Experiences of whānau/families when injured children are admitted to hospital: a multi-ethnic qualitative study from Aotearoa/New Zealand.
OBJECTIVE
Several quantitative studies in the international literature have described disparities in the provision of and access to health services for a variety of health conditions among 'minority' populations. This New Zealand qualitative study aimed to explore and describe the experiences of indigenous Māori and Pacific families (both minority populations) and Pākehā (New Zealand European) families when their children were admitted to hospital for an unintended injury.


METHODS
Twenty-three children (eight Máori, eight Pacific and seven Pákehā) who were admitted to hospital following an injury were selected using maximum variation sampling from a trauma database and snowball sampling. In-depth individual and group interviews undertaken with the child's whānau/family explored the issues they encountered in the hospital setting. The data were analysed by key ideas and coded into main themes. Each strand was analysed separately by lead researchers of the same ethnic group prior to a comparative synthesis of the overall findings.


RESULTS
While many families praised the dedication of the staff, the interviews revealed important concerns regarding their encounters with hospitals and related health and support services. These could be broadly characterised as (a) inadequate communication and information; (b) difficulties negotiating an environment perceived as foreign; (c) the stress of conflicting demands placed on families; and (d) issues relating to ethnicity and cultural miscommunication. Of note, many Māori and Pacific whānau/families felt particularly alienated within the hospital setting and did not appear to see themselves as being entitled to high-quality information or services.


CONCLUSIONS
The findings have important implications for the structure, professional and institutional practices in the delivery of health services. The research also indicates the need for wider societal policies that increase Māori and Pacific whānau/families' sense of entitlement to the full range of available support services, and reduce alienation within public institutions such as hospitals.
Arlidge
Brooke
B
Te Kupenga Hauora Māori (Department of Māori Health), School of Population Health, University of Auckland, Auckland, New Zealand.
Abel
Sally
S
Asiasiga
Lanuola
L
Milne
Sharon L
SL
Crengle
Sue
S
Ameratunga
Shanthi N
SN
D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003142:Communication; D018864:Cultural Diversity; D003695:Delivery of Health Care; D005006:Ethnicity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009520:New Zealand; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010343:Patient Admission / Q000706:statistics & numerical data; D011368:Professional-Family Relations; D036301:Qualitative Research; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014947:Wounds and Injuries / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy*