There are numerous cultural values important to Native Hawaiians. Those mentioned here were selected because they are often relevant or helpful in the healthcare setting. However, this is not meant to be an exhaustive list of Native Hawaiian values or beliefs.
Central to Native Hawaiian understanding of health is the concept of lokahi (balance or harmony). This is sometimes referred to as the “Lokahi Triangle”. Health is holistic. One is healthy when the physical, mental and spiritual parts of a person are all in harmony. These three “points of the triangle” include not only the physical body but also the environment surrounding that person, relationships with others, particularly family members, ancestors and god(s), as well as mental and emotional states. Traditionally, healing for the physical body cannot occur without setting right any problems within the mental or spiritual realm. This requires spending time with the patient in order to get to know them and ascertaining the true origins of an illness. In addition, the patient has to be willing to take responsibility for the healing including making amends for any wrongs that they might have caused in the past.
The extended family was the primary social structure for an ethnic Native Hawaiian. Many still live in multi-generational homes. Illness affects the entire family and therefore, family members need to be involved in the decision-making and treatment plans. This also ties in to the Hawaiian values of laulima (cooperation/helping) and kuleana (responsibility).
Aloha (love, compassion) and Malama (to care for)
Aloha has many meanings but the majority center around the concepts of love, caring and compassion. Native Hawaiians need to feel that they are being respected and cared for if they are to be willing partners in the patient-physician relationship. This entails the establishment of trust. In addition, Native Hawaiians feel a strong responsibility to “take care”, particularly of their loved ones. This concept is summarized in the saying, “aloha aku, aloha mai (give love, get love).” For example, you may find many Native Hawaiians living in large, extended families consisting of multiple generations. Grandparents may often be the primary caregivers of the children.