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Kaupapa Māori research (KMR) is an Indigenous research approach that is decolonizing and transformative. Interpretive description (ID) is a qualitative methodology used to generate knowledge relevant to the applied health disciplines. In this article, we discuss how we combined KMR and ID to investigate the experiences of Māori (the Indigenous peoples of New Zealand) with aphasia and their whānau (extended family). This is novel because it is the first time these two approaches have been combined. In the context of aphasia research, we discuss how they work together in theory, and the synergies that became apparent in practice. We conclude that the combination of KMR and ID enables clinicians and Māori with aphasia to learn from each other and work together, thereby generating knowledge that makes a difference for Māori with aphasia and their whānau., (© The Author(s) 2014.)

To investigate the rehabilitation experiences of Māori who were still reporting disability 24 months after an injury resulting in hospitalisation. Participants had been hospitalised for an Accident Compensation Corporation (New Zealand's no-fault injury compensation insurer) entitlement claim injury between 2007 and 2009, and were experiencing disability 24 months post-injury. In-depth kanohi ki te kanohi (face-to-face) qualitative interviews with 12 participants aged between 37 and 71 years at the time of interviews were conducted. Interpretive analyses of interview transcripts, focused on the impacts of injury was conducted with the aid of NVivo software. The overarching theme identified during the analysis was "Impact" with four sub-themes of: Impact on daily life; Impact on relationships, Impact on employment; and, long-term or ongoing impacts. For Māori living with disability 24 months after hospitalisation for injury, adjusting to life after the injury and the rehabilitation process was challenging. Participants discussed frustration with feeling dependent on others, being bored and feeling unfulfilled after their injury, and that many aspects of their lives were impacted on and not always in the expected directions. Many reported longer lasting impacts even after rehabilitation was completed. Implications for rehabilitation programmes e.g., strengthening programmes by taking into account issues discussed by participants, recognising the long-term impacts on both those injured and their whānau (family), and further investigations required are also discussed. Disability after injury can have long term impacts for injured Māori and their relationships. Social impacts can be perceived as more debilitating than the physical impacts after injury. Experiences of employment changes and future prospects are often difficult to navigate for Māori returning to work after an injury. [ABSTRACT FROM AUTHOR]

Background: This paper presents the pilot testing of an online professional development (PD) course for New Zealand (NZ) speech-language therapists (SLTs) working with Māori with stroke-related communication disorders (predominantly aphasia). Taking a public health approach and focusing on the context of Māori as Indigenous peoples in a colonised society, the course lays the foundation for aphasia management for Māori. It consists of two modules. Module One addresses health inequities, social determinants of health, racism, the Treaty of Waitangi, cultural safety and power inherent in the role of the SLT. Module Two includes specific information about providing therapy for Māori stroke patients (particularly those with aphasia) and family members and working with Māori health colleagues. Aim: The primary aim was to ascertain the impact of the course on participants' clinical practice with Māori with aphasia. A secondary aim was to examine participants' assessment of the content and delivery of the course. Methods & Procedures: This was a qualitative longitudinal pilot study. Eleven SLTs completed the online course, immediately followed by a survey in which they gave feedback on the course and named three activities they would do to apply their learning in the following six months. Eight participants were available for interview six months later. Interviews aimed to ascertain what participants learned from the course, how they applied their learning and how the course could be improved. Interview data were analysed using a "general inductive approach", in conjunction with responses to the survey. Outcomes & Results: Interview findings were divided into two main themes – "putting it into practice" which revealed what participants learned and how they applied their learning and "keeping it at the forefront" which focused on maintaining that learning and practice, including reflection on the course content and delivery. All participants were positive about the course and all would recommend it to colleagues. Conclusions: The pilot testing revealed that participants made positive changes to their practice as a result of their learning. Challenges inherent in completing the course and applying learning and suggestions for improvement were also identified. Although the course content is NZ-specific, many of the ideas in the course are relevant to numerous multiethnic contexts across the world in which the speech-language therapy culture in service delivery could be impacted by issues such as power, racism, and inequity. [ABSTRACT FROM AUTHOR]

This study explored Māori experiences of aphasia therapy, with a view to ascertaining what makes a service culturally safe as well as "accessible to and culturally appropriate for" Māori with aphasia and their whānau (extended family). Māori are the indigenous peoples of New Zealand. This study incorporated interpretive description (a qualitative methodology) within kaupapa Māori research (a Māori approach to research). In-depth semi-structured interviews were undertaken with 11 Māori with aphasia and 23 of their nominated whanau members. They reported a wide variety of experiences of aphasia therapy, in six themes: We're happy to do the work, but we can't do it alone; Relationship; Our worldview; The speech-language therapy setting; Aphasia resources; and Is this as good as it gets? While some Māori with aphasia reportedly received an accessible and culturally appropriate service, others did not. It is concluded that, for Māori with aphasia, a strong therapeutic relationship is central. The success of this relationship is shaped by the SLP's appreciation of the worldview of the person with aphasia and whanau, the setting of the therapy, and the resources used. Successful therapy will involve collaboration between clinician and whānau, and therapy resources that affirm the identity of the person with aphasia. [ABSTRACT FROM AUTHOR]

Background:Experiences of aphasia are shaped by culture. Therefore, to provide appropriate services for people with aphasia (PWA), speech-language therapists (SLTs) must understand aphasia from their potential clients’ cultural perspective. Aims:This study aimed to describe and interpret the experiences of Māori with aphasia and their whānau (extended family), to inform service delivery for this population. Methods & Procedures:This study is kaupapa Māori research (KMR), an Indigenous research approach that privileges Māori culture and knowledge. A qualitative methodology, interpretive description (ID), was incorporated to produce clinically relevant findings that will benefit SLTs and Māori. In-depth interviews were undertaken with 11 Māori with aphasia and their nominated whānau members. Participants spoke about aphasia-related changes in relationships, health, spirituality, activities and family and community roles. Analysis was informed by interpretive description (ID) and kaupapa Māori. Outcomes & Results:Participants described a range of positive and negative experiences of aphasia. These developed into two pairs of themes: (1) “Grieving for what is lost” and “Recognising what we have got” (2) “It is hard” and “Choosing how to respond”. Conclusions:Aphasia can have a profound effect on Māori families and bring many changes in family roles and relationships. Despite difficulties, whānau can actively manage their situation, and enable the person with aphasia to participate in the whānau and community. The findings of this study will inform clinical practice and provide the basis for the development of resources for use in speech-language therapy services for Māori with aphasia and their whānau. [ABSTRACT FROM PUBLISHER]