Struggling to be involved: An interprofessional approach to examine Maori whanau engagement with healthcare services

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Aims and objectives: Identify the key concepts, principles and values embedded within Indigenous Māori models of health and wellbeing; and determine how these could inform the development of a Māori-centred relational model of care.Background: Improving health equity for Māori, similar to other colonised Indigenous peoples globally, requires urgent attention. Improving the quality of health practitioners' engagement with Indigenous Māori accessing health services is one area that could support improving Māori health equity. While the Fundamentals of Care framework offers a promising relational approach, it lacks consideration of culture, whānau or family, and spirituality, important for Indigenous health and wellbeing. Design and methods:A qualitative literature review on Māori models of health and wellbeing yielded nine models to inform a Māori-centred relational model of care. We followed the PRISMA guidelines for reporting literature reviews.Results: Four overarching themes were identified that included dimensions of health and wellbeing; whanaungatanga (connectedness); whakawhanaungatanga (building relationships); and socio-political health context (colonisation, urbanisation, racism, and marginalisation). Health and wellbeing for Māori is a holistic and relational concept. Building relationships that include whānau (extended family) is a cultural imperative. Conclusions:This study highlights the importance and relevance of relational approaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust-based relationships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empathy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (importance of spiritual wellbeing).

Section: Fundamentals Of Carementioning

confidence: 99%

Section: Key Elements Descriptionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Creating an Indigenous Māori‐centred model of relational health: A literature review of Māori models of health

Wilson

Moloney

Parr

et al. 2021

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“…Research with Māori and whānau demonstrates how instead of engaging with nurses and health professionals who value a relational approach to healthcare delivery, they are frequently met with being treated differently from other patients and families and instead made to feel whakamā (feelings of embarrassment and shame) (Wepa, 2016; Wepa & Wilson, 2019; Wilson, 2008; Wilson & Barton, 2012). Māori also experiences higher levels of discrimination (Cormack, Stanley, & Harris, 2018; Harris et al., 2012a, 2012b).…”

Section: It's a Cultural Thing—situating Māori Models Of Carementioning

confidence: 99%

The culture conversation: Report from the 2nd Australasian ILC meeting—Auckland 2019

Aspinall

Parr

Slark

et al. 2020

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Aim and objective: This paper reports on the proceedings of the second AustralasianInternational Learning Collaborative conference and summit.Background: In December 2019, over a hundred people attended the second Australasian International Learning Collaborative Conference and Summit. This was the first to be held in Aotearoa New Zealand, the land where cultural safety was developed, its origins being in nursing education. Perhaps not surprisingly, culture, cultural safety and the context of care featured highly in the presentations and workshops.Design and methods: Discussion paper. Results:A key outcome of the conference proceedings and workshops was the call for nurses and the International Learning Collaborative to work in partnership with indigenous groups to iterate the importance of the Fundamentals of Care framework and evaluate the impact of that on health equity. Other essential messages were to value establishing relationships, to continue to talk about the fundamentals of care, to research and to own them. Nurses were reminded to use their humanity to create a climate and culture in which patients and staff feel valued, safe and trusted. Conclusions: Future iterations of the Fundamentals of Care framework must incorporate indigenous worldviews, which emphasise the importance of relationships, family and spirituality on wellbeing. Such additions will provide an opportunity for the International Learning Collaborative to optimally respond and direct nursing practice. Relevance to clinical practice: International Learning Collaborative members and conference attendees learned, listened and worked on meeting the challenges of consistently implementing and applying the fundamentals of care in practice and its importance to education, research and policy. The takeaway message is, when this does not happen, nurses must speak up. K E Y W O R D S cultural issues, fundamental care, holistic care, indigenous health, inequalities in health, models of care, nurse-patient relationship, spirituality

“…For instance, New Zealand Māori are more likely to have noncommunicable diseases early in life and die prematurely by seven years compared to non‐Māori living in Aotearoa/New Zealand, with avoidable mortality explaining 53% of the life expectancy gap they experience (Walsh & Grey, 2019). When Māori do engage with health services, they are more likely to experience sub‐optimal quality in care (Wepa & Wilson, 2019). The experiences and outcomes Indigenous peoples experience negatively impact their trust in those people delivering the services and can act as deterrents from seeking timely care.…”

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confidence: 99%

The haka: Wonderful bonding, sending a challenge in a global crisis or merely cultural appropriation?

Wilson

2020

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