He pito ora : exploring the role of Māori cancer navigators : a thesis presented in partial fulfilment of the requirements of the degree of Doctor of Philosophy in Public Health (Māori Health)
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Date
2019
DOI
Open Access Location
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Publisher
Massey University
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Abstract
In Aotearoa, New Zealand, cancer is now the leading cause of death. The cancer burden
is disproportionately high for Māori, the indigenous people, compared with non-Māori
across all stages of the cancer continuum. Additionally, Māori experience access barriers
to timely and quality cancer care. Māori cancer navigator positions were created to assist
patients in negotiating the complex cancer system. To date, no research has examined the
Māori cancer navigator’s contribution to cancer service provision, including the ways in
which they undertake their key role of providing supportive care to patients with cancer.
The overall aim of this study was to examine the implementation of Māori cancer
navigator/coordinator roles, and their contribution to and impact on the experience of
Māori health consumers, patients, and whānau during their cancer care journey.
The objectives of the study were to:
1) describe the ways in which Māori cancer navigator positions have been developed
across the cancer continuum;
2) examine the contextual factors impacting on Māori cancer navigator roles; and
3) identify key success factors relating to the ways in which Māori cancer navigator
positions make a difference to the patient/whānau cancer experience.
The study is underpinned by kaupapa Māori methodology. Participants were recruited
from Māori health consumers, patients, whānau, Māori cancer navigators, and clinical
and non-clinical health professionals involved in cancer care. Data was collected via
semi-structured interviews, observation and hui (n=24), and an online survey (n=52). The
data were analysed using thematic, whakapapa and experiential analysis and the emergent
themes applied to a continuity of care framework.
The major themes/principles identified from this work were: whanaungatanga, which
relates to trust and multiple relationships; whakamōhio, which encompasses
communication and the sharing of information and; manaakitanga, where consistency in
care and system influences are the key factors. These principles were developed into a
model He Pito Ora for this thesis.
Māori cancer navigator/coordinator positions help facilitate patient/whānau continuity of
care. Greater integration of Māori cancer navigators/coordinators within cancer services
will help address fragmentation in care and improve communication between health
professionals and with patients and whānau. These are key areas which can improve the
quality of care and potentially make a difference to patient/whānau cancer outcomes.
Description
Listed in 2019 Dean's List of Exceptional Theses
Appendices 24, 26, 27, 28, 29 & 32 have been removed.
Appendices 24, 26, 27, 28, 29 & 32 have been removed.
Keywords
Cancer, Patients, Care, New Zealand, Maori (New Zealand people), Medical care, Services for, Community health services, Caregivers, Mate pukupuku, Ratonga ki te iwi, Tuku ratonga, Māori Doctoral Thesis, Dean's List of Exceptional Theses