Māori aspirations following stroke: A pathway forward for the speech-language therapy field

Abstract

Background: Attempts to improve Indigenous health outcomes are evident in the speech-language therapy (SLT) field, although they are restricted by a limited evidence base. Prior research has shown that SLT services do not always meet Indigenous stroke survivors’ needs, however, few studies have investigated this phe- nomenon and fewer have explored solutions. Consequently, the SLT field lacks knowledge of appropriate and optimal supports. Aims: To identify and compare experiences and aspirations of Māori stroke survivors, whānau (family), and speech-language therapists (SLTs) in Aotearoa New Zealand regarding SLT service provision. Methods & Procedures: Kaupapa Māori research and interpretive description methodologies underpinned this study. Four Māori stroke survivors, two whānau members, and five SLTs participated in semi-structured interviews. Data were analysed using constant comparative analysis and collaboratively interpreted during a hui (meeting) between researchers and participants. Outcomes & Results: Analysis highlighted six themes spanning experiences and aspirations: (1) tautoko (support), (2) kaupapa Māori (Māori approach), (3) whanaungatanga (relationships), (4) tino rangatiratanga (autonomy), (5) taiao (environment), and (6) kōnekeneke (change). Positive aspects of SLT were described, how- ever, Māori often did not receive optimal supports. Aspirations centred on changes to SLT services and the wider healthcare system. Conclusions: Adaptations to SLT services are indicated to improve the quality of SLT received by Māori following stroke. To meet aspirations described in this study, the SLT profession may incorpo- rate Māori approaches; prioritise strong, collaborative relationships; offer more autonomy to Māori stroke survivors; support the devel- opment of SLTs and SLT students; increase public awareness; and encourage change in the wider healthcare system. Many aspirations identified in the current study are consistent with those identified by Indigenous people in Australia, suggesting that some common solutions may exist to improving Indigenous SLT services.