This research study explored the meanings attributed by migrant Arab Muslim women to their experiences of childbirth in the UK. The objectives of the study were: • To explore migrant Arab Muslim women's experiences of maternity services in the UK. • To examine the traditional childbearing beliefs and practices of Arab Muslim society. • To suggest ways to provide culturally sensitive care for this group of women. An interpretive ontological-phenomenological perspective informed by the philosophical tenets of Heidegger (1927/1962) was used to examine the childbirth experiences of eight Arab Muslim women who had migrated to one multicultural city in the Midlands. Three in-depth semi structured audiotaped interviews were conducted with each woman; the first during the third trimester of pregnancy (28 weeks onwards), the second early in the postnatal period (1-2 weeks after birth) and the third one to three months later. Each interview was conducted in Arabic, then transcribed and translated into English. An adapted version of Smith’s model of interpretive phenomenological analysis (Smith 2003) together with the principles of Gadamer (1989) were used to analyse the interview data, aided by the use of the software package NVivo2. The analysis of the women’s experiences captures the significance of giving birth in a new cultural context, their perception of the positive and negative aspects of their maternity care and the importance of a culturally competent approach to midwifery practice. Six main themes emerged from analysis of the interviews: ‘displacement and reformation of the self’, ‘by the grace of God’, ‘the vulnerable women,’ ‘adaptation to the new culture,’ ‘dissonance between two maternity health systems’ and ‘the valuable experience’. These themes reflected the women’s lived experiences of their childbirth in the UK. The implications for communities, institutions, midwifery practice and further research are outlined. The study concludes that in providing culturally competent care, maternity caregivers should be aware of what might be significant in the religious and cultural understandings of Arab women but also avoid cultural stereotyping by maintaining an emphasis on individualised care.

This study explores the phenomenon of dilemma in paediatric practice. Using a hermeneutic phenomenological method informed by the writings of Heidegger [1889-1976] and Gadamer [1900 -2002] this study provides an understanding of the meaning of ‘being in dilemma’ from the perspective of predominantly paediatric health care professionals but also families in New Zealand. Study participants include four families who had a child requiring health care and fifteen health care practitioners from the disciplines of medicine, nursing, physiotherapy, play specialist and occupational therapy who work with families and children requiring health care. Participants’ narratives of their experiences of ‘being in dilemma’ were captured via audio taped interviewing. These stories uncover the everyday realities facing health professionals and families and provide an ontological understanding for the notion of dilemma. The findings of this study suggest that experience of dilemma for health professionals reveals a world that is uncertain and questionable where they are thrown into having to make uncomfortable choices and must live with the painful consequences of their actions. The consequences of being in such dilemma have to find ways of living with the angst, or risk becoming too sensitive or desensitizing. For families the experience of dilemma reveals a similar phenomenon most evident in circumstances where they feel totalized by the impact of heath care encounters. This study has uncovered that the perspectives that health professionals and families bring to the experience of dilemma reveal different concerns and commitments and may be hidden from each other. This thesis proposes that health professionals and families need support in living with their own personal encounters of enduring experiences of dilemma.

This study explores the phenomenon of dilemma in paediatric practice. Using a hermeneutic phenomenological method informed by the writings of Heidegger [1889-1976] and Gadamer [1900 -2002] this study provides an understanding of the meaning of ‘being in dilemma’ from the perspective of predominantly paediatric health care professionals but also families in New Zealand. Study participants include four families who had a child requiring health care and fifteen health care practitioners from the disciplines of medicine, nursing, physiotherapy, play specialist and occupational therapy who work with families and children requiring health care. Participants’ narratives of their experiences of ‘being in dilemma’ were captured via audio taped interviewing. These stories uncover the everyday realities facing health professionals and families and provide an ontological understanding for the notion of dilemma. The findings of this study suggest that experience of dilemma for health professionals reveals a world that is uncertain and questionable where they are thrown into having to make uncomfortable choices and must live with the painful consequences of their actions. The consequences of being in such dilemma have to find ways of living with the angst, or risk becoming too sensitive or desensitizing. For families the experience of dilemma reveals a similar phenomenon most evident in circumstances where they feel totalized by the impact of heath care encounters. This study has uncovered that the perspectives that health professionals and families bring to the experience of dilemma reveal different concerns and commitments and may be hidden from each other. This thesis proposes that health professionals and families need support in living with their own personal encounters of enduring experiences of dilemma.

This study explores therapists' experience of working with suicidal clients. Using a Hermeneutic-phenomenological method informed by Heidegger [1889 – 1976] this study provides an understanding of the meaning of therapists' experiences from their perspective as mental health professionals in New Zealand. Study participants include thirteen therapists working as mental health professionals in District Health Boards from the disciplines of psychiatry, psychology and psychiatric nursing. Participants' narratives of their experiences of working with suicidal clients were captured via audio taped interviewing. These stories uncover the everyday realities facing therapists and provide an ontological understanding of their experiences working with suicidal clients in District Health Boards. The findings of this study identified three themes. All the participants experienced shock and surprise upon hearing their clients had committed suicide without presenting with signs and symptoms associated with suicidality in their assessment. All the participants experienced the responsibility of assessing suicidal clients and intervening to be a burden. Further, they suffered from guilt and fear of punishment in the aftermath of a client's suicide. They also found themselves in a professional and personal crisis as a result of their experiences and struggled to come to terms with events. This study has shown how these experiences could be understood by uncovering the perspectives therapists bring to working with suicidal clients. I have shown how mainstream prevention and intervention strategies follow on from the misrepresentation and misinterpretation of our traditional way of knowing what it means to be human. I show when therapists discover that phenomena are not necessarily what they appear to be they feel unsettled and confused about their responsibilities and what it means to live and die as a human being. The experience of being a therapist to a person who commits suicide has been revealed in this thesis to leave a profound legacy of guilt, doubt and fear. This thesis proposes that it may be time for the profession to care for its own that therapists in turn may not shy back from caring for and about the vulnerable other.

This study explores therapists' experience of working with suicidal clients. Using a Hermeneutic-phenomenological method informed by Heidegger [1889 – 1976] this study provides an understanding of the meaning of therapists' experiences from their perspective as mental health professionals in New Zealand. Study participants include thirteen therapists working as mental health professionals in District Health Boards from the disciplines of psychiatry, psychology and psychiatric nursing. Participants' narratives of their experiences of working with suicidal clients were captured via audio taped interviewing. These stories uncover the everyday realities facing therapists and provide an ontological understanding of their experiences working with suicidal clients in District Health Boards. The findings of this study identified three themes. All the participants experienced shock and surprise upon hearing their clients had committed suicide without presenting with signs and symptoms associated with suicidality in their assessment. All the participants experienced the responsibility of assessing suicidal clients and intervening to be a burden. Further, they suffered from guilt and fear of punishment in the aftermath of a client's suicide. They also found themselves in a professional and personal crisis as a result of their experiences and struggled to come to terms with events. This study has shown how these experiences could be understood by uncovering the perspectives therapists bring to working with suicidal clients. I have shown how mainstream prevention and intervention strategies follow on from the misrepresentation and misinterpretation of our traditional way of knowing what it means to be human. I show when therapists discover that phenomena are not necessarily what they appear to be they feel unsettled and confused about their responsibilities and what it means to live and die as a human being. The experience of being a therapist to a person who commits suicide has been revealed in this thesis to leave a profound legacy of guilt, doubt and fear. This thesis proposes that it may be time for the profession to care for its own that therapists in turn may not shy back from caring for and about the vulnerable other.