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Out of Time, Out of Place: Pastoral and Theological Implications for Parents of Extremely Premature Infants

Heard, Gary D. (2011) Out of Time, Out of Place: Pastoral and Theological Implications for Parents of Extremely Premature Infants. Doctor of Philosophy thesis, UNSPECIFIED.


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This thesis is an original exploration of the experience of parents in the wake of their child’s extremely premature birth, using grounded theory analyis. Biographical narratives, intercultural frameworks, and anthropological models offer insights into the identified experience of dislocation which find some integration through theological metaphors of exile and return; and faith, hope and love. A pastoral care strategy is developed in response to the disruption experienced.
The last five decades have seen rapid growth in the extent and incidence of premature birth, such that the thresholds of viability have been steadily pushed back to the point where babies only slightly more than half way through a normal gestation are resuscitated and hospitalised for extended periods. At the same time the percentage of births which are classified as premature has increased to more than 10% of all live births. Whilst extensive research has been undertaken – and continues today – investigating the impact on the child born at such margins of viability, little research exists investigating the impact of this experience on the parents who will ultimately care for and nurture these premature infants through to adulthood. The parent experience is at the centre of focus for this study.
This research has been undertaken through an on-line discussion list, comprising members drawn from different countries from around the world, and a repository of over 60,000 email postings during the period under consideration (1996-2003). The methodology employed in this study is that of an unobtrusive researcher, utilising grounded theory analysis of an on-line resource interpreted through a pastoral-theological framework of interpretation and understanding.
The research findings reveal that parents suffer a significant experience of dislocation which leaves them unable at the time of discharge to reintegrate into the world they knew and experienced prior to the experience of premature birth. The existing literature which informs the parent experience of premature birth is shown to be both misleading and inadequate, failing to prepare parents for the experience, and providing no helpful insight for the parents‟ social community which would enable or foster support during this crisis, and in re-adjustment to home life subsequent to discharge.
Different epistemologies are explored in an effort to develop a framework for understanding this experience of displacement and disconnect and to develop an interpretive grid which provides the basis for a strategy for pastoral care of parents. Biographical narratives, intercultural frameworks, and anthropological models offer insights into the nature of the premparent experience, which ultimately highlight the impact of social isolation which flows from the hospital experience. Two theological metaphors: exile and return; and faith, hope and love provide interpretive insights which serve as a basis for developing a pastoral response to the parents.
The practice of pastoral care within the current setting is examined in light of the principles of pastoral care within the christian tradition, with particular view towards the ways in which care can be facilitated towards helping parents cope not only with the journey within the hospital setting, but also with the attendant impact on personal identity and values, and in relationship with their wider communal setting.
In the concluding chapter, recommendations for change which provide strategies to address the social disruption and isolation, and which provide frameworks for assisting parents in addressing the multifaceted losses associated with extreme premature birth are offered.

Item Type: Theses (Doctor of Philosophy)
Repository Version: Author's Final Manuscript
Keywords: Premature infants, pastoral care, theological approach,
Fields of Research: 22 Philosophy and Religious Studies > 2204 Religion and Religious Studies > 220405 Religion and Society
Socio-Economic Objective: C Society > 95 Cultural Understanding > 9504 Religion and Ethics > 950404 Religion and Society
E Expanding Knowledge > 97 Expanding Knowledge > 970122 Expanding Knowledge in Philosophy and Religious Studies
Type of Activity: Applied Research
Subjects: D - Pastoral Studies
College/Association with University of Divinity: Whitley College
Depositing User: Cate Headey
Date Deposited: 23 Aug 2011 22:57
Last Modified: 25 Aug 2011 01:11
URI: http://repository.divinity.edu.au/id/eprint/902

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