Nursing and Midwifery
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Item He iwi ke koutou, he iwi ke matou, engari i tenei wa, tatou, tatou e = You are different, we are different, but we are able to work together : Family Partnership as a model for cultural responsiveness in a Well Child context : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Nursing at Massey University, Albany, New Zealand(Massey University, 2013) Tipa, Zoe KristenIn 2006 the Royal New Zealand Plunket Society embraced a model of communication and practice titled Family Partnership. The Family Partnership model and training is designed to develop the communication skills of professionals working with families in order to acknowledge and enhance the capabilities of parents. It is acknowledged that the degree to which a service is culturally safe is defined by the individual receiving the service. Nurse leaders, educators and peers are consistently required to make judgements as to the extent to which the nurse being observed is culturally safe, without obtaining client feedback. This research examined whether the Family Partnership model could be considered a model for cultural responsiveness with the dual benefit of providing a platform to more accurately assess the cultural competence of Plunket nurse practice. An evaluation design and methodology was used to determine the relationship between Family Partnership training for Plunket nurses in relation to Māori health outcomes. There were two phases in the data collection process. In phase one an online survey was completed by a group of Plunket nurses who had completed Family Partnership training along with a group that had not completed Family Partnership training. Phase two included ten observations and interviews with Plunket nurses and Plunket clients who identified as Māori. A combination of evaluation tables to determine merit and thematic analysis were used for the analysis of the mixed methods data. The results were presented in three sections relating to Plunket nurse practice, client experience and the impact on Plunket as an organisation. All Plunket nurses who participated in the research believed that Family Partnership had a positive impact on their clinical practice. The extent to which their practice had changed was difficult to determine, however the need for ongoing updates in Family Partnership was strongly indicated. Māori Plunket clients were generally satisfied with the Plunket service and their responses aligned with the concepts outlined in Family Partnership communication theory. The relationship between the findings and the principles of the Treaty of Waitangi were highlighted. This research has indicated that cultural responsiveness can be defined as the way in which a service identifies and attempts to meet the needs of the individual. It has discussed the complexity around what constitutes a health outcome for Māori clients and ultimately how cultural competence may be better assessed in practice.Item Hei aha nga whakaaro o Ngati Ruanui mo te Whanau Ora? : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy (Nursing) at Massey University, Palmerston North, New Zealand(Massey University, 2012) Campbell-Knowles, Te MoanaIn Aotearoa New Zealand poorer health outcomes for Māori have been well documented. There is growing evidence that limited contact between whānau members has a potential negative impact on the health and wellbeing within the whānau. The term Whānau Ora has been widely used and variously defined by Māori over many years however there is no single shared definition of Whānau Ora, and little understanding about how it can be implemented by Māori health providers as a service delivery framework. This research expands on existing knowledge of Whānau Ora by identifying definitions, gathering data about Whānau Ora values and concepts, cultural beliefs and practices. This research is informed by the worldview of healthcare for Māori. A number of hui (meetings) were held where Ngāti Ruanui iwi members were consulted and ten Ngāti Ruanui participants were interviewed. These participants identified meanings of Whānau Ora that included ‘being Māori’ and who they are (whakapapa) and how this translates to ‘how they live’ (Matauranga Māori), ‘self-definition’ (tino-rangatiranga) and how Whānau Ora is the ‘way forward’ to address past and present issues such as colonisation and inequalities. This research employed a Māori-centred qualitative methodology which allowed Māori and Western belief systems their own integrity whilst working side by side, utilizing the energy of the two systems. Localising the research to Ngāti Ruanui Iwi members was intentional, to understand what members considered important. As the integrity of the participants was a central concern in the research, a methodology was adopted that was respectful and valued the participant’s worldview. Participants regarded Whānau Ora as a mechanism to assist whānau to “move on”, and advance as Māori. Whānau Ora was also regarded as an important future model of health that has the potential ‘do away’ with disparities and assist Māori in their efforts to strive for good health. The research concluded that Māori health outcomes will be much improved when they are delivered in ways that meet the cultural needs of Māori. The roles and responsibilities of the Crown must ensure that these changes develop and are done in collaboration with Māori organisations themselves which will ensure that any changes reflect the philosophies of Whānau Ora: optimal wellbeing.
