Department of General Practice and Rural Health, University of Otago, Ōtepoti/Dunedin, New Zealand.
Bioethics Centre, University of Otago, Ōtepoti/Dunedin, New Zealand.
N Z Med J. 2023 Jul 21;136(1579):96-103. doi: 10.26635/6965.6166.
Many ethnic groups traditionally value familism, which emphasises interdependence and the extended family unit. However, Aotearoa New Zealand's health system remains largely individual-oriented, with the implementation of family-centred care remaining inconsistent. This is known to have negative effects on Māori healthcare experiences and outcomes. Our research, exploring the experiences of ethnic Chinese using mental health services in Aotearoa New Zealand, indicated that this could also be a barrier for ethnic Chinese, who have similarly strong cultural links to familism, accessing mental health care. To balance the cultural importance of family involvement with the protection of individual patient autonomy, we propose a moderate Confucian familist approach, encouraging family involvement and participation in individual patients' care, with patients' consent. The approach acknowledges individual patients as interconnected members of a wider family unit, emphasising their reciprocal, mutual responsibility in maintaining a well-functioning, harmonious family. We highlight Whānau Ora as a potential exemplar for a culturally grounded, family-centred approach to mental health care which could be feasibly implemented and deliver positive outcomes. Parallels between Māori and ethnic Chinese cultural views around whānau, community, and collectivism suggest a Kaupapa Māori approach could also be beneficial to Aotearoa New Zealand's ethnic Chinese populations. However, ethnic Chinese lack the specific legal obligations empowering the implementation of interventions such as Whānau Ora. This is an obstacle which remains to be addressed before mental health services which are sensitive to the needs of ethnic Chinese or of other ethnicities can be effectively implemented.
许多族群传统上重视家庭主义，强调相互依存和大家庭单位。然而，新西兰的卫生系统仍然主要以个人为导向，家庭为中心的护理实施仍然不一致。这被认为对毛利人的医疗保健体验和结果产生负面影响。我们的研究探索了在新西兰使用心理健康服务的华裔族群的体验，表明这也可能是华裔族群的一个障碍，他们同样与家庭主义有着强烈的文化联系，难以获得心理健康护理。为了平衡家庭参与的文化重要性和保护个人患者自主权，我们提出了一种适度的儒家家庭主义方法，鼓励家庭参与和参与个体患者的护理，并征得患者同意。这种方法将个体患者视为更广泛家庭单位的相互关联的成员，强调他们在维护一个功能良好、和谐家庭方面的相互责任。我们强调 Whānau Ora 是一种潜在的范例，展示了一种基于文化的、以家庭为中心的心理健康护理方法，这种方法可以切实实施并带来积极的结果。毛利人和华裔族群在家庭、社区和集体主义方面的文化观点之间存在相似之处，这表明毛利人 Kaupapa 方法也可能对新西兰的华裔族群有益。然而，华裔族群缺乏实施干预措施（如 Whānau Ora）的具体法律义务。在能够有效实施对华裔或其他族裔的心理健康服务之前，这是一个需要解决的障碍。
