Abstract
Background: The aim was to examine the validity of a new measure, Te Waka Kuaka, in assessing the cultural needs of Māori with traumatic brain injury (TBI). Methods: Māori from around Aotearoa, New Zealand were recruited. 319 people with a history of TBI, their whānau (extended family members), friends, work associates, and interested community members participated. All completed the 46-item measure. Rasch analysis of the data was undertaken. Results: All four subscales; Wā (time), Wāhi (place), Tangata (people) and Wairua practices (activities that strengthen spiritual connection) were unidimensional. Ten items were deleted because they did not fit the model, due to statistically significant disordered thresholds, non-uniform differential item functioning (DIF) and local dependence. Five items were re-scored in the fourth subscale resulting in ordered thresholds. Conclusions: Rasch analysis facilitated a robust validation process of Te Waka Kuaka.
Highlights
Traumatic brain injury (TBI) in Māori is a significant health problem
Recent population data shows that Māori youth are three times more likely to sustain clinically significant traumatic brain injury (TBI) compared to non-Māori (Feigin et al, 2013)
A complicating factor in responding to Māori with TBI has been the lack of understanding of the cultural importance of injury to the brain and head to Māori, given the primacy placed on the head in Māori culture
Summary
Traumatic brain injury (TBI) in Māori is a significant health problem. Recent population data shows that Māori youth are three times more likely to sustain clinically significant TBI compared to non-Māori (Feigin et al, 2013). Allocating enough time when working with Māori has recently been identified as vital to ensuring cultural practices are undertaken and more accurate assessment and recommendations are provided (Elder et al, 2016). These aspects of comprehensive assessment of Māori may be in tension with clinical imperatives that emphasize efficiencies of time and prioritize brevity of assessment and treatment. The aim was to examine the validity of a new measure, Te Waka Kuaka, in assessing the cultural needs of Māori with traumatic brain injury (TBI). Results: All four subscales; Wā (time), Wāhi (place), Tangata (people) and Wairua practices (activities that strengthen spiritual connection) were unidimensional. Conclusions: Rasch analysis facilitated a robust validation process of Te Waka Kuaka
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