Haoura Maori Models of Care and Well Being Reflection – Medical Science Assignment Help

Assignment Task


Part 1 how a pa site relates to Pae ora( healthy futures) framework and its concept for modern maori (for introduction)

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This paper provides a description of how each article of Te Tiriti o Waitangi can be applied to the profes-sional nursing role. Discuss and identifies two haoura Maori models of care and well being. Reflects on the implications of incorporating hauora Maori models into nursing practice. Being the Treaty a founding docu-ment of New Zealand its implementation in nursing education and practice outcomes are essential when car-ing for Maori. The representation of Maori culture in health care models and the importance of them as part of the health care system are related to the newly framework known as Pae ora (healthy futures) that pro-poses changes in delivering better health outcomes for tangata whenua. Pae ora comes in three simple ways to get involved with individual’s health, collective well being and environment well being. This means bring-ing us all together and having a model of wellness.

In this perspective it weaves a connection to the past present and future whether is a physical pa remnants of a previous one, or starts a new one. Early Maori Pa represents the mana (power or prestige) life escense . Tangata whenua have built Pa in various defensible locations. Pa functions were used to safeguard food and water and storage food and supplies. Early maori settlements were very hygienic-sanitary. The relation be-tween a Pa to a Pae ora (healthy futures) are the social structures and processes ie: tapu/noa( sacred) and the community. Regulating certain practices and activities ie: clean water for drinking, what woman did when they had their periods,special sites for rubbish disposal, with designated people to ensure the waste was put, these were ahikaa korero, and how these practices translates into good on going public health practices. Treaty is a essential component of care and well being.

Part 2 provides a clear comprehensive definition for each article of te tiriti, kawanatanga, tino rangati-ratanga, oritetanga, wairuatanga. Provides a description on how each article is applied on the profes-sional nursing practice role when caring for maori. (explanation)

Nursing practice in New Zealand is shaped by the founding document known as Treaty of Waitangi. The sig-nificance of Te Tiriti o Waitangi and its implementation to nursing practice role is vital part of how we want to work in partnership with Maori. Each article contains a better understanding and outlines the M?ori text of TeTiriti and its four articles. Arti-cle one, K?wanatanga or governorship, outlined the Crown’s obligations and responsibilities to govern its own people. The second article, Tino Rangatiratanga affirmed M?ori sovereignty over M?ori affairs and ta-onga (treasures) including health . Article three, guarantees M?ori the same rights and privileges as British subjects. The fourth article Wairuatanga affirmed the right to religious freedom. Came & Tudor (2016).

Kawanatanga, outlines the right for the crown to govern, having the right to make laws and practices that are beneficial and fair for all. Facilitates Maori health gain and reduces inequalities (Barlow,1991). Includes cul-tural responsiveness and improved continuity of care, using tikanga Manaakitanga to enable Maori aspira-tions for their own health and wellbeing. In nursing practice the implementation of kawanatanga are mechanisms to ensure equitable M?ori participa-tion and leadership in different settings, resourcing, implementing and evaluating.

They can be incorporated by health practitioners in reflective practice, active listening, and prioritize M?ori voices. Came et al.,2021. Manakitanga is a part of tikanga that aligns with kawanatanga, ensures that Maori clients get the care they seek. Ensures their values and practices are respected, it involves the act of sharing and caring, uplifting their (mana) prestige. As an instance a 32 year old, Maori woman who’s baby has been birthed in a healthcare setting, had the opportunity to do a karakia and karanga as part of tikanga, her mana and wairua (spiritual wellbeing) were respected and it showed that cultural responsive care was deliver with whanau strenght based approach.

Tino Rangatiratanga is the arcticle that defines leadership and participation with opportunities in relation to health services, including Maori controlled health services, and Maori involvement in the governance, plan-ning and delivery of health services in general. This provides for M?ori self-determination and mana, con-tributes to equitable health outcomes for M?ori. This requires the Nursing Council to work with partners in the design, delivery and monitoring of our relevant statutory work. (NCNZ,2019)

For the implementation of Tino rangatiratanga in nursing practice, becoming approachable by engaging in meaningful communication is comprehendible and allows everyone’ s participation. Includes whanau partic-ipation and encourage Maori inclusion. As an example before entering to a patient’s room perhaps take time to build rapport and introduce yourself and role. Make face to face connections, greet and converse with whanau. Make them feel welcome having the role in the recovery of their love ones. Become a culturally re-sponsive by actively engaging in whakawhanaungatanga (the act of building relationships) to establish wha-naungatanga with both people and space. Take time to active listen what the patients needs are this may lead to increase their participation in healthcare context. Stevenson et al., 2019.

Article Three refers to equity, working towards M?ori enjoying the same levels of health and well-being as Pakeha. Oritetanga enables M?ori to live, thrive and flourish as M?ori. (NCNZ, 2019). Equity sat within the Oritetanga one of the treaty articles, which stablishes that kanohi ki te kanohi- face to face encounters are crucial for nurses when taking care of maori patients. Nurses are to be challenged to achieve equitable health outcomes and arise issues that are not equitable.(Kaitiaki 2021)

According to Baker, 2018. The immunization rate for babies was improved through the use of a pro-equity approach. There have been significantly higher gains in immunisation of Maori infants than for the total pop-ulation. However, even in this relatively favorable example, the rates for Maori were still lower than for any other population at December 2016. So setting an expectation of equity will only get you so far. Wairuatanga is an expression of Maori spirituality,acknowledges the importance of wairua related health do-mains of mana, tapu (sacred), mauri (life force) and whenua (land). Came et al, 2020. Spirituality is a key component of holistic approach and wellness. Ways of making meaning of their lives and the acknowledgment of the presence of a higher being”. Kiyimba & Anderson, 2022.

Wairua (spirit) is an integral aspect of existence and important source of well-being within M?ori culture. Take as an example at the time of a death happens, make an inmediate referral to the tupapaku(deceased) whanau, do not leave the body unnatended, give whanau the opportunity to perform cultural and spiritual tikanga practices, be guided by whanau on the spiritual practice they wish to follow, allowed for karakia to be performed, from a Maori perspective the room is not spiritually cleansed if karakia was not performed, the room doesn’t need to be clean until karakia is performed. Knowledge of Maori best practices allow health care workers to enquire the spiritual and cultural preferences of Maori patients and whanau. Being familiar of tikanga practices are part of establishing trusting relationships and consider traditional beliefs may influ-ence in clients spiritual well being.

Part 3 two hauora maori models have been examined and clearly , describes similarities and differ-ences.

why is essential to implement hauora models of health in professional nursing practice?
To provide high quality care based in a holistic based approach hauora models are essential to be imple-mented in nursing practice . Te whare ta pa wha consists of four important cornerstones, taha tinana (physi-cal health); taha hinengaro (mental and emotional health) ; taha wh?nau (family health) and taha wairua (spiritual dimension). This is a model with better understanding of a holistic approach, very useful model in the health care sector. Keeping your wharenui balanced is not going to affect the dimensions of the wharenui if it is upright. Te whare ta pa wha is a model that has been used and adopted widely in Aotearoa, its is rele-vant to nursing practice as this reflects the culture and representation of its own people. Te whare ta pa wha can be used by Maori and non Maori nurses. It requires the understanding of the four sided house designed by Dr.Mason Durie. The meaning of the model when one side /wall of a house is unstable, (unwell or im-pacted by disease) the entire structure (your holistic health and well being ) is compromised. Ensure Nurses acknowledge the value of the ‘pou tokomanawa’( heart space) that is the centre of the whole model and whare and this is how the whole structure and elements of someone’s life interconnect together.

Te Pae Mahutonga model that was developed by Mason Durie and consists of four important goals: maouri ora, waiora, toiora( healthy lifestyles), and te oranga( participation in society). The goal is to achieve better health outcomes for Maori and implement best approaches for tangata whenua( indigenous of the land) pro-moting Maori health and wellbeing. (Grueber, 2021). Applying Te Pae Mahutonga to nursing practice as a model is widely used by health professionals as a way to view holistic well being of all New Zealanders. It is similar to other health models on how each dimension interralates with one another for total wellbeing. It uses the four centralstars of the Southern Cross,to repre-sent foru key tasks of health promotion. The two pointers represent Nga Manakura(comunity leadership) and Te Mana Whakahaere(autonomy).

Implementing hauora models of care in professional nursing practice it is essential because as professional nurses the aim is to work in partnership with Maori clients. Ways we can do do this is to have resources that reflect toiora (healthy lyfestyles), being good role models ourselves to make healthy choices. Te oranga is about promoting health and encouraging participation in the community which enhances levels of well being. Ways we can do this is to get and about the community sharing ideas, building whanaugatanga with patients and whanau. Involved patients in decision making and the treatment they decide to take, value their contribu-tion towards improvement on their health and well being. For tangata whenua to have a sense of connection to their cultural identity, they need to have access to their language and knowledge about their culture. To show you truly support their identity it is important to encourage open communication about inclusion and diversity. Mauri ora encompasses values and beliefs, family rituals, and celebrations.

In conclusion , Te tiriti is all about connection and whakapapa, treat people with respect and aroha, ensuring equity, is a constant challenge in process, start at the levels of principles, articles and incorporates knowledge to Nurses to work with Maori. Provides a background to work in a culturally safe manner. Being cultural aware and building trusting relationships with whanau/clients to attend tangata whenua needs. There are hauora models of care that has helped to have a better understanding of delivering health services to, and with, Maori consumers. In modern times it is essential to have an analysis of the historical and contemporary realities that affect Maori health status, identifying Maori care models that exist and develop strategies for working positively to improve Maori health outcome.

The Pae ora (healthy futures) proposes to protect, promote and improve the health of New Zealanders. Achieve equity by reducing health disparities among Aotearoa population. The newly maori health strategy plan introduces a practical home model of care, leading to a better quality of care, consists of 3 elements whanau ora, mauri ora and wai ora. This embarks on bulding blocks of a home model of care to make it stronger and protect it as it was a fortified Pa.(Maori village)

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