The aim of this thesis was to develop yoga as a complex intervention in health care for
the improvement of health-related quality of life (HRQoL) in adult cancer. As the
Indian tradition of practising yoga increases in popularity worldwide, populations in the
West are beginning to see yoga as an opportunity to prevent and treat health conditions. The
Medical Research Council's framework has provided a methodology to address a paucity of
coherent evidence for the myriad of unsupported health claims made by yoga enthusiasts.
The thesis structure included a step-by-step approach to investigate biomedical theories
of how yoga might work to improve health, to synthesise evidence of yoga interventions,
to model their process and outcomes, and to test evaluation procedures in the context
of a randomised controlled trial (RCT). The results of a bibliometric analysis indicated an
overall increase in the publication rate of yoga research in health care, and in 2005 this
research began to focus on cancer. A component analysis, semi-structured patient
interviews (n=10) and oncologist surveys (n=29) were successively designed, implemented
and analysed to advance a model of yoga intervention specific to adult cancer. The
cumulative results were applied to design three yoga interventions randomly allocated to
men and women receiving treatment for cancer (n=15). Outcomes of the feasibility
study demonstrated that yoga intervention is appropriate for adult patients and can be
administered safely in a clinical setting. In its conclusion, this thesis produces
evidence-based support for the optimisation of yoga intervention in the context of a
large-scale RCT for HRQoL in adult cancer, and it provides recommendations to improve
research methodology and reporting of complex interventions in health care.
