stages in Maori health
Child health, mental health and the health of
older Maori will be key areas of focus for the Te Pumanawa Hauora research
group's HRC-funded programme.
Professor Mason Durie, Assistant Vice-Chancellor and Professor of Maori
Research and Development, says most of the group’s health research
to date has focused on service delivery, health promotion, and Maori public
health. New funding of $1.6 million from the Health Research Council
will allow the team to pursue two new projects, as well as take an existing
project to a new level.
One new project, Oranga Kaumatua, will investigate the health needs of
two cohorts of Maori, one a traditionally conservative group of 'Kaumatua',
the other a group of 'older Maori' who do not necessarily have close links
with conventional Mäori networks. Professor Durie says that
the demographic profile of Maori is changing, and the number of Maori
elderly will increase quite dramatically over the next 25 years, from
about 4% to around 9%.
" It is going to be important to know what planning needs to be done
in order to be ready for quite a major shift in Maori demography,"
he says. "We think that the stresses and the lifestyles of
the two groups are significantly different and that different health needs
might be experienced, requiring a range of health interventions."
The other new project involves the validation of the Hua Oranga, a Maori
measure of mental health outcome. Unlike many conventional outcome
measures that focus on clinical symptoms Hua Oranga is largely a measure
of well-being. “It is more concerned with function rather than residual
illness and depends on three perspectives. It actually asks a clinician,
a patient and a patient's family member for their opinions about the results
of treatment or care. Many outcome measures rely entirely on what
the doctor thinks, but patients and their families sometimes have quite
different views about how successful an intervention has been.”
Professor Durie says that although Hua Oranga is designed for use in mental
health settings it canvasses gains in mental health, physical health,
spiritual health, and social health.
Te Pumanawa Hauora's existing project involves formally validating another
outcome measure, Te Ahuatanga o Te Waiora Tamariki - a picture of child
health. Trailed initially with women after childbirth the set of
questionnaires have been developed to assess the health status of Maori
children in terminology, contexts and constructs relevant to Maori.
Professor Durie says that the shift to measuring outcome is likely to
be increasingly important in New Zealand. "Those outcome measures
that are available focus very much on the reduction or removal of symptoms,
but symptoms are a narrow way of measuring well-being. What our two outcome
measurement projects have in common is the shift in focus from a sickness
model to a wellness model.
" The point about validation is that before any of the measures can
be useful, they've really got to be tested so that they can be portable
and used in a range of settings by different people, with reliable results."
The research programme will involve researchers at the Palmerston North
and Wellington campuses, including a number of HRC Maori postdoctoral