Breathlessness clinics within specialist palliative care settings can improve the quality of life and functional capacity of patients with lung cancer

Abstract

This paper is a development on recent research that proved the value of non-pharmacological techniques and strategies in the management of breathlessness in lung cancer. It evaluates the intervention in a specialist palliative care setting using an outpatient clinic at Lewis-Manning House. Referrals were made by the patients' physician or specialist nurse. Patients (n = 30) were assessed and treated by the senior physiotherapist in charge of the clinic over three sessions. A number of outcomes were measured at various stages of the patients' treatment. The results have confirmed and strengthened the previous published results. Highly significant improvements in patients' breathlessness, functional capacity, activity levels and distress levels have been shown. For example, the percentage of patients experiencing breathlessness several times or more per day was reduced from 73% to 27% four weeks later. In addition, this project has been able to demonstrate significant improvements in quality of life and high levels of satisfaction with the interventions. Qualitative data enhanced the findings of objective measurements.

Physical Function in Hospice Patients and Physiotherapy Interventions: A Profile of Hospice Physiotherapy

“…[14][15][16][17][18] Breathlessness programs for lung cancer patients improve breathlessness, quality of life (QOL), and functional capacity and enhance coping mechanisms. [19][20][21] They also benefit patients with advanced nonmalignant lung disease. 22 Decongestive treatments for lymphedema can be adapted for palliative care patients.…”

Validation of a Swedish Version of the Cancer Dyspnea Scale

“…Levels of breathlessness, functional capacity, activity levels and distress levels improved in patients with lung cancer after three sessions of non-pharmacological treatments including breathing retraining, relaxation techniques activity pacing and psychosocial support (Hately et al 2003).…”

“…The avoidance or pacing of straining activities has also been encouraged in nursing interventions (Hately et al 2003). In order to respect patients' autonomy, their apprehension of what precedes dyspnea should be highlighted and used in individual care plans to manage dyspnea.…”

“…Several non-pharmacologic interventions to manage dyspnea in patients with lung cancer have been introduced. Such interventions have included assessment of breathlessness, advice and training of management strategies, explorations of the meaning of breathlessness, as well as early recognition of problems amenable to pharmacological or medical intervention (Corner et al 1996;Bredin et al 1999), breathing retraining, relaxation techniques, activity pacing and psychosocial support (Hately et al 2003) and exercise training, (Spruit et al 2006). Although worthwhile, some of these interventions are similar to strategies the patients themselves used in Paper IV and represent efforts by the patients to take control over their dyspnea experience.…”

The Assessment of Quality of life at the End of Life (AQEL) questionnaire: a brief but comprehensive instrument for use in patients with cancer in palliative care

“…The AQEL has previously been tested in patients with incurable and symptomatic cancer [13] and was used in patients with lung cancer attending a breathlessness clinic [14].…”