Māori whānau experiences of a neonatal intensive care unit: Waikato hospital

Abstract

This thesis topic emerged from my personal experience of having a premature baby in the Neonatal Intensive Care Unit (NICU) at Waikato hospital. My whānau and I felt like aliens; culturally inept, and totally alone during our time in the NICU. It was not until I spoke to other Māori mothers that I realised our stories were similar.

I sought to understand how other Māori whānau members made sense of their own experiences, how they coped/adjusted to the experience of having a premature baby in an NICU and at home, and the sources of support they utilised. This study did not seek to delineate parents' experiences but attempted to allow whānau members to share their stories and explore their experiences of having a premature or special-care baby in an NICU.

The event of childbirth and the placing of a natural event into a pathological illness model through necessity has repercussions for the ways in which women experience and make sense of the event. Knowing this, six whānau stories were collected comprising of four individual interviews with the mothers and two whānau hui (focus groups). My use of a narrative methodology and kaupapa Māori approach enabled all the participants the opportunity to share their stories on how they make sense of their own experiences without the frame of pathological illness.

The findings present each whānau story autonomously, to highlight the key events that occur once the birth of a premature/special-care infant is admitted into an NICU. The participants' narratives followed their transitions through an NICU and return home. The narrative analysis and discussion confirmed that this research had been successful in creating a space for the mothers and their whānau members to share their stories. The discussion combined their narratives to reveal that the effective coping strategies did not remove the sources of stress but rather lessened the impact of the stresses. In situations where sources of stress were unable to be removed or reduced, participants perceptions of ineffective coping translated into narratives of negative perceptions of the NICU, and birthing experience.

The importance of positive relationships within an NICU, and in particular, the role of the nurse as a key facilitator, highlighted that efficacious communication resulted in positive experiences for Māori whānau. Whānau support was identified as one of the most important coping strategies for mothers in the NICU. Those participants who were encouraged to maintain connections with whānau members reported more positive experiences overall.

Three levels of implications were identified in this research. Firstly, that the participants'narratives provided a range of coping strategies for future Māori parents and their whānau who enter an NICU. Secondly, there are implications for NICU policy, and best practice particularly when supporting Māori in an NICU environment. Lastly, the narratives provided meaningful insights that contribute to gaps in local, national, and international literature. Overall, I realised that just like me, these mothers, and other whānau members, constructed narratives that are meaningful accounts to be shared with others.