Virtual ethnography of singing for breathing in COPD and ILD patients

<bold>Introduction/Aim:</bold> Many international in-person singing for lung health programs have demonstrated benefits in improving participants’ breathlessness and quality of life, but the onset of the pandemic prompted a shift to online delivery. Limited research exists regarding how online delivery of these programs impacts participants’ interactions and behaviours. This study evaluated how the digital format influences participant engagement in an Australian-wide program “SINFONIA: A clinical trial examining the benefits of SingINg For breathing in COPD aNd ILD pAtients.” <bold>Methods:</bold> A virtual ethnographic study was conducted, including observations of 18 participants with chronic obstructive pulmonary disease and interstitial lung disease across 20 weekly 1.5-hour Zoom sessions led by two singing leaders. Analysis of qualitative data yielded descriptive and analytical themes. <bold>Results:</bold> Three themes emerged: (1) adaptation and community building; (2) evolution of group dynamics; and (3) dynamics of leadership and influence. As the singing program progressed, participants formed social connections that transcended geographical limitations, both facilitated and inhibited by online delivery. The program fostered a supportive environment where participants could normalise their conditions, thus challenging stigmas and promoting resilience within the evolving group dynamics, which were shaped by the leaders. <bold>Conclusion:</bold> Evolving relationships and group dynamics were observed, emphasising the importance of managing online group social dynamics and balancing guidance with participant autonomy in future programs.