Melody Mendenhall, DNP, RN, MSN, NP-C

Abstract:

Background: Lung cancer ranks as the second most prevalent form of cancer in the United States, excluding non-melanoma skin cancers. Despite a noticeable decline in the incidence of new lung cancer cases and associated mortality rates, lung cancer remains the leading cause of cancer-related deaths. Patients with metastatic (stage IV) lung cancer often experience severe psychological distress, with high rates of anxiety and depression. These mental health challenges can exacerbate physical symptoms, reduce treatment adherence, and negatively impact overall survival and quality of life. Objectives: This Doctor of Nursing Practice (DNP) project aims to investigate the effectiveness of an app-based mindfulness intervention designed to support patients with metastatic (stage IV) lung cancer who are struggling with anxiety or depression. The central question of this study is whether utilizing a mobile application can significantly reduce the levels of anxiety and depression in this patient population. Quality of life (QOL) and feasibility were listed as secondary outcomes. Methods: Patients from a single institution were screened for anxiety and depression and offered to participate in the project if they exhibited at least mild depression, anxiety, or both. Patients were invited to use the daily intervention, effectiveness and feasibility were evaluated through patient feedback and clinical outcomes, including measures of psychological well-being and overall health status. Results: The app-based intervention was implemented with a sample of 4 patients with metastatic lung cancer. Over an 8-week period, participants showed a decrease in anxiety (p=.374, d=1.06) and depression scores (p=.25, d= .93), as well as improvement in QOL (p=.125, d=1.06). Results were not statistically significant but did show a large effect size. Qualitative feedback highlighted the app's usability and the value of meditation. Conclusion: Lung cancer patients, particularly those with metastatic disease, experience significant psychological distress that impacts their overall health and treatment outcomes. This DNP project highlighted the importance of addressing the mental health needs of these patients. By improving the resources and support available, it is possible to enhance the overall well-being and clinical outcomes, including overall survival and cost of care, for patients with metastatic lung cancer. Further research is needed to refine these interventions and ensure their effectiveness across broader lung cancer populations.

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