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Consumers with high complex needs co-create a relationship-based approach to care

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Authors:
Summary:

This paper describes how a comprehensive model of healthcare successfully co-created a relationship-based approach to care with older Māori adults with high complex health and social needs. The study recruited 15 older Māori adults living with chronic conditions (on average, 4 chronic conditions each) in a poor urban and semi-rural community. All were enrolled with Ki A Ora Ngatiwai, a Māori Health Provider Organisation that embraces a community-based primary health care approach. Interviews held with the participants sought to understand their experiences about living with chronic conditions, accessing/receiving health and social services, the most important challenges faced daily and the quality of relationships with health professionals in Ki A Ora Ngatiwai. The material demonstrated that these older adults were motivated to actively engage with health professionals, seeking to build knowledge and skills to be more able to care for themselves and their extended whānau/family. They valued health professional relationships for their own sake with people who cared about them and attended to their social concerns. This relationship-based model extended beyond solely transactional healthcare services that provide access to services and entitlements. As they gained health literacy and became more self-sufficient, the participants willingly assumed new roles within the extended family and more widely, such as whānau advocate, health specialist, social support, communicator, marketer for (health) programmes and knowledge broker. The quality of healthcare delivered by Ki A Ora Ngatiwai was rated as “excellent”.

Comment:
In my experience, there continue to be health professionals and managers that think health providers should attend to clinical issues only. However, the findings from this research suggest that whānau value clinicians who also attend to social issues. What this means in practice is less definite, but we have to give thought as to how we make it happen. Finally, I was a little disappointed to not see authors from Ki A Ora Ngatiwai listed here.
Reference: Int J Integrated Care. 2016;16(6):A330
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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