Thesis (MHSc--Health Science) -- Auckland University of Technology, 2003. / Also held in print (142 leaves, 30 cm.) in Akoranga Theses Collection (T 618.4 VAG)

Thesis (MHSc--Health Science) -- Auckland University of Technology, 2004. / Also held in print (93 leaves, 30 cm.) in Akoranga Theses Collection (T 618.2 DUN)

Thesis (MHSc--Health Science) -- Auckland University of Technology, 2005. / Appendices not included in e-thesis. Also held in print (iii, 154 leaves, 30 cm.) in Akoranga Theses Collection (T 618.24 PAY)

Thesis (M.A.) - Carleton University, 2006. / Includes bibliographical references (p. 172-190). Also available in electronic format on the Internet.

Diss. med. Univ. Bern, 1983. / Bibliographie: S. 156-163. Literaturverz. S. 156-163.

The approaches taken in teaching reflection to adult student nurses varies across the UK despite national curriculum outcomes from the professional statutory and regulatory body, The Nursing and Midwifery Council (NMC). This study highlights pertinent aspects of the various approaches to teaching, the inclusion of theory and the roles of the student, mentor and nurse lecturers in the utilisation of reflection to develop professional knowledge from experiences. Ethical approval was gained to conduct the study, utilising a case study approach, including nurse lecturers and curriculum documentation from a range of NMC accredited Higher Education Institutes across the UK. Semi structured interviews were conducted face to face with all participants in their home sites. Curriculum documentation used with students such as lecture notes, slides, module and programme handbooks and practice assessment documents were also collated in order to understand and analyse the approaches taken to teaching reflection. These two main data sources (interviews and curriculum documents) were also complemented by the use of field notes and a researcher journal in order to gain deeper understanding of the detail during data collection. A thematic analysis of the interview data and curriculum documents was undertaken to highlight and explore patterns and assist in the emergence of a theme and subthemes. Following in depth data analysis, the findings of this study detail an overarching theme of safe and caring practices, alongside three subthemes: II  Personal and Professional Dimensions of Reflection  Dimensions of Reflection in Nurse Education  Articulation of Practice Although the publication of the Francis Inquiry (2013) was unanticipated at the inception of this research, it has shown to be a very important factor in analysing the data. The issue of patient safety that arose during data collection and became evident during analysis align closely to the publication of this significant report. The findings from this study are timely as the review of standards for nurse education and mentoring are underway. The findings from this study will also contribute to strengthening the student nurse role in assuring the best standards of care in the practice setting are achieved in order to improve patient safety through thoughtful approaches.

Women with raised BMIs ≥30kg/m2 have now become the ‘norm’ in maternity practice due to the recent obesity epidemic. To date only very limited research evidence exists highlighting midwives’ experiences of caring for this group of women. This thesis aims to provide original research on what it means to midwives and student midwives on the point of qualification to care for this client group throughout the childbirth continuum.

This case study explored the factors that influence the experience of night-time postural management equipment by children with cerebral palsy in the South-West of England. The aims were to explore the views of children on using a sleep system, the role of their parents and therapist in its use and the quality of sleep experienced before and during use of a sleep system. Further objectives were the identification of factors that affect the use of sleep systems and the production of findings to guide therapists' clinical practice. Seven subunits made up the whole case, with each one consisting of a child, aged 18 months to nine years who had just been prescribed a sleep system, the child's therapist and parents. All participants, excepting children under three years old, were interviewed. Talking Mats, an innovative communication tool, was used to enable children with little or no verbal communication to give their views. Children as young as three years old were able to express their views on sleeping in a sleep system and to provide reasons for waking in the night. The findings included sleep difficulties in six out of seven children, two of whom improved with the use of a sleep system. Six children were thought to experience regular pain or discomfort, two of whom were more comfortable when sleeping in their sleep system. Factors were identified that influenced whether a child and family were able to continue using a sleep system at night including the finding that some of the therapists who were prescribing sleep systems did not have the necessary knowledge and experience. It was concluded that when children are given the appropriate tools they can have a voice and be able to practice making decisions about their healthcare. It is suggested that when considering prescription of a sleep system, use of the ICF framework model would assist clinicians in focussing on those factors that predict the child and family are most likely to continue to use it. Therapy services should consider the role of a specialist clinician to lead local postural management services and to put in place training and competency measures for generalist therapists to ensure that they have the necessary knowledge and experience.

For midwifery practitioners, the concept of excellence is central to the ethos of quality midwifery care (DH 2009, NMC 2009) and although midwives are being asked to aspire to ‘a standard of excellence’ (DH 2009), the meaning of ‘excellence’ for both women and midwifery practitioners has not been defined. The focus of this study is to understand excellence at a personal level, what makes some midwives ‘stand out’ and what it means to ‘be’ an excellent midwife, from the service users perspective.

This work grew out of a need to try to understand my often experienced sense of being misunderstood, misrepresented and marginalised. A prerequisite to helping others in mental health nursing is arguably some requirement to understand one’s self. But who is the self? In this thesis I use an autoethnographic approach to examine how the self, multiple selves and identity formation is socially constructed. Social constructionism contends that categories of knowledge and reality are actively created by social relationships and interactions. As an autobiographical genre of writing, this evocative autoethnography has been written in the first person displaying my multiple layers, connecting my selves to the cultures I inhabit. As a reflexive methodology it offers the researcher a means of critically exploring the social forces and discursive practices that have shaped his own cultures. In addition I discuss the contrast between traditional guidelines and protocol driven ethics with more progressive relational ethics. Central to relational ethics is the question ‘What should I do now?’ rather than the statement ‘This is what you should do now.’ I continue by arguing that we use stories as ‘equipment for living’, as tools to understand, negotiate and make sense of the many different situations we encounter. In recent years, as part of the ‘narrative turn’ in the social sciences, a growing number of scholars have suggested that we live in a world shaped by these stories. I discuss connections between the cultures people occupy and how an individual’s reflexivity can keep them stuck or liberated and emancipated with regard to their personal narratives. Whilst the text is not intentionally instructional, storytelling can be instructive. By showing my vulnerabilities the work is a prism for the reader to reflect on their narratives and the cultures they inhabit.