Keelan Karen, Pitama Suzanne, Wilkinson Tim, Lacey Cameron
Māori Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand.
Int J Health Plann Manage. 2024 Mar;39(2):447-460. doi: 10.1002/hpm.3734. Epub 2023 Nov 21.
New Zealand's older Indigenous Māori people experience poorer health and reduced access to healthcare than their older non-Māori counterparts. Organisational factors (such as leadership or workforce) may influence the attitudes and perceptions of older Māori and their family (whānau) to use aged residential care services. Currently, there is a paucity of research surrounding the organisational barriers that impact the experiences of older Māori people who seek care in aged residential care (ARC) services.
This study used a Kaupapa Māori qualitative research approach that legitimises Māori knowledge and critiques structures that subjugate Māori autonomy and control over their wellbeing. Interviews regarding their experiences of care were carried out with older Māori (n = 30) and whānau (family) members (n = 18) who had used, or declined to use an aged residential care facility. Narrative data were analysed inductively for themes that illustrated organisational barriers.
The key organisational theme was 'Culturally safe care', within which there were three barriers: 'Acceptability and Adequacy of Facility', 'Interface Between Aged Residential Care and Whānau Models of Care', and 'Workforce'. Collectively, these barriers emphasise the importance of an organisational approach to improving the quality of care delivered to older Māori and whānau in ARC.
Fostering a collective culture of equity within ARC provider services and equipping healthcare leaders and staff with the skills and knowledge to deliver culturally safe care is critical to addressing organisational barriers to ARC.
与新西兰非毛利族老年人相比，该国年长的原住民毛利人健康状况较差，获得医疗保健的机会也更少。组织因素（如领导力或劳动力）可能会影响年长毛利人及其家庭（毛利大家庭）对使用老年住宅护理服务的态度和看法。目前，围绕影响在老年住宅护理（ARC）服务机构寻求护理的年长毛利人经历的组织障碍的研究很少。
本研究采用了毛利人研究方法，该方法认可毛利人的知识，并对那些压制毛利人自主权和对其福祉控制权的结构进行批判。对使用过或拒绝使用老年住宅护理机构的年长毛利人（n = 30）和毛利大家庭成员（n = 18）进行了关于他们护理经历的访谈。对叙事性数据进行归纳分析，以找出说明组织障碍的主题。
关键的组织主题是“文化安全护理”，其中存在三个障碍：“设施的可接受性和充分性”、“老年住宅护理与毛利大家庭护理模式之间的衔接”以及“劳动力”。总体而言，这些障碍强调了采用组织方法来提高向ARC机构中的年长毛利人和毛利大家庭提供的护理质量的重要性。
在ARC服务提供者中培育一种公平的集体文化，并使医疗保健领导者和工作人员具备提供文化安全护理的技能和知识，对于消除ARC的组织障碍至关重要。
