Māori experience of Anaesthesia in the perioperative setting: A pilot study of research methodology

Student prerequisites

This pilot study is part of a wider study that will employ Kaupapa Māori Research methodology. Hence it is important that the design and conduct of the project is Māori led. Associate Professor Pitama will specifically recruit a student for this project.

How to apply

Contact the first supervisor, Dr Courtney Thomas, to express your interest:

Tel +64 21 301 4764
Email mrs.cthomasnz@gmail.com

Project brief

Introduction

Māori are the indigenous people of New Zealand and continue to experience disparities in access to care and poorer health outcomes (1). The latest report from the Postoperative Mortality Review Committee found Māori living in the most deprived areas, who had an elective admission with general anaesthesia, had a much higher 30-day perioperative mortality rate than New Zealand Europeans (3). Investigation of Māori patients’ experiences of care in the pre-operative setting and the role for both quantitative and qualitative research was recognised (3).

Funding has been awarded by the Australia and New Zealand College of Anaesthetists for a multicentre study between Christchurch and Auckland in 2019/2020. This study will investigate Māori experience of Anaesthesia in the perioperative setting utilising a mixed methods approach with patient surveys and interviews. The pilot study proposed for 2018/2019 will investigate the practical and logistical considerations associated with participant recruitment and follow-up, the feasibility of the assessment tools already developed and assist refinement of the study’s methodology.

Aim

• To assess utilization of the patient survey tool with regard to ease of administration and question suitability.
• To assess the ability of the structured patient interview to adequately capture participants experiences.
• To provide feedback on potential changes to the patient survey tool and structured interview schedule.
• To provide feedback on the proposed patient recruitment and follow-up processes with regard to recording of ethnicity data, logistical considerations and efficiency.
• To assist construction of a database for the formal study.

Method

Prospective recruitment of Māori patients who have undergone surgery at Christchurch Public Hospital in the post-operative period of their current admission. Patients will need to be >18 years old and well enough to provide informed consent for their participation. 10 participants will be recruited and administered the previously developed patient survey face-to-face. A broad range of subspecialty Anaesthesia will be sampled. 2–3 participants will be invited to take part in a structured face-to-face interview within 3–4 weeks of the original admission. In accordance with informed consent, the interviews will be audio recorded, transcribed and thematic analysis performed using NVivo, a qualitative data analysis tool.

Adherence to Kaupapa Māori Methodology is important and will be closely supervised. This approach entails research methods that are culturally acceptable to Māori and prioritise Māori beliefs, values and experiences at the centre of that inquiry (2). Safe processes, accountability and a commitment to meeting the highest standards of research are integral to the process (2).

Student researcher’s component of the study

• Recruitment and follow up of study participants using the pre-defined processes developed.
• Participant survey and structured interview administration.
• Assist construction of a database for tabulation of the pilot study data.
• Provision of feedback surrounding the project aims, design, conduct and any particular problems encountered.
• Regular meetings with the project supervisor(s) to discuss approach, potential problems and for guidance on conduct.

References

1. Ministry of Health (2014). The Guide to He Korowai Oranga: Maori Health Strategy 2014. (page 9).
2. Pitama, S., Wells, J., Faatoese, A., Tikao-Mason, K., Robertson, P., Huria, T., Gillies, T., Doughty, R., Whalley, G., Troughton, R., Sheerin, I., Richards, M. & Cameron, V. (2011). A Kaupapa Maori Approach to a Community Cohort Study of Heart Disease in New Zealand. Australian and New Zealand Journal of Public Health, 35(3), 249-255.
3. Postoperative Mortality Review Committee (2017). Perioperative Mortality in New Zealand: Sixth report of the Postoperative Mortality Review Committee. (pp. 47-49).