Re-orientating health and nursing care: a qualitative study on indigenous conceptualisations of wellbeing.

Background: Health systems often fail to address the wellbeing needs of older Indigenous populations; this is attributed to a lack of knowledge of Indigenous health systems arising from a privileging of dominant western biomedical epistemologies. In Aotearoa/New Zealand, there is a dearth of nursing knowledge relating to Māori, which negatively impacts on the provision of holistic nursing care. This research explores insights and perspectives of older Māori adult's (pakeke) perceptions of wellbeing so nurses can provide culturally responsive care and support the wellbeing of Indigenous New Zealanders.

Methods: An Indigenous kaupapa Māori methodology underpinned and directed this research project. Audio-recorded interviews were conducted face to face in participants' homes, marae (meeting house) and workplaces. Pakeke over the age of 55 participated in in-depth interviews. A total of 10 pakeke were interviewed and narratives were thematically analysed in accordance with meanings derived from Māori worldviews.

Results: Wellbeing was attributed to the holistic interconnection and balancing of whānau (wider family), whanaungatanga (social connectedness), hinengaro (mental and emotional wellbeing), taha tinana (physical wellbeing) and wairua (spirituality).

Conclusion: The findings offer unique insights into how wellbeing is constructed for pakeke; the results are unique but consistent with international accounts of older Indigenous peoples. Pakeke wellbeing can be supported by acknowledging existing cultural and spiritual beliefs and peer-support initiatives. Nursing models of care should prioritise Indigenous ways of knowing; this research offers nursing-focused recommendations to improve care.