Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer
M Bredin, J Corner, M Krishnasamy, H Plant, C Bailey, R A'Hern, M Bredin, J Corner, M Krishnasamy, H Plant, C Bailey, R A'Hern
Abstract
Objective: To evaluate the effectiveness of nursing intervention for breathlessness in patients with lung cancer.
Design: Patients diagnosed with lung cancer participated in a multicentre randomised controlled trial where they either attended a nursing clinic offering intervention for their breathlessness or received best supportive care. The intervention consisted of a range of strategies combining breathing control, activity pacing, relaxation techniques, and psychosocial support. Best supportive care involved receiving standard management and treatment available for breathlessness, and breathing assessments. Participants completed a range of self assessment questionnaires at baseline, 4 weeks, and 8 weeks.
Setting: Nursing clinics within 6 hospital settings in the United Kingdom.
Participants: 119 patients diagnosed with small cell or non-small cell lung cancer or with mesothelioma who had completed first line treatment for their disease and reported breathlessness.
Outcome measures: Visual analogue scales measuring distress due to breathlessness, breathlessness at best and worst, WHO performance status scale, hospital anxiety and depression scale, and Rotterdam symptom checklist.
Results: The intervention group improved significantly at 8 weeks in 5 of the 11 items assessed: breathlessness at best, WHO performance status, levels of depression, and two Rotterdam symptom checklist measures (physical symptom distress and breathlessness) and showed slight improvement in 3 of the remaining 6 items.
Conclusion: Most patients who completed the study had a poor prognosis, and breathlessness was typically a symptom of their deteriorating condition. Patients who attended nursing clinics and received the breathlessness intervention experienced improvements in breathlessness, performance status, and physical and emotional states relative to control patients.
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Source: PubMed