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

ABSTRACT

PURPOSE: The purpose of this review was to explore what is currently known about Maori experiences of physical rehabilitation services in Aotearoa New Zealand. METHODS: 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 Maori 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. RESULTS: Fourteen studies were included in this review. Four themes were generated that describe Maori experiences of rehabilitation. The first theme captures the expectations of receiving culturally unsafe care that become a reality for Maori during rehabilitation. The second theme describes whanau as crucial for navigating the culturally alien world of rehabilitation. The third theme offers solutions for the incorporation of culturally appropriate Maori practices. The final theme encompasses solutions for the provision of rehabilitation that empowers Maori. CONCLUSIONS: This scoping review highlights ongoing inequities experienced by Maori when engaging with rehabilitation services. Strategies for facilitating culturally safe rehabilitation for Maori 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 Maori.

Maori 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 whanau-centred approach to rehabilitation is key to recovery and healing for Maori.There are opportunities for clinicians to disrupt the culturally unsafe care experienced by Maori by facilitating rehabilitation that normalises Maori cultural practices and embeds Maori approaches to health and wellbeing.