A38-04 Identifying and Addressing Barriers and Facilitators to Reducing Dyspnoea and Improving Quality of Life in People With Lung Cancer; An International Delphi Consensus

Rationale Dyspnoea is a prevalent and distressing symptom in people with lung cancer, adversely affecting quality of life and functionality. While evidence supports the efficacy of yoga-based mind-body interventions in alleviating dyspnoea, their clinical application is limited. Understanding the barriers to participation and facilitators of engagement is crucial for designing effective yoga programs. This study aims to achieve international consensus on the barriers and facilitators related to implementing yoga for dyspnoea management and quality of life enhancement in people with lung cancer. Methods A modified Delphi method was employed to establish consensus among experienced yoga teachers working with individuals affected by respiratory diseases or cancer. Fifty-seven qualified teachers were invited to participate in the study. Two rounds of online surveys were conducted, with the second round designed based on the responses from the first. The surveys focused on yoga-based strategies for managing dyspnoea and included a section that specifically addressed the barriers and facilitators to practising yoga in clinical settings. Quantitative agreement was defined as achieving a pre-established consensus of 75% or more on Likert-scale items, while qualitative comments were analysed thematically. Results A total of thirty-three yoga teachers participated in the study, with 19 completing the first round and 15 completing the second round. The countries represented among the first-round participants (n = 19) included Australia (4), Canada (2), India (6), Turkey (4), and the USA (3). Among the participants, eleven were healthcare professionals. Consensus was achieved in the second round with an overall agreement level of 79%. Participants identified several barriers that prevented patients from fully engaging in yoga, including time constraints, transportation issues, lack of knowledge, low motivation, anxiety, fatigue, mobility challenges, low self-esteem, and disease-related fears such as infection risk and treatment side effects. Facilitators that supported patient engagement included supportive clinical environments, qualified instructors, integration with medical care, patient education, motivation, perceived physical and psychological benefits, and readiness for spiritual engagement. Conclusions This international Delphi consensus highlights the essential practical and psychosocial factors influencing yoga participation among people with lung cancer. The findings have emphasised the necessity for tailored, accessible, and medically integrated yoga programs led by skilled instructors in supportive settings. Future research should focus on these consensus findings by implementing clinical trials to evaluate the effectiveness of yoga-based interventions for dyspnoea in people with lung cancer.