Corner, J., Plant, H., A’Hern, R., & Bailey, C. (1996). Non-pharmacological intervention for breathlessness in lung cancer. Palliative Medicine, 10(4), 299–305.

DOI Link

Intervention Characteristics/Basic Study Process

The intervention included weekly sessions with a nurse research practitioner, lasting one hour, using counseling, breathing retraining, relaxation, and the teaching of alternate coping and adaptation strategies. The interventions are the same as those commonly used to treat patients with chronic pulmonary disease. Patients were randomized either to an intervention group or control group. The intervention group met over a three- to six-week period. Additional follow-up sessions were available if necessary. The number of sessions was not stated. The control group received usual nursing care such as breathing assessment with documentation in the medical record.

Sample Characteristics

The study reported on a sample of 20 patients with lung cancer. The patients had completed either chemotherapy or radiotherapy and were experiencing breathlessness.

Setting

The study was conducted in a nurse-led clinic in a specialist cancer center.

Study Design

Randomized, controlled pilot study

Measurement Instruments/Methods

  • A 10-point VAS measuring three time frames (best, worst, and usual) to rate breathlessness over the previous week
  • Distress caused by breathlessness
  • Functional Capacity Scale
  • HADS

Results

Median scores on all measures were improved. Distress from breathlessness improved 53%, breathlessness at worst improved 35%, and functional capacity improved by 21%. Distress in the control group worsened by a median of 10%. Significant improvements compared with the control group were observed in breathlessness at best (p < 0.02) and at worst (p < 0.5), distress caused by breathlessness (p < 0.01), and functional capacity (p < 0.02). Improvements were not observed for anxiety or depression.

Conclusions

The study demonstrates that patients with lung cancer and breathlessness benefit from a rehabilitative approach.

Limitations

The effect of time and attention on a weekly basis independent of intervention is unknown. The contribution of each component of the intervention is unknown. Are all components needed to achieve the same outcome, or was one aspect of the intervention most significant? The study had a small sample, and baseline data show that the intervention group rated distress caused by breathlessness higher than did the control group.

Nursing Implications

The study is valuable as a pilot study with an aim to test feasibility.