New Zealand speech-language therapists’ perspectives on service provision for Māori with aphasia

Abstract

This article examines New Zealand speech–language therapists' (SLTs') perspectives on service provision for Māori with aphasia. The New Zealand Disability Strategy states that disability services should be ‘accessible to and culturally appropriate for disabled Māori and their whānau (extended family)’ ( Minister for Disability Issues, 2001). However, until recently, SLTs have had little guidance as to what makes a service ‘accessible’ and ‘culturally appropriate’. In light of this, the current study sought to describe and analyze service provision for Māori with aphasia and SLTs' perceptions of an accessible and culturally appropriate service. Using the qualitative methodology of interpretive description (ID), interviews were conducted with 10 SLTs (5 managers and 5 clinicians) working with Māori with aphasia across New Zealand. Inductive analysis revealed three factors that together determine the service provided for Māori with aphasia. These are ‘individual clinician factors’, ‘resources’ (human and non-human), and ‘ways of working’. Individual clinician factors include the clinician's knowledge, attitudes, and willingness to make connections. ‘Resources’ include the people, funding, assessments, and therapy materials that are available. ‘Ways of working’ include team culture and expectations as well as such practical aspects as the timing and location of SLT appointments and the content of the sessions. As each of these factors varies greatly between districts, so too does the service provided for Māori with aphasia. The results show that, despite many limitations to their practice, SLTs desire to provide a service that is accessible, culturally safe, and culturally appropriate for Māori with aphasia.