Journal of Professional Nursing

Role of whānau in self-management for adults receiving haemodialysis in Aotearoa New Zealand: A qualitative study

Te wāhi ki te whānau i te whakahaere ā-kiri i te mate tākihi wāhanga whakamutunga, i runga anō i te titiro a te hanga pakeke kei te tātaritia ngā toto. He rangahau whakaahua kounga

Birgit Haufe RN, MN Clinical Nurse Educator, Northland DHB, Whangarei, NZ
Michelle Honey RN, PhD, Senior Lecturer, School of Nursing, University of Auckland, Auckland, NZ

Reference:  Haufe, B., & Honey, M. (2019). Role of whānau in selfmanagement for adults receiving haemodialysis in Aotearoa New Zealand: A qualitative study. Nursing Praxis in New Zealand, 35(3), 15-24. doi: 10.36951/NgPxNZ.2019.011

Abstract:

Abstract
End stage renal disease (ESRD) is the most severe form of chronic kidney disease and a global health concern. Since there is no cure available for ESRD, controlling and self-managing this chronic disease, as well as minimising the negative effects are important aspects of treatment. This study was designed to explore the role of whānau (family, extended family) on selfmanagement of ESRD from the perspective of adults receiving haemodialysis. In Aotearoa New Zealand the role of whānau in self-management for adults receiving haemodialysis is of great importance, especially for Northland as this region has the second highest rate of ESRD in the country and large Māori population. A qualitative approach was used to address the research question: what are the perspectives of patients receiving haemodialysis on the role their whānau have in their self-management? Semi-structured interviews were conducted with seven haemodialysis patients, of which five were Māori, attending a satellite renal unit in Northland, Aotearoa New Zealand. Thematic analysis identified three themes: support from whānau; whānau matter; and whānau as a barrier to self-management. Participants described the constant requirements of self-management in the context of their ongoing lives that include whānau and friends. The findings from this study emphasise previous research reporting that each individual's self-management behaviour is unique, but that a good support system helps self-managing ESRD and dialysis. Implications for nursing this population group comprise including whānau and friends in care provision wherever possible. Future research is needed to specifically address cultural issues relating to Māori experiencing ESRD.

Ngā ariā matua
Ko te mate tākihi wāhanga whakamutunga (ESRD) te tino mate tākihi pūputu taumaha rawa, ā, he āwangawanga hauora i te ao katoa. Nā te korenga e kitea he rongoā tūturu mō te mate tākihi wāhanga whakamutunga, he mea hira mō te taurima tangata te pēhi atu me te whakahaere ā-kiri i tēnei mate pūputu, waihoki, te kaupare atu i ōna pānga hē. I hoahoatia tēnei rangahau hei tūhura i te wāhi ki te whānau i te whakahaere ā-kiri i te mate tākihi wāhanga whakamutunga, i runga anō i te titiro a te hanga pakeke kei te tātaritia ngā toto. I roto i Aotearoa he mea hira te wāhi ki whānau mō te whakahaere ā-kiri a te pakeke i a ia i tōna tātaritanga ā-toto, otirā mō Te Tai Tokerau he mea tino nui, ina hoki, kei te taumata tuarua taua rohe o te pāpātanga o te tangata e te mate tākihi wāhanga whakamutunga, me te tokomaha hoki o tōna taupori Māori. I whakamahia tētahi whāinga kounga mō te pātai rangahau: He aha te titiro o ngā tūroro ka whiwhi tātaritanga ā-toto i Aotearoa mō te mahi a ō rātou whānau mō te whakahaere ā-kiri a aua tūroro. I whakahaeretia ētahi uiui āhua ngāwari ki ētahi tūroro whiwhi tātaritanga ā-toto, e hokihoki mai ana ki tētahi pūtahi tākihi i Te Tai Tokerau, i Aotearoa. E toru ngā kaupapa i kōwaea i raro i ngā mahi tātari kaupapa; te tautoko a te whānau, he mea nui te whānau, ko te whānau pea tētahi ārai ki te whakahaere ā-kiri. I whakamārama ngā tāngata whai wāhi i ngā whakaritenga mutunga-kore mō te whakahaere ā-kiri i tō rātou noho i te ao, tae atu ki ō rātou whānau, hoa hoki. Ka whakaū ngā kitenga o tēnei tirohanga i ngā kitenga o ō mua rangahau, he rerekē katoa ngā whanonga whakahaere ā-kiri o tēnā tangata, o tēnā tangata, engari mā tētahi pūnaha tautoko pai e āwhina te whakahaere mate tākihi wāhanga hakamutunga me te tātaritanga toto. Ko ngā tikanga ka hua ake mō te mahi tapuhi i roto i tēnei rōpu taupori, hei whakaū i te hira o te wāhi o te whānau me ngā hoa i roto i te horanga taurimatanga i ngā wā katoa e taea ai. Me haere ētahi rangahau ā ngā rā e tū mai nei kia tino anga atu ki ngā take ahurea ka ara ake i waenga i a ngā Māori o Aotearoa kua pāngia e te mate tākihi wāhanga whakamutunga.

Keywords / Ngā kupu matua
chronic kidney disease / te mate tākihi pūputu; family / whānau; New Zealand / Aotearoa; qualitative research / te rangahau whakaahua kounga; self-management / whakahaere ā-kiri

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