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Samoan Families Experience and Interpretation of the Person and Family Centred Model of Care in Adult Community Mental Health Services

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Thesis(2.27 MB)

Date

2023

Authors

Supervisor

Vaka, Sione
Holroyd, Eleanor

Item type

Degree name

Doctor of Health Science

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Volume Title

Publisher

Auckland University of Technology

Abstract

This doctoral study explored Samoans’ experiences and interpretation of the person- and family-centred model of care delivery in specific mental health services in Aotearoa, New Zealand. The literature review presented here highlights the core principles of the approach; however, there is no clear definition of its application to care practice. A succinct history of healthcare in New Zealand, including an overview of the mental health services, provides an outline of the healthcare system as well as the establishment of specialised mental health services for Pacific people. In addition, a brief history of the foundation of Samoans’ ancient beliefs, values and existence provides an overview of participants’ worldviews and offers a rationale for their experiences of the research topic. The fa’afaletui cultural lens was applied to guide the study, and feedback was collected from six semi-structured talanoa group discussions with families who had been previously or were at the time engaged with mental health services. Moreover, a local stakeholder group was recruited to guide stages of the fa’afaletui. A total of 13 individual participants from six families participated. Participants consisted of four mothers, two fathers, five sisters, one son, and one husband. The research aim What does the person and family centred care mean for Samoan families accessing mental health services? was answered via the qualitative exploration and five themes were identified: (i) Fa‘atuatua ile Atua; Spiritual faith in God; (ii) It’s a hush-hush topic; stigma of mental illness; (iii) We are in the dark with our communication and dealings with the services; (iv) Practice what you preach; clinical service delivery misaligned with the model of care aim and vision; and (v) The values of alofa (love) and fa‘aaloalo (respect); enablers of positive experience. The findings overall highlight spirituality and religion as core to a Samoan’s faith in fostering resilience and healing when facing adverse mental health events with their family members. Also, the findings revealed spirituality as the foundation of the Samoan culture where the person is identified with family, village, community, and others. In addition, the role of church affiliation is vital to nurture social connection and cultural wellbeing for Samoans. Moreover, there is a need to build up capacity for Pacific-staffed specialist services and a Pacific model to achieve equity and holistic care for Samoans and other Pacific populations at risk of adverse mental health outcomes. Also recommended is the need to raise awareness and to educate future and current mental health professionals about Samoan/Pacific cultural beliefs and values and how these can promote and strengthen quality of care for the person and their families.

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https://hdl.handle.net/10292/16236

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Doctoral Theses