TY  - JOUR
PY  - 2023//
TI  - Disrupted mana and systemic abdication: Māori qualitative experiences accessing healthcare in the 12 years post-injury
JO  - BMC health services research
A1  - Bourke, John A.
A1  - Owen, Helen E.
A1  - Derrett, Sarah
A1  - Wyeth, Emma H.
SP  - e130
EP  - e130
VL  - 23
IS  - 1
N2  - BACKGROUND: Māori have been found to experience marked health inequities compared to non-Māori, including for injury. Accessing healthcare services post-injury can improve outcomes; however, longer-term experiences of healthcare access for injured Māori are unknown. This paper reports on data from the longitudinal Prospective Outcomes of Injury Study - 10 year follow up (POIS-10) Māori study in Aotearoa/New Zealand (NZ), to qualitatively understand Māori experiences of accessing injury-related healthcare services long-term. <br><br>METHODS: Follow-up telephone interviews were conducted with 305 POIS-10 Māori participants, who were injured and recruited 12-years earlier, experiencing a range of injury types and severities. Free text responses about trouble accessing injury-related health services were thematically analysed. <br><br>RESULTS: Sixty-one participants (20%) reported trouble accessing injury-related health services and provided free text responses. Three related themes describing participants' experiences were connected by the overarching concept that participants were engaging with a system that was not operating in a way it was intended to work: 1) Competing responsibilities and commitments encapsulates practical barriers to accessing services, such as a lack of time and having to prioritise other responsibilities such as work or whānau (family); 2) Disrupted mana refers to the feelings of personal disempowerment through, for example, receiving limited support, care or information tailored to participants' circumstances and is a consequence of patients contending with the practical barriers to accessing services; and 3) Systemic abdication highlights systemic barriers including conflicting information regarding diagnoses and treatment plans, and healthcare provider distrust of participants. <br><br>CONCLUSIONS: Twelve years post-injury, a considerable proportion of Māori reported experiencing barriers to accessing healthcare services. To restore a sense of manaakitanga and improve Māori access to healthcare, Māori-specific supports are required and systemic barriers must be addressed and removed.<p />  <p>Language: en</p>
LA  - en
SN  - 1472-6963
UR  - http://dx.doi.org/10.1186/s12913-023-09124-0
ID  - ref1
ER  -