The Effect of Mindfulness-Based Breathing Exercises on Dyspnea, Symptom Control, and Quality of Life in Lung Cancer Patients Undergoing Chemotherapy

Primary outcomes

1. Edmonton Symptom Assessment Scale:

   Time frame: 8 week

   The Edmonton Symptom Assessment Scale was developed by Bruera et al. to assess .nine common symptoms in cancer patients (Çalışkan, Gürhan, and Tekgündüz, 2017). The scale includes nine symptoms: pain, fatigue, nausea, sadness, anxiety, insomnia, loss of appetite, malaise, and shortness of breath. In the Turkish validity and reliability study conducted by Sadırlı (2008), skin and nail changes, mouth sores, and numbness in the hands were added to the original scale. Each symptom is evaluated on a numerical scale from 0 to 10. A score of 0 indicates that the symptom is not experienced at all; a score of 10 indicates that the symptom is experienced at its most severe level. The basic principle of the scale is that the patient makes their own assessment. Patients are asked to indicate the number that they think best reflects the severity of the symptom they are experiencing."Higher scores on the Edmonton Symptom Assessment Scale indicate greater symptom severity."

2. EORTC QLQ-C 30 Quality of Life Scale

   Time frame: 8 week

   The EORTC QLQ-C30 Quality of Life Scale was developed in 1987 by the European Organization for Cancer Treatment and Research (EORTC) to assess the quality of life of cancer patients and was later revised by Aaronson et al. (Jameson et al., 2018). The adaptation of the scale to the Turkish population and the validity-reliability study were carried out by Güzelant et al., and the Cronbach alpha coefficient was found to be 0.70.

3. DYSPNEA-12 TR SCALE

   Time frame: 8 week

   The Dyspnea-12 scale was developed by Yorke et al. to assess both the physical and emotional dimensions of dyspnea symptoms and was published in 2011 (Yorke et al., 2011). Consisting of 12 items, the scale has a four-point Likert-type response system, with each item scored from 0 to "none", 1 to "mild", 2 to "moderate", and 3 to "severe".

   The first seven items of the scale are aimed at evaluating the physical symptoms related to dyspnea. Through these items, physical symptoms such as difficulty breathing, insufficient air reaching the lungs, and increased effort required during breathing are investigated. The remaining five items of the scale evaluate the effects of shortness of breath on the individual's emotional state; focusing on emotional responses such as stress, irritability, depressive mood, general distress, and restlessness.Higher scores on the Dyspnea-12 indicate greater severity of breathlessness.