Strategies Employed

Person-centred care

Patient-centred care also known as “Person-centred care”, can be described as "providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions." (Institute of Medicine)

Person-centred approaches are widely used in the New Zealand healthcare sector. It can be seen as a 'toolbox' of ways to listen and gather information enabling patients to share health decisions and inform a care plan.

Principles of patient-centred care include:

• respect
• emotional support
• physical comfort
• information and communication
• continuity and transition
• care coordination
• involvement of family and carers
• access to care

You may want to re-visit this website: Patient-centred care for healthcare providers.

Holistic approach (whole person approach)

A holistic approach to health means providing support that looks at the whole person. This approach considers a person's physical, emotional, social and spiritual wellbeing.

Physical wellbeing

• encourage independence with daily tasks
• work alongside health professionals to help with exercises
• empower clients to make lifestyle changes
• encourage healthy personal hygiene habits and independence

Spiritual wellbeing

• support connections to nature and their environment
• respect beliefs, values, traditions, and practices that support self-awareness and identity
• follow certain procedures or protocols if asked when providing support care
• ask the person about appropriate personal contact for them, such as touching their head or exposure of body parts

Social wellbeing

• support activities that have positive social relationships, for example, classes, interests, hobbies, coffee with friends
• encourage communication with friends, whānau, etc.

Cognitive or mental and emotional wellbeing

• maintaining physical health
• managing stress
• helping them keep their mind healthy by doing mind activities such as puzzles, games
• being aware that they are eating a proper diet
• limiting alcohol intake
• getting them social and joining in with activities
• listening to your client without judgement
• responding accordingly and emphatically
• showing compassion
• encouraging healthy sleeping habits

Pae Ora strategies

The Pae Ora (Health Futures) Act was passed in 2022. From the Act, six strategies were developed to set the direction for how health services would meet the needs of New Zealanders. The strategies are as follows:

• The New Zealand Health Strategy

• Pae Tū: Hauora Māori Strategy
• Te Mana Ola: The Pacific Health Strategy
• The Women's Health Strategy
• The Health of Disabled People Strategy
• The Rural Health Strategy

The strategy that you use will depend on the needs of the service user that you are supporting.

Click on the link to access the Ministry of Health page listing the six strategies. Click on the link for each strategy and review the content.

Te Wheke | The Octopus

Image referenced from Therapeutic Landscapes paper by Jacqueline McIntosh et al.

Te Wheke also known as the octopus, is a health concept by Rose Pere, a renowned Māori spiritual and academic leader.

This concept recognises that all aspects of a person's life are interconnected and must be addressed for overall health and flourishing. The following is a breakdown of the elements:

Te Whānau | The family. The body and head represent the individual whānau unit.

Waiora | Wellbeing. The "eye" of the symbolic family unit will reflect total well-being.

Wairuatanga | Spirituality. The creator is a powerful influence, and the uniqueness of being Maori is sustained through this belief.

Mana Ake | Awareness of hereditary from forebearers. Unique identity of individuals and family.

Mauri | Life force. An appreciation of the mauri (life force) of objects, individuals, whānau (family), and every whānau within a community.

Hinengaro | The mind. Learning that arouses, stimulates and uplifts is important.

Whatumanawa | Open and healthy expression of emotion. An understanding of emotional development in all areas.

Whanaungatanga | Extended family. The principle of all working to support each other across generations.

Taha Tinana | Physical Wellbeing. Specific physical, material, emotional and social needs related to physical survival.

Ha a koro ma a kui ma | Breath of life from forbearers. Links with heritage passed down by our forebearers.

Fonofale | A Resilient Home

Image referenced from Pacific Advance Secondary School.

A model developed by Fuimaono Karl Pulotu-Endemann, incorporates the values and beliefs of Samoans, Cook Islanders, Tongans, Niueans, Tokelauans and Fijians.

It encompasses different foundations of life, including family, cultural values and beliefs, spiritual, physical, mental and other. These foundations are interrelated, and health is about maintaining and sustaining balance between these foundations (Pulotu-Endeman, 2001).

In a health and well-being context, it is important to be able to notice any changes in a person's health or abilities, whether they are improvements or deteriorations.

When professionals talk about changes, this means changes in emotional, psychosocial, cognitive, physical, sensory, psychological, or environmental.

Te Whare Tapa Whā | The Four Cornerstones

Image referenced from Therapeutic Landscapes paper by Jacqueline McIntosh et al.

Te Whare Tapa Whā, a model developed by Sir Mason Durie, shows the importance of balance and encompasses four main elements using the analogy of a house with four walls:

Taha tinana | Physical health

Its first element, taha tinana (physical body), refers to the body and is the physical expression of health and wellbeing.

Taha wairua | Spiritual health

The second element, taha wairua (spiritual realm), reflects the spiritual aspects of wellbeing.

Taha whānau | Family health

The third element, taha whānau (family and community), highlights the need and significance of the family and community to one’s health and wellbeing.

Taha hinengaro | Mental health

The last element, taha hinengaro (mental health), describes the importance of the mind.

All four elements are interwoven and interact to support a strong and healthy person. Rochford (2004) suggests if one of these key elements is missing or damaged, then the resulting imbalance may lead to negative health outcomes. To achieve balance and good health, individuals must live in harmony with others, their communities and the spiritual realm. (Jacqueline McIntosh et al, 2021)

Te Pae Māhutonga

Te Pae Māhutonga (Southern Cross Star Constellation) was developed by Mason Durie to represent the elements of modern health promotion.

The following content is adapted from Te Pae Māhutonga: A Model for Māori Health Promotion.

The four central stars are used to represent the four key tasks of health promotion and are named accordingly to reflect particular goals of health promotion:

• Mauriora - cultural identity
• Waiora – physical environment
• Toiora – healthy lifestyles
• Te Oranga – participation in society

The two pointers are:

• Ngā Manukura - leadership
• Te Mana Whakahaere - autonomy

Empathy is the ability to identify and share the emotions another person is feeling. Empathy is different to sympathy.

• With sympathy, you understand the challenges a person is going through and feel compassion for them.
• With empathy, you experience emotions that are similar to the tangata’s, which provides a deeper understanding of their situation.

Watch: Brené Brown on Empathy vs Sympathy (2.53)

Watch the following video and reflect on the question that follows.

Empathy in health care

Empathy is a powerful tool in health and social care work. Moudatsou et al. describe the ways in which empathy can improve health and social care.

• It allows the provider to identify the patient’s experiences and concerns.
• It strengthens the relationship between patient and provider.
• It leads to better health outcomes.
• It increases patient satisfaction.
• It reduces patient stress.
• It leads to increased productivity and improved job satisfaction for the health care provider.

(Ref: Moudatsou et al., 2020 ).

How to improve your empathy

• Put yourself in the tangata’s shoes: try and understand how they may be feeling about their current circumstances.
• Active listening: concentrate on what the person is saying to help identify what they are thinking and feeling.
• Ask questions: asking open-ended questions will allow you to better understand how the tangata is feeling.
• Encourage open communication: encourage the tangata to share their thoughts and concerns, and let them know it is safe to do so.
• Whakawhanaungatanga: form a personal relationship with the tangata, within the limits of your professional boundaries.
• Practice person-centred care: when you focus on the whole person, you will be better able to understand their thoughts and feelings.
• Apply a non-judgemental attitude: the tangata is more likely to share with you if they are not being judged.
• Practice cultural competence: respecting the tangata’s cultural preferences will make your interactions more constructive and informative. 

You have already revised your communication skills in this module. Be aware that good communication can also be used to support the needs and goals of your tangata.  Consider the following communication strategies:

• Listen actively to their concerns and requirements.
• Using open-ended questions to ask about their goals.
• Use plain language with tangata and their whānau when explaining options and discussing needs.
• When the tangata describes their goal, try rephrasing it to ensure you have understood correctly.
• Identify when clarity is needed, for example, if a translator is required to facilitate important discussions.