Nursing Dissertations and Theses
Permanent URI for this collection
Browse
Recent Additions
Item Local community knowledge, perceptions, and experiences of malaria prevention in the highlands of Papua New Guinea(2010) Bang, Kolly Tongamp; Unitec Institute of TechnologyRESEARCH QUESTION: What are the experience and perceptions of malaria prevention and control by local Highlands people? BACKGROUND: Malaria is becoming common and causing seasonal epidemics in the Highlands of Papua New Guinea (Mueller et al., 2005). Malaria is mainly affecting the health of the local population who live in bush huts. The Highland’s local people’s knowledge, perception and practical measures to prevent malaria were explored in this study. OBJECTIVE: This study was aimed at identifying knowledge gaps and other possible environmental impediments that may influence effective participation of the local people. METHOD: Interpretive description (a qualitative approach) was used for this study. Data was collected through focus groups (x4) and individual interviews (x4). RESULTS: There were seven main themes that emerged from this study. Theme One revealed the locals’ knowledge gaps and misconceptions of malaria. Theme Two indicated climate change as a trigger for malaria increase in the Highlands. Theme Three revealed locals’ experiences of current malaria prevention and control strategies. Theme Four emerged as alternative malaria treatment. Theme Five revealed some problems faced by locals with the health care system. Theme Six showed locals’ perception of socio-economic disempowerment, and Theme Seven related to locals’ behavioural factors contributing to malaria. CONCLUSION: This study identified Highlands local knowledge gaps answering the original focus of study. The knowledge gaps indicated essential components for primary health care functions as needing attention, PHC workers in rural areas increased, and health planners to implement suitable approaches with local involvement to build locals’ knowledge capacity for malaria prevention and control.Item ‘On the edge of a whirlpool’: Living with a fear of needle procedures(2011) Matthews, Shona; Unitec Institute of TechnologyThis study explores the lived experience of needle phobia through individual interviews with five participants. The understanding and experience of three medical imaging nurses carrying out procedures on patients with needle phobia is also explored to provide clinical context and comparison. The study is guided by the values of phenomenology and in particular the body philosopher Merleau-Ponty. It will also draw on the research of nurse scholars Patricia Benner and Irena Madjar who have focused on the body and embodiment in nursing practice. Interpretation of the data is informed by the work of Anthony Giddens. The study unravelled a fear notable for its personal idiosyncrasies, and variable origins. It is an obscure fear that is experienced as intensely physical and embodied but is not primarily about pain. A needle piercing the skin violates the integrity of the skin surface, even the sense of self and at worst threatens to overwhelm, likened by one participant to being on the edge of a whirlpool. Living with the fear involves managing a wayward body, with particular capacities for action, but plagued by uncertainty at how it will respond when faced with a needle procedure. It is an irrational fear that impacts upon life choices and ‘pierces the protective cocoon’; the main emotional support that allows us to cope with life, arousing a sense of shame that something so simple cannot be mastered and threatening the usual competent face the person presents to the world. In contrast, the nurses saw needle phobia as an emotional reaction related to pain; they felt empathy and concern for their patient but also personal anxiety when faced with a distressed or fearful patient. Narratives revealed the challenge and dichotomy of their caring, learning and instrumental role. This was particularly acute for the novice practitioner. Caring and coping with their own reactions was closely intertwined with getting the job done. Ethical dilemmas arose. Mutual vulnerability was demonstrated with the nurse’s sense of competence also threatened when the procedure failed. The study revealed significant implications for clinical practice both in regard to caring for people with needle phobia and in teaching and mentoring nurses. A partnership approach to care emerged as the most appropriate way to meet the varying subjective needs of people with needle phobia, while allowing nurses to combine both their pathic and instrumental touch.Item Will someone walk with me? A case study exploration of graduate nurses’ perceptions of the preceptored experience(2008) Atherfold, Cheryl; Unitec Institute of TechnologyThe transition from student to registered nurse is a challenging and often stressful time in a nurse’s career. “Will someone walk with me?’ is a case study research project that explores the graduate nurses’ perceptions of preceptorship as a strategy to support this transition at Lakes District Health Board (DHB). As a provider of graduate nurse programmes since 1995, Lakes DHB has provided preceptorship for the nurse in the initial period of clinical practice. Annual evaluation by questionnaire identified that this has been applied in a range of ways in different clinical settings with varying degrees of effectiveness. Further inquiry into graduate nurses’ perceptions of the preceptored experience during the first twelve weeks of practice within Lakes DHB forms the basis of this research project. The intention is to utilise this insight to further inform the development of preceptor education programmes and application of the preceptor role in the practice setting. Using the case study research method, data has been collected from fourteen participants using semi-structured interviews, focus groups and secondary data from the previous year’s questionnaire undertaken by preceptors and graduate nurses. Thematic analysis of the data has resulted in two categories, each with three associated themes. The first category relates to functional factors in the way the preceptorship role is applied. This explores the role of the Clinical Nurse Educator (CNE), organisation within the unit and the teaching of clinical skills. The second category relates to psychosocial considerations and includes the graduates sense of being scared and advocacy of the preceptor, socialization and team support, and the preceptor’s own experience as a registered nurse. Recommendations from the research include the allocation of a dedicated preceptor selected with consideration for relational ability; complementary rostering and workload allocation to ensure that the preceptor and graduate nurse work together; early notification when preceptor arrangements break down; implementation of a clinical coaching plan; and strengthening the CNE’s role as a leader facilitating and supporting preceptorship in the units. Opportunities for further research that arise from the study include the perceptions of the preceptors and the nursing leadership in clinical areas. Structuring the application of preceptorship, to ensure that all of these aspects are woven throughout the graduate nurse’s transition results in Korowai Aroha, a cloak of covering for a supported transition that facilitates the development of practice.