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毛利人的眼部健康观:毛利人对眼部健康的思考和看法。

Ngā whakāro hauora Māori o te karu: Māori thoughts and considerations surrounding eye health.

机构信息

Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.

School of Nursing (Māori), Manukau Institute of Technology, Auckland, New Zealand.

出版信息

Clin Exp Optom. 2023 Mar;106(2):133-139. doi: 10.1080/08164622.2022.2136513. Epub 2022 Dec 12.

Abstract

CLINICAL RELEVANCE

Research highlighting Indigenous patient perspectives is essential in the pursuit of understanding and addressing longstanding health inequities.

BACKGROUND

Evidence indicates that disparities in ocular health outcomes between Māori and non-Māori are pervasive in the New Zealand health system. Evidence shows the cause of these inequities is often multifactorial; due to factors such as colonisation, ongoing marginalisation, racism, socioeconomic status, poverty and culturally unsafe practice between health professionals and Māori patients.

METHODS

This project used kaupapa Māori methodology to identify the perceptions of Māori surrounding ocular healthcare within a Māori context in Aotearoa New Zealand. Three focus groups with Māori community members and three individual interviews with Māori eyecare practitioners were conducted. Participants discussed sub-topics relating to Māori health, ocular health consultations, ocular examination and access to ocular health services in Aotearoa New Zealand. Reflexive thematic analysis was undertaken using NVivo qualitative research software.

RESULTS

Five key themes were derived from the data: (1) the importance of effective clinician-patient communication; (2) historical experiences of patients inform their health attitudes; (3) barriers to access are systemic; (4) Māori health is important to Māori and (5) Te Ao Māori, Tikanga and Tapu are significant cultural concepts for Māori. Overall, Māori patients recognise the value of ocular healthcare and the importance of acknowledging Māori models of health within services.

CONCLUSION

The key issues Māori patients face within ocular health services resonate strongly with wider concepts intrinsically important to Māori. These are the right to cultural safety within clinical settings, the right to accurate and pertinent communication of information between clinician and patient and the respect of cultural beliefs and acknowledgement of power imbalances within the wider healthcare system. Participant discussions and suggestions raise possible pathways to begin addressing ocular ethnic disparities in healthcare delivery.

摘要

临床相关性

强调原住民患者观点的研究对于理解和解决长期存在的健康不平等至关重要。

背景

有证据表明,在新西兰卫生系统中,毛利人和非毛利人之间的眼部健康结果存在明显差异。证据表明,造成这些不平等的原因往往是多方面的;由于殖民化、持续边缘化、种族主义、社会经济地位、贫困以及卫生专业人员和毛利患者之间的文化不安全做法等因素。

方法

本项目使用毛利人方法论来确定在新西兰奥特亚罗瓦的毛利背景下,毛利人对眼部保健的看法。对毛利社区成员进行了三次焦点小组讨论和三次与毛利眼科从业者的个别访谈。参与者讨论了与毛利人健康、眼部健康咨询、眼部检查以及在新西兰获得眼部健康服务相关的子主题。使用 NVivo 定性研究软件进行了反思性主题分析。

结果

从数据中得出了五个关键主题:(1)临床医生与患者之间有效沟通的重要性;(2)患者的历史经验影响他们的健康态度;(3)获取服务的障碍是系统性的;(4)毛利人健康对毛利人很重要;(5)Te Ao Māori、Tikanga 和 Tapu 是毛利人重要的文化概念。总体而言,毛利患者认识到眼部保健的价值,以及在服务中承认毛利人健康模式的重要性。

结论

毛利患者在眼部保健服务中面临的关键问题与毛利人内在重要的更广泛概念强烈共鸣。这些是临床环境中文化安全的权利、临床医生和患者之间准确和相关信息交流的权利以及对文化信仰的尊重和对更广泛医疗保健系统中权力失衡的承认。参与者的讨论和建议提出了可能的途径,开始解决医疗保健提供中的眼部种族差异问题。

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