Maori Values in Healthcare

Introduction

• The focus is on preparing for a specific exam question in Section B, a short answer question which requires a concise yet comprehensive application of Maori values within a healthcare context. Understanding and articulating these values is crucial for demonstrating cultural competence.

• Applying Maori values in a health setting requires not only knowledge of the values themselves but also an understanding of how they interact and influence healthcare practices. This involves recognizing the interconnectedness of these values and their practical implications in patient care.

Maori Values Diagram (James Ritchie)

• James Ritchie's diagram illustrates the interconnectedness of Maori values, emphasizing their holistic nature and mutual influence. The diagram serves as a visual aid to understand how these values function in a cohesive system.

• Wairuatanga is central and foundational, acting as the core from which all other values derive meaning and purpose.

  • Central: It integrates and informs all other values, ensuring a spiritual dimension in all aspects of life and health.

  • Foundational: It represents the primary guiding principle, influencing priorities and decisions within the framework of Maori values.

Key Maori Values Explained

Kotahitanga

• Kotahitanga embodies relational values that link individuals and communities together, emphasizing social dimensions and interactions. It promotes unity, collaboration, and a sense of belonging.

Rangatiratanga

• Rangatiratanga is frequently discussed in a political context, highlighting Maori self-determination, leadership, and authority. It encompasses the right to exercise autonomy and decision-making power over one's own affairs and resources.

Wairuatanga

• Wairuatanga stands as a cultural value of fundamental importance, representing spiritual connectedness, cultural identity, and holistic well-being. It acknowledges the spiritual dimension of life and its impact on health.

• Maori view of reality: Whakapapa (interconnectedness) illustrates the genealogical links between all living things, emphasizing the relationships between the past, present, and future. This interconnectedness highlights the responsibilities and obligations that come with these relationships.

• Elemental essences that create life- Thinking about Wairua permeating everything emphasizes the spiritual essence that infuses all aspects of existence. This spiritual essence influences health, well-being, and the way individuals interact with the world.

Kaitiakitanga

• Kaitiakitanga focuses on the connection between people and the environment, emphasizing a kinship relationship and the responsibility to act as guardians of natural resources. It promotes sustainable practices and environmental stewardship.

• Ethic of being in relation to the environment highlights the reciprocal relationship between humans and the natural world. Recognizing our dependence on the environment fosters a sense of responsibility and care.

• Obligation to care for akin, including the natural environment, extends kinship responsibilities beyond human relationships to include the environment. This obligation entails protecting, preserving, and nurturing the environment for future generations.

• Central to exercising Mana Whenua, Kaitiakitanga underscores the authority and responsibility of Maori to act as stewards of their ancestral lands and resources. This authority is grounded in historical connections, cultural practices, and the obligation to maintain the integrity of the environment.

• Preserving Maori of the natural environment ensures the sustainability of ecosystems, protects biodiversity, and maintains cultural heritage. Preservation efforts align with traditional Maori knowledge and practices that promote long-term environmental health.

Other Concepts

• Numerous interwoven concepts exist that contribute to a comprehensive understanding of Maori values. These concepts include but are not limited to whakapapa, mana, tapu, and noa, each adding layers of meaning and complexity to the overall framework.

Values Table Activity

• Populate values table to consolidate understanding of Maori values and their practical applications in healthcare. This activity involves defining values, describing their manifestations, and identifying ways to incorporate them into practice.

Columns

• Particular value serves as the central focus of each row in the table, representing a specific Maori value.

• Brief description/definition provides a concise explanation of the value's meaning and significance.

• Notes on what it looks like describe how the value is demonstrated in various contexts.

• How to incorporate it into practice offers practical guidance on integrating the value into healthcare settings.

Emphasis

• Being values-informed is beneficial for everyone in health-related sectors, not just Maori, because it promotes culturally responsive care, improves patient outcomes, and fosters trust and understanding between healthcare providers and patients.

• Crucial for cultural competence, understanding and applying Maori values are essential components of cultural competence in healthcare. This competence enables healthcare providers to deliver services that are respectful, effective, and tailored to the unique needs of Maori patients.

Video Examples and Analysis

Example 1

• Young Maori girl in pain not receiving adequate care highlights the importance of cultural sensitivity and responsiveness in pain management. This example illustrates the potential consequences of neglecting cultural factors in healthcare delivery.

• Relates to Whanaungatanga (connection) and Manaakitanga (care), emphasizing the need for healthcare providers to establish meaningful connections with patients and provide compassionate care that respects their cultural background.

• Creating connections and relationship building between nurse and patient is crucial for fostering trust, improving communication, and ensuring that patients feel valued and respected. Building this relationship would help get to the root of the young girls trauma.

Example 2

• Family supporting father's care in the hospital demonstrates the significance of whanau involvement in healthcare decision-making and the provision of holistic support.

• Whanau provides support and care (Manaakitanga), reinforcing the importance of family in Maori culture and the role of whanau in providing emotional, social, and practical support to patients.

• Kotahitanga: Oneness and solidarity around the patient underscores the unity and collective effort of family members in supporting the patient's well-being. This solidarity fosters a sense of belonging and strengthens the patient's resilience.

• Working in partnership with him for his health promotes shared decision-making, mutual respect, and collaboration between healthcare providers, patients, and their families. This partnership ensures that the patient's preferences and values are central to their care plan.

• Mutual focus for both family and staff emphasizes the alignment of goals and the collaborative approach to achieving the best possible health outcomes for the patient. This mutual focus promotes a sense of shared responsibility and accountability.

Example 3

• Nurses preventing Maori from singing (Waiata, Karakia) illustrates the importance of respecting cultural practices and spiritual beliefs in healthcare settings. This example underscores the potential harm of cultural insensitivity and the need for healthcare providers to accommodate patients' spiritual needs.

• Relates to Wairuatanga (spiritual connectedness), highlighting the significance of spiritual expression and connection to cultural identity in Maori culture.

• Rangatiratanga and Mana Motuhake: Get to have that self management of, you know, being able to sing to their sick family members and that kind of thing, which emphasizes the right of individuals to exercise autonomy and self-determination in expressing their cultural and spiritual beliefs. Honoring these rights promotes dignity, respect, and cultural pride.

Example 4

• Family bringing Maori Kai (food) and providing whanau support illustrates the importance of cultural traditions and social connections in promoting well-being and healing.

• Connects to Wairuatanga (spiritual connectedness) and Manaakitanga (care), reinforcing the holistic view of health that integrates physical, emotional, and spiritual dimensions.

Example 5

• Importance of Karakia (prayer) illustrates the role of spiritual practices in providing comfort, guidance, and a sense of community during challenging times.

• Connects to Wairuatanga, Kotahitanga (unity), and providing comfort, highlighting the interconnectedness of spiritual well-being, social support, and emotional resilience.

• Grounding, bringing together the group and having a safe space, emphasizing the role of spiritual practices in creating a sense of stability, connection, and security for individuals and communities.

Example 6

• Pakeha comrades who didn't believe in Whakamaimiti, shows a cultural difference that needs to be approached with cultural safety and humility to ensure appropriate interventions.

• Treating holistically by also considering Whakamaimiti, because it's a cultural practice that could support the recovery journey.

• Integrate Whanau, because it also provides a safe space and support from people they know.

Example 7

• Whanau filling in gaps on delivery of care by caring for the patient to give medicine, shows how Whanau is an integral part of the patient's recovery journey.

• Manaketanga absolutely part of what Yes, shows that family has taken on the roll of caregiver to provide support for the patient.

• Maybe also Kotahitanga because the gap-filling is a collaboration for the patients well-being.

Example 8

• Greeting using "Kia Ora" is a sign of respect.

• Importance of correct pronunciation of names shows cultural sensitivity.

• Showing the patient value through greeting in native tongue

• Building trust to introduce self shows professionalism.

• Related to Manaakitanga (respect, caring).

Exam Preparation

• Define three values from the sheet to demonstrate understanding of core Maori values and their relevance to healthcare practice.

• Provide examples of how values are demonstrated/ensured in health interactions to show how Maori values translate into observable behaviors and practices in healthcare settings.

• Additional material available on the learning page to help flesh our notes, offering further insights and resources to enhance exam preparation.