Prior to moving to New Zealand my practice in the UK was revolved around a model known as the Biopsychosocial model of healthcare, which was first proposed in 1979. This model offers the notion of the co-existence of the biological, social and psychological factors of health and pain. Before I was able to work in New Zealand, I had to complete professional competencies to demonstrate an awareness of the native Māori needs and beliefs in healthcare. The Māori beliefs are noted as the 4 pillars of care, demonstrated below.
- Taha hinegaro (Mental health): Māori belief that taha hinegaro is about the styles of thinking and how their emotion is expressed. Māori believe that reduced emotional expression is associated with reduced health and well-being.
- Taha whanau (Family health): It is important to understand how family, friends and community can contribute the illness and the curing on illness. Consider that Māori may wish to have family present during consultations to help make decisions about their healthcare and treatment. It would be beneficial to ask Māori about their role within their community as a way of gauging their priorities and created a manageable treatment plan.
- Taha wairua (spiritual health): Māori believe that any influences on their spiritual health can manifest as physical impairment and they value communion with their native environment. It may be appropriate to incorporate a spiritual dimension to treatment, by encouraging physical activity outdoors in their environment, relaxation, and mindfulness to an individual’s physiotherapy treatment plan
- Taha tinana (physical health): Good physical health can differ based on cultural beliefs. It may be appropriate to provide resources to help patients make healthier lifestyle choices, such as smoking cessation, reducing alcohol consumption and adopting a healthy diet with regular physical activity to promote taha tinana
Learning about the pillars of health helped me to become more holistic in my care. I realised that in many western societies we assume we are ahead of the game when it comes to treating the individual. However, learning and understanding more about these pillars of care demonstrated to me how cultures like the Māori have been treating people holistically for 100s of years, whilst new holistic models only seemed to exist in western societies for the last 50. Understanding this, whilst treating more people from a Māori background has helped me to appreciate the importance of spiritual health in different cultures, and how important it is in managing patients from all walks of life. It has opened my eyes to the fact that in many aspects, westernised based health beliefs still have a lot to learn!