Dissertations / Theses on the topic 'Degree Name: Master of Clinical Research'
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Mace, Janet-Lee. "An inquiry into the meaning of Guillain-Barré syndrome : a thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts." Massey University, 2001. http://hdl.handle.net/10179/1180.
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Guillain-Barré Syndrome (GBS) is an autoimmune syndrome characterized by a severe and rapid onset of paralysis that ascends without warning. It has an unknown aetiology and is generally unknown by most people, including medical professionals. When a person who has had GBS is asked to speak about their experience, they are likely to talk about aspects of it that are personally meaningful. Their account can be likened to a story in that it collates seemingly unconnected facts, episodes of activity and emotional attributions into a sequence that provides knowledge and understanding. A story is a powerful form for expressing suffering and experiences and so is particularly suitable for the study of trauma and illness. The actual process of creating the story, plus its presentational and organisational forms, provides sources for uncovering the identities authors choose to create and present of themselves. Six people who have had GBS were interviewed about their experience, and their stories were analysed using a narrative inquiry to discern the meanings attributed to GBS from the participants’ own understandings and perspectives. The intended focus of the research was holistic and content based. The result of the narrative inquiry was a plot common to all six narratives. Namely, GBS is an inexplicable condition, during which horrendous things happen, but people do recover with time and it is likely their life view will be changed in the process. Four fundamental issues, identity, meaning, making sense and meaningfulness were drawn from the stories and configured into a narrative of the researcher’s making. What the participants chose to speak about became the meanings, or themes, major and minor, of their stories. No event has meaning in itself, however traumatic events can precipitate crises of meaning. When these crises are viewed within the context of other events, and are perceived to add value to life, then they have meaningfulness. In the telling of meanings and meaningfulness, the purpose for storying and the audience to whom the story is directed are the criteria for which the storylines are chosen. Both the story and the storying provide opportunities for the authors to create and offer images of themselves, that are then open to interpretation by an audience. As a traumatic experience, GBS enabled six people to tell their stories. In doing so they were able to make sense of important issues for themselves, and re-examine the way they saw themselves and the world.
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Jarden, Rebecca Jane. "Gastric residual volumes in the adult intensive care patient : a systematic review : a thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Master of Nursing (Clinical) /." ResearchArchive@Victoria e-Thesis, 2009. http://hdl.handle.net/10063/1188.
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Dodsworth, Caroline. "How can midlife nurses be supported to deliver bedside care in the acute clinical services until retirement? : a thesis presented in partial fulfilment of the degree of Master of Philosophy (Nursing), Massey University, Turitea, Palmerston North, New Zealand." Massey University, 2008. http://hdl.handle.net/10179/902.
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As the baby boomer generation move inexorably towards retirement and the requirement for health care services increases, the supply of nurses available to provide care at the patient bedside is forecast to fall significantly short of demand. This thesis has explored the perspectives of midlife nurses, asking what it would take to keep them in bedside practice until retirement. These nurses have provided insights which offer employers of valuable senior nurses, suggestions for maximising their potential. Through the use of questionnaires and focus groups nurses aged 45 years and over were asked what the employer can do to ensure that they are able to continue to work at the patient bedside until they reach the age of retirement. The results of this research demonstrate a workforce of nurses who are passionate and committed to their profession, but feeling disillusioned and disempowered. The nursing environment has changed over the span of their career and they find the increased workload, together with increasing professional demands, too hard to cope with. They feel they have no control over their workload, their shift patterns, or the expectations of their patients and colleagues. They want their experience to be recognized but they do not want to have to prove competency; they want to have a voice but they are unwilling to pursue postgraduate education to learn how to become visible and emancipated.
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Rifshana, Fathimath. "Outcome evaluation of the Massey University Concussion Clinic: a pilot study : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Palmerston North, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1165.
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The primary aim of the present study was to evaluate the effectiveness of the intervention provided by Massey University Concussion Clinic for individuals following Mild Traumatic Brain Injury (MTBI). Concussion Clinics were set up across New Zealand to provide early intervention and assessment for individuals with MTBI to prevent long term complaints. Treatment outcomes at these clinics have not been empirically examined before. The current study compared the levels of post concussion symptoms, anxiety, depression, and psychosocial functioning between an intervention and a control group using a quasi-experimental design. In addition, reasons for nonattendance to the clinic, and participants’ perceptions of their recovery were also explored. The main outcome measures used were the Rivermead Postconcussion Symptoms Questionnaire, the Hospital Anxiety and Depression Scale, and the Sydney Psychosocial Reintegration Scale-2. Outcomes were initially assessed soon after injury or referral to the clinic and then three months later. Participants were recruited from the Palmerston North Hospital Emergency Department and the Massey University Concussion Clinic. With 20 participants in the intervention group and 15 in the control group, the main results showed that the Concussion Clinic intervention significantly decreased the level of anxiety and depression reported by participants in the intervention group over the control group. Greater improvements in post concussion symptoms and psychosocial functioning were also indicated in the intervention group. Additional findings suggest difficulty with transportation as a reason for nonattendance, which could be a potential barrier to recovery. Furthermore, participants highlighted the benefits of attending the service and its role in their recovery. Important issues relating to the referral processes were also identified. Findings of the current study suggest that the Concussion Clinic intervention is effective in improving recovery for those accessing the service. Nevertheless, these results must be interpreted with caution due to the small sample size. Further research is warranted to examine the effectiveness of the Concussion Clinics with larger samples, and the current study may serve as a valuable pilot for these future investigations.
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Andrae, Daniela. ""Diabetes? I can live with it" : a qualitative evaluation of a diabetes self-management programme : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1199.
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Self-management programmes provide one form of education for people with diabetes. Evaluations of these programmes allow for a better understanding in regard to their impact and whether outcomes are met. Very little research has used qualitative methods to capture participants’ experiences of these programmes and their perception of psychological outcomes. This is the first qualitative evaluation of the Type 2 Diabetes Self-Management Programme in Whangarei. It has adopted an interpretative-phenomenological approach to explore participants’ experiences of the programme and participants’ perceptions in regard to their self-efficacy and quality of life after attending a course. A sample of 7 participants with diabetes provided data via interviews 4 weeks and 3 months after attending the course. The themes that emerged from the initial interview were separated into three evaluation components. In “6 weeks sounded very long but it was worth the time”, participants discussed enrolment, benefits of the course and suggestions for future participants. In “I know what I need to do and I’m confident to do it”, participants linked the gained knowledge from the course to improvements in their self-efficacy regarding self-management behaviours, education and control of own life. In “Life is good, diabetes is just another thing to handle”, participants reflected on the impact of living with diabetes and changes to their life. An overarching theme of settling into a comfortable routine emerged from the follow-up interview. Participants reflected positively on their course and research participation. The programme was perceived to be beneficial to participants, impacting positively on increasing knowledge, self-efficacy development, behaviour changes and quality of life. The participants maintained these benefits in the short-term. These results are discussed in terms of the need for further research to evaluate if benefits are maintained in the long-term, referral process to the programme, decision-making process in regard to enrolment and impact of a support person attending the programme. Practice implications for the programme are discussed in regard to incorporating a follow-up phone call to participants after they attended a course and offering follow-up sessions with the latest information on diabetes care.
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Wilkinson, Catherine Joy. "Reflections and analysis to improve clinical practice : a student music therapist's journey with a preschool child with special needs : a dissertation presented in partial fulfilment of the requirements for the degree of Master of Music Therapy at the New Zealand School of Music, Wellington, New Zealand." Massey University, 2008. http://hdl.handle.net/10179/858.
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This qualitative study critically examines the researcher’s music therapy clinical practice with a preschool child with global developmental delay. The researcher/student music therapist critically examined and refined her clinical practice using an action research model. Each cycle consisted of a plan, action, data collection, reflection, and analysis. The researcher was the main participant. The child, his mother and a speech-language therapist were co-participants with different roles. The child and his mother participated in the sessions. The speech-language therapist observed three sessions through a window. Feedback from the child’s mother and the speech-language therapist contributed to the reflective data. Important issues that developed through the cycles related to early intervention techniques (having fun, being playful and spontaneous, and being in close proximity). Other important issues that developed were, the use of the voice and guitar; confidence; professionalism with parents and other health professionals; self-awareness; and the understanding of early childhood development (especially in the area of communication). Related literature on aspects of music therapy practice, music therapy in early intervention, music therapy and communication, and action research are described. These results cannot be generalised. However, they may firstly, illustrate relevant trends in early intervention, and secondly, enable the researcher to adapt skills learnt to use in future practice in early intervention
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Eyre, Janet Mary. "Communication in clinical practice: critical success factors for ESL students : a thesis completed in fulfilment of the requirements for the degree of Master of Philosophy at Massey University, Palmerston North." 2010. http://hdl.handle.net/10179/1661.
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This study investigates the factors most likely to support effective communication in clinical placements for ESL nursing students in New Zealand. The experiences of ESL students as they complete a clinical placement are examined and compared with data from the students‟ clinical lecturers and preceptors. Data for the study was collected through interviews with individual students before, during and after their Transition to Practice placement. Interviews were also held with two of the students‟ preceptors, and a focus group was held with clinical lecturers who had experience of working with ESL students. Results from the study underline the importance of facilitating students‟ entry to the placement community of practice, and access to its interactions. A number of factors supported or inhibited students‟ participation and learning within the placement community. The study identified two critical factors intrinsic to the student, and two extrinsic to the student. Intrinsic factors included the student‟s proficiency with English language: in particular, the sophisticated sociopragmatic language skills used by nurses in their daily interactions. The student‟s use of learning strategies, including the proactive approach best suited to learning on placement, was also critical. Extrinsic factors likely to support the student‟s integration within the community of practice were the quality of the preceptor, in terms of attitude to and training for the preceptoring role, and the tone of the placement environment. The major outcomes of this study point to the importance of providing direct instruction for ESL students in the kinds of language and learning styles required for placement. There are also implications for the selection and training of preceptors and for the placing of students in appropriate clinical environments. The study concludes with suggestions for a specific communication programme for ESL students.
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Niland, Patricia Ruth. "Metaphors of menopause in medicine : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Wellington, New Zealand." 2010. http://hdl.handle.net/10179/1338.
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Medical textbooks have previously represented women’s bodies and menopause life transitions by using notions of ‘machine productivity’ and ‘machine breakdown’ (Martin, 1987). This study aimed to explore whether these representations have changed, especially given recent HRT clinical trial results. Eight relevant compulsory medical textbooks for first and second year medical students at two New Zealand Universities were identified. A Foucauldian discourse analysis (Parker, 1990) was undertaken on relevant content to identify representations of menopause, HRT, women’s bodies, and ageing. Five major discourses were employed in the textbooks in descriptions of menopause and HRT: failure, estrogen deficiency as disease; HRT as saviour; obscurity and the new discovery discourse. Menopause continues to be represented as resulting from a ‘failure’ of a machine-like body. Although the recent HRT clinical trials were reported as a serious risk factor in half of the textbooks, HRT was also represented as a saviour particularly against postmenopausal osteoporosis. The discovery of ‘new’ drugs to ‘treat’ HRT and the ‘postmenopausal’ patient were heralded with much excitement. Medical textbooks continue to use failure discourses to describe women’s bodies at menopause. New risk-based HRT assessments for ‘patients’ with menopause ‘symptoms’ are promoted. These portrayals reinforce linear and reductionist ways of thinking about menopause and women at midlife and provide few spaces for resistance or alternative constructions to more accurately reflect women’s embodied worlds.
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Malur, Malini. "Experiencing natural environments, experiencing health : a health psychology perspective : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Health Psychology, Massey University, Albany, New Zealand." 2010. http://hdl.handle.net/10179/1655.
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This aim of this study was to explore the importance of natural surroundings to human health from a health psychology perspective. The increase in built environments have replaced green spaces in the urban areas and the effects of this has been explored by several disciplines ranging from environmental psychology, leisure studies, urban planning, public health to name a few. Findings from these studies have shown that natural environments do play a significant role in human health. However, it was deemed that exploring the influence of nature on human health from a health psychology viewpoint would provide a different dimension to this established link between nature and humans to press for preserving and providing more green spaces in the cities. Urban green areas offer several benefits such as space for exercise, leisure, psychological space for rejuvenating, healing and social connections that are all crucial for our wellbeing. This study explores the many ways natural settings contribute to health and well-being from a health psychology angle. A qualitative design was employed using a phenomenological approach to understand the everyday experience of being in nature/natural environments. Cornwall Park/One Tree Hill in Auckland was chosen as the site for this study. Nine women and men between the ages of 30 and 70 were chosen from this site to take part in the study. Methods of data collection were mainly in-depth interviews and photo-discussion. The data was analysed using a phenomenological approach based on the guidelines developed by Moustakas (1994) and van Manen (1990). The findings revealed that natural surroundings influenced people positively in many ways that contributed to their physical, mental and spiritual well-being. Natural environments satisfied a wide-range of needs, such as providing a place/space to exercise, to be alone and reflect, connect with nature, recreate, heal and socialise to name a few, in green, quiet, pollution-free, aesthetically pleasing settings. The essence of the phenomenon that is estimated to have been captured in the study is, “human experience in nature from the point of view of health psychology, or human experience of wellness, being in nature”.
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Chin, Edwin Chun-Hong. "The reliability of retrospective methods for exploring onset of height fear : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Palmerston North, New Zealand." 2008. http://hdl.handle.net/10179/1360.
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The non-associative framework on fear argues that evolutionary-relevant fears, such as heights and water, are largely innate and do not require associative conditioning experiences to develop (Menzies & Clarke, 1993a, b; Poulton & Menzies, 2002a). However, this framework has been criticized for its reliance on retrospective recall for empirical support (Mineka & Öhman, 2002), which has been found to be highly unreliable (Taylor, Deane, & Podd, 1999). Thirty height-fearful undergraduate students completed the Origins Questionnaire-II (OQ-II; Menzies & Parker, 2001) and were classified into one of the several associative and non-associative pathways of fear onset based on their responses. A control group of 43 non-fearful students completed a modified version of the OQ-II to report any past experiences with heights. To examine the stability of these responses over time, the same questionnaires for both groups were completed again three months (Time 2) and 12 months (Time 3) after the initial administration of the test, along with measures of fear severity. Results showed that neither associative nor non-associative accounts took precedence over the other in explaining the onset of height fear. Instabilities in pathway ascriptions were observed in 18.18% of cases over three months (between Time 1 and Time 2), and 27.27% of cases over nine months (between Time 2 and Time 3). The theoretical and practical implications of the results are discussed with consideration of some of the study’s procedural and instrumental limitations. In light of these limitations, this study identified a substantial role of non-associative pathways on the development of height fear, and provided further support for the limitations of retrospective recall for ascertaining the pathway to fear onset.
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Heron, Heather Adele. "Meta-analysis of moderators of psycho-oncology therapy effectiveness : "it's the sick who need a doctor" : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand." 2009. http://hdl.handle.net/10179/1707.
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Reviews conflict regarding the effectiveness of psycho-oncological therapies at reducing patient anxiety, depression and general distress, suggesting that unknown factors are moderating trial results. This meta-analysis investigates the moderating impact of a large range of socio-demographic, psychological, medical and therapy factors using published and unpublished data from 146 prospective controlled trials, including non-random designs. Preliminary analyses of trial design quality features exposed 2 moderators: recruit screening for psychological distress or history, and the nature of the control condition. These structured a 2 x 2 matrix used to conduct substantive analyses. Admitting only recruits with established baseline distress was found to predict greater effect size, as was excluding patients with a history of distress. Main effects for patients with baseline distress compared with untreated controls, were medium-strong at g = 0.52 - 0.70. Evidence of varying strengths indicated that patients who were older, of lower income, male, single, or suffering from cancer sited elsewhere than breast produced higher effect sizes. Data also highlighted particular stages in the cancer journey: re-entry to normal life at the end of medical treatment, recurrence, and distant disease spread. Findings suggest that risk and distress screening should be employed by both clinicians and researchers. Researchers should also re-direct attention away from unscreened middle class early stage breast cancer patients, towards more vulnerable socio-demographic and medical groups. The potential of using survivors and indirect therapies to effectively and efficiently reach vulnerable groups deserves exploration. Reviewers need to take into account the 2 trial design moderators discovered, and should include non-random controlled trials which may have more access to particularly vulnerable groups because some past conclusions were confounded by the co-variation of study design with sampling characteristics.
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Stubbs, Marika Jane. "Qualitative description of the adult patient experience of cancer-related cachexia (CRC) : a pilot study : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Nursing, Massey University, Palmerston North, New Zealand." 2008. http://hdl.handle.net/10179/785.
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This thesis explores the experience of living with cancer-related cachexia (CRC) from the patient perspective. Critique of the literature indicates few examples where patients have had the opportunity to speak. Following a challenging recruitment process, six people living with the syndrome were interviewed to elicit their narrative. Their stories were examined and themes identified relating to their personal feelings and how these affected social interactions. Thematic analysis was applied to produce what is a rich qualitative description of the experience from this small sample. Living with CRC requires development of strategies to survive. Emergent themes included the loss of sense of self and a changing relationship to the social world, social isolation and dissatisfaction with truth-telling by health professionals. Recommendations are made to mitigate the suffering of patients by empowering them through better information and acknowledgement of their condition. The balance between nutrition and wellbeing is re-examined, calling for a reorientation of perspective from a focus on intake towards a focus on quality of life. This clearly falls within the nurse-as patient-advocate paradigm and the relevance and meaning of this research to the nursing profession is explored. Potential areas for further research in regards to both patient experience and nursing practice are extrapolated.
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Hetherington, Sally. "Evaluation of a community based programme for male perpetrators of intimate partner violence : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Albany." 2009. http://hdl.handle.net/10179/1361.
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Treatment for perpetrators of Intimate partner violence (IPV) is most often provided by community based IPV perpetrator programmes. These programmes have become an integral part of the response to IPV despite the fact that they are plagued by high rates of attrition and researchers suggest their effectiveness may be limited. It has been suggested that the retention rates and effectiveness of the programmes may be improved by tailoring treatment to specific subgroups of IPV perpetrators. This study was an evaluation of a community based IPV perpetrator programme. Participants were twenty two male IPV perpetrators who were court and not court ordered to treatment for violence towards a female intimate partner. Only seven participants completed the programme. Their self reported incidents of violence, alcohol consumption, change readiness and levels of working alliance were measured up to four times during the 18 week programme. Results indicated that participants who completed the programme or the majority of it significantly reduced their violence towards intimate partners and their levels of alcohol consumption. Higher levels of violence were associated with alcohol abuse and non court ordered status. As expected, court ordered participants reported lower levels of readiness to change and working alliance, and higher levels of alcohol abuse. However they were more likely to complete the programme compared with non court ordered participants. Implications of these findings are discussed.
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Tuohy, Robyn Jean. "Older adults' experiences of a flood disaster : making sense of an extraordinary event : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand." 2009. http://hdl.handle.net/10179/1094.
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Disasters occur within the routines of everyday life and have a disruptive and destructive impact on human lives. To understand how older individuals make sense of a disaster, nine older adults in Kaitaia, New Zealand were interviewed about their experience of a flood they experienced in July 2007. These interviews were conducted with four residents living in a rest home and five pensioners living independently who were evacuated from their homes. The two groups differed in the levels of support and assistance received before, during, and after the disaster. The rest home residents experienced little disruption and did not require relocation; the pensioners experienced major disruption and relocation. Thematic analysis was used to describe how these older adults’ accounted for their experiences of the flood. The narratives were influenced by the participants’ identity as either dependent rest home residents or pensioners living independently in the community. The analysis revealed that their accounts of the disaster were incorporated and integrated into the personal and social context of each person’s life story. Narrative themes that emerged from the analysis for the pensioner group were: coping with limited assistance, the importance of treasured possessions, and social support and community. The pensioner themes reflected their vulnerability to a disaster and the challenges they faced during the post disaster recovery phase. Themes for the rest home residents were ageing and dependency, and the importance of protection, care, and trust. These themes reflected the dependent world of the rest home residents and the security of being cared for.
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Choi, Hee-Chan. "Multicultural encounters in music therapy in New Zealand : What particular clinical experiences do NZ music therapists describe when encountering clients who identify closely with a culture different from their own? : research dissertation in partial fulfillment of the requirements for the degree of Master of Music Therapy at the New Zealand School of Music, Wellington, New Zealand." 2008. http://hdl.handle.net/10179/1494.
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This qualitative study investigates how music therapists work within a culturally diverse environment in New Zealand and the researcher's own growing experience as a student clinician. This research endeavoured to answer two research questions. Firstly, what do music therapists in New Zealand perceive from their experience of working with clients from different culture? Secondly, how does my own experience as a second generation Korean MTS affect my clinical work in a multicultural environment in New Zealand? This study applied aspects of qualitative research. Four qualified New Zealand music therapists and the researcher herself participated in this study. Data was collected from the interviews with the music therapy participatns, the music therapy student's reflection on case notes from two clinical cases, and a research journal. Music therapists identified various issues that associated with their experiences of working cross-culturally. The main areas of key ideas were categorized under 1) cultural considerations 2) preconceptions 3) building a communicative bridge 4) clinical competency 5) different approaches 6) culturally appropriate practice. The ideas under these categories have crystallized to articulate the different voices of participants for the benefit of the knowledge in the existing literatures and for the enhancement of personal tools towards self awareness and culturally appropriate clinical practice. From the overview of all the participants consulted in this study it was concluded that recognition of the importance of self awareness was one of the most significant factors in building culturally appropriate practice in a multicultural environment.