Rueda, J. R., Sola, I., Pascual, A., & Subirana Casacuberta, M. (2011). Non-invasive interventions for improving well-being and quality of life in patients with lung cancer. Cochrane Database of Systematic Reviews (Online), 9, CD004282.

The objective of the systematic review was to assess the effectiveness of non-invasive interventions delivered by healthcare professionals in improving symptoms, psychological functioning, and quality of life.

Databases searched were Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, AMED, British Nursing Index and Archive, and reference lists from relevant studies.

Search keywords were non-invasive interventions and lung cancer.

Randomized controlled trials and controlled clinical trials were included. The trials included involved

• Patients of any age or gender diagnosed with lung cancer
• Any stage of illness
• Any non-invasive intervention treatment or action performed by healthcare professional to enhance well-being or quality of life defined to include symptoms related to cancer.

A total of 20 references were retrieved. Two authors independently assessed all the references. Three of 15 studies included in this review were evaluated together in one category labeled “Nursing Interventions to Manage Breathlessness.” Of the three studies that focused solely on breathlessness, two studies previously were evaluated in the 2009 Putting Evidence Into Practice publication.  

The final number of studies included was 15. The breathlessness category included 165 patients with lung cancer. The sample range across studies was 22-109.

Patients had lung cancer with refractory breathlessness, the majority of which were not receiving active therapy. Patients received breathlessness rehabilitation, which focused on emotional as well as physical aspects of the symptom, or breathlessness training intervention, described as training in diaphragmatic breathing, pacing, anxiety management, and relaxation.

The three studies found that the intervention was effective in improving the sensation of breathlessness at best and also had beneficial effects on performance status, functional ability, and depression. Due to the stage of disease and limited life expectancy of those diagnosed with advanced lung cancer, rapid deterioration and attrition were seen in one of the studies.

The studies of breathlessness management indicate that nurse-led breathing programs may produce beneficial effects and should be encouraged.