title: Dissonant roles: The experience of Māori in cancer care.
abstract: Indigenous peoples have poorer health outcomes than their non-indigenous counterparts and this applies to cancer outcomes for Māori in Aotearoa/New Zealand. Differential access to and quality of healthcare contributes to poorer survival rates for Māori. This research provides insight into some of the mechanisms that hinder and facilitate care access. Thirty four people who had undergone cancer treatment (19 Māori and 15 non-Māori) were interviewed by two Māori researchers. The analysis of the interview transcripts was informed by membership categorization analysis. This form of analysis attends to the categories that are used and the activities and characteristics associated with those categories. From this analysis it is argued that the classical patient role, or sick role, inadequately captures the kind of role that some Māori take in relation to their healthcare. Māori can also have culturally specific family (whānau) influences and a greater draw towards alternative approaches to healthcare. Dissonant roles contribute to a different experience for Māori. A better understanding of the categories and roles that are relevant to those who have cancer provides opportunities to attenuate the monocultural impacts of healthcare.
authors.affiliation: Sociology and Social Policy Programme, Victoria University of Wellington, New Zealand. Electronic address: Kevin.Dew@vuw.ac.nz.
authors.forename: Kevin
authors.initials: K
authors.lastname: Dew
authors.affiliation: Cancer Control and Screening Research Group, University of Otago, New Zealand.
authors.forename: Louise
authors.initials: L
authors.lastname: Signal
authors.affiliation: Tu Kotahi Maori Asthma Trust, Lower Hutt, New Zealand.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Davies
authors.affiliation: Tu Kotahi Maori Asthma Trust, Lower Hutt, New Zealand.
authors.forename: Huia
authors.initials: H
authors.lastname: Tavite
authors.affiliation: Cancer Control and Screening Research Group, University of Otago, New Zealand.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Hooper
authors.affiliation: Cancer Control and Screening Research Group, University of Otago, New Zealand.
authors.forename: Diana
authors.initials: D
authors.lastname: Sarfati
authors.affiliation: Cancer Control and Screening Research Group, University of Otago, New Zealand.
authors.forename: Jeannine
authors.initials: J
authors.lastname: Stairmand
authors.affiliation: Research Centre for Māori Health and Development, Massey University, New Zealand.
authors.forename: Chris
authors.initials: C
authors.lastname: Cunningham
mesh_terms: D003469:Culture; D005260:Female; D006303:Health Services, Indigenous; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology* / Q000628:therapy; D009520:New Zealand; D011369:Professional-Patient Relations; D036301:Qualitative Research; D063508:Social Discrimination
keywords: Categorization analysis; Cultural dissonance; Discrimination; Health inequity; Indigenous health; New Zealand; Sick role