The purpose of this study is to evaluate the effects of Progressive Muscle Relaxation (PMR) exercises and deep breathing exercises on dyspnea, fatigue, and self-care behaviors among cancer patients receiving palliative care. Advanced-stage cancer patients frequently experience debilitating symptoms such as shortness of breath (dyspnea) and severe fatigue, which significantly impair their functional capacity and daily self-care activities. Participants in this study will be assigned to either a progressive muscle relaxation intervention group or a structured deep breathing exercise group. The study aims to determine whether these non-pharmacological relaxation techniques can effectively reduce the severity of dyspnea and fatigue, thereby improving the patients' overall self-care behaviors and physical comfort in a palliative care setting.
Being 18 years of age or older
Currently practicing or having recently practiced Progressive Muscle Relaxation (PMR) or deep breathing exercises actively
Parallel
Progressive Muscle Relaxation
BehavioralA structured relaxation training based on tension and release of major muscle groups. In the initial session, patients will receive visual and practical education on how to perform PMR. They will be provided with an MP3 player containing guided audio instructions to facilitate independent practice. Patients will be instructed to perform the PMR program once daily for 6 weeks. For hospitalized patients, the sessions will be guided directly by the researcher; discharged patients will be followed up via phone.
Deep Breathing Exercises
BehavioralA structured respiratory intervention consisting of controlled breathing techniques, specifically diaphragmatic (abdominal) breathing and pursed-lip breathing, aimed at managing dyspnea. Detailed practical training on these techniques will be provided to the patients in the first interview. Patients will be requested to perform these breathing exercises twice daily for 6 weeks. Hospitalized patients will perform them under the researcher's supervision, and discharged patients will be monitored via weekly phone calls.
Cancer Dyspnea Scale (CDS)
The Cancer Dyspnea Scale (CDS) will be used to evaluate the multidimensional breathlessness/dyspnea experienced by cancer patients. It consists of 12 items across 3 subscales: sense of effort, sense of anxiety, and sense of discomfort. Each item is rated on a 5-point Likert scale (from 1 to 5). Total scores range from 12 to 60, with higher scores indicating a higher intensity and severity of cancer-related dyspnea.
Hirai Cancer Fatigue Scale
Used to assess the level of cancer-related fatigue in patients. Higher scores on this clinical scale reflect a higher severity and burden of fatigue, impacting the patient's daily functional capacity.
Katz Index of Independence in Activities of Daily Living (ADL)
Used to measure the patient's functional independence in performing basic daily activities (bathing, dressing, toileting, transferring, continence, and feeding). Total scores range from 0 to 6, where higher scores indicate a higher level of independence.
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