Theunissen Katherine Evelyn
Department of Nursing, Auckland University of Technology, Auckland, New Zealand.
Contemp Nurse. 2011 Oct;39(2):281-6. doi: 10.5172/conu.2011.281.
Many countries across the globe experience disparities in health between their indigenous and non-indigenous people. The indigenous Māori of New Zealand are the most marginalized and deprived ethnic group with the poorest health status overall. Factors including the historical British colonization, institutional discrimination, healthcare workforce bias and the personal attitudes and beliefs of Māori significantly contribute to disparities, differential access and receipt of quality health services. Māori experience more barriers towards accessing health services and as a result achieve poorer health outcomes. Contradicting translations of Te Tiriti o Waitangi have created much debate regarding social rights as interpreted by Oritetanga (equal British citizenship rights) and whether or not Māori are entitled to equal opportunities or equal outcomes. Inconsistent consideration of Māori culture in the New Zealand health system and social policy greatly contributes to the current health disparities. Nurses and healthcare professionals alike have the gifted opportunity to truly change attitudes toward Māori health and move forward in adopting culturally appropriate care practices. More specifically the nursing workforce provides 80% of direct patient care, thus are in a unique position to be the forefront of change in reducing health disparities experienced by Māori. Incorporating cultural safety, patient advocacy, and Māori-centred models of care will support nurses in adopting a new approach toward improving Māori health outcomes overall.
全球许多国家的原住民和非原住民之间都存在健康差异。新西兰的原住民毛利人是最边缘化、最贫困的族群，总体健康状况最差。包括英国历史上的殖民统治、制度性歧视、医疗保健人员的偏见以及毛利人的个人态度和信仰等因素，都极大地导致了健康差异、获得高质量医疗服务的机会不均等以及实际接受服务情况的不同。毛利人在获取医疗服务方面面临更多障碍，因此健康状况更差。《怀唐伊条约》相互矛盾的译文引发了诸多关于社会权利的争论，这些权利按照“奥里特坦加”（英国平等公民权）的解释，以及毛利人是否有权享有平等机会或平等结果。新西兰医疗系统和社会政策对毛利文化的考量不一致，这在很大程度上导致了当前的健康差异。护士和医疗保健专业人员都有难得的机会真正改变对毛利人健康的态度，并在采用符合文化习惯的护理实践方面取得进展。更具体地说，护理人员提供了80%的直接患者护理，因此处于独特的地位，能够成为减少毛利人所经历的健康差异的变革前沿。纳入文化安全、患者权益倡导以及以毛利人为中心的护理模式，将支持护士采用新方法来全面改善毛利人的健康状况。
