METHODS: A qualitative Māori-centred research design using a Thought Space Wānanga (learning through in-depth group discussion, deliberation and consideration) approach.
METHODS: Two wānanga were conducted between May 2022 and June 2022, with 13 Māori patients who had been acutely hospitalized within the past 12 months and their whānau members. The first wānanga utilized storytelling and journey mapping to collect data. The second wānanga refined the initial themes. Wānanga were audio-recorded and then inductively coded and developed into themes.
RESULTS: Thirteen patients and whānau attended the first wānanga, while 10 patients and whānau participated in the second wānanga). Four themes were developed: (1) Whakawhanaungatanga (establishing connections and relationships), (2) Whakamana (uplifting the status and esteem of Māori), (3) Whakawhitiwhiti kōrero (the importance of communicating, discussing and deliberating) and (4) Kotahitanga (working together with purpose) all provide insights into the importance of effectively engaging and connecting with Māori patients and whānau when acutely hospitalized.
CONCLUSIONS: The experiences and priorities of Māori patients and whānau affirm the international literature, suggesting that Indigenous relational concepts are critical to building relationships, connections and trust. Despite existing healthcare models for working with Indigenous peoples, their poor application contributes to sub-optimal healthcare experiences at all points of their healthcare journey. A relational mode of practice focused on engagement and forming connections better meets the needs of Indigenous peoples engaging with inpatient health services.
UNASSIGNED: Despite the existence of Indigenous models of care, Indigenous peoples consistently report a lack of engagement and connection when accessing inpatient health services. Without establishing relationships, applying models of care is challenging.
UNASSIGNED: What problem did the study address? Internationally, healthcare systems are consistently ill-equipped to deliver culturally safe care for Indigenous and marginalized peoples, evident in ongoing health inequities. Like other reports of Indigenous experiences of health services, Māori express dissatisfaction with care delivery in an acute inpatient setting. This study investigated Māori patients and whānau experiences engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. What were the main findings? Māori patients and whānau recounted negative experiences with healthcare professionals lacking effective relationships and trust. Satisfaction occurred when engagement with health care professionals resembled Indigenous cultural rituals of encounter that considered their holistic, collective and dynamic worldviews. Previous models of relational care, while helpful, are not Indigenous and so do not address their needs, such as engagement as a mode of practice (how) to achieve this. Where and on whom will the research have an impact? This research impacts Indigenous peoples\' health outcomes, particularly Māori, and nurses and clinicians working and interacting within acute inpatient and other hospital settings. Indigenous research methods support co-constructing knowledge for translation into practical outcomes through transformational practices, policies and theory development.
UNASSIGNED: We used the Consolidated Criteria for Strengthening the Reporting of Health Research Involving Indigenous Peoples (CONSIDER) statement (see File S2-CONSIDER Checklist) and the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (see File S3-COREQ Checklist).
UNASSIGNED: Māori patients and their whānau interviewed about their experiences were involved in data interpretation.
方法:使用思想空间Wānanga进行以毛利人为中心的定性研究设计(通过深入的小组讨论学习,审议和考虑)方法。
方法:在2022年5月至2022年6月之间进行了两次手术,其中有13名在过去12个月内急性住院的毛利人患者及其成员。第一个wānanga利用讲故事和旅程映射来收集数据。第二个wānanga完善了最初的主题。Wānanga被录音,然后进行感应编码并发展为主题。
结果:13名患者和whānau参加了第一次wānanga,而10名患者和whānau参加了第二次wānanga)。开发了四个主题:(1)Whakawhanaungatanga(建立联系和关系),(2)Whakamana(提高毛利人的地位和尊严),(3)Whakawwhitwhitwhitik_rero(沟通的重要性,讨论和审议)和(4)Kotahitanga(有目的地合作)都提供了对急性住院时有效参与和联系毛利人患者和whhānau的重要性的见解。
结论:毛利人患者和whānau的经验和优先事项肯定了国际文献,这表明土著关系概念对建立关系至关重要,联系和信任。尽管现有与土著人民合作的医疗保健模式,他们糟糕的应用有助于在他们的医疗旅程的所有点次优的医疗体验。注重参与和建立联系的关系实践模式更好地满足了土著人民参与住院医疗服务的需求。
■尽管存在土著护理模式,土著人民在获得住院医疗服务时一直报告缺乏参与和联系。没有建立关系,应用护理模式是具有挑战性的。
■这项研究解决了什么问题?在国际上,医疗保健系统始终没有能力为土著和边缘化人民提供文化上安全的护理,在持续的健康不平等中很明显。像其他关于土著卫生服务经验的报告一样,毛利人对急性住院患者的护理服务表示不满。这项研究调查了毛利人患者和whānau参与急性医院住院服务的经历,以及他们在以毛利人为中心的关系护理模式中的优先事项。主要发现是什么?毛利人患者和whānau讲述了缺乏有效关系和信任的医疗保健专业人员的负面经历。当与医疗保健专业人员的接触类似于土著文化仪式时,就会出现满意度,集体和动态的世界观。以前的关系护理模式,虽然有用,不是土著,所以不能满足他们的需求,例如参与作为一种实践模式(如何)来实现这一点。这项研究将在哪里以及对谁产生影响?这项研究影响土著人民的健康结果,尤其是毛利人,以及在急性住院和其他医院环境中工作和互动的护士和临床医生。土著研究方法支持共同构建知识,通过转化实践转化为实际成果,政策和理论发展。
我们使用了《关于加强涉及土著人民的健康研究报告的综合标准》(见文件S2-CONSIDER清单)和《报告定性研究的综合标准》(见文件S3-COREQ清单)指南(见文件S3-COREQ清单)。
■毛利人患者和他们的whānau采访他们的经历参与了数据解释。