NZREX Cultural Safety & Māori Health

Question 1

Who developed the concept of cultural safety (kawa whakaruruhau) in New Zealand nursing?

Accepted Answer

Irihapeti Ramsden

Answer

Irihapeti Ramsden (Māori nurse and academic) developed the concept of kawa whakaruruhau (cultural safety) in the 1980s–90s in NZ, emphasising that safety is defined by the patient, not the provider, and that power imbalances in healthcare must be examined.

Question 2

Which of the following best defines 'cultural safety' in the NZ health context?

Accepted Answer

An environment where patients feel respected and safe to share their culture, as determined by the patient

Answer

Cultural safety is about the patient's experience of feeling safe. It requires health professionals to reflect on their own identity, attitudes, and biases. Safety is assessed by the recipient of care — not the provider. This distinguishes it from cultural awareness or competence.

Question 3

What does the concept of 'whanaungatanga' mean and how is it relevant to clinical care?

Accepted Answer

Relationships and kinship — relevant because Māori patients often prefer whānau involvement in health decisions

Answer

Whanaungatanga refers to relationships, kinship, and a sense of connection. In clinical care, it means recognising the central role of whānau in Māori patients' wellbeing and decision-making, and actively facilitating whānau involvement.

Question 4

A Māori patient is dying in hospital. The whānau requests that the patient not be left alone and that karakia (prayer/incantation) be performed. What is the most appropriate response?

Accepted Answer

Accommodate these requests as much as possible and involve the Māori health team or kaiāwhina

Answer

Cultural safety requires accommodating the spiritual and cultural practices of dying patients and their whānau. Karakia and the need for whānau presence are important tikanga practices around death (mate). Flexible visiting and spiritual support are expected in culturally safe hospitals.

Question 5

Which of the following health disparities is most accurately documented for Māori compared to non-Māori in New Zealand?

Accepted Answer

Māori have significantly lower life expectancy, higher rates of chronic disease, and poorer access to primary care

Answer

Persistent and significant health inequities exist for Māori across most indicators: lower life expectancy (~7 years), higher rates of diabetes, CVD, respiratory disease, cancer, and mental illness, and reduced access to timely primary care.

NZREX Practice Test

NZREX Practice Test

NZREX Cultural Safety & Māori Health