Open Access Te Herenga Waka-Victoria University of Wellington
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Meeting the Needs of Maori with Diabetes: an Evaluation of a Nurse-Led Service

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posted on 2021-11-08, 23:35 authored by Janssen, Josephine Mary Elizabeth

Designated Maori health service providers and specialised Maori nursing roles using "culturally appropriate" practices have been developed in New Zealand to address health disparities between Maori and non-Maori citizens. This study considers the effectiveness, from several perspectives, of a Maori nurse-led diabetes programme offered by Te Hauora O Ngati Rarua. It also identifies salient features of the experience of having diabetes and being on the programme, which consists of the combination of a six week course of group education sessions with one-to-one case management, involving health care, education and support. Programme evaluation was conducted using an embedded case study design. Seven programme participants were followed for 9-12 months, during which time multiple sources of data were accessed, including programme documents, clinical notes, laboratory results and stakeholder interviews. Client outcomes were measured in terms of physiological measures, knowledge acquisition, diabetes management and lifestyle behaviour. Some participants demonstrated improved diabetes management and lifestyle behaviour while actively engaged with the programme, but efforts tended to lapse once support was reduced. This highlighted the importance of optimising the level of long-term self-management support for clients with diabetes. High levels of co-morbidity were common and tended to complicate management. The Transtheoretical Model of Change, Chronic Care Model and Systems Theory shaped the evaluation. The study makes four important contributions to knowledge in this area: 1) it confirms the importance of Maori values and processes in "by Maori for Maori" services as they help to keep clients engaged, 2) it describes how small Maori health providers meet the needs of the local community, and 3) it identifies the value of the Maori Diabetes Nurse Educator (MDNE) role in primary health care. Thus it serves as an affirmation of the importance of the Maori Health Strategy and Maori self-determination in organising and delivering health care for Maori clients. The fourth valuable contribution is the insight gained into the dynamics of Pakeha researchers working in partnership with Maori organisations.

History

Copyright Date

2008-01-01

Date of Award

2008-01-01

Publisher

Te Herenga Waka—Victoria University of Wellington

Rights License

Author Retains Copyright

Degree Discipline

Nursing

Degree Grantor

Te Herenga Waka—Victoria University of Wellington

Degree Level

Masters

Degree Name

Master of Nursing

Victoria University of Wellington Item Type

Awarded Research Masters Thesis

Language

en_NZ

Victoria University of Wellington School

Graduate School of Nursing, Midwifery and Health

Advisors

Nelson, Katherine; McEldowney, Rose