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Title: Meaning of visual impairment : developing ophthalmic nursing care
Author: Waterman, Heather Anne
ISNI:       0000 0001 2416 0269
Awarding Body: University of Manchester : University of Manchester
Current Institution: University of Manchester
Date of Award: 1994
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This thesis discusses the meaning of visual impairment from ophthalmic patients', nurses' and nurs1ng auxiliaries' perspectives, and analyses the roles of nursing staff in ophthalmic out-patient departments. Drawing on philosophical hermeneutics, I justify an important theme of this text - reflexivity. In doing so, I reject the notion of objective knowledge, claiming that, in particular, historical prejudices, or the collective and individual experiences of people and the process of dialogue, are the cornerstone to understanding. The research was carried out at two out-patient settings. First, reflexive ethnography was selected to enable the collection of in-depth data suitable for developing theory. Reflexive, flexible, largely informal interviews, consisting mainly of open-ended questions, were employed to further this aim, and concurrent comparative analysis of data enabled probing of emerging themes. A conceptual framework is detailed for understanding the meaning of visual impairment. within the framework, I highlight that the most influential factors in patients' emotional and social experiences of visual impairment are their perception of losses incurred through reduction in sight, and their prognosis of the eye condition. Nurses and nursing auxiliaries evaluated the prospect of visual impairment negatively, as do most people, and tended to overlook the complex nature of the experiences of ophthalmic patients. My sample of visually impaired patients conceived nurses' and nursing auxiliaries' work in out-patient departments as marginal and subsidiary to that of the doctors. Nurses' and nursing auxiliaries' perceptions of their current roles were largely cognisant with those of the patients. I discuss twelve categories which outline their roles, and draw on feminist and sociological theory to explain the present situation. I also argue that medically oriented care dominates at the expense of holistic care. It was planned that this initial analysis would lead to an action research project. Philosophical hermeneutics and reflexivity were integrated into other philosophical notions of action research to form a reflexive model of action research. A multi-method research strategy was employed to enable analysis of the process of change, in which I formally introduce the notion of dialectics, in order to link philosophical hermeneutics and reflexivity to action research. I identify eleven areas of achievement of the project, and I discuss thirteen factors which, depending on the local and national context, may stand in contradiction and, consequently, hinder change. I conclude that these hindrances and contradictions need to be resolved for advances to be made in nursing practice.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available