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Creating an Indigenous Māori‐centred Model of Relational Health: A Literature Review of Māori Models of Health

Wilson, D; Moloney, E; Parr, JM; Aspinall, C; Slark, J
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http://hdl.handle.net/10292/14232
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Abstract
Aims and objectives

Identify the key concepts, principles and values embedded within Indigenous Māori models of health and wellbeing; and determine how these could inform the development of a Māori-centred relational model of care.

Background

Improving health equity for Māori, similar to other colonised Indigenous peoples globally, requires urgent attention. Improving the quality of health practitioners’ engagement with Indigenous Māori accessing health services is one area that could support improving Māori health equity. While the Fundamentals of Care framework offers a promising relational approach, it lacks consideration of culture, whānau or family, and spirituality, important for Indigenous health and wellbeing.

Design and methods

A qualitative literature review on Māori models of health and wellbeing yielded nine models to inform a Māori-centred relational model of care. We followed the PRISMA guidelines for reporting literature reviews.

Results

Four overarching themes were identified that included dimensions of health and wellbeing; whanaungatanga (connectedness); whakawhanaungatanga (building relationships); and socio-political health context (colonisation, urbanisation, racism, and marginalisation). Health and wellbeing for Māori is a holistic and relational concept. Building relationships that include whānau (extended family) is a cultural imperative.

Conclusions

This study highlights the importance and relevance of relational approaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust-based relationships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empathy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (importance of spiritual wellbeing).

Relevance to clinical practice

Culturally-based models of health and wellbeing provide indicators of important cultural values, concepts and practices and processes. These can then inform the development of a Māori-centred relational model of care to address inequity.
Keywords
Cultural competency; Cultural safety; Fundamental care; Indigenous; Literature review; Nursepatient relationship
Source
Journal of Clinical Nursing. https://doi.org/10.1111/jocn.15859
Item Type
Journal Article
Publisher
Wiley
DOI
10.1111/jocn.15859
Publisher's Version
https://onlinelibrary.wiley.com/doi/10.1111/jocn.15859
Rights Statement
© The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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