title: Pilot Study of a Brief Behavioral Intervention for Dyspnea in Patients With Advanced Lung Cancer.
abstract: BACKGROUND
  Dyspnea is a common symptom in patients with advanced cancer that interferes with functional ability and quality of life (QOL). Although few evidence-based treatments for dyspnea exist, prior studies show support for nonpharmacological interventions that include elements of cognitive-behavioral therapy.
  
  
  OBJECTIVE
  To examine the feasibility and utility of delivering a brief behavioral intervention for dyspnea in patients with lung cancer.
  
  
  METHODS
  For this single-group pilot study, eligible patients included those with advanced lung cancer (Stage III or IV non-small cell or extensive-stage small cell lung cancer) receiving outpatient cancer treatment who reported at least moderate breathlessness. The manualized intervention consisted of two sessions in which nurse practitioners taught participants breathing and relaxation techniques within the infusion clinic and encouraged home practice. Participants completed measures of breathlessness (Modified Medical Research Council Dyspnea Scale), QOL (Functional Assessment of Cancer Therapy-Lung Trial Outcome Index), and anxiety and depression symptoms (Hospital Anxiety and Depression Scale) at baseline and within six weeks after enrollment.
  
  
  RESULTS
  Of the 32 patients enrolled in the study (56.3% females; mean age 63.34 [SD] = 7.96 years), 84.4% (N = 27) completed all study procedures. Comparing the baseline to postassessments, we found significant improvements in Modified Medical Research Council Dyspnea Scale (P < 0.001), Functional Assessment of Cancer Therapy-Lung Trial Outcome Index (P = 0.01), and Hospital Anxiety and Depression Scale-depression subscale (P < 0.001) scores.
  
  
  CONCLUSIONS
  In this sample of patients with advanced lung cancer and dyspnea, we observed a high completion rate for the two-session behavioral intervention. Patients also reported improvements in dyspnea, QOL, and mood. Follow-up randomized controlled trials are needed to examine the efficacy of brief behavioral interventions for cancer-related dyspnea.
authors.affiliation: Massachusetts General Hospital Cancer Center & Harvard Medical School, Boston, Massachusetts, USA. Electronic address: jgreer2@mgh.harvard.edu.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Greer
authors.affiliation: Massachusetts General Hospital Cancer Center & Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: MacDonald
authors.affiliation: Massachusetts General Hospital Cancer Center & Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Vaughn
authors.affiliation: Massachusetts General Hospital Cancer Center & Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Elene
authors.initials: E
authors.lastname: Viscosi
authors.affiliation: Massachusetts General Hospital Cancer Center & Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Traeger
authors.affiliation: Massachusetts General Hospital Cancer Center & Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: McDonnell
authors.affiliation: Massachusetts General Hospital Cancer Center & Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: William F
authors.initials: WF
authors.lastname: Pirl
authors.affiliation: Massachusetts General Hospital Cancer Center & Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Temel
mesh_terms: D001007:Anxiety / Q000503:physiopathology / Q000628:therapy; D001521:Behavior Therapy / Q000379:methods*; D003863:Depression / Q000503:physiopathology / Q000628:therapy; D004417:Dyspnea / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome
keywords: Non-small cell; dyspnea; lung cancer; small cell