What matters to the heart: Hawaiian belief and value systems relating to disease and spirituality

Past studies have treated Native Hawaiians as subjects of investigation and may not have been concerned with beliefs and values in their research on health. Over 40 years of quantitative data strongly suggests Hawaiian health has declined specifically concerning hypertension and heart related issues. This qualitative study was designed to engage Native Hawaiians in a discussion concerning their beliefs and values in relation to disease and spirituality.;Four focus groups, consisting of 18 Hawaiians, were conducted over a period of 5 months. Focus groups were introduced to the Hawaiian community by another Hawaiian living in the community. One of the focus groups was composed of traditional Hawaiian healers who are respected leaders in the community and familiar with native healing systems and Western medical models. A total of 4 La'au Lapa'au (traditional healers) were interviewed. Two are practitioners of healing massage and one is teaching la'au classes at the University of Hawaii. The final La'au interviewed is working with the school of medicine on an integrative design of Hawaiian la'au practice and the medical model. Four community leaders were interviewed. All focus groups and interviews were recorded and transcribed for coding and thematic analysis.;Emergent themes presented as: connection to family, relationships, language, and stewardship of the land and island environment. These themes focus on the importance of spiritual balance. Hawaiians in this sample, seek balance in all relationships and environments. The implications of this study's findings are the introduction of traditional Hawaiian healers with medical doctors and including Hawaiian families in treatment planning for the patient. One way to improve the health outcomes for Native Hawaiians may be to integrate natural remedies, medical prescriptions, and to include the relationships that are important influences in a Hawaiian's health.