Deepening understandings of rehabilitation in the Cook Islands: An action research study with Te Vaerua Rehabilitation Service
This study is a qualitative research project with Te Vaerua, a community based rehabilitation service in the Cook Islands, that had the aim of establishing a culturally-congruent framework for rehabilitation services provided by the organisation. It employed participatory action research (PAR) methods, drawing on data from focus groups, interviews and observations to look at the meanings and values of rehabilitation held by Te Vaerua. The participants included individuals associated with Te Vaerua: Board Members, therapists, funders, and the researcher, who was also employed as a physiotherapist during the data collection phase of August to October 2013. Thematic analysis identified three key emergent values: 1) rehabilitation is available, 2) rehabilitation has heart, and 3) rehabilitation gives hope, with an overarching concept of ‘people are the most important thing: Ko te iti tangata te mea maata’. In addition, Te Vaerua identified action points which were considered important to achieve a service that matched their values: the need for accurate data collection, the importance of service visibility, the importance of service links with other island-based providers and a strategic plan that aligns values with measurable goals in order to show success. Furthermore, this thesis provides guidance for other projects within the Pacific when establishing a new service: the importance of taking time to build relationships within the community and to offer contributions and reciprocal generosity as a basis for relationship building and service visibility. PAR as a research framework is explored in the context of community based rehabilitation (CBR), with discussion of the alignment evident between the underlying principles of PAR and CBR. This suggests that PAR is a good fit for qualitative research in these settings. Existing literature discusses challenges for both CBR and PAR related to gaining participation and the tension of reliance on overseas ‘experts’ to manage such projects. This study discusses these challenges as they arose in this research journey and reflects on three learnings related to the use of PAR: the need for flexibility to gain shared control, the importance of a research question that engages the participants, and early identification of key informants or project champions.
Advisor: Levack, William; Currey, Nandika; Graham, Fiona
Degree Name: Master of Health Sciences
Degree Discipline: RTRU
Publisher: University of Otago
Keywords: rehabilitation; action research; community based participatory research; Cook Islands; Pacific
Research Type: Thesis