Whānau Māori and their experiences of attention-deficit/hyperactivity disorder : implications for clinical practice : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Manawatū, New Zealand

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dc.confidentialEmbargo : No
dc.contributor.advisorRoss, Kirsty
dc.contributor.authorTipene, Charlene Mereana
dc.date.accessioned2024-03-20T02:08:14Z
dc.date.available2024-03-20T02:08:14Z
dc.date.issued2023-06-30
dc.description.abstractHealth care in New Zealand (NZ) is based on the ideal of universal health coverage for all. However, for many Māori health inequities exist in health outcomes and in access to services which adequately meet the needs of whānau Māori. Researchers have considered explanations (and solutions) for this situation, including whether health services are able to meet the cultural needs of Māori clients through a more holistic approach. Rather than considering this generally for all services, this research considers this specifically in relation to Attention-Deficit Hyperactivity Disorder (ADHD). Alongside core symptoms of hyperactivity, impulsivity, and inattention, for there to be a diagnosis of ADHD there must be associated functional impairment and diffuse impact of behavioural symptoms in multiple domains of a person’s life. This means that ADHD is well suited to the application of holistic understandings of wellbeing, such as those that exist in mātauranga Māori. A lack of research about ADHD among Māori highlights a need for research which explores the experiences of tamariki Māori and their whānau as they navigate ADHD diagnosis and treatment. This research used a Māori-centred framework and throughout, was guided by He Awa Whiria (Gillon & Macfarlane, 2017) which emphasises the importance of drawing together cultural and clinical knowledge. There were three main objectives: to understand the experiences of whānau Māori with a child assessed and treated for ADHD; to describe how whānau understood and accommodated ADHD behaviours before diagnosis; and to identify any barriers or facilitators for whānau Māori in accessing assessment and/or treatment. Semi-structured interviews took place with 10 whānau members, representing 13 young people who had been diagnosed with ADHD. The interview responses were analysed using (codebook) thematic analysis. The main findings revealed firstly that there were different levels of knowledge about ADHD among caregivers and some whānau struggled to know where to begin, to get support; secondly, it was difficult to access the service, and there was a lack of ongoing support available other than medication; and thirdly, while in all cases medication was offered as treatment, whānau found this a difficult decision to make for their child, preferring a more holistic approach. Most whānau were not asked about their cultural background or beliefs during assessment and half of the participants would have accessed a kaupapa Māori service if available. The implications of the findings for clinical practice are discussed with recommendations for how to blend cultural and clinical knowledge to ultimately benefit whānau Māori and achieve the best possible outcomes.
dc.identifier.urihttps://mro.massey.ac.nz/handle/10179/69419
dc.publisherMassey Universityen
dc.rightsThe Authoren
dc.subjectAttention-deficit hyperactivity disorderen
dc.subjectDiagnosisen
dc.subjectTreatmenten
dc.subjectMāori (New Zealand people)en
dc.subjectMental healthen
dc.subjectMental health servicesen
dc.subjectHauora whānauen
dc.subjectHauora hinengaroen
dc.subjectTahumaeroen
dc.subjectMāori Doctoral Thesisen
dc.subjectWhānau Māori, tamariki, rangatahi, mātauranga, tikanga, ADHD, ADD, assessment, case formulation, clinical practice, health equityen
dc.subject.anzsrc451013 Mātauranga hinengaro kaupapa Māori (Māori psychology)en
dc.subject.anzsrc520302 Clinical psychologyen
dc.titleWhānau Māori and their experiences of attention-deficit/hyperactivity disorder : implications for clinical practice : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Manawatū, New Zealanden
thesis.degree.disciplineClinical Psychology
thesis.degree.nameDoctor of Clinical Psychology (DClinPsych)
thesis.description.doctoral-citation-abridgedTo achieve equitable health outcomes for Māori requires access to services which adequately meet the needs of whānau. Whānau Māori spoke with Ms Tipene about supporting a young person diagnosed with Attention-Deficit/Hyperactivity Disorder, and how these experiences impacted service use. The implications for clinical practice were discussed, with recommendations to blend cultural and clinical knowledge to optimise outcomes for Māori.
thesis.description.doctoral-citation-longHealth care in New Zealand is based on the ideal of universal health coverage. However, for many Māori, inequities exist in health outcomes and in access to services which adequately meet the needs of whānau Māori. This treatment gap potentially exists for Attention-Deficit/Hyperactivity Disorder (ADHD). Taking a Māori-centred approach this study explored the experiences of whānau Māori supporting a young person diagnosed with ADHD, to understand how these experiences impacted service use. Whānau identified several barriers and facilitators in accessing support. The implications for clinical practice were discussed with recommendations for how to blend cultural and clinical knowledge to optimise the outcomes for Māori. Thereby whānau experience informed a broader, more consistent model of clinical practice.
thesis.description.name-pronounciationSHAR-LEAN TEA-PEH-NEH
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