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dc.contributor.advisorHowden-Chapman, Philippa L.
dc.contributor.advisorDean, Sarah
dc.contributor.authorTiatia, Ramona
dc.date.available2014-07-10T22:45:14Z
dc.date.copyright2014
dc.identifier.citationTiatia, R. (2014). Family-Centred Healing At Home: A Samoan Epistemology of Samoan Families’ Experiences of Home Dialysis and Home Detention in Aotearoa/New Zealand (Thesis, Doctor of Philosophy). University of Otago. Retrieved from http://hdl.handle.net/10523/4916en
dc.identifier.urihttp://hdl.handle.net/10523/4916
dc.description.abstractHome dialysis and home detention are home-based public services increasingly used in Samoan households living in Aotearoa/New Zealand. They are cheaper than institutionally-provided hospital and correctional services and save the government millions of dollars; savings which do not seem to be transferred to the households which switch to home-based services. This thesis considers the role of housing in Samoan families living in Aotearoa/New Zealand, both symbolically and practically. It analyses in depth the way these two different public services are adapted within the home built environment and the effect these have on the lives of Samoan occupants. The quality of housing and built environments are a vital and significant component of home-based services, yet, largely ignored in the literature and state policies as having an effect on the health of occupants. In this qualitative research I used a multiple-case study approach to investigate the housing experiences of five Samoan dialysis patients (n=4) and their carers (n=8); and two Samoan home detainees (n=2) and a sponsor (n=1). Using an iterative approach of the Photovoice method, disposable cameras were used by the participants to produce photographs about their experiences. In consultation with Samoan elders, I also developed an epistemological model of Samoan health and well-being based on the traditional house and descriptions of tides and winds. The participants’ photographs and in-depth interviews in the Samoan and English languages were matched to the three stratified areas of the Samoan traditional dwelling: front of house, middle of house and back of house. Key informant interviews with public service officials were also analysed to provide important information about the Wellington Hospital Renal Unit (n=2) and the New Zealand Prison Services of the Corrections Department (n=5). Home-based services, when compared to hospital and prison institutional services, gave the participants many advantages. These included the convenience of being at home, reduced transport and travelling costs, spending more time with family and friends and in some cases participation in vocational and rehabilitation programmes. Samoan culture provided a useful framework for families to respond to the sensitive issues and obligations associated with palliative renal care, death, spirituality, gender arrangements, transplantation, cultural identity and restorative justice. Other unexpected and less favourable outcomes associated with home-dialysis were fuel poverty, lack of indoor storage, minimal spatial heating and issues of waste disposal. Samoan participants expected far more support at home from public authorities than they in fact received and many of them experienced stigmatisation and social isolation. These everyday experiences forced some dialysis patients to give up home-based services and return to hospital services, which are more expensive. For some home detainees, spousal violence and problems with other family members increased because they were confined at home. They also failed to gain access to vocational and rehabilitation programmes. Finally, while there was general agreement by participants that home-based services are a positive and effective way of increasing individuals’ independence and freedom, greater improvement of home built environments as well as increased assistance from public authorities is needed so that families can better meet the formal requirements of home dialysis and home detention. The results, recommendations and the photographs produced by the participants were reported directly to the key governmental stakeholders supporting the study.
dc.format.mimetypeapplication/pdf
dc.language.isoen
dc.publisherUniversity of Otago
dc.rightsAll items in OUR Archive are provided for private study and research purposes and are protected by copyright with all rights reserved unless otherwise indicated.
dc.subjecthome dialysis
dc.subjecthome detention
dc.subjectprisoner health
dc.subjecthome-based services
dc.subjectPhotovoice
dc.subjectrenal kidney disease
dc.subjectSamoan health
dc.subjectSamoan architecture
dc.subjectPacific housing
dc.subjectparticipatory methods
dc.subjecthousing and health
dc.subjectcommunity-based sentences
dc.subjectwhanau ora
dc.subjectpatient-centred
dc.subjectfuel poverty
dc.subjectperitoneal dialysis
dc.subjectSamoan metaphors
dc.subjectIfoga
dc.subjectrestorative justice
dc.subjectCorrections
dc.subjectPacific health inequalities
dc.subjecthousing as determinant of health
dc.subjectSamoan epistemologies of dwellings
dc.subjectSamoan tides and winds
dc.subjectprevalence of home dialysis
dc.subjectprevalence of home detention
dc.subjectdialysis workforce
dc.subjectCorrections workforce
dc.subjectPatient empowerment
dc.subjecthospital and home
dc.subjectprison and home
dc.subjectfemale prisoners
dc.subjectSamoan spirituality
dc.subjectSamoan cultural identity
dc.subjectSamoan traditional healing
dc.subjecthealing at home
dc.subjectdying at home
dc.subjectrenal palliative care
dc.subjectSamoan prisoner rehabilitation
dc.subjectSamoan renal patients
dc.subjectyounger dialysis patients
dc.subjecthome haemodialysis
dc.subjectprisoner violence
dc.subjectliving with home dialysis
dc.subjectlife on home detention
dc.subjectSamoan tattoo
dc.subjectfront of house
dc.subjectback of house
dc.subjectmiddle of house
dc.subjecturban youth gangs
dc.subjectprivate household space for public services
dc.subjectelectronic monitoring
dc.subjectelectronic bracelet
dc.subjectPacific prison officers
dc.subjectcompliance at home
dc.subjectisolation at home
dc.subjectfamilies and the State
dc.subjectcaregivers
dc.subjecthome detatinees
dc.subjecthome imprisonment
dc.subjectdecentralisation
dc.subjectchallenges of home dialysis
dc.subjectfear of haemodialysis
dc.subjectboredom on home detention
dc.subjectbreach of home detention
dc.subjectforgiveness and punishment
dc.subjectHNZC renovations
dc.subjectpatient independence
dc.subjectcold houses
dc.subjectelderly caregivers
dc.subjectkidney transplantation
dc.subjectSamoan deaths
dc.subjectSegregated status
dc.subjectSamoan communities
dc.subjectSamoan populations in New Zealand
dc.subjectSamoan protocols
dc.subjectSamoan culture
dc.subjectlinks between primary and secondary care services
dc.subjectsupport services at home
dc.subjectchildren of prisoners
dc.subjectunresolved grief
dc.subjectprivacy at home
dc.subjectsurveillance equipment
dc.subjectcarer roles
dc.subjectpatient transport problems
dc.subjectmedical waste
dc.subjectstorage problems for dialysis
dc.subjectVa Tapuia
dc.subjectHouse of Healing
dc.subjectHouse of Ashes
dc.subjectprimary health care and dialysis patients
dc.subjectprisoner accommodation
dc.subjectcosts of dialysis
dc.subjectcosts of home detention
dc.subjectthe primacy of home
dc.subjectSamoan epistemological approach
dc.subjecthousing availability for big families
dc.subjecthousing and the poverty trap for Pacific families
dc.subjectapproved premises
dc.subjecthousing for home detention
dc.subjectthe advantages of home detention
dc.subjectthe advantages of home dialysis
dc.subjectSamoan traditional houses
dc.subjectSamoan religion
dc.subjectSamoan graves
dc.subjectcare protection advocacy
dc.subjectrecruiting Pacific participants
dc.subjectqualitative research
dc.subjectvisual methods
dc.subjectphoto documentary with Pacific communities
dc.subjectvisual data
dc.subjectindepth interviews
dc.subjectcoding and data analysis
dc.subjectanalysing photographs
dc.subjecthousing tenure for dialysis patients
dc.subjecthousing tenure for home detainees
dc.subjectinstitutional setting and home setting
dc.subjectwaste disposal and home dialysis
dc.subjectghosts and mirrors
dc.subjectphoto images
dc.subjectelectricity bills and home treatments
dc.subjectnon-clinical issues and home-based services
dc.subjectelectrical appliance for medical treatment
dc.subjectolder prisoners
dc.subjectprivate rentals
dc.titleFamily-Centred Healing At Home: A Samoan Epistemology of Samoan Families’ Experiences of Home Dialysis and Home Detention in Aotearoa/New Zealand
dc.typeThesis
dc.date.updated2014-07-10T10:12:58Z
dc.language.rfc3066en
thesis.degree.disciplinePublic Health
thesis.degree.nameDoctor of Philosophy
thesis.degree.grantorUniversity of Otago
thesis.degree.levelDoctoral
otago.openaccessOpen
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