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Thesis (Ph.D.)--University of Wollongong, 2004. / Typescript. Includes bibliographical references: leaf 216-231.

A quasi-experimental design was used in this study to determine if guided practice would result in higher breast cancer knowledge scores, higher breast self-examination (BSE) knowledge scores and higher intent to practice scores then modeling alone or teaching without modeling or guided practice. Fifty-eight women participated in the study. There were 19 women in the guided practice group, 22 in the modeling group and 17 in the control group. A pre-test, post-test format was used. ANCOVA was used to statistically control for the variance in pre-test scores. Descriptive statistics were used to analyze demographic data. The results showed that all methods of teaching resulted in higher breast cancer and BSE knowledge scores and in higher intent to practice scores. There were no statistically significant differences between the groups. Nursing research need to continue in this area to find the most effective method of teaching women breast self-examination.

In recent years there have been a number of pieces of research published which suggest that the phenomenon of self-harm in adolescence is increasing (Hall & Place, 2010, Beauchaine et al.,2014, Garcıa-Nieto et al., 2015). Heath et al., (2006) found that a majority of school teachers shared this view. In their study, 74% of teachers reported a first-hand encounter with self-injury. The subject of self-harm is also receiving more media coverage in mainstream newspapers and magazines (Dutta, 2015 & Money-Coutts, 2015), suggesting a rise in public consciousness about mental health issues such as self-harm. The extent of mental health problems amongst adolescents has also been publicly acknowledged by the Department of Health, who state that “Over half of mental health problems in adult life (excluding dementia) start by the age of 14 and seventy-five per cent by age 18” (2015:9). Research into adolescent self-harm has suggested that the most likely age for adolescents to commence self-harm is within the 10-15 years age bracket (Garcıa-Nieto et al., 2015 & Hanania et al., 2015) demonstrating that many adolescents are self-harming at an age where they are expected to be in school for the majority of their time. However, in studies of teachers, a ‘patchy' awareness of self-harm has been demonstrated (Best, 2005a; 2005b), and a lack of ability to know how best to deal with the situation, should it present itself, has been acknowledged by teachers in a number of research articles (Hall & Place 2010; Heath et al. 2006 and Kidger et al., 2010). This issue was discussed further in my Critical Analytical Study (Margrett, 2014). This study is guided by two main questions; firstly, “what are the experiences of independent school staff of pupil disclosures of self-harm?” and secondly, “how well equipped do independent school staff feel to deal with pupil disclosures of self-harm?” Interviews with four subject teachers, two housemistresses, and a school matron were conducted as a participant researcher within one girls' independent boarding school. The interviews were analysed through the use of Interpretative Phenomenological Analysis (Smith, Flowers and Larkin, 2013) and findings were synthesised with some of the key concepts found in the work of Foucault (1982; 1977/1991) concerning discourses of power, knowledge and truth. Five main superordinate themes emerged from the analysis of the data: knowledge and awareness of self-harm; reasons why pupils have self-harmed; the hidden nature of self-harm; personal responses to self-harm disclosure by staff; lack of training and support; and reasons for participating. The study finds that within the small sample interviewed, the participants demonstrated a lack of confidence in their own understanding of the term ‘self-harm', but a wide experience of pupil self-harm disclosures. It suggests the need for the training of all staff, not just key pastoral staff, in dealing with pupil disclosures of self-harm; and the requirement for schools to develop a self-harm policy (Robinson et al., 2008) and clear guidelines for referral and follow-up of disclosures of self-harm. It also supports the concept of supervision style meetings for school staff to have the ability to discuss their own anxieties and concerns about pupil behaviour (Best, 2005a & 2005b). Finally, the study examines how staff and parental avoidance of self-harm can lead to the development of concentric circles of complicit secrecy surrounding the pupil who is self-harming. It considers how ‘over-parenting' and ‘spoon-feeding' of educational concepts may be damaging pupils' ability to manage their fear of failure and suggests that this may lead to a lack of resilience and a lack of an ability to deal with problems effectively (Lahey, 2015) particularly when pupils feel that they do not conform to the accepted norms of society (Foucault, 1977/ 1991).

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