The experience of whanau caring for members disabled from the effects of stroke : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy at Massey University

Abstract

This thesis explores the experience of whanau caring for members disabled from the effects of stroke. The decision to undertake this study arose from my experience in rehabilitation nursing where I observed Maori accepting the responsibility for the care of their whanau member following a stroke with little assistance from existing rehabilitation and community based services. I wanted to understand why this was so, from the perspectives of the whanau. A review of epidemiological data demonstrated the negative disparity in the incidence of stroke in Maori when compared with non-Maori. Further review of the literature specifically related to Maori health issues revealed that whilst there was acknowledgement of the importance of whanau, kaumatua and kuia to Maori as a society, there was little that dealt with disability issues and stroke in particular. Where issues related to the provision of, and access to, health and disability services had been noted, little appears to have been accomplished. A descriptive qualitative research study was undertaken in the Taranaki region with support of the eight Taranaki iwi. Seven whanau focus groups interviews and three key informant interviews were undertaken. From analysis of the data a descriptive account of the whanau experience of onset of the stroke event, hospitalisation and service delivery following discharge of their whanau member is provided. The impact on the whanau of their ongoing provision of care with limited service provision from health and disability services is explored. On the basis of this analysis a number of recommendations are made. The key recommendation is that there needs to be a review of current rehabilitation service provision in Taranaki. From such a review it is hoped that changes will be implemented that will enable service provision to be more beneficial, accessible and acceptable to Taranaki Maori.