Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-28T00:02:02.908Z Has data issue: false hasContentIssue false

Te Waka Oranga: An Indigenous Intervention for Working with Māori Children and Adolescents with Traumatic Brain Injury

Published online by Cambridge University Press:  19 November 2013

Hinemoa Elder*
Affiliation:
Te Whare Wānanga o Awanuiārangi, New Zealand
*
Address for correspondence: Dr Hinemoa Elder, FRANZCP, PhD, PO Box 334, Oneroa, Waiheke Island, New Zealand. E-mail: [email protected]
Get access

Abstract

Background: Application of salient cultural knowledge held by families following child and adolescent traumatic brain injury (TBI) has yet to be documented in the literature. While the importance of the family is a well-established determinant of enhanced outcomes in child and adolescent TBI, the emphasis to date has been on the leading role of professional knowledge. The role of whānau (extended family) is recognised as an essential aspect of hauora (wellbeing) for Māori, who are overrepresented in TBI populations. However, whānau knowledge systems as a potent resource for enhancing recovery outcomes have not previously been explored. This paper describes the development of an indigenous intervention, Te Waka Oranga.

Method: Rangahau Kaupapa Māori (Māori determined research methods) theory building was used to develop a TBI intervention for working with Māori. The intervention emerged from the findings and analysis of data from 18 wānanga (culturally determined fora) held on rural, remote and urban marae (traditional meeting houses).

Results: The intervention framework, called Te Waka Oranga, describes a process akin to teams of paddlers working together to move a waka (canoe, vessel) in a desired direction of recovery. This activity occurs within a Māori defined space, enabling both world views, that of the whānau and the clinical world, to work together. Whānau knowledge therefore has a vital role alongside clinical knowledge in maximising outcomes in mokopuna (infants, children, adolescents and young adults) with TBI.

Conclusion: Te Waka Oranga provides for the equal participation of two knowledge systems, that of whānau and of clinical staff in their work in the context of mokopuna TBI. This framework challenges the existing paradigm of the role of families in child and adolescent TBI rehabilitation by highlighting the essential role of cultural knowledge and practices held within culturally determined groups. Further research is needed to test the intervention.

Type
Articles
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adekoya, N., & Wallace, L. (2002). Traumatic brain injury among American Indians/Alaska Natives – United States, 1992–1996. [Morbidity and Mortality]. Morbidity and Mortality Weekly Report Surveillance Summaries, 51 (14), 303304.Google Scholar
Anderson, V.A., Catroppa, C., Hariton, F., Morse, S., & Rosenfeld, J.V. (2005). Identifying factors contributing to child and family outcome 30 months after TBI in children. Journal of Neurology, Neurosurgery and Psychiatry, 76, 401408.CrossRefGoogle Scholar
Barlow, C. (2005). Tikanga whakaaro, key concepts in Māori culture. South Melbourne: Oxford University Press.Google Scholar
Blackmer, J., & Marshall, S. (1999). A comparison of traumatic brain injury in the Saskatchewan native North American and non-native North American populations. Brain Injury, 13 (8), 627635.CrossRefGoogle ScholarPubMed
Braga, L.W., Da Paz Junior, A.C., & Ylvisaker, M. (2005). Direct clinician-delivered versus indirect family-supported rehabilitation of children with Traumatic Brain Injury: a randomised control trial. Brain Injury, 19, 819831.CrossRefGoogle Scholar
Brown, D. (2009). Māori architecture, from fale to wharenui and beyond. North Shore: Penguin Group.Google Scholar
Burgess, E.S., Droktar, D., Taylor, H.G., Wade, S., Stancin, T., & Yeates, K.O. (1999). The Family Burden of Injury Interview (FBII). Reliability and validity studies. Journal of Head Trauma and Rehabilitation, 14, 394405.CrossRefGoogle ScholarPubMed
Cheung, M. (2010). Cellular and cultural studies of human neurodegenerative diseases. University of Auckland, Auckland.Google Scholar
Collins, A., & Hickey, H. (2006). The role of whānau in the lives of Māori with physical disabilities. Wellington: The Families Commission.Google Scholar
Durie, M. (1995a). Characteristics of Mâori health research. Paper presented at the Hui Whakapiripiri.Google Scholar
Durie, M. (1995b). Te hoa nuku roa framework. A Māori identity measure. The Journal of the Polynesian Society, 104 (4), 461470.Google Scholar
Durie, M. (2001). Mauri ora, dynamics of Māori health. Auckland: Oxford University Press.Google Scholar
Durie, M. (2002). Is there a distinctive Māori psychology? Paper presented at the National Mâori Graduates of Psychology Symposium, University of Waikato, Hamilton, New Zealand.Google Scholar
Durie, M. (2004). Understanding health and illness: research at the interface between science and indigenous knowledge. International Journal of Epidemiology 33, 11381143.CrossRefGoogle ScholarPubMed
Durie, M. (2011). Indigenizing mental health services: The New Zealalnd experience. Transcultural Psychiatry, 48 (1–2), 2436.CrossRefGoogle ScholarPubMed
Durie, M., & Kingi, T.K. (1997). A framework for measuring Māori mental health outcomes. Wellington: Ministry of Health.Google Scholar
Elder, H. (2012). An examination of Māori tamariki (child) and taiohi (adolescent) traumatic brain injury within a global cultural context. Australaisian Psychiatry, 20 (1), 2023.CrossRefGoogle ScholarPubMed
Elder, H. (2013). Indigenous theory building for Māori children and adolescents with traumatic brain injury and their extended family. Brain Impairment. doi: 10.1017/BrImp.2013.28.Google Scholar
Glavish, N. (2007). Tikanga best practice guidelines. Auckland: Auckland District Health Board.Google Scholar
Kingi, J., & Bray, A. (1999). Maori concepts of disability. Dunedin, New Zealand: Donald Beasley Institute Incorporated.Google Scholar
Langlois, J., Kegler, S.R., Butler, J.A., Gotsch, K.E., Johnson, R.I., Reichard, A.A., . . . Thurman, D.J. (2003). Traumatic brain injury-related hospital discharges. Results from a 14-state surveillance system. Morbidity and Mortality Weekly Report Surveillance Summaries, 52, SS-4.Google ScholarPubMed
Langlois, J., Rutland-Brown, W., & Thomas, K.E. (2005). The incidence of traumatic brain injury among children in the United States. Journal of Head Trauma and Rehabilitation, 20 (3), 229238.CrossRefGoogle ScholarPubMed
Lilley, S.C. (2009). The marae as an information ground. Retrieved from http://ibec.ischool.washington.edu/pubs/maraeInfoGround.pdf.Google Scholar
Marsden, M. (2003). The woven universe: selected writings of Rev. Mâori Marsden. Otaki: Estate of Rev. Māori Marsden.Google Scholar
McClintock, K., Mellsop, G., Moeke-Maxwell, T., & Merry, S. (2010). Pōwhiri process in mental health research. International Journal of Social Psychiatry, 58 (1), 9697.CrossRefGoogle ScholarPubMed
New Zealand Guidelines Group. (2006). Traumatic Brain Injury: Diagnosis, acute management and rehabilitation. Evidence based practice guideline. Wellington: Accident Compensation Corporation.Google Scholar
Rivara, J.B., Jaffe, K.M., Polissar, N.L., Fay, G.C., Martin, K.M., Shurtleff, H.A., & Liao, S. (1994). Family functioning and children's academic performance and behavior problems in the year following traumatic brain injury. Archives of Physical Medical Rehabilitation, 75, 369379.CrossRefGoogle ScholarPubMed
Saltapidas, H., & Ponsford, J. (2007). The influence of cultural background on motivation for and participation in rehabilitation and outcomes following traumatic brain injury. Journal of Head Trauma and Rehabilitation, 22 (2), 132139.CrossRefGoogle ScholarPubMed
Saltapidas, H., & Ponsford, J. (2008). The influence of cultural background on experiences and beliefs about traumatic brain injury and their association with outcome. Brain Impairment, 9 (1), 113.CrossRefGoogle Scholar
Sander, A.M., Cole Davis, L., Struchen, M.A., Atchison, T., Sherer, M., Malec, J.F., & Nakase-Richardson, R. (2007). Relationship of race/ethnicity to caregivers’ coping, appraisals, and distress after traumatic brain injury. NeuroRehabilitation, 22, 917.CrossRefGoogle Scholar
Simpson, G., Mohr, R., & Redman, A. (2000). Cultural variations in the understanding of traumatic brain injury and brain injury rehabilitation. Brain Injury, 14 (2), 125140.Google ScholarPubMed
Statistics New Zealand, & Ministry of Culture and Heritage. (2003). A measure of culture: cultural experiences and cultural spending in New Zealand. Wellington, New Zealand: Statistics New Zealand, Ministry of Culture and Heritage.Google Scholar
Staudenmayer, K., Diaz-Arrastia, R., Oliveira, A. d., Gentilello, L., & Shafti, S. (2007). Ethnic disparities in long-term functional outcomes after traumatic brain injury. Journal of Trauma: Injury, Infection, and Critical Care, 63 (6), 13641369.Google ScholarPubMed
Taylor, H.G., Drotar, D., & Wade, S. (1995). Recovery from traumatic brain injury in children: the importance of the family. In Roman, S. & Michal, M. (Eds.), Traumatic head injury in children. New York: Oxford University Press.Google Scholar
Taylor, H.G., Yeates, K.O., Wade, S.L., Drotar, D., Klein, S.K., & Stancin, T. (1999). Influences on first-year recovery from traumatic brain injury in children. Neuropsychology, 7, 755767.Google Scholar
Taylor, H.G., Yeates, K.O., Wade, S.L., Drotar, D., Stancin, T., & Burant, C. (2001). Bidirectional child–family influences on outcomes of traumatic brain injury in children. Journal of the International Neuropsychological Society, 7, 755767.CrossRefGoogle ScholarPubMed
Te Puni Kokiri. (2007). Te tirohanga ki te reo Māori. The Māori language survey. Wellington, New Zealand: Te Puni Kokiri.Google Scholar
Te Puni Kokiri. (2010). 2009 rangahau i ngā waiaro, ngā uara me ngā whakapono mō te reo Maori. 2009 Survey of attitudes, values and beliefs towards the Māori language. Wellington: Te Puni Kokiri.Google Scholar
Uomoto, J.M. (2005). Multicultural perspectives. In High, W.M. (Ed.), Rehabilitation for traumatic brain injury (pp. 247267). Oxford: Oxford University Press.CrossRefGoogle Scholar
Woods, D.T., Catroppa, C., & Anderson, V. (2012). Family-centred and parent-based models for treating socio-behavioural problems in children with aquired brain injury. In Anderson, V. & Beauchamp, M.H. (Eds.), Developmental social neuroscience and childhood brain insult. Theory and practice. New York: The Guilford Press.Google Scholar
Woods, D.T., Catroppa, C., Barnett, P., & Anderson, V.A. (2011). Parental disciplinary practices following acquired brain injury in children. Developmental Neurorehabilitation, 14, 274282.CrossRefGoogle ScholarPubMed
Yeates, K.O., Taylor, H.G., Woodrome, S.E., Wade, S.L., Stancin, T., & Drotar, D. (2002). Race as a moderator of parent and family outcomes following pediatric traumatic brain injury. Journal of Pediatric Psychology, 27 (4), 393403.CrossRefGoogle Scholar