Resilience Measurement in Older Adults With Late-Stage Lung Cancer (SST Resilience)

The purpose of this study to test measures of physical and psychological resilience while using Self-System therapy (SST), to treat depression and lung-cancer-related distress in older adults (65 years and older).

The investigator will examine the feasibility of delivering measures of psychological and physical resilience while delivering the SST intervention. The investigator will also examine whether participation in SST can help alleviate symptoms of depression and distress while helping improve overall physical functioning in older adults with advanced lung cancer.

Older adults with stage III or stage IV lung cancer will be enrolled in the Self-System Therapy intervention to treat illness-related distress, depression, and to enhance self-efficacy via delivery of behavioral coping skills across a period of 10 weeks.

The SST-LC is a brief structured intervention deliverable by video conference. The SST-LC Resilience protocol will incorporate behavioral strategies designed to meet the needs of older adults with lung cancer, including examining individual and shared expectations for lung cancer care, identifying discrepancies between expectations and realistic possibilities, and modifying stress-exacerbating behaviors. The focus will be to test measures of resilience during the intervention period.

The Cancer Behavior Inventory measure will be used for rating confidence in behavior. The measure consist of 12 items. Scores range from 12-108 with higher scores indicating greater confidence.

The Brief COPE measure will be used for rating coping skills related to stress. The measure consists of 28 items. Scores range from 28-112 with higher scores indicating lower stress.

The Connor-Davidson Resilience Scale (CD-RISC-10) will be used for measuring resilience. The measure consists of 25 items. Scores range from 0-40, with higher scores being an indicator of high resilience.

Depression will be measured using the Beck Depression Inventory (BDI-II). The measure consists of 21 items. The BDIII is scored by summing the ratings for the 21 items. Each item is rated on a 4-point scale ranging from 0 to 3. The maximum total score is 63. Higher scores indicate greater depression.

The Positive and Negative Scale (PANAS) measure will be used for rating to measure both positive and negative affect. The measure consists of two 10-item scales. Scores range from 10-50, with higher scores indicating higher positive and negative affect.

Physical Activity will be measured using the Physical Activity Scale for the Elderly (PASE)The instrument is comprised of self-reported occupational, household and leisure activities items over a one-week period. PASE scores are calculated from weights and frequency values for each of 12 types of activity.

The Pain Interference PROMIS Scale measure will be used for rating pain interference in daily living. The measure consists of 6 items. Scores range from 6-30, with higher scores indicating higher pain interference.

The Quality-of-Life measure will be used for rating quality of life. The measure consists of 26 items. Scores range from 26-130, with higher scores indicating higher quality of life.

Inclusion Criteria: Age 65 or older English-speaking The patient has a diagnosis of late-stage (III-IV) lung cancer and is living at his/her home. Exclusion Criteria: Unable to provide informed consent Visual or hearing impairments that preclude participation Serious mental illness