Factors influencing physiotherapists’ decisions to supervise physiotherapy students: results from a Canadian national survey (original) (raw)
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New Zealand Journal of Physiotherapy
We report and discuss the findings of a survey of a range of health care providers serving hauä (disabled) Mäori in the Murihiku (Southland) region of Aotearoa New Zealand. To explore hauä Mäori access to health services, we used a mixed methods approach beginning with a quantitative survey and followed by qualitative interviews. Twenty-nine (58%) completed surveys were returned and we interviewed representatives from 15 organisations. We found all organisations were disability accessible in the physical sense, but were less accessible from a cultural perspective. There appeared a misunderstanding between what could be deemed a non-racial, human rights approach of respect for all people, no matter the ethnicity ("We treat everyone who walks through the door the same") and the importance of tikaka (customary Mäori practice), for services provided for Mäori. The most significant proposal resulting from this research was for organisations to have a local, trusted, cultural advisor to regularly discuss and review Mäori clients. Individually, health facilities that provide services to Mäori should evaluate their cultural awareness, service access and promotion, health information, and service effectiveness. This paper provides insights and suggestions to health organisations, such as physiotherapy services, on how they can improve their service accessibility to hauä Mäori.
Whānau Māori explain how the Harti Hauora Tool assists with better access to health services
Australian Journal of Primary Health
In this paper, whānau Māori highlight how a Kaupapa Māori-centred intervention (the Harti Hauora Tamariki tool, hereafter Harti tool) has improved interactions with health services. The Harti tool is undergoing a randomised control trial (RCT) at Waikato Hospital in New Zealand. As part of the RCT, the authors engaged in a series of qualitative interviews with whānau members of tamariki Māori (children aged 0–5 years) admitted to Waikato Hospital’s paediatric ward. Whānau who met at least one criteria for New Zealand’s domains of deprivation were included. Using a Kaupapa Māori approach to the study, participants shared their views on barriers and facilitators to accessing health resources and primary care services. The interviews conducted highlight how the Harti tool, when administered in a culturally appropriate and respectful manner that prioritised relationship-building, enabled better connection to healthcare services. Prevalent in our analysis were connections to wider determ...
Australian and New Zealand Journal of Public Health
Objective: This paper aims to synthesise the broader perspectives of Māori patients and their whānau (extended family, family group) of their treatment within the public health system. Our research question was 'What are the experiences of Māori in the public health and/or hospital system in Aotearoa New Zealand?' Methods: A systematic search using PRISMA protocols and reflexive typology organised around the categories of Māori, public healthcare and qualitative research identified 14 papers that covered all three categories. We undertook a qualitative metasynthesis on these papers using a critical community psychology approach. Results: Māori patients and whānau from the included papers mention both barriers and facilitators to health. We categorised barriers as organisational structures, staff interactions and practical considerations. Facilitators were categorised as the provision of whānau support in the form of practical assistance, emotional care and health system navigation. Conclusions: For many Māori, the existing public health system is experienced as hostile and alienating. Whānau members provide support to mitigate this, but it comes as a cost to whānau. Implications for public health: Public health providers must find ways to ensure that Māori consistently experience positive, high-quality healthcare interactions that support Māori ways of being.
AlterNative: An International Journal of Indigenous Peoples, 2020
Research on collaboration between health and social service organisations and professions often views collaboration from the narrow perspective of being between practitioners from different professions at a set point in time. This is often also focused on issues of efficacy and does not address the role of identity, values, and practices, or “culture” within collaboration, an important aspect when engaging with indigenous populations. This study presents a Kaupapa Māori qualitative case study in a small rural community, which highlights how western culture has permeated within and across a health care system. Recommendations are made to guide Crown and other western health and social service organisations and practitioners in first understanding the ongoing history of people and place, and its impact on health and social practice, and how to engage with Māori in a way that affirms, enables, and where requested supports a for Māori by Māori approach to wellbeing.
International Journal of Environmental Research and Public Health
The predominant focus of Aotearoa New Zealand’s public health system on biomedical models of health has left little room for meaningful engagement with holistic indigenous approaches. Culturally appropriate provision and support are recognized for their relevance and importance during hospital transferals. Hospital staff involved in transfers to one of New Zealand’s trauma centers share their observations of whānau Māori engagement during an admission away from their home base. Sixteen key informants share their experiences, which are presented as strategies and challenges to whānau engagement. Three main themes highlight challenges within the health system that make it difficult for hospital staff to engage whānau in the desired ways and as often as both parties would like. Key informants described services and practices that are not designed with patients and their whānau in mind; instead they are designed by clinicians around the needs of administrative systems. As employees with...
International Journal of Environmental Research and Public Health
People with lived experience of disability have poorer health and socioeconomic outcomes than people without it. However, within this population, certain social groups are more likely to experience poorer outcomes due to the impacts of multiple intersecting forms of oppression including colonisation, coloniality and racism. This paper describes the multidimensional impacts of inequities for Indigenous tāngata whaikaha Māori (Māori with lived experience of disability). Semi-structured in-depth interviews were conducted with 28 tāngata whaikaha Māori and their whānau (extended family) using a kaupapa Māori Research methodology. An equity framework was used to analyse the data. The results describe: (1) inequitable access to the determinants of health and well-being; (2) inequitable access to and through health and disability care; (3) differential quality of health and disability care received; and (4) Indigenous Māori-driven solutions. These data confirm that tāngata whaikaha Māori i...
The recently implemented Health Practitioners Competency Assurance Act (HPCA Act) has required registration authorities to develop standards for competence that must be met by practitioners. For the physiotherapy profession, the standards provide an opportunity for strengthening understandings and enhancing clarity as to the range of cultural competencies required for safe and effective practice. The Standards potentially provide direction for practical measures that can be taken in everyday practice settings to address ethnic inequalities in health, give meaning to the Treaty of Waitangi, strengthen workforce quality, and address ethnicity as a determinant of health. The latter refers to the extent to which ethnicity has an independent effect on health status due to factors, like racism, impacting differentially across ethnic groups. In order for the potential of the cultural competence standards for physiotherapy to be met it is important that there is a clear understanding among physiotherapists in private and public settings of the meaning, relevance, and value of cultural competence and how to implement it in practice. This paper discusses those issues with reference to addressing inequalities in health between Mäori and non-Mäori, and draws on the Guidelines for Cultural Competence in Physiotherapy Education and Practice in Aotearoa/New Zealand in identifying a Framework for the implementation of cultural competence in the physiotherapy profession. The Framework is of relevance not only to individual physiotherapists, but also to physiotherapy bodies that have responsibilities for ensuring the cultural competence of the profession. Ratima M, Waetford C, Wikaire E (2006): Cultural competence of physiotherapists: reducing inequalities in health between mäori and non-Mäori. New Zealand Journal of Physiotherapy 34(3): 153-159.
Mapping the themes of Maori talk about health
The New Zealand Medical Journal, 2003
Aim This paper reports the findings of a qualitative research project that investigated: how Maori talk about health; Maori health; and Maori experiences of interacting with both mainstream and Maori providers of healthcare. Methods Twenty eight self-identified Maori were recruited from urban, marae-based healthcare services. Rich descriptions of commonly occurring themes were used to examine participants' experiences, explanations and ideas. Results Twelve themes provide an overview of how Maori health is conceptualised, the importance of 'traditional' concepts, the experiences of Maori within mainstream healthcare, and Maori health promotion mechanisms. Conclusions Providing holistic healthcare to Maori in a respectful and collaborative way will provide opportunities for health professionals to have a positive impact on the health of individuals, their whanau and, in turn, their communities, hapu and Iwi. The present research began with our interest in how Maori health was being talked about, thought about, and experienced by urban Maori. The study was part of a larger study in which Pakeha researchers also interviewed Pakeha general practitioners (GPs) about Maori health. 1 Descriptions of a Maori view of health are invariably holistic and centred on whanau health and wellbeing rather than the health of the individual. 2-4 Cultural concepts and practices, such as tapu and noa and the ritual of tangi, have been described as key components, as has the use of karakia and processes around food, exercise and illness. 3,5,6 These descriptions have historically been formed by Maori and have, in turn, informed Maori, developing over time as our understanding has grown of what promotes and what undermines good health and wellbeing. For example, a view of Maori health that once encompassed tinana (the physical element), hinengaro (the mental state), wairua (the spirit), and whanau (the immediate and wider family), is now contextualised within te whenua (land providing a sense of identity and belonging), te reo (the language of communication), te ao turoa (environment), and whanaungatanga (extended family). 3,7