An investigation of perceived barriers and cultural factors in treatment for traumatic brain injury in Aotearoa New Zealand.
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Abstract
Prior research has shown that the harm due to Traumatic Brain Injury (TBI) is greater among Māori and Pacific populations in Aotearoa New Zealand. One potential factor that contributes to this disparity is differential access to health care. The main goal of the present study was to determine if Māori and Pacific persons perceived greater barriers to seeking medical treatment after sustaining a TBI than other ethnic groups. To address this question, we conducted an online survey in which students from the University of Canterbury community (N = 116) responded to questions relating to knowledge and beliefs about TBI, the importance of cultural attitudes when seeking medical treatment after a TBI, barriers to treatment, and responses to a hypothetical scenario in which a child has sustained a head injury. Due to the relatively small sample size, results from Māori and Pacific participants (n = 44) were compared against New Zealand European/Other groups (n = 72). Responses to subsets of questions for cultural attitudes and barriers to treatment had adequate internal reliability (Cronbach’s alpha = .732 and .742, respectively), so these items were summed to yield separate scales. Results showed that the Māori/Pacific group perceived significantly greater barriers to treatment than the NZ European/Other group (Ms = 38.3 and 32.6, respectively, d = 1.029), whereas there was no significant difference in terms of the importance of cultural factors (Ms = 31.7 and 30.1, respectively). Responses to questions on knowledge and beliefs about TBI and reactions when a child has a head injury generally showed no significant difference between groups. Overall, these results suggest that Māori and Pacific persons perceive greater barriers to accessing treatment after a TBI, which may contribute to disparities in health outcomes. Healthcare practitioners need to understand and address these barriers of TBI within Māori and Pacific populations to mitigate the negative outcomes associated with the reluctance to seeking medical treatment. By acknowledging cultural differences, practitioners may engage more effectively those needing treatment and improve health outcomes.