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Sadlier, C. (2002). Gaining insight into the experience of diabetes. Kai Tiaki: Nursing New Zealand, 8(1), 14–16.
Abstract: This article reports a research project that investigated the experience and expectations of Maori who were newly-diagnosed with non-insulin-dependent diabetes mellitus (NIDDM). Four people diagnosed with NIDDM were interviewed over 12 months. Participant recommendations are incorporated into suggested improvements for managing the condition.
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Framp, A. (2006). Diffuse gastric cancer. Gastroenterology Nursing, 29(3), 232–238.
Abstract: This article provides an overview of gastric cancer using a unique case study involving a Maori family genetically predisposed to diffuse gastric cancer. The pathophysiology of diffuse gastric cancer, including prognosis, diagnosis, and treatment, along with important patient considerations is highlighted.
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Horrocks, T. (2001). Implementing change combining Maori and Western knowledge in health delivery. Vision: A Journal of Nursing, 7(13), 37–41.
Abstract: This article explores the incorporation of western knowledge with kaupapa Maori in the delivery of health care. It presents a fictional kaupapa Maori service, as a tool to explore the change process and influence that organisational culture and leadership styles have on a process of integrating a kaupapa Maori nursing service. The importance of continual evaluation through quality assurance measures was also conveyed.
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Horsburgh, M., Merry, A., Seddon, M., Baker, H., Poole, P., Shaw, J., et al. (2006). Educating for healthcare quality improvement in an interprofessional learning environment: A New Zealand initiative. Journal of Interprofessional Care, 20(5), 555–557.
Abstract: This article describes two interprofessional learning modules offered by the Faculty of Medical and Health Sciences at the University of Auckland to undergraduate medicine, nursing and pharmacy students. The modules, 'Maori Health“ and ”Patient Safety", have a focus on quality improvement in healthcare and are used to bring together students for a shared learning programme.The specific dimensions of healthcare quality covered in the programme are: patient safety, equity, access, effectiveness, efficacy and patient-centeredness.
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Richardson, F. I., & Carryer, J. B. (2005). Teaching cultural safety in a New Zealand nursing education program. Journal of Nursing Education, 44(5), 201–208.
Abstract: This article describes the findings of a research study on the experience of teaching cultural safety. As a teacher of cultural safety, the first author was interested in exploring the experience of teaching the topic with other cultural safety teachers. A qualitative approach situated in a critical theory paradigm was used for the study. The study was informed by the ideas of Foucault and feminist theory. Fourteen women between ages 20 and 60 were interviewed about their experience of teaching cultural safety. Five women were Maori and 9 were Pakeha. Following data analysis, three major themes were identified: that the Treaty of Waitangi provides for an examination of power in cultural safety education; that the broad concept of difference influences the experience of teaching cultural safety; and that the experience of teaching cultural safety has personal, professional, and political dimensions. These dimensions were experienced differently by Maori and Pakeha teachers.
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Ramsden, I. (2002). Cultural safety and nursing education in Aotearoa and Te Waipounamu. Ph.D. thesis, , .
Abstract: The research on which this thesis is based involves both a private narrative and a public narrative, with the story of cultural safety, and the history, theory and the future direction gathered into one qualitative work. The work is divided into three sections. The first is entitled, Ko Wai Matou? The Private Narrative. This section seeks to explore the historical, social, educational, physical, emotional, political and moral influences and ephiphanies which brought about the personality which introduced cultural safety ideas into nursing and midwifery. Early nursing practice is investigated and examples from practice are used to illustrate learning and consolidation of the ideas which led to Cultural Safety Theory. The second section is entitled He Huarahi Hou: A New Pathway. This section explains the progress of the theory and its relationship to education pedagogy and to nursing practice. Comparison between the work of Madeline Leininger and the Transcultural Theory of Nursing and the New Zealand concept of cultural safety is undertaken. The role and application of the Treaty of Waitangi to the theory of cultural safety is explored in this section. The third section, entitled He Whakawhanuitanga: The Public Narrative, looks at the introduction of cultural safety into the nursing education system and its implementation. The public and media reaction to the inclusion of cultural safety in the national examination for nursing registration and the subsequent parliamentary response are noted. The interviews with nursing and midwifery leadership, Maori and pakeha key players in the process and consumer views of the ideas are documented and pertinent excerpts have been included. The work concludes with a discussion on the likely future of cultural safety as a theory and in practice and outlines several issues which represent a challenge to the viability of the concept in nursing and midwifery education. The author notes that the story of cultural safety is a personal story, but also a very public one. It is set in neo-colonial New Zealand, but has implications for indigenous people throughout the world. It is about human samenesses and human differences, but is also a story about all interactions between nurses and patients because all are power laden. Finally, she points out that, although it is about nursing, it is also relevant to all encounters, all exchanges between health care workers and patients.
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Pearson, J. R. (2002). Health promotion in one New Zealand primary school: A case study. Ph.D. thesis, , .
Abstract: The objectives of this study were to explore the concept of the 'health-promoting school' in a specific New Zealand context; to develop and use appropriate research methods to assess a single low decile school in relation to World Health Organization health-promoting school components and checkpoints; to work with the school community to identify health issues; and, to record external and internal changes that could impact on school health over a finite time period. Case study was selected as the most appropriate method to collect both quantitative and qualitative evidence with the aim of providing a clear understanding of the particular case. Results confirmed that the school was working appropriately within the scope of their educational practice to provide a health-promoting school environment for the school community. Gaps and issues identified included an element of talking past each other between the cultures of the education organisation and the nominated health service provider respectively that contributed to a lack of appropriate and accessible health service delivery for the school population. Teaching staff considered that they had insufficient access to health knowledge, and input from health service staff did not meet health education requirements for the school. Staff preference for increased school nurse involvement was not realised. The consequence was that two outside agencies (KiwiCan and Life Education Trust) delivered the bulk of the Health and Physical Education curriculum which resulted in a degree of fragmentation of health education for students. The issues that were identified demonstrated that health services in the area were not satisfactorily meeting the needs of the community and were not addressing the health inequities for the predominantly Pacific Island and Maori students and of their families that formed the school community. The researcher concluded that a full-service school approach should be considered by the school and the local district health board as one way to overcome the current lack of access to health services for the school community. Assertions included the potential integration of locally available services by a school-based nurse coordinator supported by health professionals (nurse practitioner and Pacific Island Community Health Worker) and social workers. The vision included professionals working within their professional scopes of practice as part of a Primary Health Organisation with the aim of appropriately addressing the health inequities experienced by the school population.
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Adams-Smith, P. H. (2002). An exploration of issues of primary health services for Taranaki Te Atiawa children based on the expectations and perceptions of their female caregivers. Ph.D. thesis, , .
Abstract: The intention of this research is, through collaborative discussion and selective conversations, to explore female caregivers' expectations and perceptions of primary health services for some Te Atiawa Maori children. The research process was developed in a partnership between the Maori women participants and the researcher. In addition, two local kuia actively participated in and supported the process. Emancipatory critical social theory underpinned and informed the project. Power relationships between the researcher and the participants can be overtly explored within this theoretical framework. In terms of this particular exploratory study, participatory research appeared to be applicable. The participants are female caregivers of Te Atiawa children. Data collection was done using group interactions and semi-structured interviews in the winter of the year 2000. A thematic analysis of the data was used, in which common themes were identified, compared and discussed. From the analysis of the data of the participants' conversations, key ideas were identified. The major findings have been identified within two main themes. These are: a concept of health is not the same for Pakeha as for Maori, and access issues are still problematic for the participants in this study. Many quotes from the interview participants are included in order to keep the focus of the project on the voices of the women interviewed. In terms of the significant contribution of this research, this study aims to allow voices of female caregivers of Te Atiawa Maori children to be heard. Individual and collaborative interactions offer insights into what is important to them in terms of Maori child health. Clearly, the primary health initiatives promoted by the New Zealand government are not reaching at least some of the people for whom they are intended. The research participants offered their ideas as to how these deficits could be remedied in their community.
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Wilson, D. (2003). The nurse's role in improving indigenous health. Contemporary Nurse, 15(3), 232–240.
Abstract: The health status of indigenous peoples is a global concern with mortality and hospitalisation data indicating that the health of indigenous groups falls below that of other ethnic groups within their countries. The preliminary findings of grounded theory research project undertaken with a group of 23 New Zealand Maori women about their health priorities and 'mainstream' health service needs provide the foundation for an exploration of issues impacting on the health status of indigenous people. The role that nursing and nurses have in improving access and use of health services by indigenous people is discussed. Strategies are suggested that nurses can utilise within their practice when working with local indigenous groups.
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Lyford, S., & Cook, P. (2005). The Whanaungatanga model of care. Nursing Praxis in New Zealand, 21(2), 26–36.
Abstract: The authors introduce the Kaupapa nursing service at Te Puna Hauora, Tauranga Hospital. It implements an indigenous health model, the Whanaungatanga Model of Care, to guide nursing practice. This paper describes the concept of care it applies to serving its Maori population and the role of the Kaiawhina Social Worker. The authors highlights the interface between primary and secondary care after patients are discharged. The authors address the shortfall of Maori practitioners in the nursing service and the aims of a year-long pre-entry Kaupapa Health Professional Programme.
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Spence, D. (2001). The evolving meaning of 'culture' in New Zealand nursing. Nursing Praxis in New Zealand, 17(3), 51–61.
Abstract: The author traces the nursing definition of biculturalism as it has evolved from the colonial period to the present. An examination of nursing literature demonstrates that local understandings of culture have matured beyond anthropological interpretations to a sociopolitical definition of Maori culture. The author suggests that, in nursing, culture has come to mean cultural safety.
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Webby, A. (2008). Should non-Maori research and write about Maori? Kai Tiaki: Nursing New Zealand, 14(5), 20–21.
Abstract: The author examines the complexities surrounding non-Maori nurse researchers working on Maori issues. She suggests that as long as respect and observation of Maori processes is shown, and work is undertaken collaboratively with Maori, then such a role is appropriate.
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Roberts, M. H. (2004). An exploration of the experiences of Maori nurses in Aotearoa/New Zealand. Ph.D. thesis, , .
Abstract: The author describes the purpose of her writing as exploring the journeys that Maori have experienced within the nursing profession of Aotearoa/New Zealand. It presents the reader with insight into these journeys by examining a broad range of events and experiences from pre European contact up to contemporary times. The intention of providing these insights is for the reader to be made aware of not only the “uniqueness” that Maori nurses bring to the profession in New Zealand but to give voice to the many untold experiences of Maori nurses. The Nursing Council of New Zealand (NCNZ), numerous Maori and non- Maori academics have long acknowledged the uniqueness of Maori health perspectives and needs. However, the author notes there is limited literature which specifically discusses experiences of Maori consumers of health services and until recently, exploration of the experiences of Maori nurses has been limited. The Ministerial Taskforce of Nursing (1998) identified the paucity of research related to Maori nursing and acknowledges the need for Maori nurses to develop a body of knowledge specifically focused in this area. To this end, the author intended that this work would contribute to the increasing body of knowledge regarding this unique group within the nursing profession of Aotearoa/New Zealand.The discussion includes revisiting the history of nursing in Aotearoa/New Zealand and critiquing the participation of Maori nurses. The experiences of Maori nurses and students from within the education sector is detailed with a particular focus on their experiences of Kawa Whakaruruhau / Cultural safety. Contemporary issues for Maori nurses are critiqued and possible solutions offered along with details of the writer's vision for the future direction of Maori within the wider nursing profession in Aotearoa/New Zealand.
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DeSouza, R. (2008). Wellness for all: The possibilities of cultural safety and cultural competence in New Zealand. Journal of Research in Nursing, 13(2), 125–135.
Abstract: The author contends that responses to cultural diversity in nursing need to consider the theory and practice developments of the profession, whilst also responding to broader social and historical process that prevent marginalised groups from utilising universal health services. A combination of approaches is suggested in this paper to meet these two imperatives. Cultural safety is one indigenous New Zealand nursing approach derived in response to inequalities for Maori, whereas cultural competence is an imported paradigm derived from a multicultural context. Furthermore, research and dialogue are required to examine points of complementarity and tension. This paper offers a beginning for this process.
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Bolitho, S., & Huntington, A. D. (2006). Experiences of Maori families accessing health care for their unwell children: A pilot study. Nursing Praxis in New Zealand, 22(1), 23–32.
Abstract: The aim of this study was to explore with a small number of Maori families their experiences of accessing health care when their children were unwell with a respiratory condition. A qualitative research methodology was used in the study. Participating families were among those experiencing an admission to a children's ward between July and December 2003. Four families were interviewed. They discussed in depth their experience of accessing health care for their unwell children. Data were analysed using thematic analysis, and three common themes were evident: family resources, choice of health service provider and parents' feelings of vulnerability. The findings highlight that while socio-economic status plays a large part in determining the ease with which families can access the needed health care, there are other barriers within the health system which also pose difficulties for Maori.
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