Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Patricia A. Roth, EdD, RN, Chairperson; Mary Rose Mueller, PhD, RN; Martha Ann Carey, PhD, RN


culture, Grounded theory, Hawaiians, kūpuna, nursing, perspective, wellness


Few studies successfully explain the decline of Hawaiian health, nor provide enough insight to the cultural determinants that affect Hawaiian wellness. For over two hundred years, Hawaiians have been influenced by a changing landscape mostly imposed upon Hawaiians and Hawaiian lands as a consequence of being conquered by powerful Western cultures. This grounded theory study utilized video elicitation and focus group methodologies to examine the perspective of wellness in a group of Hawaiian elders known as kūpuna. Following the viewing of a documentary film designed to elicit culturally based memories, a series of interview questions were asked to foster group discussion. Participants were videotaped while participating in the group discussion. Twenty-six Hawaiian kūpuna, with an average age of 65 years participated in this study. The kūpuna were recruited through the efforts of a local Hawaiian facilitator and the researcher's established connections with the Hawaiian community. Over 70 percent of the participants had more than 70% Hawaiian ancestry, known as Hawaiian blood quantum (HBQ), 9 were 100% Hawaiian, and the minimum HBQ was 50%. The following lines of inquiry were explored: What is the contemporary Hawaiian perception of wellness? What are the social and cultural determinates that influence the Hawaiian perception of wellness? Keeping balance emerged as the core category of this study. There were three thematic categories that supported the core category: Aloha, Mastery and Belonging. The context and conditions of change and adaptation emphasize the need to instill these concepts for cultural survival and consequently, Hawaiian identity. The kūpuna perceptions of wellness in this study are balanced by spiritual fulfillment, physical and mental health. These values have been well formed by ancient Hawaiian tenets; they become stable as a result of their ancestry and life experiences. Further research will contribute to improving existing programs and developing better guidelines for clinical practice.

Document Type

Dissertation: Open Access



Included in

Nursing Commons