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Whakawhanaungatanga: culturally-meaningful connections as a pathway to better health for Maori with chronic obstructive pulmonary disease - a qualitative study

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Show simple item record Levack, William MM Jones, Bernadette Grainger, Rebecca Boland, Pauline Brown, Melanie Ingham, Tristram R. 2017-01-23T11:35:36Z 2017-01-23T11:35:36Z 2016
dc.description peer-reviewed en_US
dc.description.abstract Background: Pulmonary rehabilitation is known to improve function and quality of life for people with chronic obstructive pulmonary disease (COPD). However, little research has been conducted on the influence of culture on experiences of pulmonary rehabilitation. This study examined factors influencing uptake of pulmonary rehabilitation by Māori with COPD in New Zealand. Method: Grounded theory nested within kaupapa Māori methodology. Transcripts were analyzed from interviews and focus groups with 15 Māori and ten New Zealand non-Māori invited to attend pulmonary rehabilitation for COPD. Māori participants had either attended a mainstream hospital-based program, a community-based program designed “by Māori , for Māori ”, or had experienced both. Results: Several factors influencing uptake of pulmonary rehabilitation were common to all participants regardless of ethnicity: 1) participants’ past experiences (eg, of exercise; of health care systems), 2) attitudes and expectations, 3) access issues (eg, time, transport, and conflicting responsibilities), and 4) initial program experiences. These factors were moderated by the involvement of family and peers, interactions with health professionals, the way information on programs was presented, and by new illness events. For Māori, however, several additional factors were also identified relating to cultural experiences of pulmonary rehabilitation. In particular, Māori participants placed high value on whakawhanaungatanga: the making of culturally meaningful connections with others. Culturally appropriate communication and relationship building was deemed so important by some Māori participants that when it was absent, they felt strongly discouraged to attend pulmonary rehabilitation. Only the more holistic services offered a program in which they felt culturally safe and to which they were willing to return for ongoing rehabilitation. Conclusion: Lack of attention to cultural factors in the delivery of pulmonary rehabilitation may be a barrier to its uptake by indigenous, minority ethnic groups, such as New Zealand Māori . Indigenous-led or culturally responsive health care interventions for COPD may provide a solution to this issue. en_US
dc.language.iso eng en_US
dc.publisher Dove Medical Press en_US
dc.relation.ispartofseries International Journal of Chronic Obstructive Pulmonary Disease;11, pp. 489-501
dc.subject COPD en_US
dc.subject pulmonary rehabilitation en_US
dc.subject health care access en_US
dc.subject cultural safety en_US
dc.subject indigenous peoples en_US
dc.subject qualitative research en_US
dc.title Whakawhanaungatanga: culturally-meaningful connections as a pathway to better health for Maori with chronic obstructive pulmonary disease - a qualitative study en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US 2017-01-23T11:26:34Z
dc.description.version PUBLISHED
dc.identifier.doi 10.2147/COPD.S97665
dc.contributor.sponsor Asthma Foundation, New Zealand en_US
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 2644173
dc.internal.copyrightchecked Yes
dc.identifier.journaltitle International Journal Of Chronic Obstructive Pulmonary Disease
dc.description.status peer-reviewed

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