Context. Breathlessness, fatigue, and anxiety are distressing symptoms for patients with advanced lung cancer. Usually managed as isolated symptoms, they<br/>often can occur simultaneously. Previous research often has addressed management of discrete symptoms rather than considering them as a cluster, which, in reality, is the situation faced by patients.<br/><br/>Objectives. This study aimed to examine the effectiveness of a psychoeducational intervention (PEI) on the symptom cluster of anxiety, breathlessness, and fatigue, compared with usual care.<br/><br/>Methods. A pretest/post-test, two-group, randomized, controlled trial was conducted. Education on symptom management and coaching in the use of progressive muscle relaxation were delivered to patients one week prior to<br/>commencing radiotherapy (RT), and repeated three weeks after beginning RT. Symptom data were collected at four time points: prior to the intervention, three<br/>weeks, six weeks, and 12 weeks postintervention.<br/>Results. One hundred forty lung cancer patients receiving palliative RT were recruited from a publicly funded hospital in Hong Kong. Doubly multivariate analysis of variance revealed a significant difference (time ? group interaction effect, P ¼ 0.003) over time between the PEI and usual care control group on the pattern of change of the symptom cluster. Significant effects on the patterns of<br/>changes in breathlessness (P ¼ 0.002), fatigue (P ¼ 0.011), anxiety (P ¼ 0.001), and functional ability (P ¼ 0.000) also were found.<br/><br/>Conclusion. PEI is a promising treatment for relieving the symptom cluster and each of the individually assessed symptoms. More effort needs to be directed a
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