Self-Management Intervention for Breathlessness in Lung Cancer

Not Applicable

Completed

Brief Summary: The purpose of this study is to investigate the suitability and practicality of a coaching and support intervention in helping patients to use daily strategies for managing breathlessness. Also, the investigators will try to understand how useful it is in helping patients to reduce intensity of breathlessness and its impact their quality of life.

Detailed Description: Lung cancer is common worldwide and is a leading cause of death. Breathlessness (dyspnea or shortness of breath) is a highly prevalent clinical problem in lung cancer, developing early in 25-50% of patients due to advanced stage at presentation. It persists in 60% of survivors' post-lung resection and worsens with progressive disease with rates as high as 90% reported in the final months of life. Breathlessness is associated with a high degree of unpleasantness, negatively impacts on daily functioning, and multiple domains of quality of life, triggers fear and anxiety in patients and their family, and contributes to symptom specific and psychological distress. It is also costly to the health system as it contributes to urgent care use and hospitalization. The purpose of this pilot trial is to evaluate feasibility and acceptability of a self-management intervention for breathlessness in lung cancer.

Recruitment & Eligibility

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Arm && Interventions

Group	Intervention	Description
Self-management Intervention	Self-management Intervention	Individual, face-to-face 7-session self-management intervention delivered by a specialist oncology nurse/clinical case manager as a home-based approach using a manual for each session.
Standard of care	Self-management Intervention	Patients in this condition will receive usual care as decided by their oncology clinic team or physician.

Primary Outcome Measures

Name	Time	Method
Perceived severity of breathlessness	8 weeks	Measured by Numeric Rating Scale for breathlessness intensity.
Affective distress of breathlessness	8 weeks	Measured by Distress of Breathlessness Numerical Rating Scale.
Dyspnea with activities of daily living and exercise	8 weeks	Measured by (a) Chronic Respiratory Questionnaire, (b) Medical Research Council Dyspnea Scale, and (c) BORG scale prior to, during, and at the end of the 6-Minute-Walk Test.

Secondary Outcome Measures

Name	Time	Method
Psychological distress	8 weeks	Measured by the Hospital Anxiety and Depression Scale.
Self-efficacy and mastery for managing breathlessness	8 weeks	Measured by (a) individual self-report items for "self-efficacy for managing shortness of breath" and "self-efficacy for exercise" from the toolkit of Stanford measures; (b) Chronic Respiratory Questionnaire - Mastery subscale; (c) adapted COPD Self-Efficacy Scale developed for this study.
Beliefs about breathlessness	8 weeks	Measured by Symptom Representation Questionnaire.
Adherence and Use of Self-Management Strategies	8 weeks	Measured using (1) Daily activity log of physical activity;(2)Seven-Day Physical Activity Recall tool (7-day PAR);(3) Cognitive Symptom Management Scale;(4) Daily tracking log of self-management strategies
Exercise capacity	8 weeks	Measured by 6-Minute Walk Test.
Quality of life	8 weeks	Measured by (a) Functional Assessment of Cancer Therapy - Lung (FACT-L); and, (b)Chronic Respiratory Questionnaire.
Health care utilization	8 weeks	Measured by three questions derived from the Stanford Self-Management Program Toolkit of Measures, regarding number of hospital days, emergency room visits, and visits to physicians related to their breathlessness.

Locations (1): Princess Margaret Hospital/University Health Network
🇨🇦
Toronto, Ontario, Canada