informed by the work of Sandelowski and it incorporates a hermeneutic ‘hue’ influenced by the work of Heidegger. This approach allowed themes to be identified from straight description. The data was then further analysed using the hermeneutic approach, to bring forth the richness and meaning of the participants’ experiences. This research approach facilitated a comprehensive analysis of the data. The findings of this research are that the management of shoulder dystocia has been influenced by HELPERR, so that practitioners most commonly follow the sequence of the mnemonic, despite the fact that some of the manoeuvres are difficult to perform or remember. Alongside this, the research shows that through their experiences, practitioners have discovered by ‘accident’ the manoeuvre of axillary traction. They find this manoeuvre not only more effective, but easier to perform in any circumstance. Another important finding of this research is that there are improved neonatal outcomes when axillary traction is the method of choice for resolving shoulder dystocia. In addition, the research highlights that practitioners who are involved with shoulder dystocia, particularly when the outcome is poor, are at risk of suffering post-traumatic stress and psychological damage, which can result in loss of the practitioner from the profession. In these ways, this research has contributed to the body of knowledge of shoulder dystocia, and more importantly, provides an alternative and effective strategy for managing shoulder dystocia.

Shoulder dystocia is an obstetric emergency which can result in significant maternal and neonatal morbidity, and in some cases perinatal death. It is an unpredictable event which causes stress and trauma for all concerned. Widely accepted and current management of shoulder dystocia involves performing a set of manoeuvres described in the HELPERR mnemonic, which are taught in emergency obstetric training sessions. This qualitative interpretive study presents a descriptive and hermeneutic analysis of the narratives of five clinicians who have significant experience in the management of shoulder dystocia. The qualitative descriptive approach is informed by the work of Sandelowski and it incorporates a hermeneutic ‘hue’ influenced by the work of Heidegger. This approach allowed themes to be identified from straight description. The data was then further analysed using the hermeneutic approach, to bring forth the richness and meaning of the participants’ experiences. This research approach facilitated a comprehensive analysis of the data. The findings of this research are that the management of shoulder dystocia has been influenced by HELPERR, so that practitioners most commonly follow the sequence of the mnemonic, despite the fact that some of the manoeuvres are difficult to perform or remember. Alongside this, the research shows that through their experiences, practitioners have discovered by ‘accident’ the manoeuvre of axillary traction. They find this manoeuvre not only more effective, but easier to perform in any circumstance. Another important finding of this research is that there are improved neonatal outcomes when axillary traction is the method of choice for resolving shoulder dystocia. In addition, the research highlights that practitioners who are involved with shoulder dystocia, particularly when the outcome is poor, are at risk of suffering post-traumatic stress and psychological damage, which can result in loss of the practitioner from the profession. In these ways, this research has contributed to the body of knowledge of shoulder dystocia, and more importantly, provides an alternative and effective strategy for managing shoulder dystocia.

Thesis advisor: Chris Lee / Empathy is a vital element in the formation of meaningful and trusting relationships between nurses and patients. Studies indicate that empathetic providers promote both increased patient satisfaction and better health outcomes for patients. Given the significance of empathy, what stood out is the gap in knowledge regarding the meaning of empathy from the perspective of senior baccalaureate nursing students just prior to entering the health care context as registered nurses. The purpose of this study was to understand the meaning of empathy, in the context of clinical nursing practice from the perspective of senior baccalaureate nursing students. A hermeneutic phenomenological approach was used in the research analysis. The key research questions were: What is the meaning of empathy in the context of clinical nursing practice among senior baccalaureate students? How does clinical nursing practice shape and nurture empathy for senior baccalaureate nursing students? The researcher anticipates this study to be the first, which delineates the meaning of empathy in the context of clinical nursing practice among senior baccalaureate nursing students. Three essential themes surfaced during analysis, discovering every patient is a human person, empathy helps patients feel visible, heard and understood, and empathy breaks through bias towards patients. The results also suggest that clinical nursing practice among undergraduate nursing students shapes and nurtures empathy. / Thesis (PhD) — Boston College, 2022. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

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This study presents a qualitative analysis of six accounts of focusing, a method of embodied reflection. Six expert practitioners were interviewed, and each participant`s account was brought under two rounds of analysis. First, a modified descriptive phenomenological analysis was performed on a portion of the interview in which the participant described a particular focusing experience. This was followed by an interpretive phenomenological analysis of the participant`s interview as a whole. Analyses resulted in the identification of explicit and implicit themes that were constitutive of focusing experiences across participants. Several themes that were identified include: the importance of social support and validation for experiences that depart from the norms and values of materialist culture, the exquisite gentleness and receptivity of the focusers` attitude toward their experiences, and the dialogical qualities of the practice. The details and significance of the dialogue, which is a synesthetic exchange between the focuser and responses arising in her perceptual field, is explored in the discussion. Attention is paid to the fluid and at times ambiguous self-other experience suggested by the dialogue, and an archetypal framework for interpreting this dialogue is introduced. Additionally, the two phenomenological methods employed are reviewed and compared for their relative merit in the study of focusing. / McAnulty College and Graduate School of Liberal Arts / Clinical Psychology / PhD / Dissertation

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No description available.

This practiced-based thesis examines how a new Visual Communication methodology helps interaction designers to improve their future designs. This is achieved by engaging in creating visual interpretations from a lived experience that they need to design for, to reveal the phenomenological essence of what users have actually experienced, rather than what they say they have. This new Visual Phenomenological Methodology (VPM) places interaction designers into a specific communicational situation, in order to understand the phenomena of users’ lived experience ‘through their eyes.’ Thus immersed, interaction designers montage visual interpretations of what users saw/felt/did in the lived experience. The VPM facilitates interaction designers into designer-interpreters, who can interpret sensory data into a behavioural story of what its like to be the user in a lived experience. This thesis has developed the VPM across three peer reviewed, practice-based projects, using a synthesis of the pragmatic semiotics of Peirce, Hermeneutic Phenomenology, and visual communication techniques. Following the Frascaran view that the design discipline of Visual Communication (graphic design and illustration) is a positive facilitator of behavioural change, the VPM employs this hermeneutic-semiosis synthesis to facilitate interaction designers to develop a deeper and emergent understanding of the hidden motivations behind user behaviour. Through a contextual review into Visual Communication, Interaction Design, Phenomenology and Semiosis, this thesis develops the VPM from a theoretical concept, to a set of designer-friendly method cards that interaction designers can employ during their ideation phase. Throughout its development the VPM and its method cards were workshopped and peer reviewed by interaction designers. This thesis, over the following seven chapters, demonstrates how the VPM successfully provided Visual Communication design with a fresh way to re-influence Interaction Design, as a new contribution to knowledge.

The relationship between teacher and student has always been a central interest of the educational process. While the nature of this relationship can be understood from various theoretical frameworks, research that seeks to understand the “lived experience” of this relationship is less prevalent. This research explores the phenomenological nature of the teacher-student relationship in the context of teacher education. Stories of the lived experience of this relationship were hermeneutically interpreted against the philosophical writings of Heidegger, Gadamer, and Buber. The research answers the question: what is the meaning of the teacher-student relationship? Relationships are essential to the educational experience whether this is recognised or not, and whether we are consciously aware of this or not. Once established, relationships continue to exist beyond the time and space of the individuals influencing future relational experiences. In addition, a teacher’s comportment has been found to have a communicative aspect that is felt and sensed by others. A further essential understanding opens the play of relating. That is, the teacher and student experience their relationship as a play that is unscripted, uncertain, and lived beyond the rules of engagement. In this play, teachers who are attuned to relationship show a phronesis, or practical wisdom, as they relate moment by moment. The outcomes of this research call into question technicist and instrumental models of teacher education which are presently underpinned by the dominant neoliberal ideology. Consistent with critical and humanistic approaches to education, this research calls for the humanising of the educational experience through the educating and re-educating of teacher educators and teachers towards essential understandings of relationship.