A) Meihana Model
1) Demographics:
- Age: 62
- Gender: Female
- Iwi: Ngāti Porou
- Others present in the consult: Daughter
2) Kaupapa:
- Presenting complaint/issue: Patient presents with increasing shortness of breath and fatigue over the past 3 months.
- Brief overview of case: A 62-year-old Māori woman with a history of hypertension and type 2 diabetes presents with worsening respiratory symptoms. The consultation explored her current health concerns, family history, and cultural context.
3) Waka Hourua:
- Which elements of the Waka Hourua did you explore? (Tinana, Hinengaro, Iwi Katoa, Wairua, Taiao): Explored Tinana (physical health), Hinengaro (mental health), and Wairua (spiritual health).
- In what way was this information relevant and how did this influence your history or management plan?: Understanding her physical symptoms (Tinana), the impact on her mental wellbeing (Hinengaro), and her spiritual beliefs (Wairua) helped tailor a holistic management plan.
4) Ngā Hau e Whā:
- Which determinants of health did you explore or were most relevant to your patient/their whānau? (Colonisation: Housing, employment, education/financial barriers, Racism: negative experiences in health care/Life, Migration: supports current Marginalisation data for Māori): Explored housing and financial barriers.
- How did this influence your history or management plan?: Identified that the patient was struggling to afford her medications and lived in damp housing, which was exacerbating her respiratory symptoms. This influenced the management plan by including a referral to social services for financial assistance and housing support.
5) Ngā Roma Moana (NRM):
- What influence have NRM currents had with your patient, their history or been incorporated into their management plan? (Their connectedness to traditional whenua/Their roles and responsibilities? Ahua and role of tikanga to them and their wellbeing): The patient's connection to her marae and involvement in cultural activities were discussed.
- Could any of them be utilised to try to positively influence health outcomes now and/or in the future?: Encouraging her to participate in marae activities and connect with her whānau to improve her overall wellbeing.
B) Whakatere
1) Management plan:
- What was the management plan that emerged from the consultation?: The management plan included medication review, referral to a respiratory specialist, referral to social services, and encouragement to connect with her marae.
- Is it aligned with best practice recommendations?: Yes, the plan aligns with best practice guidelines for managing hypertension, diabetes, and respiratory symptoms, while also addressing social determinants of health.
- How did the information gathered using Hui Process & Meihana Model influence your plan?: The information gathered through the Hui Process and Meihana Model helped to create a patient-centred plan that considered her cultural context and social needs.
2) Hui Process:
- How successful do you think you were with utilising the Hui process?: I believe the Hui process was successful in building rapport and understanding the patient's needs.
- What could’ve been improved?: More time could have been allocated to discuss her spiritual beliefs in more detail.
- How do you think using the Hui Process may have enhanced the quality of the consultation?: The Hui Process enhanced the quality of the consultation by creating a safe space for the patient to share her concerns and allowing for a more holistic approach to her care.
- Do you think that the consultation promoted equity of health outcomes for your patient? If so, how? If not, how could this have been improved?: Yes, the consultation promoted equity by addressing her social determinants of health and providing culturally appropriate care.
C) Cultural safety
1) Self reflection:
- Reflect and comment on any personal factors or power imbalance that may have influenced this interaction. (Your culture, thoughts, feelings, beliefs, assumptions, language or biases etc.): As a non-Māori GP, I am aware of the potential for power imbalances. I ensured I was respectful of her cultural beliefs and used clear, non-technical language.
- What steps did you take, or could you have taken to mitigate any negative impact(s) from these personal factors or any power imbalance?: I actively listened to the patient, acknowledged her cultural values, and involved her daughter in the consultation to ensure understanding and support.
A) Meihana Model
1) Demographics:
- [Age] (only include age if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [Gender] (only include gender if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [Iwi] (only include iwi if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [Others present in the consult] (only include others present in the consult if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
2) Kaupapa:
- [Presenting complaint/issue] (only include presenting complaint/issue if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [Brief overview of case] (only include brief overview of case if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
3) Waka Hourua:
- [Which elements of the Waka Hourua did you explore? (Tinana, Hinengaro, Iwi Katoa, Wairua, Taiao)] (only include which elements of the Waka Hourua did you explore if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [In what way was this information relevant and how did this influence your history or management plan?] (only include in what way was this information relevant and how did this influence your history or management plan if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
4) Ngā Hau e Whā:
- [Which determinants of health did you explore or were most relevant to your patient/their whānau? (Colonisation: Housing, employment, education/financial barriers, Racism: negative experiences in health care/Life, Migration: supports current Marginalisation data for Māori)] (only include which determinants of health did you explore or were most relevant to your patient/their whānau if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [How did this influence your history or management plan?] (only include how did this influence your history or management plan if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
5) Ngā Roma Moana (NRM):
- [What influence have NRM currents had with your patient, their history or been incorporated into their management plan? (Their connectedness to traditional whenua/Their roles and responsibilities? Ahua and role of tikanga to them and their wellbeing)] (only include what influence have NRM currents had with your patient, their history or been incorporated into their management plan if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [Could any of them be utilised to try to positively influence health outcomes now and/or in the future?] (only include could any of them be utilised to try to positively influence health outcomes now and/or in the future if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
B) Whakatere
1) Management plan:
- [What was the management plan that emerged from the consultation?] (only include what was the management plan that emerged from the consultation if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [Is it aligned with best practice recommendations?] (only include is it aligned with best practice recommendations if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [How did the information gathered using Hui Process & Meihana Model influence your plan?] (only include how did the information gathered using Hui Process & Meihana Model influence your plan if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
2) Hui Process:
- [How successful do you think you were with utilising the Hui process?] (only include how successful do you think you were with utilising the Hui process if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [What could’ve been improved?] (only include what could’ve been improved if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [How do you think using the Hui Process may have enhanced the quality of the consultation?] (only include how do you think using the Hui Process may have enhanced the quality of the consultation if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [Do you think that the consultation promoted equity of health outcomes for your patient? If so, how? If not, how could this have been improved?] (only include do you think that the consultation promoted equity of health outcomes for your patient if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
C) Cultural safety
1) Self reflection:
- [Reflect and comment on any personal factors or power imbalance that may have influenced this interaction. (Your culture, thoughts, feelings, beliefs, assumptions, language or biases etc.)] (only include reflect and comment on any personal factors or power imbalance that may have influenced this interaction if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
- [What steps did you take, or could you have taken to mitigate any negative impact(s) from these personal factors or any power imbalance?] (only include what steps did you take, or could you have taken to mitigate any negative impact(s) from these personal factors or any power imbalance if it has been explicitly mentioned in the transcript, contextual notes or clinical note, otherwise omit completely.)
(Never come up with your own patient details, assessment, plan, interventions, evaluation, and plan for continuing care - use only the transcript, contextual notes or clinical note as a reference for the information include in your note. If any information related to a placeholder has not been explicitly mentioned in the transcript, contextual notes or clinical note, you must not state the information has not been explicitly mentioned in your output, just leave the relevant placeholder or omit the placeholder completely.) (Use as many lines, paragraphs or bullet points, depending on the format, as needed to capture all the relevant information from the transcript.)