Massey University Departments
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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.Item Me aro ki te ha o hineahuone : women, miscarriage stories, and midwifery : towards a contextually relevant research methodology : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Midwifery at Massey University, Palmerston North, New Zealand(Massey University, 2009) Kenney, Christine M.Professional ethics and legal competencies require midwives practising in New Zealand to provide care for childbearing women in a partnership characterised by continuity, equality, mutual respect, trust, shared responsibility and decision making. New Zealand is culturally and legislatively a bi-cultural environment and the cultural safety of Maori (indigenous peoples) are prioritised within health legislation. The midwifery philosophy of partnership and bi-cultural legislation, have provided a foundation for developing a research methodology for the profession. This thesis stories the interweaving of multiple epistemologies, theoretical tenets, philosophical concepts, indigenous and Western European world views as well as women’s narratives in creating and implementing a contextually relevant qualitative research methodology, ‘Te Whakamaramtanga’. The methodology was trialled in the field of miscarriage; a practice issue for midwives in New Zealand. Research participants were recruited through ‘word of mouth’ and snowballing methods. Twenty women participated in the research project and of these nine identified as midwives. Twelve participants were of Non Maori descent, including four women who were immigrants to New Zealand, and eight participants identified as Maori. Participants’ stories were gathered through dialogical interviews, which recognised the co-construction and exploration of knowledge. Ethical tenets outlined in the methodology involved the use of extensive, ongoing consultation with Maori, midwifery and local communities. Maori, women, and midwives share an oral culture that values narratives as facilitating the constitution of identities, creation and transmission of knowledge, and the development of social relationships. Whole narrative, thematic and narrative elements analyses of participants’ miscarriage-related talk have been developed through drawing on kaupapa Maori philosophy, the social theories of Pierre Bourdieu, Michel Foucault, Bruno Latour, Paul Ricouer, and Rom Harre as well as the narrative concepts of Arthur Frank and Margaret Somers. Substantive chapters explore whakapapa, corporeal temporalities, narrative silences and women’s desires for recognition and relationships. A new theory is advanced that methodologies, narratives, genealogies, temporalities, silences and women voices are simultaneously co-constituted metaphysical and material technologies. These heterogeneous and relational entities are collectively perceived as actants, hybrid actors, actor networks as well as technologies, which exist within a range of dynamic and hierarchical networks and/or fields in which this thesis is also embedded. My development of a multicultural midwifery research methodology informed by multidisciplinary theoretical approaches is innovative for midwifery research and theory, and potentially other health disciplines. My research also addresses gaps in midwifery, miscarriage–related, professional development, Maori health and health research literature.Item 'A kind of ritual Pakeha tikanga'-- Maori experiences of hospitalisation : a case study : 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, 2008) Barton, PipiMinimal literature exists relating to the experiences of Maori within the New Zealand public hospital system. Maori are highly represented in morbidity and mortality statistics and are high users of the secondary health care system. A Case Study methodology with a Maori centred approach was used to describe Maori experiences of hospitalisation. Multiple sources of evidence were gathered, including participant interviews, statistical data from the New Zealand Health Information Service, and international literature relating to indigenous experiences of hospitalisation. Eleven people (nine female and two males) identifying as Maori, of various iwi (tribal) affiliations and from a range of regions, participated in the interviews. All participants had either been admitted, or cared for by a family member who had been admitted to a medical or surgical ward in a public hospital anywhere in New Zealand within the last 15 years. Participants were aged between 20 to 75 years. All interviews were audio recorded, transcribed and then thematically analysed. A retrospective interrupted time series design was used to examine length of stay for Maori patients receiving treatment in the secondary medical and surgical setting, from 1989-2004. The data included the records of all medical and surgical discharges for Maori and non-Maori from the New Zealand public hospitals. Medical and surgical admissions were screened to include those over the age of 17 years and who had a length of stay greater than 1 day and less than 90 days. From the analysis of all the data three key interpretations emerged: 1. Maori are marginalised within the mainstream health system. 2. Maori believe that the hospital environment is not conducive to healing. 3. Maori experiences in hospital contribute to their decision to leave as soon as possible. The recommendations include the integration of more culturally acceptable and appropriate interventions within secondary and tertiary health services, and a review of the effectiveness of cultural safety education in practice and inclusion/revision of the cultural competence for all health care workers.
