Abstract
Stroke is a major cause of long-term disability in Aotearoa (New Zealand) and continues to disproportionately affect Māori (Indigenous People of Aotearoa), who experience stroke at younger ages and face poorer outcomes compared with non-Māori. While stroke rehabilitation services in Aotearoa are guided by well-established clinical frameworks, there remains a limited understanding of how Māori stroke survivors and their whānau (Family network) experience rehabilitation, particularly how rehabilitation services reflect Māori ways of understanding health, wellbeing, recovery, and whānau support. This thesis explores the experiences of Māori stroke survivors and their whānau to better understand what supports or hinders recovery from a Māori worldview.
Using a qualitative approach grounded in Kaupapa Māori Research and Interpretive Description, this study centres Māori voices and knowledge. Māori stroke survivors and, where appropriate, their whānau shared their experiences of stroke rehabilitation across hospital and community settings. The research prioritised culturally safe engagement, relational accountability, and respect for tikanga Māori (The correct process from Māori contexts), recognising the interconnectedness of physical, emotional, spiritual, and whānau dimensions of recovery.
The findings show that stroke rehabilitation for Māori is experienced as a holistic and relational journey rather than as a purely clinical process focused solely on physical function. Participants described recovery as deeply influenced by the quality of relationships with rehabilitation staff, the inclusion of whānau, and the extent to which services recognised Māori identity, values, and wairuatanga (spirituality). Whānau played a central role in supporting recovery, acting as advocates, caregivers, and sources of motivation, particularly when navigating complex health systems or transitions between services. Despite this, whānau were not always acknowledged or supported as partners in rehabilitation.
While participants recognised the technical competence of rehabilitation services, many described care that prioritised individualised, biomedical goals over whānau-centred and culturally meaningful approaches. Experiences of cultural safety, inconsistent communication, and limited long-term rehabilitation support influenced engagement and confidence in recovery. Geographic location, service access, and transitions from hospital to community-based care further shaped experiences, highlighting ongoing inequities within the rehabilitation system.
This study concludes that improving stroke rehabilitation outcomes for Māori requires more than clinical effectiveness alone. Rehabilitation services must intentionally embed culturally safe, whānau-centred practices that align with Māori worldviews and uphold Te Tiriti o Waitangi obligations. By centring Māori and whānau experiences, this research provides insights to support more equitable, responsive, and meaningful stroke rehabilitation services in Aotearoa.