Corner J, Plant H, A'Hern R, Bailey C
Centre for Cancer and Palliative Care Studies, Institute of Cancer Research, London, UK.
Palliat Med. 1996 Oct;10(4):299-305. doi: 10.1177/026921639601000405.
To evaluate the effect of non-pharmacological intervention for breathlessness in lung cancer on breathlessness ratings and patient functioning.
Randomised controlled pilot study.
A nurse led clinic in a specialist cancer centre.
20 patients with advanced small cell and non-small cell lung cancer.
Weekly sessions with a nurse research practitioner over 3-6 weeks using counselling, breathing re-training, relaxation and teaching coping and adaptation strategies.
Visual analogue scale ratings of breathlessness, distress caused by breathlessness, functional capacity, ability to perform activities of daily living and the Hospital Anxiety and Depression Scale.
Improvements in median scores on all measures were observed in the intervention group with the exception of depression, compared with the control group where median scores were static or worsened. Distress from breathlessness was improved by a median of 53%, breathlessness at worst by 35% and functional capacity by 21%. In contrast, distress in the control group worsened by a median of 10%. Significant improvements compared with the control group were observed in breathlessness at best (p < 0.02), breathlessness at worst (p < 0.05), distress caused by breathlessness (p < 0.01), functional capacity (p < 0.02) and ability to perform activities of daily living (p < 0.03) but were not observed for anxiety or depression.
Lung cancer patients suffering from breathlessness benefited from this rehabilitative approach to breathlessness management and strategies employed in this pilot study warrant further multicentre research. Macmillan nurses and palliative care teams are recommended to explore the potential of adopting similar approaches.
评估肺癌患者呼吸急促的非药物干预对呼吸急促评分及患者功能的影响。
随机对照试验性研究。
某专科癌症中心由护士主导的门诊。
20例晚期小细胞肺癌和非小细胞肺癌患者。
在3 - 6周内，每周与护士研究从业者进行一次会面，采用咨询、呼吸再训练、放松以及教授应对和适应策略。
呼吸急促的视觉模拟量表评分、呼吸急促引起的痛苦、功能能力、日常生活活动能力以及医院焦虑抑郁量表。
与中位数评分保持不变或恶化的对照组相比，干预组除抑郁外，所有指标的中位数评分均有改善。呼吸急促引起的痛苦中位数改善了53%，最严重时的呼吸急促改善了35%，功能能力改善了21%。相比之下，对照组的痛苦中位数恶化了10%。与对照组相比，干预组在最佳呼吸状态（p < 0.02）、最严重呼吸状态（p < 0.05）、呼吸急促引起的痛苦（p < 0.01）、功能能力（p < 0.02）和日常生活活动能力（p < 0.03）方面有显著改善，但焦虑或抑郁方面未观察到显著改善。
患有呼吸急促的肺癌患者从这种呼吸急促管理的康复方法中受益，本试验性研究中采用的策略值得进一步开展多中心研究。建议麦克米伦护士和姑息治疗团队探索采用类似方法的可能性。
