1009 - Development of a Nurse-Led Pulmonary Rehabilitation Program for Lung Cancer Patients Undergoing Radiotherapy: A Delphi Study

Purpose/Objective(s): Pulmonary rehabilitation plays a crucial role in alleviating treatment-related symptoms and enhancing the recovery of physical and psycho-social function among lung cancer patients undergoing radiotherapy. Nurses serve as pivotal contributors to this process. This study aims to develop a systematic, specialized, and standardized nurse-led pulmonary rehabilitation program tailored to this patient population.

Materials/Methods: A preliminary pulmonary rehabilitation framework was established between March and June 2024 through a synthesis of evidence from literature reviews and expert panel discussions. Subsequently, from July to September 2024, two rounds of Delphi consultations were conducted with 15 multidisciplinary experts (including nursing specialists, clinical radiation oncologists, and rehabilitation professionals) to refine the program. Expert opinions were evaluated using Kendall’s W coefficient and coefficient of variation.

Results: 16 high-quality evidence sources were analyzed, including 4 clinical guidelines, 5 consensus statements,3 systematic reviews, and 4 randomized controlled trials. 38 evidence-based recommendations related to nurse-led pulmonary rehabilitation were identified. Both consultation rounds achieved 100% response rates. The expert authority coefficient was 0.84, with Kendall's harmony coefficients being 0.111 and 0.172, respectively(P<0.05). The items' importance and feasibility scores in the second consultation round ranged from 0 to 0.16 and 0 to 0.023, respectively. The finalized program comprises 5 core components: multidisciplinary team collaboration, intervention timing determination, pre-evaluation procedures, multidimensional intervention, and follow-up strategies. The multidimensional intervention details 6 evidence-based domains: (1)systematic exercise rehabilitation program incorporating warm-up routines, endurance exercises, and resistance exercises; (2) individually tailored psychological interventions informed by dynamic psychosocial screening; (3) phased nutritional optimization implemented through serial nutritional assessments; (4) comprehensive health promotion combining structured patient education with evidence-based smoking cessation protocols; (5)continuous safety surveillance throughout the rehabilitation process.

Conclusion: This rigorously developed nurse-led pulmonary rehabilitation program addresses critical clinical needs and provides a scientifically grounded protocol for implementation. It establishes a theoretical and practical foundation for optimizing functional recovery in lung cancer patients receiving radiotherapy.