Masters Dissertations

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https://hdl.handle.net/10292/476

The Masters Dissertations collection contains digital copies of AUT University masters dissertations deposited with the Library since 2007 and made available open access. From 2007 onwards, all dissertations for masters degrees awarded are required to be deposited in Tuwhera Open Theses & Dissertations unless subject to an embargo.

Dissertations submitted prior to 2007 are usually recorded in the AUT Library catalogue where the full text, if available, may be accessed with an AUT password. Other people should request an Interlibrary Loan through their library.

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The contribution of medio-lateral balance during activities in sitting and standing in hemiplegic subjects
(Auckland University of Technology, 2002) Recordon, Anne; Vujnovich, Andrea
Research on balance in the medio-lateral direction is sparse compared to that undertaken in the anterior-posterior direction. There is a correlation between poor medio-lateral balance and falls investigated in elderly and recently in subjects with hemiplegia. Investigations into the muscle activity required for medio-lateral balance in normal and hemiplegic subjects suggest falls may occur as a result of poor timing, modulation and duration of specific muscle activity essential for medio-lateral balance. Further, there is support for retraining medio-lateral balance using task related functional activities. The results of a single subject design experiment undertaken as part of this dissertation indicated that medio-lateral balance in a hemiplegic subject, can be retrained using body weight support treadmill training, two years after stroke. Results from this study therefore provide support for this physiotherapy technique being effective in improving medio-lateral balance in subjects with hemiplegia.
Living with peripheral vascular disease: A one-person case study
(Auckland University of Technology, 2002) Richardson, Jim; Wong, Grace
This single-person case study, informed by phenomenology, describes the meaning for Tom (the participant) of living with peripheral vascular disease (PVD). Data collection included one face-to-face semistructured conversation and a further brief telephone conversation to seek Tom’s confirmation of the study findings. The data was analysed using Colaizzi’s (1978) phenomenological seven-step descriptive analysis framework. The findings are presented in the form of five narrative themes that best represent Tom’s experience of living with PVD. They include Living in a Mindset, A Male Thing, Facing Reality, A Weird Existence and A Heightened Awareness. They reveal how living with peripheral vascular disease has been incorporated into Tom’s way of life. The themes demonstrate how Tom managed his ulcers, how he accommodated his limitations, his state of vulnerability and how he continued to lead a “weird” yet rewarding life, despite the hardship he endured. The unexplained weirdness of Tom’s story has been presented in a way that aims to facilitate understanding of the phenomenon. Some of the significance of this study therefore lies in the tactful action of the phenomenologically informed approach, which enables the reader to understand the puzzle and weirdness of why Tom delayed treatment and acted as he did. The study facilitates the potential to heighten the awareness and challenge assumptions of nurses and other health professionals as they attempt to interpret a chronic illness experience from the patient’s perspective. A key suggestion made from the study findings is that health professionals should include in their practice routine assessments for patient fears and self-imposed delays to treatment in order to facilitate the provision of timely and suitable interventions. Further research allowing patients’ voices to be heard is necessary to substantiate the extent of this problem and how it can most appropriately be resolved.
Cause related marketing: A New Zealand investigation
(Auckland University of Technology, 2003) Hartigan, Tony; Glynn, Mark
Cause Related Marketing (CRM) is a phenomenon which has gained impetus in the New Zealand market over the last few years. From buying a loaf of bread to using your credit card, organisations are linking in with causes such as The Breast Cancer Research Foundation or Team New Zealand’s bid for the America’s Cup. New Zealand and overseas research would indicate that consumers view CRM in a favourable light if implemented correctly. The research in this document replicates part of a study carried out by Strahilevitz et al. (1998) in the New Zealand market. It looks at the notion that people respond better to CRM programmes when the product is of a frivolous nature than a practical nature. The original study found a correlation to frivolous products over practical. This research also found a correlation with the hypothesis in the New Zealand market. The research found a better response to service type offering than product offerings - for instance, harbour cruises or tickets to the circus. Future research opportunities in the New Zealand market were identified as being linked to brand exploration of products and the link to what constitutes a frivolous or practical product. From the research, the implication for managers was the need to consider CRM programmes in terms not only of a financial return, but also of the organisation being seen as a good corporate citizen - thus enhancing the company’s brand equity.
The efficacy of arcuate dynamic traction splintage in the treatment of intra-articular fractures of the proximal interphalangeal joints of the hand: A retrospective descriptive review
(Auckland University of Technology, 2003) van Essen, Ellen; Taylor, Lynne
Intra-articular fractures involving the proximal interphalangeal joint of the hand present both the surgeon and hand therapist with one of the most challenging problems in which to achieve an acceptable functional outcome. The main aim of this study was to document the outcomes of patients treated with dynamic traction splintage treatment. Secondly, the study aimed to compare the results of patients treated with dynamic traction splintage with those of patients treated with similar or different treatment regimes as documented in the literature. Results from 21 patients treated with Dynamic Traction Splinting are presented. Average follow-up was 16.5 months (5 weeks – 36 months) with a mean TAROM outcome of 78o as compared to 95o on the uninjured side. Mean patient age was 36 years (16 – 74 years). Imaging documented an average articular surface involvement of 53%. The average time between injury and splintage was 3.1 days in 19 patients and 14.5 days in 2 patients - these later two were defined as chronic injuries. The majority of patients injured their finger at sport, the most common of these being cricket. The splint was worn for an average of 4 weeks (3 –7 weeks). All patients were fully employed at the time of injury and returned to work within 3 months. Pin site infection was the main early complication, whereas mild coronal angular deformity was the only late complication noted. Patient feedback related to the cumbersome nature of the splint in two thirds of the group, with intermittent pain, stiffness and cold intolerance being equally shared by a third of the group. The majority of patients stated that they were satisfied with their final functional outcome at the time of follow-up.
An evaluation of the professional development component of the overseas doctors training programme
(Auckland University of Technology, 2003) Hawken, Susan James; Shaw, Susan; Jones, Marion
This study set out to determine how useful the professional development component of the Overseas Doctors Training Programme in Auckland was in preparing these doctors to work in the New Zealand health context. An anonymous postal questionnaire was sent to all 89 doctors that passed the first three cohorts of the Overseas Doctors Training Programme, resulting in a response rate of 30%. The main findings were that the professional development component was seen as valuable and effective with respect to improving communication skills, and patient-centred consultations. There was a significant increase in the level of comfort with communicating with patients after the course and once they were in a clinical setting (p<0.001) and with communicating effectively and safely with Maori (p<0.001). The ethical, legal and reflective practice sessions also prepared these doctors adequately to work in New Zealand. Limitations of the study included the low response rate, the potential for response bias in the self-rating scale used, and that these doctors’ perceptions of skill, not actual clinical performance, were measured. This evaluation discusses the multiple contextual and in particular cultural factors that influence the learning on the programme and the barriers to success for these overseas trained doctors, including English proficiency, previous experience, and stress. Recommendations include more emphasis to be given to English proficiency prior to the course and the development of tools to help screen for those doctors who are most likely to be able to make the changes in behaviour required to practise in New Zealand.
Embodied Relationships: The Therapist’s Experience
(Auckland University of Technology, 2003) Goulding, Josie; Solomon, Margot; Smythe, Liz
This study explores the lived experiences of the therapist in the therapeutic relationship. It focuses on therapists understandings of their own bodies showing a range of experiences that therapists have in their day-to-day practice of psychotherapy. It then explores the understandings that these therapists bring to their experiences. The study is different from much of the current writing about therapists body experiences in that it is not written to illustrate theoretical views but is the gathering of experiences to explore how the therapists body is part of the every-day therapeutic relationship. Hermeneutic phenomenology is chosen as a methodology in order to stay close to the therapist’s experiences. The philosophical underpinnings that guide the methodology are drawn from Heidegger and van Manen. The findings of this study show that embodied experience is a dimension of the therapeutic relationship that is often hidden in its always-there-ness but is a rich source of relational and symbolic information. The significance and dynamics of the hidden-ness and revealed-ness of the embodied relationship is revealed. This includes notions such as, the body is the relational surface; it is the site of our interpretive interaction with the world. Each participant described his/her body as a site or dimension of experience that was ‘lived’ and contained dynamics, both in and out of awareness, which arose in the relational context. The therapist’s body responses often appeared to be a way of accessing material that was difficult to know about. The therapist’s ability to access, understand and consciously use the body experiences was a complex mix of their own capacities and what was possible in the moment-to-moment living engagement between client and therapist; what the therapeutic dyad were capable of engendering and exploring between them. There is richness to the lived bodily experiences that the therapists shared, which captures the realness of the therapeutic relationship and the complexity of what is enacted in the therapeutic space. The study showed that the therapists experience, understanding and use of their body, brings together the science and art of psychotherapy elucidating the use of theory in the context of each therapist’s personal capacity, sensitivity, creativity and spontaneity. The study provides a starting place for a deeper exploration of the role of the therapist’s body in the praxis of psychotherapy and the impact of the embodied experience of the therapeutic encounter on the person of the therapist.
Congenital nausea
(Auckland University of Technology, 2003) Campbell-Macdonald, Daniel
The central concept underpinning this project is the notion of ‘congenital nausea’ a term coined as a metaphorical representation of an omnipresent condition, this is characterised by a cognitive informational gluti that is a consequence of the sensory impact of our given environment - an environment of speed and excess. This art project explores this notion through installational practice.
Host country attractiveness to inward foreign direct investment: A case of small countries
(Auckland University of Technology, 2003) Laporte, Veronique; Littrell, Romie; Matheny, Jonathan
Building on prior literature and drawing on cross-country data, this paper investigated the attractiveness of small developing host countries to foreign direct investment. A model that portrayed the attractiveness of countries to be influenced by political, economic and social factors was used to assess the factors that contribute to the attractiveness of small countries. Six variables as proxies for the three factors were identified and validated as FDI determinants for small countries based on the literature. Although this study has been constrained by no-cost data availability, the findings suggest that a combination of political, economic and social factors are important in attracting FDI in small developing countries. In addition, the socio-economic factors are more important than the political factors.
Countertransference Guilt: The Therapeutic Relationship: A Literature Review With Clinical Illustrations
(Auckland University of Technology, 2003) Rudolph, Helmut M.; Duncan, Andrew; Appel, Stephen
Guilt is an important concept in psychodynamic psychotherapy and much literature exists describing clients’ feelings of guilt and how the therapist can treat them. This dissertation explores the less published area of the therapist’s feelings of guilt, or “countertransference guilt”. Guided by personal and professional curiosity, I wished to know in what ways the therapist’s feelings of guilt affected his clinical working in the therapeutic relationship. A full and fair review of the literature available in the English language was carried out selecting all examples of literature where the therapist’s feelings of guilt appeared at least once. The literature was read, annotated and analysed according to an existing countertransference model (Marshall, 1979). Clinical vignettes from my own work further illustrated the literature. Countertransference guilt examples were distinguished according to therapist origin or client origin and grouped into the most frequent themes. An additional dimension of conscious / unconscious could not be verified as intended due to a lack of consistent description. Countertransference guilt was found to lessen therapist intentionality if unrecognised and unmanaged. Conversely the successful recognition and management of countertransference guilt was found to lead to appropriate interventions. An “Intrapersonal / Interpersonal Model of Countertransference Guilt” was created as the originally intended countertransference model proved not fully workable due to the inadequate level of description in the literature. Two additional tables succinctly list the numerous intrapersonal and interpersonal manifestations of countertransference guilt. The limitations and applications of this study are discussed, including recommendations for clinical practice and further research. In a final section I describe some aspects of how producing this dissertation has affected myself and my clinical work.
Cultural Matching and the Psychotherapeutic Relationship
(Auckland University of Technology, 2003) Patterson, Seilosa W.; Culbertson, Philip
“Cultural matching and the psychotherapeutic relationship” challenges and explores therapists’ work with cultural otherness. Firstly, it considers the history of psychoanalysis, in terms of Freud, sexism, white blindness, white privilege and racism. Some of these critical white theories continue to oppress, marginalize and colonize the culturally different client. Therapists of Aotearoa are encouraged to culturally match the changing needs of our clientele by privileging culture within the relationship. Writings from Culbertson, Makasiale, Bowden, Seeley, Christopher, Fanon and many more are reviewed to support working with cultural differences within the psychotherapeutic relationship. Case illustrations of working with Polynesian clients are shared to highlight the needs of cultural matching in assessment, diagnosis, treatment planning, and supervision. Cultural issues within training programmes are critiqued for their contemporary monocultural approach, and challenged to consider the literature of cultural knowledge and competency written internationally and also within New Zealand.
Craft art practice
(Auckland University of Technology, 2003) Hare, Richard Paul
This project involves an exploration within Art and Craft debate focusing on five issues of space, structure, production, collection and installation. A practical component is used to contextualise a ceramics craft practice within an art discourse. This takes the form of an installation, whose discourse references the collection, and the nature of space and structure within Art and Craft production. Accompanying this is an exegesis whose method will be to take a comparative approach between phenomenology and critical theory. Phenomenology acts as a catalyst to enable critical examination of the key points of the five issues, and several relevant artists are referenced.
The effect of concentric and eccentric muscle action on muscle stiffness at the knee in subjects with spasticity of the quadriceps
(Auckland University of Technology, 2003) Hoessly, Margaret; McNair, Peter
A higher than normal level of muscle stiffness is found in a wide variety of upper motor neurone disorders. This is reflected in elevated levels of resistance to lengthening of muscle often described as hypertonia or spasticity. Muscle weakness is also thought to be one of the major problems of motor function in many patients with these disorders. Another feature of the spastic condition is that of associated reactions, contraction of spastic muscle occurring on effort, especially in subjects with stroke. They appear to be the cause of a further increase in spasticity and a source of muscle shortening and joint contracture. To remedy muscle strength deficits patients should work at high levels of effort, however effort during treatment has been avoided by clinicians on the grounds that it would increase muscle stiffness and further hinder the patient’s motor performance. The present study was designed to investigate the effects of effort on spastic stiffness during concentric and eccentric muscle work of the quadriceps muscle. Nine subjects with significant spasticity of the quadriceps muscle participated in the study. Subjects undertook a modified ‘drop test’, using an isokinetic dynamometer that flexed the knee joint at 100 deg/sec, through a range of motion from 20 to 80 degrees prior to and after exercise. Force–angle ratios were used to calculate muscle stiffness in two parts of the range of motion, and electromyography (EMG) was used to monitor muscle activity both at rest and during the passive movement of the drop test. The exercise intervention involved 20 repetitions of concentric muscle work and 20 repetitions of eccentric muscle work performed on separate occasions at 75% of maximum voluntary muscle action (MVA). The results showed that under the conditions described above both resisted concentric and eccentric muscle work decreased stiffness (p < 0.05) of spastic muscle, there being no difference in effect between the two conditions. EMG of the quadriceps and hamstrings showed that there was no significant change in muscle activity (p < 0.05) at rest or during the ‘drop test’ following either concentric or eccentric contractions. This study demonstrated that effort occurring during resisted exercise did not increase muscle stiffness in spastic patients. Furthermore, there is some evidence to suggest that the decrease in stiffness resulted from change in the mechanical properties of the muscle. The findings are encouraging for clinicians as they support the therapeutic use of high levels of muscle work, which is the most efficacious means of increasing strength.
Towards a Māori Psychotherapy - The Therapeutic Relationship and Māori Concepts of Relationship: A Systematic Literature Review with Case Illustrations
(Auckland University of Technology, 2003) Morice, Margaret Poutu; Appel, Stephen; Makasiale, Cabrini
This dissertation explores what a Maori psychotherapy might look like. To do this I will define and describe core relational concepts of traditional Maori society within a Kaupapa Maori frame of reference. I have identified the following six relationships as central or core: Manaakitanga (generosity, hospitality), Whanaungatanga (nurturing connection and belonging), Kaitiakitanga (guardianship, protection, caretaking), Kotahitanga ( developing oneness, unity and integration), Rangatiratanga ( self-determination, self-actualisation and leadership), and Wairuatanga ( spiritual awareness and the practice of spirituality). These concepts will be introduced through a systematic literature review and then linked to the practice of psychotherapy. Each core relationship has the potential to make a unique contribution to our understanding of the therapeutic process. Clinical examples from my own psychotherapy practice will be used to illustrate how I think about and use these concepts in my work with clients. Maori concepts of relationship will be located within a holistic context and worldview and shown to be relevant both to the specific interpersonal practice called psychotherapy and to the broader field of human experience and self-understanding.
An exploratory review of consumer trust and its antecedents in E-commerce
(Auckland University of Technology, 2003) Ding, Celina; Glynn, Mark
There is a general agreement in literature that improving online trust between businesses and consumers would create a greater success for e-commerce. Building consumer trust in e-commerce and developing long-term relationships with consumers is the key to exploiting the potential of e-commerce (Grabner-Krauter and Kaluscha, 2003). Trust in the e-commerce context is a relatively new phenomenon and traditional trust research does not provide enough knowledge to explain and predict consumer trust in e-commerce. The conceptualizations of the trust construct and the relationship between trust and its antecedents are not theoretically derived nor thoroughly validated in e-commerce. Hence there is a need to examine the notion of trust in this emerging context. This study takes the form of a literature review, which integrates literature on e-trust by critically synthesizing and analysing articles published on the topic of consumer trust in e-commerce (e-trust). This approach is achieved by discussing trust in diverse disciplines which e-trust models are based on. Literature on the topic of antecedents of e-trust is selected and analysed, and the results and findings are presented at the end. The findings suggest that there still exist conceptual confusions of trust in e-commerce. The literature on consumer e-trust suffers because of the complexity and multi-dimensions of trust (Lewis and Weigert, 1985). This hinders empirical studies from examining a broader picture of consumer e-trust. Most of the selected literature is based on different theoretical foundations or disciplines and each study has focused on a selected aspect of the relationship between the on-line consumer, the Internet vendor and the Internet channel. This makes it difficult to compare and contrast the relationship between trust and the antecedents of trust in e-commerce. Disposition to trust (consumer’s personality trait), trustworthiness of the Internet vendor, and institutional trust are found to be major antecedents of consumer e-trust in this study.
The image as metaphor: An exploration into the metaphorical and experiential operations of the installed image
(Auckland University of Technology, 2003) Fong, Helen
This is a practical art project intended to complete research into an Image that has concentrated creative energies over the past four years. It is accompanied by a 6000 word exegesis contextualising the practical work, including discussion of past work, and the project methodology. This has been a reflective year in which past research both academic and studio has been reviewed. The main focus is on consideration of the concept of metaphor, the role it has played in past studio research and painting works, and the possibilities it may hold for a further series. Major emphasis is placed on studio practice, the aim being to create an installation of works which implicate the spectator directly into reflection and construction of their own experience of the Image. The area of studio research is painting, involving also the processes of photography, printing and the further integration of computer technology into one’s process. As one probes deeper into the Image, issues of transparency and reflection assume greater importance and in line with this emphasis, transparent and reflective materials such as glass and perspex have been researched and experimented with for evaluation of the possibilities of their use in the installation. The aim of the installation is to develop ideas of 2002, in which a space that was open to all directions was created for the viewer to enter and consider translation No 4 of the Image. In light of the view that metaphor involves not only an understanding but also an experience of a concept, one hopes to extend this experiential aspect and create a series of spaces for the viewer to walk through and create their own experience of the Image.
An occupational perspective of short-term unemployment
(Auckland University of Technology, 2003) Dunn, Tim J.; Hocking, Clare
This qualitative study explores the experiences of occupational engagement during short term unemployment, which is defined as being less than six months in duration. It specifically explores the lived experiences of unemployment and occupational engagement from the stories of six young adults living in a major city of New Zealand. Research participation was voluntary and all volunteers were recruited from one office of Work and Income New Zealand. They identified themselves as individuals who had been receiving the unemployment benefit for six months or less, and had a desire to return to employment. The experience of unemployment was a novel state in that they all had an occupational history in which employment was the norm. Data was collected over a four month period in the form of semi-structured audio-taped interviews that inquired about how unemployment had affected their daily occupational engagement in all categories of occupations (leisure, self maintenance and productivity). Data analysis was then conducted over a further four months using thematic analysis, guided by phenomenological assumptions as described by van Manen. The four main themes that emerged from the data analysis are presented as: 1) The freedom of unemployment, 2) Falling off, 3) Feelings of needing more than this and 4) I’ll get going eventually. The findings are discussed in relation to the four existentials of ‘lifeworld’ suggested by van Manen. These are lived space (spatiality), lived body (corporeality), lived time (temporality) and lived other (relationality). The findings suggest that the experience of short term unemployment affected all aspects of the participants daily occupational engagement. Participant experiences reflected that all of the four existentials of ‘lifeworld’ were impacted upon during short term unemployment. Occupational therapy and occupational science paradigms would suggest, from this study, that fundamental concepts of unemployment needing to be addressed are daily structure, goals, and engagement in occupation that has meaning or purpose for the individual without the experience of employment. I would suggest that further research is required to explore the process and common themes that emerged from the data analysis of this study.
Treatment by the law and society of parents of minors who have died in circumstances where they were denied medical intervention
(Auckland University of Technology, 2003) Worley, Heather; Diesfeld, Kate; Seedhouse, David
Between 1999 and 2001, three children belonging to three sets of parents developed illnesses which were to prove fatal. In each of the cases the parents chose non-orthodox treatment ahead of medical treatment and the law and society responded very differently to each of the three cases. In one case all orders against the parents were dropped for the paramountcy of their child’s welfare, in the second case the parents received convictions with suspended sentences and in the third case the parents received prison sentences for manslaughter. The purpose of the research is to identify and highlight inconsistencies which occurred not only in the courts, but also with general public reaction and to examine possible reasons for the different legal penalties inflicted on the parents. It is also important to illustrate differing attitudes of some members of society towards alternative versus conventional medicine and also to intense religious beliefs. The research asks a number of questions concerning the paramountcy of children’s right to life, self-determination and the court’s role in these circumstances. Critical legal theory is used, exploring case law and legislation internationally and within New Zealand. From this a framework is established which consists of investigating the historical relationship between medicine and the law and best interests as it relates to the cases in the research. The rights of children as autonomous individuals are seen to be of major importance in medical decision-making. The legal positions for people who refuse consent to treatment either on their own behalf or on the behalf of minors are also examined, including the rights of parents who refuse consent to medical treatment on religious grounds. There is a brief discussion concerning accountability for alternative health therapy practitioners. It is found that although the Code of Health and Disability Services Consumers’ Rights 1996 offers the presumption of capacity to consent to treatment without age providing an artificial barrier, the legal position of a minor to refuse consent to treatment is unclear. The law and society appear reluctant to allow a child to be placed at risk of death or harm because of religious beliefs. Possibly this is due to the value the State places on the sanctity of life, which sometimes overrides the right to practice religion without interference. Finally, there is a discussion about New Zealand’s progress with guidelines which have been suggested by national and international organisations regarding improving situations for families who find themselves in similar circumstances and for at-risk children in general. It is seen that New Zealand has been slow to implement recommended proposals. The exploratory nature of this research serves to highlight certain inconsistencies and areas of concern involving children and their families, in the hospital setting and in a court situation. These concerns could warrant further investigation within both the health and legal professions, which is beyond the scope of the current discussion.
A lamp to light the way: Public health nurses' perceptions and experiences of professional/clinical supervision
(Auckland University of Technology, 2003) Farrell, Elizabeth; Walton, Jo
Clinical supervision is a relatively new concept in nursing with no New Zealand research on the topic to date. However taking a lead from our colleagues in Britain and elsewhere, clinical supervision is gaining momentum in nursing in this country because of the perceived benefits it can have for both nurses and clients. This study sought answers to the question ‘What are Public Health Nurses’ perceptions and experiences of clinical supervision?’ It consisted of a comprehensive literature review and a small qualitative descriptive research project. As part of the study, two focus group interviews involving seven PHNs were conducted. The data analysis uncovered a developmental process that the participant PHNs went through as they began to understand the principles of clinical supervision and began to relate their practice to the peer reciprocal model of supervision, which had recently been introduced to their organisation. Four key themes were identified - ‘needing’, ‘knowing’, ‘learning’, and ‘doing’ clinical supervision. The study also demonstrated how public health nursing practice was inextricably woven throughout. I have called this process a ‘journey of discovery’. From the participants’ perspective, the rationale for clinical supervision revolved around the perceived need to understand the complexity of this nursing speciality, and in the recognition of the impact this practice had on the PHNs’ personal well-being and subsequent ability to provide competent nursing care. Thus, practice became the ‘essence’ of the peer reciprocal clinical supervision sessions that developed after the introduction of this model. As this is a small qualitative descriptive study, limitations are acknowledged. However, it is hoped that the outcome of this research will improve the understanding of clinical supervision from a public health nursing perspective, facilitate more debate, guide others attempts to introduce clinical supervision and influence future research direction.
Diagnostic ultrasound imaging and its role within musculoskeletal medicine
(Auckland University of Technology, 2003) Jeffery, Roland
No abstract.
Maternal request for an elective caesarean section: An interpretive descriptive study of primigravid women's request for an elective caesarean section
(Auckland University of Technology, 2003) Arthur, Dianne; Payne, Debbie
This research explores and identifies primigravid women’s reasons for requesting an elective caesarean section when there is no medical reason for them to give birth this way. The issue of women requesting caesarean section is a complex topic being debated worldwide and is full of contradictions. A review of the literature related to maternal request for an elective caesarean section reveals an abundance of papers covering the topic from medical journals to the tabloid press. Few studies have focused on the women and why they are choosing this method of birth. Five women who had experienced a caesarean section without medical indication were interviewed over a two-month period. Interpretive description was used as the method of data analysis because it involves description about a shared health or illness phenomenon from the perspective of those who have lived it. Six themes were identified from the study. The two predominant themes were, influencing voices and safety of the unborn child. Each woman in the study related stories from friends and families that considered vaginal birth as being risky and unpredictable. The safety of the child was paramount for four out of the five women. They perceived that a caesarean section was best method of delivery to ensure a normal healthy child. The remaining four themes voiced by the participants were, vaginal birth as hazardous to the mother, feelings of guilt, the right to choose and staying in control. These findings all helped to answer my question of why primigravid women chose to birth by caesarean section.

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