MBChB, BA, RMO, Middlemore Hospital, Auckland.
PhD, Senior Lecturer, Te Kupenga Hauora Māori, University of Auckland, Auckland.
N Z Med J. 2021 Nov 26;134(1546):47-58.
This paper reports the findings of a literature review to answer the research question, "What are the barriers and facilitators of access to hospital services for Māori?"
MEDLINE (Ovid) and PsycINFO were searched using keywords to identify relevant literature published between 2000 and 2020. The data analysis was informed by a Kaupapa Māori positioning and the CONSIDER statement on reporting of health research involving Indigenous peoples.
Twenty-three papers met the inclusion criteria. We identified five themes that captured the barriers for Māori accessing hospital services (practical barriers, poor communication, hostile healthcare environment, primary care barriers and racism) and five facilitatory themes were identified (practical facilitators, whakawhanaungatanga, whānau, manaakitanga and cultural safety).
This article confirms existing knowledge about practical barriers and facilitators to healthcare access for Māori and contributes to an emerging body of evidence about the impact of racism and culturally unsafe services in preventing Māori from accessing healthcare services. The facilitators identified provide a potential roadmap for the redesign of services so they are accessible and effective for Māori. Improving services in this way would support district health boards, the Ministry of Health and professional organisations to comply with their commitments to providing culturally safe services and health professionals.
本文报告了一项文献综述的结果,旨在回答研究问题,“影响毛利人获得医院服务的障碍和促进因素有哪些?”
使用关键词在 MEDLINE(Ovid)和 PsycINFO 上进行搜索,以确定 2000 年至 2020 年期间发表的相关文献。数据分析受到毛利人定位的 Kaupapa Māori 和报告涉及原住民的健康研究的 CONSIDER 声明的指导。
有 23 篇论文符合纳入标准。我们确定了五个主题,这些主题描述了毛利人获得医院服务的障碍(实际障碍、沟通不畅、敌对的医疗环境、初级保健障碍和种族主义),并确定了五个促进主题(实际促进因素、whakawhanaungatanga、whānau、manaakitanga 和文化安全)。
本文证实了现有关于毛利人获得医疗保健的实际障碍和促进因素的知识,并为关于种族主义和文化不安全服务阻碍毛利人获得医疗服务的影响的新兴证据做出了贡献。确定的促进因素为服务的重新设计提供了潜在的路线图,以便为毛利人提供可及且有效的服务。通过这种方式改善服务将支持地区卫生委员会、卫生部和专业组织履行其提供文化安全服务和卫生专业人员的承诺。