Ngā kairaranga oranga = The weavers of health and wellbeing : a grounded theory study : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, New Zealand
Ngā Kairaranga Oranga – The Weavers of Health and Wellbeing is a theory about the health and wellbeing of Māori women. Health data about Māori women indicate that their health status is less than that of the non-Māori population despite the right to experience equality in health outcomes. Māori women’s health and wellbeing influences the nature of their health outcomes, varies across their lifetime. ‘What is happening for Māori women, their health and interactions with ‘mainstream’ health services?’ is the question that guided the research with Māori women. A grounded theory informed by a Māori centred approach was developed that utilised Mason Durie’s Māori-centred concepts of mana Māori (control), whakapiki tangata (enablement) and whakatuia (integration), and integrated Glaserian grounded theory to guide the collection and analysis of the data. Twenty-three women who identified as Māori within the Te Arawa rohe, and who were between the ages of 18 and 80 years were formally interviewed as either a group, pairs or individuals, with a further 15 informally interviewed during the process of theoretical sampling. Semi-structured interviews and field notes were used to collect the data, and the processes of constant comparative analysis, theoretical sampling and saturation were used to generate a middle-range substantive Māori centred grounded theory. Three core categories were identified relating to the health and wellbeing of Māori women: (a) Mana Māori, which describes what is important for their health and wellbeing; (b) The Way It Is, which outlines the resigned acceptance they have of their reality and life circumstances, and the barriers and challenges that are encountered; and (c) Engaging with Health Services, which describes what they require from ‘mainstream’ health services to improve the access and use of these services. The basic social psychological process of ‘weaving health and wellbeing’ integrates these core categories. The interpretations Māori women have of health and wellbeing, and health-related actions are explained by the theory generated. This substantive grounded theory provides a model to guide the education and practice of health care providers working within ‘mainstream’ health services.