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Shame is a painful feeling of humiliation or distress caused by the consciousness of wrong or foolish behaviour. The effect of shame on the health of the Maori client would be a client was diagnosed by type 2 diabetic and was recommended by the general practitioner to loss his /her weight. The general practitioner also made appointment with the weight loss program people and asked the client to attend the program but the client itself was feeling kind off embarrassed or bit shame as he/she have to attend the program, people will gossip about it and how will they react. The client may feel uncomfortable if at first he /she wold have controlled this it wouldn’t have come to this stage.
Feeling inadequate not enough or insufficient. The effect of feeling inadequate on the health of a Māori client would be a Māori client visited a doctor as she was not feeling well, she had difficulty in sleeping and usually sweating, nervousness. After proper examination the doctor concluded that she has got hypertension(high blood pressure).the doctor started to inform her what she needs to do to control high blood pressure without medication and with medication too but after that brief information the doctor has given her time to think and decide and he went away giving her space but she felt that she had less information given to her regarding hypertension and she couldn’t say anything as she lacked knowledge and was not able to ask the doctor more about it as she felt embarrassed.
Withdrawal (maunu) being pull out, to draw out or to loosened or get isolated. Example a person was feeling sick and needs to see a doctor, but when she went to the hospital she could not access any health services as she didn’t knew anything about health , it was all new to her. Neither has she known about the health services nor has appriopate knowledge felt withdrawn as people there knew where to go and where not to go.
Feeling misunderstood took it in a wrong way, improperly understood or interpreted. For an example a Māori client visited a doctor and informed that the medication he prescribed did not do anything and no important in her health but the doctor got bit angry as and said are you trying to teach me.The Māori client felt that what she was trying to say doctor took in a wrong way, she just wanted to get a better medication that will improve her health.
One to one consultation with a health worker
A Māori lady goes to see a doctor and the doctor was male, she went to see the doctor to know how to avoid type two diabetic, but when she found out it was a male doctor she felt bit uncomfortable with him. The doctor tries his best to make feel comfortable. She seemed like she was nervous so the doctor tried to take her stress away by asking her to take deep breaths. She got bit worried to whether the doctor will provide her adequate information or not and whether it will be better for her or not. The doctor provided her with all information and how to avoid them also he also provided a guide book for her to read on her own too.
As a health nurse educator she went to a boarding school to all the students doing consumer survey about the ascertain number of smokers. Firstly she asked permission from the parents to continue this survey. During this survey she looked at a simpler way to meet the age group of students made questionnaires that students can understand also got online website which is usually accessed by youths. She conducted this survey through face to face interview. Questionnaires were given out to them simple answers like yes/no .While conducting this survey she also maintained confidentiality and privacy for students. She explained the students while she was doing this survey in a simple way for their understanding.
One to one consultation with a health worker of a different gender.
For an example a male nurse promoting breast feeding for Māori mothers. Firstly before going near to the mother the male nurse would get permission from the family or the husband to explain this to his wife about breast feeding. If the mother does not agree a male nurse he would give that information to the family members or to the husband so that they can explain to her. He will also get a Māori nurse with him to assist him in communicating with the Māori client as his first language is English. While communicating with the Maori client he will provide privacy to her. Explain her things as simple as he can. Providing information about support and also getting feedback from her is she does not understand anything.
Group consultation with a health worker.
The health worker having a group of Maori people who came for consultation together about influenza risk and how to reduce the spread of it. The health worker firstly made the environment suitable for them like in a room or office to maintain the privacy. When the clients arrives he greets them in their language by respecting there culture and belief. He also speaks to them in a very respective manner. The health worker provides adequate information to them and they all actively participate in the group where they could not understand things and need to know a bit more about it. He also informed them that if they feel they have not got enough information they ask questions to him.
Adverse socio-cultural factor one
If you as a Māori are not educated you won’t be able to communicate well in front of others. If you are less educated you feel shame (whakama) in yourself as you won’t know what to do if want to see a doctor. You won’t have direct impact to health services. For an example you want to see a doctor but you don’t know where to go and get the information from and you feel shame on yourself as you are not educated how will other people react on it.
Adverse socio-factor two
Lack of identity (age, gender)-
You will feel shame on yourself as people won’t know you who you are and where you are from. Example you have got diabetic and you want to go and access health services at district health but you cannot access as you don’t have an identity and knowledge about it. Another example can be the ministry of health NZ published pamphlet in Māori language to make it easier for people who cannot understand English to read but still you don’t know how to read it in your language too.
Adverse socio-economic factor one
A Māori person goes for job interview and does well in the interview but the employer does not give the designation he should get as he does not have the appropriate qualification or degree. He won’t be getting better pay as he should be. He won’t be able to excess any health services as whatever income he earns is spent on the family needs. Sometimes Māori people doesn’t even have job as they don’t have any qualification and feel shame on themselves (whakama) people are laughing at him whenever they go to look for job.
Adverse socio-economic factor two-
Discrimination in education-
The child won’t be getting education up to a better level or appropriate standard as they come from the poor family or due to the ethnicity. The child won’t be treated friendly by other students and teases the child how poor he is and the child will feel shame on himself (whakama) which will make him to avoid going to school. The child will not be getting proper health services as his family does not earn much.
Negative outcome one-
No access to medical treatments-
Like a Māori client was very ill and wanted to go and see a doctor to get treated but he could not go as he was not educated he didn’t knew where to go and felt shame on himself and didn’t knew which medical treatment to access.
Negative outcome two-
In Māori there is a medicine that they use that is rongoa it is use to prevent many sickness and provide remedies for the sickness. But the medicine making is passed down to generation to generation so the new generation may not know how to make the medicine and maybe don’t even know what ingredients maybe used. Some maybe feel bit embarrassed on themselves as they know anything about their traditional medicine.
Negative outcome three-
Non-Māori speaking person-
A health care assistant goes to meet a client and before going to that client she got bit background about that person and learnt that the person is Maori. When she went there she greeted the families and the client in Māori and was able to speak bit fluently to them all were bit shocked and ashamed on themselves that they are Māori themselves but they cannot speak their own language but a person who is a non-Māori person speaks well.
Positive outcome one-
Cultural appropriate programmes-
In a rest home they have people there who wants to get more knowledge about Māori culture so the company organises a teaching session in a culturally appropriate setting to the clients, the health care assistants and clinical staffs.
Positive outcome two-
Maori provider group-
Like for some Māori clients they are special needs clients they require some special aids in their life so the good thing is that now in New Zealand there is a Māori provider group they do funding for Maori health and disabilities issues, taking accounts of the Manaia Health PHO population profile and health needs, building Maori provider capacity in service delivery and improving upon quality issues.
Positive outcome three-
The ministry of New Zealand is trying to look for solutions and information to support the whanua plans and track the whanua goals. All this solutions will be used with a group of people or by range of people from the whanua ora navigators or to staff at whanua ora collectives to whanua themselves, although people whose information is captured in whÄnau plans will be able to have a say in who is allowed to access that information.
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