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Kidd, J. D. (2008). Aroha mai: Nurses, Nursing and Mental Illness. Ph.D. thesis, University of Auckland, Auckland.
Abstract: The research takes an autoethnographical approach to exploring the connections between being a nurse, doing nursing work, and experiencing a mental illness.
Data is comprosed of autoethnographical stories from 18 nurses. Drawing on Lyotard's (1988) postmodern philosophy of 'regimes of phrases' and 'genres of discourse', the nurses' stories yeilded three motifs: Nursing, Tangata Whaiora (people seeking wellness) and Bullying. Motifs ate recurring topical, emotional and contextual patterns which have been created in this research by means of the formation of collective stories from the content of the nurses' stories, artwork, ficitonal vignettes and poetry.
Interpretation of the motigs was undertaken by identifying and exploring connected or dissenting aspectis within and between the motifs. Using Fine's (1994) notion of hyphenated lives, the spaces between these aspects were conceptualised as hyphens. The Nursing motif revealed a hyophen between the notion of the nurses as selfless and tireless carers, and the mastery requirements of professionalism. The nurses' hope for caring, belonging, expertise and 'goodness' were also features of the nursing motif. The Tangata Whaiora motif revealed the hyphen between being a compliant patient and a self-determined person seeking wellness, and also foreshadowed the notion that the nursing identity does not 'permit' the dual identities of nurse and tangata whaiora.
This research ahs found that nurses who have experience, or are vulnerable to, mental illness negotiate a nexus of hyphens between societal, professional and personal expectations of the nurse. Ongoing unsuccessful negotiation of their identities is exhausting and leads to enduring distress. At times, negotiation is not possible and the nurse is immobilised in a differend of silence and injustice. At such times, the only resolution possible for the nurse is to leave the nursing profession. Bullying surfaced as a feature of the hypohen between the nursing and tangata whaiora identities, as well as being a part of each identity as colonising, silencing and/or discriminatory acts.
Successful negotiation between and among the nursing and tangata whaiora hyphens requires a radical restructuring of the nursing image and culture across the education, workplace and personal/clinical areas. Three strategies are proposed for the discipline of nursing to achieve this cahnge: transformatory education, a conscientisation programme, and mandatory emanicpatory clinical supervision.
Keywords: Nurses, Mental Illness
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Coupe, N. M. (2005). Whakamomori Maori Suicide Prevention. Ph.D. thesis, Massey University, Palmerston North.
Abstract: Introduction: Suicidal behaviour is a major public health issue globally. The incidence of suicide and attempted suicide internationally is excessive, particularly among indigenous populations. The Mäori (indigenous people of New Zealand) suicide and attempted suicide rates have exceeded the non-Mäori rates in New Zealand. In an attempt to address the high incidence of Mäori suicidal behaviour an epidemiological case control study was initiated.
Method: 250 consecutive cases of Mäori who attempted suicide who were admitted to one of the three Auckland public hospitals were compared to 250 random, Mäori community-based controls (found through door knocking). Participants were compared on a variety of measures including the General Health Questionnaire–28 (GHQ–28), Hospital Anxiety and Depression Scale (HADS), CAGE Alcohol Screening Test; Composite International Diagnostic Interview (CIDI–suicidality), Beck’s Scale of Suicide Intent (SIS); and cultural identity validated questionnaires.
Results: Response rates were high for both cases (85.6%) and controls (81.2%). The multivariate analysis revealed that poor general health status was the key risk factor associated with attempted suicide among Mäori.
Once the health indicator is taken out of the analysis, cultural identity, marijuana utilisation and interpersonal abuse are the next major risk factors in attempted suicide among Mäori.
Conclusion: Suffering from poor general health can increase attempted suicide among Mäori. Having a notional identity and not being connected to Mäoritanga (those things Mäori; Mäori culture) is associated with the risk of suicidal behaviour.
Keywords: Maori, Suicide, Suicide Prevention
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Ihimaera, L. V. (2004). He ara ki te ao mārama : a pathway to understanding the facilitation of taha wairua in mental health services. Master's thesis, Massey University, Palmerston North.
Abstract: This research is about the facilitation of taha wairua (spirituality) in mental health services. This research has been guided by kaupapa Maori frameworks and aimed to answer three questions: • Whether taha wairua, supported by matauranga Maori can be verified as a valid concept for use in mental health services • How Maori cultural and clinical workers facilitate taha wairua within a kaupapa Maori approach, and, • How the use and influence of taha wairua facilitates the inclusion of matauranga Maori. The increasing acceptability of alternative and holistic approaches to healing often with a spiritual component deserves serious consideration, especially within the area of mental health services. The literature shows that indigenous views of health and healing are valid and deserve recognition and acceptance in mental health services. The Treaty of Waitangi, the founding document of New Zealand, underpins Maori rights to the facilitation of taha wairua practices in Western health systems. Current New Zealand mental health policy and legislation provide strategies to progress the facilitation of Maori healing interventions in mental health services. It is noticeable, however, that these strategies are not built on the Treaty of Waitangi but are built on health disparities. The literature also supports the concept that there is a place in the recovery process for both spirituality and religious beliefs, and Western and cultural interventions. The data illustrate how tikanga Maori either practised solely in its natural form or within the framework of Maori models of health is beneficial to health outcomes for tangata whai ora and whanau when supported by the facilitation of taha wairua. The research data provided the foundation for components that can produce a framework for the facilitation of the concept of taha wairua within the scopes of practice of kaimahi Maori in mental health services. Some standards for best practice in supporting taha wairua within the cultural component of all Maori working in mental health have also been proposed. Maori do not have the critical mass to achieve all that has been raised in this research, and the principle of collective responsibility needs to be applied to provide the necessary resources and support to achieve implementation of Maori healing frameworks to facilitate taha wairua in mental health services. It is hoped the knowledge gained from this research will be useful to policy makers and managers in gaining insight into the benefits of healing for tangata whaiora, whanau and kaimahi Maori through the provision of appropriate cultural interventions and in providing an appropriate environment to enable physical and spiritual healing to take place. It is also hoped Maori too will find this research of benefit, particularly to inform scopes of practice, thereby providing potential for new ways to achieve best practice cultural and clinical practice.
Keywords: Maori, Mental health, Taha wairua, Spirituality, Mental health services
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Ware, F. J. R. (2009). Youth development: Maui styles Kia tipu te rito o te pa harakeke; Tikanga and ahuatanga as a basis for a positive Maori youth development approach. Master's thesis, Massey University, Palmerston North.
Abstract: The Youth Development Strategy Aotearoa has been seen as an innovative approach to youth develpment. The E tipu e rea – Rangatahi Development Package was particularly useful for organisations implementing the strategy with Maori youth. There have been successful Maori youth development initiatives, though these have been ad hoc. Nonetheless, the realities and experiences of Maori youth are still not being fully addressed in national policy. This has implications for the support and resourcing of Maori youth development initiatives.
Maori yout are members of a range of groups including whanau, hapu, iwi and Maori communities in te ao Maori as well as the wider youth population and New Zealand society. The histories, expeeriences and viewpoints of each distict group contribute to diversity in the Maori youth population which presents challenges for Maori youth development. Maori development goals do not adequately focus on Maori youth and youth development theory does not fully consider culture. The challenge is to successfully integrate Maori culture and youth culture in a relevant and meaningful manner so that Maori youth can positively contribute to Maori development and wider New Zealand society.
This study examines purakau (naaratives) about Maui (Polynesian ancestor) as a template for the analysis of Maori youth from the Manawatu region. The research showed tikanga and ahuatanga were relevant to the contemporary daily lives of the participants. The study found that positive development and the realisation of potential for Maori youth was affected by individual and environmental influences. This thesis concludes by making recommendations for policy, practice and further research. Finally, it offers a culturally appropriate theoretical approach for positive Maori youth development.
Keywords: Maori youth, youth development
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Gillies, A. M. (2006). Kia Taupunga te Ngakau Maori Anchoring Maori Health Workforce Potential. Ph.D. thesis, Massey University, Palmerston North.
Abstract: In New Zealand Maori are under-reperesented in the workforce across multiple sectors. This thesis explores this incongruity with regard to Maori health. A Maori perspective and philosophical foundation formed the basis of the methodological approach, utilising a case study research design to inform the study. This provided the opportunity to explore Maori health workforce development initiaitves and their potential to contribute to improvements and gains in Maori health.
It was important that this work take into account social and ecomonic factors and their impact on health, as well as the varying political climates of market oreinted reform and a fiscal policy focus, because it has not only challenged Maori health development but also provided opportunites for increased Maori involvement and participation in health and New Zealand soicety. Therefore the thesis, while focused on health takes cognisance of and, coincides with the capacity and capability building efforts that have been a feature of overall Maori development, progress and advancement.
In the context of this thesis Maori health workers are seen as leaders within their whanau, hapu, iwi, and Maori communities. Consequently a potentional workforce that is strong and powerful can lead to anticipated gians in Maori health alongside other Maori movements for advancement. The potential cannot be under-estimated.
This thesis argues that there are critical success factors, specific determinants, influencing Maori health workforce potential, and that these success factors have wider application. Therefore, as this thesis suggests Maori workforce development, especially in relationship to the health workforce, is dependent on effective Maori leadership, the application of Maori values to workplace practices, levels of resourcing that are compatible with training and development, critical mass, and targeted policies and programmes.
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This database has been funded by the Ministry of Health to ensure more ready access to research, literature, and conference papers relating to Māori mental health. Over 1200 abstracts are included, with many links and full text articles as well as a growing collection of Masters and PhD theses.
Please note, inclusion in the database does not indicate endorsement of the content by Te Rau Matatini. It is our hope that the database will increase access to relevant literature by students, policy makers, researchers, whānau and mental health workers, and from this, further Māori mental health service development, service delivery, and workforce development gains will be made.
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Copyright © 2009 Te Rau Matatini Contact: Roimata Tauroa
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