A culturally safe health workforce has the capability to remove or reduce the barriers that Pacific peoples face in accessing and receiving high-quality health services by translating Pacific cultural values, concepts and world views into high-quality, evidence-informed health services. However, there is no specific guidance available on how the Physiotherapy profession could plan, promote and deliver culturally safe health services when working with and for Pacific peoples.

This doctoral research aimed to explore the cultural knowledge of Samoan families and Physiotherapists living in Aotearoa and Samoa with the view of illuminating how understandings of Samoan cultural philosophies and ways of being and knowing could enhance the rehabilitative role of Physiotherapists.

This qualitative research utilised Talanoa (Vaioleti, 2006) and Fa’afaletui (Tamasese et al., 2005) research methodologies as data collection and thematic analysis tools. Drawing from the Fa’afaletui methodology, participants were clustered into five groups: (1) Physiotherapists in New Zealand, (2) Families in New Zealand, (3) Physiotherapists in Samoa, (4) Families, Traditional healers and Health officials in Samoa; (5)and finally, a transnational group of Elders.

The participants collectively emphasised the importance of the following thematic concepts in delivering culturally safe physiotherapy with Samoan families: Aiga and Tamaliiaga (Extended family and Genealogy), Teu le va (Tending to relational spaces), Holistic healthcare, Traditional healing practices and Health systems. These concepts and notable comments from participants led to the utilisation of the traditional Samoan dance called 'taualuga' as a conceptual framework to guide cultural safety in engagements with Samoan families.

Samoan families and physiotherapists have described the essential concepts required for best practice, evidence-informed, culturally safe physiotherapy when engaging Samoan families and communities.

These research findings and the conceptual framework drawing upon the taualuga provides guidance for physiotherapy clinicians, researchers, policy makers and educators in delivering culturally safe services for and with Samoan families.

Background: Longstanding inequities in the Aotearoa New Zealand healthcare system have contributed to a higher prevalence of risk factors for mate wareware (dementia) among Māori. There is a need for improved health literacy for Māori around healthy lifestyle activities that can reduce this risk and optimise brain health. In addition, physiotherapists need to consider culturally-appropriate ways of delivering education to inspire healthy lifestyle changes and ensure equitable practice.

Purpose: This research explored the perspectives of Māori kaumātua (Māori elders) regarding heathy lifestyle activities and how these could be encouraged within a digital health literacy application called the Mate Wareware App.

Method: The study used a qualitative, Māori-centred approach, underpinned by kaupapa Māori principles. The participants were 11 Māori kaumātua (mean age 70 years) living in rural and urban areas of Northland. The kaumātua attended a wānanga and shared their experiences and views during small focus-group discussions. The audio data collected were thematically analysed.

Results: Two overarching themes were identified. 1) “Actively connecting to wairua” emphasised wairua (spirit, soul) as the foundation of a healthy lifestyle and a key supporting feature of hauora (health and wellbeing). 2) “Mahi through the generations” highlighted the central and dynamic role of mahi (work) in the lives of Māori, particularly mahi through life roles, kai (food), and whānau (family) and community activities.

Conclusions: The findings emphasised the importance of returning to ancestral and cultural activities for Māori to live a healthy lifestyle. Kaumātua suggested a range of features to be implemented within the Mate Wareware App to support wairua and draw Māori back to mahi that encourages healthy lifestyle activities.

Implications: The findings provide a foundation for healthy lifestyle advice directed towards the needs of Māori and encourage physiotherapists to reflect on holistic and whānau-centred activities that could be encouraged with Māori patients and whānau.

Background:
This research explores the intersection of physiotherapy practice and the experiences of trans, non-binary or gender diverse (TGNB) individuals in Aotearoa New Zealand.

Purpose:
By exploring the experiences of the TGNB community accessing and utilising physiotherapy services, the aim of the study was to understand specific barriers and facilitators of positive physiotherapy experiences within the NZ context.

Methods:
Semi-structured interviews were conducted with current or former clients of a physiotherapy clinic providing sex and gender-affirming services. Data collection occurred via online videoconferencing. Qualitative data were analysed using reflexive thematic analysis with key themes and subthemes mapped to the socioecological model.

Results:
Seventeen participants aged between 15 and 64 years with diverse identities participated in the study. Most (88%) participants were of NZ European ethnicity and lived in metropolitan/urban areas. Participants described having poor experiences with physiotherapy prior to engaging with the sex and gender affirming clinic. Four key themes relating to affirming physiotherapy experiences were identified: safety and trust in care, understanding body discomfort or dysphoria, trans inclusive approaches and challenging cisnormative contexts. Organisational factors contributing to positive experiences centred around the clinic’s credibility, safety, visible inclusivity, and consistent sensitivity across the clinical encounter. Interpersonal factors linked to positive experiences included clinicians possessing higher levels of TGNB specific health knowledge, culturally inclusive practice, and a client-led biopsychosocial approach to care.

Conclusion:
While challenges persist for TGNB individuals in the context of physiotherapy, this study underscores achievable changes at organisational and interpersonal levels within physiotherapy clinics.

Implications:
By prioritising safety, inclusivity and TGNB specific knowledge, physiotherapists can actively contribute to fostering positive experiences for the TGNB community.