School of Health and Social Services

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    Whakaoranga whānau : a whānau resilience framework : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Public Health at Massey University, Wellington, New Zealand
    (Massey University, 2014) Waiti, Jordan Te Aramoana McPherson
    This research explored the capacity of whanau (family, extended family) to overcome adversity, flourish and enjoy better health and well-being. While external factors, internal dynamics, and financial pressures often constrain capacity, whanau have nevertheless demonstrated an innate ability to respond to these challenges – to make use of limited resources, and to react in positive and innovative ways. Three key objectives were identified to help seek and understand Maori notions of whanau resilience and how they are utilised by whanau for positive growth and development. The three objectives were: 1. To identify resilience mechanisms which exist within whanau; 2. To consider the cultural underpinnings of resilience; and 3. To construct an evidenced based framework for resilient whanau. A thematic analysis detailed the components of a Whanau Resilience Framework. The framework consists of four resilience platforms: (1) Whanaungatanga (networks and relationships); (2) Pukenga (skills and abilities); (3) Tikanga (values and beliefs); and (4) Tuakiri-a-Maori (cultural identity). This thesis highlights both the synergies and dissonance between Maori and non-Maori perspectives of resilience and how cultural factors might best guide Maori and whanau development. Insofar as this framework exhibits similar resilence strategies to other populations, it is at the micro-level where there are differences between Maori and other cultures or populations.
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    The health status of Māori nursing students : a cross-sectional survey : a thesis in partial fulfilment of the requirements for the degree of Masters of Philosophy in Nursing at Massey University, Albany, New Zealand
    (Massey University, 2009) Panapa, Shahana
    In New Zealand Maori are less likely to engage in tertiary level education and less likely to complete a tertiary level qualification than non Maori. These issues of recruitment and retention are reflected in other areas for Maori such as health, where Maori have worse levels of health Maori are more likely to have lower socioeconomic status. The initial findings of recent research indicate that Maori nursing students find it a struggle to remain on the Bachelor of Health Science in nursing degree programme. This study is designed to explore further what might be occurring for Maori nursing students by obtaining a snapshot of their health. Aim: To describe the health status of Maori nursing students. Participants: 75 nursing students undertaking nursing degree programmes in New Zealand, who identified as Maori. Method: A cross-sectional survey was undertaken with Maori nursing students completing nursing degrees from thirteen of sixteen tertiary institutions in New Zealand. Instrument: A questionnaire comprising demographic data, SF-36, and two cultural questions was used for students to self assess their health status. Participants were also invited to write relevant comments on the survey. Findings: Descriptive statistical data revealed participants with a stronger cultural identity as Maori were more likely to have their cultural needs met whilst studying compared to participants with a weaker Maori cultural identity. Participants in a relationship had more income than those who were not in a relationship. Participants’ overall health was worse than one year prior and their physical health was better than their mental health. More specifically, for physical health, general health, tiredness and lack of vitality were most affected, while roles and relationships were most affected for mental health. Implications: Institutions providing cultural support and kaupapa Maori programmes may assist in improving the recruitment and retention of Maori in nursing programmes. These results revealed a snapshot picture of the health 3 status of Maori nursing students and identified issues around their health status which is consistent with the literature.
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    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
    (Massey University, 2004) Wilson, Denise
    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.