Presented at the Neonatal Society 2014 Autumn Meeting.
Hull York Medical School, UK
Background: There is evidence that attending to cultural and spiritual needs can have a positive influence during dying and bereavement. Historically, New Zealand is a bicultural society with distinct traditions and beliefs differentially held between Māori and Europeans, which are reflected in approaches to health and healthcare. This presentation aims to address challenges that have arisen when Māori based health care is combined with a Western approach to medicine, and how New Zealand health services have attempted to address these challenges as pertaining to neonatal palliative care.
Methods: Cochrane and Medline searches were conducted using keywords “paediatric”, “neonatal”, “palliative care”, “cultural needs”, and “Māori”. Interviews with a palliative care consultant and a specialist nurse with an interest in neonatal palliative care were conducted to identify any specific challenges encountered in the provision of palliative care. A specific case study was discussed that highlighted particular challenges in providing Māori centred neonatal palliative care. A hospital based Māori research advisor was further consulted to understand the origins of various Māori health beliefs and their role of in healthcare provision in New Zealand.
Results: The Treaty of Waitangi is a historical piece of legislation defining the relationship between Māori and Europeans in New Zealand, emphasizing that the values and traditions of both cultures should be reflected in society at large. The He Korowa Oranga further outlines how health services are to be attentive to the cultural needs and health beliefs of Māori. The research conducted suggested that the delivery of culturally appropriate palliative care on the NICU should address the wellbeing and needs of the whānau as well as the need for spiritual protection for the Māori baby. In Auckland, these needs are catered for by having tools to accommodate the shared decision making process of the whānau, the provision of whānau accommodation, access to Māori support services and the creation of a Tupapaku pathway, as highlighted through the case study provided in this presentation.
Conclusion: The literature provides evidence that the delivery of culturally appropriate palliative care, that takes into account the individual spiritual needs of the affected families, is helpful in the dying and bereavement processes. The neonatal palliative care services in Auckland, New Zealand, provide an example of how to integrate biculturalism into health services and highlights various challenges experienced.
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