This study examined factors influencing the uptake and completion of pulmonary rehabilitation by Māori with chronic obstructive pulmonary disease (COPD) in NZ. Grounded theory nested within kaupapa Māori methodology was used to analyse transcripts from interviews and focus groups with 15 Māori and 10 NZ non-Māori invited to attend pulmonary rehabilitation for COPD. Māori participants had either attended a mainstream hospital-based programme, a community-based programme designed “by Māori, for Māori”, or had experienced both. A number of factors influencing the uptake of pulmonary rehabilitation were common to all participants, regardless of ethnicity or background: 1) participants’ past experiences (e.g. of exercise; of health care systems), 2) attitudes and expectations, 3) access issues (e.g. time, transport, and conflicting responsibilities), and 4) initial programme experiences. These factors were moderated by the involvement of family or whānau and peers, interactions with health professionals, the way information on programmes was presented, and the experience of new illness events. For Māori participants, however, several additional factors were also identified relating to cultural experiences of pulmonary rehabilitation. In particular, many (but not all) Māori participants placed high value on whakawhanaungatanga within their pulmonary rehabilitation programmes: they sought regular opportunities to make culturally meaningful connections with the other people involved. If they perceived such opportunities as being absent in pulmonary rehabilitation programmes, these Māori participants felt dissatisfied, were less inclined to join, or felt disinclined to attend pulmonary rehabilitation. Only the more holistic services offered a programme in which they felt culturally safe and to which they were willing to return for ongoing rehabilitation.
