Cultural Safety in Paramedic Practice: Experiences of Māori and Their Whānau Who Have Received Acute Pre-Hospital Care for Cardiac Symptoms from Paramedics
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Journal Article
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CSIRO Publishing
Abstract
Background Cardiovascular disease is a major health issue for Māori that requires timely and effective first-response care. Māori report culturally unsafe experiences in health care, resulting in poor health outcomes. Research in the pre-hospital context is lacking. This study aimed to explore experiences of cultural (un)safety for Māori and their whānau who received acute pre-hospital cardiovascular care from paramedics. Methods Utilising a qualitative descriptive methodology and Kaupapa Māori Research (KMR), in-depth semi-structured interviews were undertaken with 10 Māori patients and/or whānau, and a general inductive approach was used for analysis. Results Three key themes were identified: (1) interpersonal workforce skills, (2) access and service factors and (3) active protection of Māori. Participants described paramedics’ clinical knowledge and interpersonal skills, including appropriate communication and ability to connect. Barriers to accessing ambulance services included limited personal and community resources and workforce issues. The impact of heart health on communities and desire for better preventative care highlighted the role of ambulance services in heart health. Conclusion Māori experience culturally unsafe pre-hospital care. Systemic and structural barriers were found to be harmful despite there being fewer reports of interpersonal discrimination than in previous research. Efforts to address workforce representation, resource disparities and cultural safety education (focussing on communication, partnership and connection) are warranted to improve experiences and outcomes for Māori.Description
Keywords
4203 Health Services and Systems, 42 Health Sciences, Cardiovascular, Health Services, Clinical Research, Heart Disease, 7.3 Management and decision making, 8 Health and social care services research, 7 Management of diseases and conditions, 8.1 Organisation and delivery of services, Cardiovascular, Generic health relevance, 1110 Nursing, 1117 Public Health and Health Services, 4203 Health services and systems
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Journal of Primary Health Care, ISSN: 1172-6156 (Print), CSIRO Publishing. doi: 10.1071/hc24010
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© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)