Lessons from Samoan traditional healers to physiotherapists: In search of the epitome of culturally dignifying physiotherapy care for Samoan families.

This doctoral research aimed to explore the cultural knowledge of Samoan families and Physiotherapists living in New Zealand and Samoa with the view of illuminating how understandings of Samoan and Pacific cultural philosophies, ways of being and practices could inform and enhance Physiotherapy theory and practise when engaging with Samoan families. 

With the imperative of employing Pacific research methodologies to seek more contextualised solutions for Pacific issues, this qualitative research utilised Talanoa (Vaioleti, 2006) and Fa’afaletui (Tamasese et al., 2005) research methods and 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. Talanoa (narrative dialogue) was conducted in person and online, utilising both English and Samoan languages as the participant(s) preferred. 

Twenty six participants were interviewed. These 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 were synthesised into the development of a conceptual framework based on the traditional Samoan dance called the taualuga, with the aim of providing clinical guidance for 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 concepts promote accessible, collective, family-centred, ecological, relational, humorous, compassionate and holistic health services as constituting the epitome of physiotherapy care. Many of these features were perceived to be present in the work of traditional healers, which provided many lessons for physiotherapy theory and practise. The proposed Fau'olo framework presents a conceptual model to guide physiotherapists' culturally-safe engagement with Samoan families. 

The findings of this study, including the proposed Fau'olo framework for Samoan cultural safety, have implications for clinicians, educators and policy makers who work with Samoan and Pacific communities. The Fau'olo framework synthesises the essential concepts required for culturally safe physiotherapy practise with Samoan families. It reveals novel areas for enhancing curriculum development and highlights the important roles of policy makers in establishing the social, economic and organisational settings needed for culturally safe health service delivery. As the first Pacific doctoral study in Physiotherapy, this research also highlights the need for more research by, with and for Pacific communities.