Experiences of Bereaved Māori Whānau in Out‐of‐Hospital Death Where Emergency Ambulance Services Respond

Abstract

Māori are disproportionately affected by out-of-hospital deaths due to higher rates of cardiac arrest and lower survival outcomes. Ambulance personnel are often the only healthcare professionals present during events, making their role in supporting bereaved whānau (families) critical. However, it remains unclear if current bereavement care meets whānau cultural and spiritual needs. Using kaupapa Māori research principles, this qualitative interview study explores the experiences of bereaved Māori whānau in Aotearoa New Zealand to understand their experiences during an out-of-hospital death when emergency ambulance services respond. Eight interviews with bereaved whānau were completed, with four themes describing how Te Ao Māori (the Māori world) informed whānau needs. Whānau navigated end-of-life collectively, with whānau kotahitanga (family unity) being central to whānau experiences. Tikanga (traditional customs, protocols) during death and dying was important, with such spiritual and cultural needs typically upheld by whānau independently. Whānau presence during the transition between life and death held emotional and cultural significance. Finally, the presence of Māori responders improved whānau experiences. Overall, bereavement care that acknowledges whānau cultural and spiritual needs remains limited during out-of-hospital deaths. Enhancing cultural safety and increasing Māori workforce representation offer key opportunities to strengthen the provision of end-of-life care by emergency ambulance services.