Māori experiences of physical rehabilitation in Aotearoa New Zealand: a scoping review

The purpose of this review was to explore what is currently known about Māori experiences of physical rehabilitation services in Aotearoa New Zealand. A scoping review was undertaken following steps described by the Joanna Briggs Institute. Databases and grey literature were searched for qualitative studies that included descriptions of Māori consumer experiences in their encounters with physical rehabilitation. Data relating to study characteristics were synthesised. Qualitative data were extracted and analysed using reflexive thematic analysis. Fourteen studies were included in this review. Four themes were generated that describe Māori experiences of rehabilitation. The first theme captures the expectations of receiving culturally unsafe care that become a reality for Māori during rehabilitation. The second theme describes whānau as crucial for navigating the culturally alien world of rehabilitation. The third theme offers solutions for the incorporation of culturally appropriate Māori practices. The final theme encompasses solutions for the provision of rehabilitation that empowers Māori. This scoping review highlights ongoing inequities experienced by Māori when engaging with rehabilitation services. Strategies for facilitating culturally safe rehabilitation for Māori have been proposed. It is essential that rehabilitation clinicians and policymakers implement culturally safe approaches to rehabilitation with a view to eliminating inequities in care provision and outcomes for Māori. Māori experiences of physical rehabilitation are comparable to the negative experiences they have in other health contexts.Although there are pockets of optimism, the results of this scoping review indicate that the delivery of culturally safe rehabilitation is inconsistent in Aotearoa New Zealand.A whānau-centred approach to rehabilitation is key to recovery and healing for Māori.There are opportunities for clinicians to disrupt the culturally unsafe care experienced by Māori by facilitating rehabilitation that normalises Māori cultural practices and embeds Māori approaches to health and wellbeing. Māori experiences of physical rehabilitation are comparable to the negative experiences they have in other health contexts. Although there are pockets of optimism, the results of this scoping review indicate that the delivery of culturally safe rehabilitation is inconsistent in Aotearoa New Zealand. A whānau-centred approach to rehabilitation is key to recovery and healing for Māori. There are opportunities for clinicians to disrupt the culturally unsafe care experienced by Māori by facilitating rehabilitation that normalises Māori cultural practices and embeds Māori approaches to health and wellbeing.

本综述旨在探究目前学界对奥特亚罗瓦新西兰(Aotearoa New Zealand)地区毛利族(Māori)群体接受物理康复服务体验的现有认知。本研究按照乔安娜·布里格斯研究所(Joanna Briggs Institute)制定的步骤开展范围综述(scoping review)。研究团队检索了数据库与灰色文献(grey literature)，纳入以描述毛利族服务使用者接触物理康复服务时的体验为核心内容的质性研究(qualitative studies)。对与研究特征相关的数据进行综合，提取质性数据并采用反思性主题分析(reflexive thematic analysis)方法开展分析。本综述共纳入14项研究，提炼出4个主题以阐述毛利族的康复服务体验。第一个主题聚焦于康复过程中，毛利族群体遭遇的与文化安全相悖的护理预期成为现实。第二个主题将家族(whānau)描述为帮助毛利族群体在康复这一文化疏离的医疗环境中适应与前行的关键支撑。第三个主题提出了融入适宜毛利族文化的实践的解决方案。第四个主题则围绕如何提供赋能毛利族群体的康复服务展开。本范围综述凸显了毛利族群体在接触康复服务时持续面临的健康不平等问题。目前已提出了推动面向毛利族群体的文化安全康复服务的相关策略。康复临床工作者与政策制定者必须推行文化安全的康复服务模式，以期消除毛利族群体在护理服务供给与结局方面的健康不平等。毛利族群体接受物理康复服务的体验，与其在其他医疗场景中的负面体验相仿。尽管存在局部的积极探索，但本范围综述的结果表明，奥特亚罗瓦新西兰地区文化安全的康复服务供给仍存在不一致性。以家族(whānau)为中心的康复服务模式是毛利族群体康复与疗愈的关键。临床工作者可通过推动将毛利族文化实践常态化、融入毛利族健康与福祉理念的康复服务，来改善毛利族群体遭遇的文化不安全护理现状。毛利族群体接受物理康复服务的体验，与其在其他医疗场景中的负面体验相仿。尽管存在局部的积极探索，但本范围综述的结果表明，奥特亚罗瓦新西兰地区文化安全的康复服务供给仍存在不一致性。以家族(whānau)为中心的康复服务模式是毛利族群体康复与疗愈的关键。临床工作者可通过推动将毛利族文化实践常态化、融入毛利族健康与福祉理念的康复服务，来改善毛利族群体遭遇的文化不安全护理现状。