Hinemoa Elder1. 1. Hauora Waikato Group, Oneroa Waiheke Island, Auckland, New Zealand. hinemoa@xtra.co.nz
Abstract
OBJECTIVE: This paper provides a pragmatic review of the literature to describe the size and shape of Māori tamariki (child) and taiohi (adolescent) traumatic brain injury (TBI) and highlight issues pertinent to psychiatrists. A review of the literature describing cultural aspects of international TBI research further contextualises these findings. METHODOLOGY: Literature searches using the words indigenous, ethnic, culture, native, native American, native Alaskan, native Hawaiian, Māori, aboriginal, traumatic brain injury, rehabilitation, paediatric, disparities and epidemiology were undertaken. Reference lists were also examined. RESULTS: The literature is adult-centric and selected papers are summarised. Significant gaps in the literature were found. Recent local epidemiological studies describe Māori tamariki and taiohi as being significantly over-represented in TBI populations, with poorer outcomes including higher mortality rates. International research shows evidence of 'minority' culture being a risk factor for certain causes of injury and a differential rehabilitation service response. CONCLUSIONS: These findings are important for psychiatrists working with Māori. They underscore the importance of asking effectively about possible TBI history. Implications for future research to address literature gaps are evident. Kaupapa Māori rangahau (research) could be used to explore application of tikanga Māori (cultural lore) in prevention, rehabilitation and psychiatric management.
OBJECTIVE: This paper provides a pragmatic review of the literature to describe the size and shape of Māori tamariki (child) and taiohi (adolescent) traumatic brain injury (TBI) and highlight issues pertinent to psychiatrists. A review of the literature describing cultural aspects of international TBI research further contextualises these findings. METHODOLOGY: Literature searches using the words indigenous, ethnic, culture, native, native American, native Alaskan, native Hawaiian, Māori, aboriginal, traumatic brain injury, rehabilitation, paediatric, disparities and epidemiology were undertaken. Reference lists were also examined. RESULTS: The literature is adult-centric and selected papers are summarised. Significant gaps in the literature were found. Recent local epidemiological studies describe Māori tamariki and taiohi as being significantly over-represented in TBI populations, with poorer outcomes including higher mortality rates. International research shows evidence of 'minority' culture being a risk factor for certain causes of injury and a differential rehabilitation service response. CONCLUSIONS: These findings are important for psychiatrists working with Māori. They underscore the importance of asking effectively about possible TBI history. Implications for future research to address literature gaps are evident. Kaupapa Māori rangahau (research) could be used to explore application of tikanga Māori (cultural lore) in prevention, rehabilitation and psychiatric management.