Self-Management Intervention for Breathlessness in Lung Cancer

• Perceived severity of breathlessness [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  Measured by Numeric Rating Scale for breathlessness intensity.
  
  
• Affective distress of breathlessness [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  Measured by Distress of Breathlessness Numerical Rating Scale.
  
  
• Dyspnea with activities of daily living and exercise [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  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.
  
  

• Self-efficacy and mastery for managing breathlessness [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  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 [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  Measured by Symptom Representation Questionnaire.
  
  
• Adherence and Use of Self-Management Strategies [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  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 [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  Measured by 6-Minute Walk Test.
  
  
• Psychological distress [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  Measured by the Hospital Anxiety and Depression Scale.
  
  
• Quality of life [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  Measured by (a) Functional Assessment of Cancer Therapy - Lung (FACT-L); and, (b)Chronic Respiratory Questionnaire.
  
  
• Health care utilization [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
  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.
  
  

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.