Ceremonious storytelling: Exploring experiences within the publicly funded health service

Abstract

Background: Chronic disease is defined as a condition impacting organs or organ systems causing dysfunction or dysregulation that lasts longer than six months or remains, despite medical intervention or treatment. Research has shown that barriers, including those of a financial, physical, institutional and patient orientated nature significantly impact on outcomes. Māori are significantly over-represented in chronic health condition statistics, particularly relating to cardiac, respiratory, renal and mental health. Further, Māori are more likely to have a negative experience engaging with primary and secondary health services, leading to disempowerment and dis-engagement. Therefore, research which explores how quality of care for Māori can be improved is of pressing value.

Objective: This study seeks to explore the experiences of Māori and non-Māori health-care consumers and providers within the publicly funded health service of Aotearoa.

Participants: Advertising across primary and secondary care settings resulted in a total of 37 responses from health care consumers (31 respondents contributing to pūrākau) and 37 responses from health professionals (27 respondents contributing to pūrākau).

Methods: This study utilised kaupapa Māori methodological approaches, frameworks and models to guide and intertwine qualitative and quantitative research methods. Participants were able to engage with any subset of questions, defining their responses through pūrākau, which supports the development of narratives within questions that are outside the limits of other worldviews. Māori methods such as pūrākau are flexible, enabling the development of research methods that are culturally aware and safe for Indigenous and non-Indigenous people globally

Results: Key themes found within pūrākau highlighted the importance of meaningful engagement, person focused, trauma informed care to positively impact willingness and ability to engage with primary, secondary and tertiary services. The study reported that consumers had a strong willingness to engage with services.

Conclusion: Health is personal and impacts people in various ways. Access to health services, while funded in Aotearoa, still create barriers for some people and perpetuates the gap between prevention and diagnosis of chronic disease. Kaupapa Māori methods within research support Māori engagement and definition within research through historical ways of being, knowing and conducting research. Participants of this study detailed experiences within health services, highlighting willingness and ability to engage with health services. Prior research defined the development of the Levesque access and accessibility framework, which correlates with the findings within this study."