Pacific perspectives of health and wellbeing

Understanding the Pacific Peoples

• fast growing population

• median personal annual income is lower compared to rest of NZ

• life expectancy is very steady and gradient, is not nearly as steep or improving as other populations

• high crude ash rates

• higher hospitalization rates

• higher unmet needs

push and pull factors of migration

• leave home environment without choice

• drawn to another environment by opportunities

• we are al the product of our ancestors

• this is usually from hard work and sacrifice of those that came before us.

Fonofale Model

Foundation = Family

• Provides support network and structures to support life

• comprises both nuclear and extended family members

• can be retrospective

• family in the health context:

  • involve families in discussions related to a members care

  • enhancing health literacy for the entire family to help support the member’s treatment

  • making families part of the solution

Roof = Culture

• culture in health context

  • can influence and determine a family structure and roles/responsibilities within a family

  • can be very diverse and may be practiced differently from traditional practice depending on family

  • contemporary context usually sees families living in a continuum between cultural ways and western practices

  • can utilize cultural space and platforms to engage with pacific peoples.

Pou

• Physical

  • biological or physical wellbeing of a person and how it is impacted by food, water, air, and medications

• Spiritual

  • spirituality relates to a sense of wellbeing through a belief system that includes christianity or other faiths.

• Mental

  • health of the mind, involves thinking and emotions as well

• Other

  • gender

  • sex

  • age

  • socioeconomic status

External

• Time

  • meanings of time in a pacific context may differ to what it means in the western world

• Context

  • understanding the where/how/what and the meaning it has for that particular person or group of people, then providing support fits appropriately with this context

• Environment

  • addresses the relationships of pacific peoples to their physical environment and also their connection to the land and surroundings.

Context for improving health outcomes for pacific peoples

• increase ethnic representation

• increase diversity in healthcare

• increase communication

• cultural competence standard

Cultural competence standard

encompass concepts which are holistic and patient centred.

physiotherapy standards of cultural competence are integrated both implicitly and explicitly throughout all physiotherapy competencies. These are incorporated in the Aotearoa New Zealand Physiotherapy Code of Ethics and Professional Conduct and the Physiotherapy practice thresholds in Australia and Aotearoa New Zealand.

improved and equitable outcomes for health consumers via

• understanding own culture and of the consumer

• developed confidence in physiotherapy-patient relationships

• improvement in communication with, and increased information gained from patients

• communication with colleagues

• patient-centred goals

• treatment plan engagement

• understanding of diverse cultures.