A Māori model of primary health care nursing : a thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Massey University, Palmerston North, New Zealand

Abstract

While the philosophy and policy of primary care nursing are consistent with Māori development objectives, the practice can fall short of this ideal. This thesis identifies and examines the shortfall in terms of Māori women's expectations and identifies ways in which traditional nursing practice among Māori communities may be enhanced. The research highlights the need for nursing to broaden our concepts of health, community, and public health nursing, to focus more on issues of capacity building, community needs, and a broader understanding of the social, political, cultural, and economic contexts of the communities we work with. This research used a critical ethnographic method underpinned by a Māori-centered approach to explore health as experienced by Māori women. The primary data collection involved, a period of intensive fieldwork within the community, use of in-depth interviews, attendance at hui, and a review of literature and policy documentation. The findings of this research articulate a model of health that is a dynamic process based on the restoration of, and maintenance of cultural integrity, and is based on the principle of self-determination. Primary health care is a process of enabling Māori to increase control over the determinants of health and strengthen their identity as Māori thereby improving their health and position is society. The findings support a substantive Māori model of Primary Health Care Nursing that provides a framework for theoretical research, which will lead to further conceptual refinement. The model also provides a framework for education curricula and nursing practice that will enhance nursing's ability to meet the needs of Māori.