Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chairperson; Ann M. Mayo, RN, DNSC, FAAN, Committee Member; Cynthia D. Connelly, PhD, RN, FAAN, Committee Member


advanced Lung Cancer, Dyspnea Perception, nursing, quality of life


Background: Dyspnea perception can be defined as a multidimensional experience of breathing discomfort, influenced by physiological, psychological, social, and environmental factors, that includes secondary psychological and behavioral responses and cannot be defined only by physical objective abnormalities (Mularski et al., 2010). Dyspnea is the most common and distressing symptom in patients with advanced lung cancer and decreases one's quality of life (QOL) (Smith et al., 2001). Furthermore, dyspnea has been found to interfere with physical activities such as walking, work, and psychological activities such as disposition, taking pleasure in life, relationship with others, and sleep (Tanaka, Akechi, Okuyama, Nishiwaki, & Uchitomi, 2002). Thus, it can be hypothesized that quality of life is related to perception of dyspnea in advanced lung cancer patients; although no published reports have examined this relationship in this population. Objective: The purpose of this study was to examine the relationship between quality of life and perception of dyspnea in a group of advanced lung cancer patients. Method: This was a descriptive correlational, cross-sectional study. Quality of life was measured using The Assessment of Quality of life at the End of Life (AQEL). Perception of dyspnea was measured using the Cancer Dyspnea Scale (CDS). The participants were 22 patients in a hospice care setting diagnosed with advanced lung cancer that reported dyspnea. Results: The findings supported the literature review suggestions that there was indeed relationship between the subscales, AQEL, and CDS measurement total scores. In the sample of advanced lung cancer patients in the hospice care setting, results revealed AQEL subscales (basic function, activity, cognitive function an perception of care) had a significant correlation to the AQEL total score. In addition, the physical symptoms (pain and bowel movement) indicated a strong inverse relationship to the AQEL total score. As indicated by prior research, analysis revealed the CDS subscales (discomfort, anxiety, and sense of effort) had a strong significant relationship to the CDS total score. Furthermore, it is important to note that the result geared toward the second aim of this research study, indicated no significant relationships between the participants demographics, AQEL total score, and CDS total score. Implications: Increased knowledge of the relationship between quality of life and perception of dyspnea in advanced lung cancer patients can provide a basis for the development of more refined assessment tools, enhanced symptom management, and overall improvement of the care of advanced stage lung cancer patients. Conclusions: Precipitants of dyspnea included both physical and emotional sensations triggered by immediate reactions connected to participants' experience of dyspnea perception amongst advanced lung cancer patients in the hospice setting.

Document Type

Dissertation: Open Access



Included in

Nursing Commons