Characterization of multidimensional dyspnea in advanced lung cancer with moderate to severe dyspnea-related...

Dyspnea impacts most patients with advanced lung cancer. However, research on dyspnea has been limited by using unidimensional self-report measures despite its multidimensional nature (sensory-perceptual experience, affective distress, and functional impact), which requires a comprehensive evaluation. To identify distinct patient profiles of dyspnea presentation and evaluate differences in demographic, clinical characteristics, and patient-reported outcomes (i.e., functional impairment, quality of life, co-occurring symptoms, and self-efficacy).

A cross-sectional, secondary analysis of 247 patients with advanced lung cancer reporting moderate-to-severe dyspnea was conducted using baseline data from a randomized controlled trial testing a behavioral intervention for dyspnea. The patient profiles of dyspnea were identified using latent profile analysis of the Cancer Dyspnea Scale. Differences among the profiles were assessed through parametric and non-parametric methods.

Four-class solutions were identified: All Mild (A-Mild: 53%), Moderate Effort and Discomfort & Mild Anxiety (Moderate ED & Mild A: 25.9%), All Moderate (A-Moderate: 16.6%), and All Severe (A-Severe: 4.5%) dyspnea profiles. No significant differences were found among demographic and clinical variables across the profiles. Compared to the A-Mild profile, the other three profiles reported more significant functional impairment due to dyspnea, increased levels of depression, anxiety, and fatigue, and reduced quality of life. The A-Severe profile exhibited lower self-efficacy than the Moderate ED & Mild A and the A-Moderate profiles.

Our findings highlight the multidimensional nature of dyspnea, which results in distinct patient presentations. Clinicians can create targeted interventions tailored to individual needs by classifying dyspnea symptom profiles.