Treating with Te Tiriti in mind: Exploring how kaiwhakaora ngangahau occupational therapists are working with tangata whenua Māori in practice

Abstract

BACKGROUND Statistics have shown inequity in health outcomes for Māori. Māori are overrepresented with higher rates of hospitalisation and lower life expectancy than non-Māori (Brewer & Andrews, 2016), have higher rates of drug and alcohol abuse (Zambas & Wright, 2016) and psychological distress (Maclennan, Wyeth, Wilson, & Derrett 2014). Māori people are more likely to come from low socio-economic backgrounds leading to inequity in employment, total household income, education, and access to healthcare (Zambas & Wright, 2016). As a profession kaiwhakaora ngangahau occupational therapists are well placed to be catalysts for change, to better the health outcomes for Māori.

AIM This study aimed to investigate and understand how kaiwhakaora ngangahau occupational therapists are working with Māori post-injury within Aotearoa and share this understanding with others to encourage discussion within the profession to inform practice with Māori.

METHODS A qualitative interpretive description approach (Thorne, 2016) was used, and ethical approval was gained from the Otago Polytechnic ethics committee. Through purposive sampling, a sample was selected from the population of kaiwhakaora ngangahau occupational therapists within a private health and rehabilitation company. Semi-structured interviews were completed with five therapists. Questions explored the thought processes of the participants when working with Māori and how the culture of the client informed the occupational therapy process. The interviews were then analysed using thematic analysis.

FINDINGS Three main themes were identified with associated subthemes. These were rapport building, therapist experience and reducing barriers. There was evidence of Māori principles being utilised, these were Manaakitanga, Kaitiakitanga, Wairuatanga, Whanaungatanga, Kotahitanga and Rangatiratanga.

CONCLUSION This study identified that kaiwhakaora ngangahau occupational therapists are actively adapting their practice when working with Māori. Implications for the funder included needing to reconsider the service and funding model to allow a more culturally responsive practice for providers. Implications for the therapists included ideas for actions to implement in practice such as involving family/whānau.