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重拾本土治疗体系:新冠疫情期间,新西兰奥特亚罗瓦以毛利人为中心的医疗服务对残疾毛利人的应对经验。

Reclaiming Indigenous systems of healing: experiences of disabled Māori of Māori-centric health service responses in Aotearoa New Zealand during the COVID-19 pandemic.

作者信息

Roguski Michael, Officer Tara N, Good Gretchen, McBride-Henry Karen

机构信息

Kaitiaki Research and Evaluation, Wellington, New Zealand.

School of Nursing, Midwifery, and Health Practice, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand.

出版信息

BMC Health Serv Res. 2025 Jan 6;25(1):29. doi: 10.1186/s12913-024-12012-w.

Abstract

BACKGROUND

The impact of the pandemic on Indigenous and disabled people's access to healthcare has resulted in significant disruptions and has exacerbated longstanding inequitable healthcare service delivery. Research within Aotearoa New Zealand has demonstrated that there has been success in the provision of healthcare by Māori for their community; however, the experiences of tāngata whaikaha Māori, disabled Māori, have yet to be considered by researchers.

METHODS

Underpinned by an empowerment theory and Kaupapa Māori methodology, this research explores the lived realities of tāngata whaikaha Māori or their primary caregivers. Twenty in-depth interviews gathered participants' lived experiences, and a discursive lens was brought to the narratives of tāngata whaikaha Māori who have accessed, and received, culturally responsive healthcare services during the pandemic.

RESULTS

Positive experiences accessing primary and secondary services were associated with Māori-centred healthcare and seamless engagement with support services that were founded upon the active dismantling of structural inequities and the prioritisation of Māori cultural values in their care delivery, inclusive of tino rangatiratanga (sovereignty), and mātauranga Māori (Māori knowledge).

CONCLUSIONS

This study provides a novel and solid foundation for comprehending how healthcare can be realigned to cater to the requirements of disabled Indigenous populations.

摘要

背景

疫情对原住民和残疾人获得医疗保健的影响导致了重大干扰,并加剧了长期存在的医疗服务不公平现象。新西兰的研究表明,毛利人为其社区提供医疗保健取得了成功;然而,毛利残疾人(tāngata whaikaha Māori)的经历尚未得到研究人员的关注。

方法

本研究以赋权理论和毛利方法(Kaupapa Māori methodology)为基础,探讨毛利残疾人或其主要照顾者的生活现实。通过20次深入访谈收集了参与者的生活经历,并对在疫情期间获得并接受了具有文化适应性的医疗服务的毛利残疾人的叙述进行了话语分析。

结果

获得初级和二级服务的积极经历与以毛利人为中心的医疗保健以及与支持服务的无缝衔接有关,这些服务基于积极消除结构性不平等以及在提供护理时优先考虑毛利文化价值观,包括自决权(tino rangatiratanga)和毛利知识(mātauranga Māori)。

结论

本研究为理解如何调整医疗保健以满足残疾原住民的需求提供了一个新颖而坚实的基础。

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