Management of Dyspnea in a Patient With Lung Cancer

Self-management of oxygen and bronchodilators to relieve the dyspnoea of lung cancer with pneumoconiosis

OBJECTIVE

This study aimed to evaluate the level of dyspnoea and the self-management strategies used to alleviate dyspnoea in lung cancer patients with concurrent pneumoconiosis, particularly oxygen therapy and bronchodilator treatment. Furthermore, the authors aimed to determine the factors associated with such self-management and to provide a basis for developing an applicable and safe treatment plan for alleviating dyspnoea.

METHOD

This study involved a cross-sectional survey. Data were collected using self-report questionnaires from 79 participants between January and July 2016, and self-management strategies were analysed using analysis of variance and multiple logistic regression analysis.

RESULTS

In terms of the self-management practices employed to relieve dyspnoea, 53.2% of the patients adjusted their oxygen intake and 70.9% used bronchodilators over the prescribed dosage. Adjusting the oxygen intake was not significantly associated with any of the patient characteristics. The factors related to increased bronchodilator use were the presence of comorbidities, cardiopulmonary function, subjective respiratory distress, activities of daily living, and the number of prescribed bronchodilators.

CONCLUSION

Dyspnoea is a severe critical condition, and urgent management of its clinical symptoms is required. Healthcare professionals who care for patients with lung cancer with pneumoconiosis should pay attention to the dyspnoea and manage it based on clinical evidence. Development of customised, integrated nursing treatment plans is needed to alleviate dyspnoea in patients with complications and chronic dyspnoea who have low daily activity levels.

The Effects of the Respiratory Rehabilitation Program on Perceived Self-Efficacy and Dyspnea in Patients with Lung Cancer

PURPOSE

This study aims to examine the effects of the respiratory rehabilitation program on perceived self-efficacy and dyspnea in patients with lung cancer.

METHODS

This is a quasi-experimental research study with a two-group repeated measures design with the pretest and post-test at Week 4 and Week 8. The theory of self-efficacy by Bandura was used as the conceptual framework. The sample consisted of patients with non-small-cell lung cancer Stage 4 who visited the oncology clinic in a university hospital. Twenty-eight patients were enrolled and equally allocated to the control group and experimental group. The control group received routine nursing care only, whereas the experimental group received the respiratory rehabilitation program. The program comprised dyspnea educating, breathing exercise, using handheld fans, effective coughing, respiratory strengthening training, and follow-up by phone in the third and sixth week. Data for perceived self-efficacy and dyspnea were collected before the program start and reassessment in the fourth and eighth week. Instrumentation was composed of the respiratory rehabilitation program, demographic data, perceived self-efficacy assessment for respiratory rehabilitation, and the Cancer Dyspnea Scale. Data were analyzed using descriptive statistics and one-factor repeated measures analysis of variance and by comparing means between groups.

RESULTS

The result revealed that almost all of the patients in the sample were men, and the mean age of the experimental group and control group was 65.80 years (standard deviation = 8.80) and 73.00 years (standard deviation = 7.60), respectively. There was significant different in the mean score of perceived self-efficacy and dyspnea between the experimental group and the control group (p < .050).

CONCLUSION

Based on the findings of the study, the respiratory rehabilitation program should be used to promote self-efficacy and relieve dyspnea in patients with lung cancer.

Is dyspnea management evidence-based?

Reviewing the articles published in the past 40 years in the Oncology Nursing Forum (ONF) can assist in the identification of trends related to lung cancer treatment and management. Fifty-eight articles or studies published in ONF during that time were specific to lung cancer. The total number of published articles increased with each decade, but no articles were identified in the 1970s. The topics were quite varied, with each of the following represented by three or more articles: symptom clusters, radiation, smoking cessation, dyspnea, nutrition, and quality of life. To better focus this review on a specific aspect of lung cancer management, dyspnea was chosen.