Nurse researches wants Maori voices heard.
Subject: Nurses (Demographic aspects)
Nurses (Practice)
Maoris (Health aspects)
Nursing (Research)
Nursing (Management)
Author: Manchester, Anne
Pub Date: 07/01/2009
Publication: Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2009 New Zealand Nurses' Organisation ISSN: 1173-2032
Issue: Date: July, 2009 Source Volume: 15 Source Issue: 6
Topic: Event Code: 200 Management dynamics Computer Subject: Company business management
Product: Product Code: 8043100 Nurses NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners
Geographic: Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand
Accession Number: 205360226

When Maori nurse researcher Bernadette Jones returned to New Zealand in 2000 after 20 years living in Sydney, she knew her career as a nurse had to take a new direction. This was largely due to a back injury, which meant she was no longer able to do the heavy lifting involved with patients.

Speaking at Te Runanga's June hui in Wellington, Jones said she reluctantly directed her energies into research, a field she had vowed never to enter. Initially she got involved in a study conducted by the University of Otago into how to prevent eczema and asthma in babies, and the use of probiotics in newborns. But an awareness that Maori were under-represented in some areas of research, despite 25 percent of Maori children experiencing asthma and Maori mortality from asthma being more than four times that of non-Maori, drove her to apply for funding to conduct her own study.

"The disparities in the prevalence, morbidity and mortality for Maori with asthma are well documented," said Jones, who is of Ngati Apa and Nga Wairiki descent. "However, there is much less evidence available explaining those differences and even less evidence for successful interventions to address the excess burden for Maori."

Back in 1991, He Mote Huango: the Mood Asthma Review, conducted by researcher Eru Pomare, made a number of recommendations. These included that these disparities could only be solved by Maori being more effectively involved in the planning and delivery of asthma care; that they needed greater education about asthma and its management; and that non-Maori needed to increase their awareness of the cultural factors impacting on Maori asthma management. "Eru Pomare's findings and recommendations are still applicable," Jones said.

Jones' own study--Pukapuka Hauora--aims to understand parents' reality of managing tamariki asthma, by listening to parents' stories, understanding the issues, developing appropriate and effective interventions, and challenging the way asthma health care is delivered for Maori tamariki. Now nearly two years on, the study has involved a team of five researchers, 32 whanau, with four visits over a year and in-depth, semi-structured interviews. Recruitment and retention rates among study participants have been 100 percent.

Of prime importance to Jones has been the use of kaupapa Maori research, a philosophy that ensures Maori protocol is followed during the research processes. Such research fully recognises Maori cultural values and systems, and ensures Maori maintain control over all phases of the research.

"Kaupapa Maori research was a new concept and a new learning journey for me," said Jones. "My father and grandfather were penalised for being Maori and our family had lost a lot of our culture. I know, however, that pakeha research works well for pakeha, but it does not work well for Maori."

To begin her research, Jones built on her nursing background, sought advice from kaumatua and kuia and formed partnerships in the community, in particular with Tu Kotahi Maori Asthma Trust. Whakawhanaungatanga--getting to know the community--ties at the heart of her methodology.

"I needed to share myself, and to acknowledge the diversity of the whanau I was interviewing. I needed to reflect on my role as a researcher, to provide information as requested, to support whanau with other issues like housing and finance, and to fit in with their complex lives.

"Why should Maori nurses get into research?" Jones asked. "We understand the issues facing Maori and their communities, and we are advocates for our patients. Mainstream health services need to take notice of what whanau want and, as a researcher, I have a responsibility to make sure Maori voices are heard." *
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