The pilot programme has a team – Noelene Rapana, Roel Austria, Mariana Vercoe and John Rapana – working with 60 whānau with respiratory conditions, such as asthma, COPD (Chronic Obstructive Pulmonary Disease) or anxiety-related breathing disorders. The group meets twice a week, and is split into two groups of 30, with one concentrating on Tōku Oranga community pulmonary rehab, while the other focuses on education sessions that address social concerns. After completing a seven-week programme, the groups changeover.

Respiratory nurse specialist and Whaimua project manager, Noelene Rapana, says all participants undergo a health assessment, which includes a review of inhalers, undergoing spirometry tests, creating self-management plans and learning to self-manage while on the Whaimua programme.

Noelene says the Tōku Oranga pulmonary rehabilitation programme has been identified as one of the best things whānau can do to keep themselves well and out of hospital for their respiratory conditions.

“Participants perform a six-minute walk test before beginning the programme, which measures how far they can walk within this time. At the end of the seven-week course, participants repeat the test, which showed an average improvement of 100m. This is a fantastic achievement as research shows an increase of 50m in walking distance is a significant improvement.”

Noelene says one of the biggest things that sets the programme apart from other health programmes is the role of the paearahi, Mariana Vercoe and John Rapana. Paearahi support whānau to achieve their goals and aspirations by addressing the things that matter the most to them.

“They support them with everyday issues and walk beside them. It’s whānau-led so whatever they see is important, we go with that, supporting them on their journey through health. That’s the difference.

“Gym work with Roel Austria involves strengthening their arms, legs and accessory muscles, especially the muscles they use for breathing – those big muscles in the chest, neck and back. But generally, just to get them fit, and make them realise that breathlessness is OK, that they shouldn’t be afraid of being breathless. Most of them had started to decondition because they were afraid of being breathless.”

One of the major issues for people with COPD is anxiety and depression. Noelene says whānau tend to isolate themselves as they become more breathless which in turn has a detrimental effect on their health.

“Some participants are not able to engage in the programme due to work or other commitments. The paearahi will support them to develop a Whānau Ora plan to set-up their goals, which may include home-based exercises or whatever suits them. Since they’ve been engaging in the programme there have been huge changes in their health and social wellbeing, and it makes them feel good. They’re exercising and the connection they have with others is huge. Whakawhanāungatanga is huge.

“We always knew whakawhanāungatanga has a hugely positive effect on health, but we didn’t fully understand how important it is for those with COPD and respiratory conditions. We’re now seeing how important it is as the objective and subjective data is coming through in their results. Asthma and respiratory diseases are two of the leading causes of sickness and death in New Zealand and costs the country six billion dollars a year in direct and indirect costs. Programmes like Whaimua can show how we can achieve better results through a whānau-centred approach – what they see as important.”