LiveWell: An Adapted Dialectical Behavioral Therapy Skills Training Protocol for Patients Living With Metastatic Lung Cancer

Intolerance of Uncertainty Scale - Short Form (IUS-12)

The 12-item Intolerance of Uncertainty Scale (IUS) Short Form will be used to measure emotional, cognitive, and behavioral reactions to uncertain situations. The IUS has a score range of 12-60, where a higher score indicates greater intolerance of uncertainty.

Time frame: Baseline (week 0), post-intervention (week 8), and 3 month follow-up (week 20)

Peace, Equanimity, and Acceptance in the Cancer (PEACE) - Peaceful Acceptance of Illness Subscale

The 5-item Peace, Equanimity, and Acceptance in the Cancer (PEACE) - Peaceful Acceptance of Illness Subscale will be used to assess patient-reported acceptance, inner peace, and tranquility in the context of cancer. The subscale has a score range of 5-20, where a higher score indicates greater peaceful acceptance of illness.

Time frame: Baseline (week 0), post-intervention (week 8), and 3 month follow-up (week 20)

PROMIS Positive Affect Short Form (15a)

The PROMIS Positive Affect Short Form 15a will be used to assess patient-reported positive emotions and well-being over the past 7 days. PROMIS scores are expressed as T-scores, with a mean of 50 and a standard deviation of 10. Higher scores indicate greater positive affect.

Time frame: Baseline (week 0), post-intervention (week 8), and 3 month follow-up (week 20)

Difficulty in Regulating Emotions Scale (DERS-18)

The DERS-18 will be used to assess emotion dysregulation. The DERS-18 has a score range of 18-80, where a higher score indicates greater difficulty with regulating emotions.

Time frame: Baseline (week 0), post-intervention (week 8), and 3 month follow-up (week 20)

Cognitive and Affective Mindfulness Scale-Revised (CAMS-R)

The 10-item Cognitive and Affective Mindfulness Scale-Revised will be used to assess patient-reported mindfulness qualities, including present-moment awareness, acceptance, and attention. The CAMS-R has a score range of 10-40, where a higher score indicates greater mindfulness.

Time frame: Baseline (week 0), post-intervention (week 8), and 3 month follow-up (week 20)

PROMIS Self-Efficacy for Managing Symptoms Short Form (8a)

The PROMIS Self-Efficacy for Managing Symptoms 8-item Short Form will be used to assess patient-reported confidence in managing symptoms and limiting their interference with daily life. PROMIS scores are expressed as T-scores, with a mean of 50 and a standard deviation of 10. Higher scores indicate greater self-efficacy for managing symptoms.

Time frame: Baseline (week 0), post-intervention (week 8), and 3 month follow-up (week 20)

PROMIS Self-Efficacy for Managing Emotions (8a) Short Form

PROMIS Self-Efficacy for Managing Emotions 8-item Short Form will be used to assess patient-reported confidence in managing negative emotions and emotional distress related to chronic illness. PROMIS scores are expressed as T-scores, with a mean of 50 and a standard deviation of 10. Higher scores indicate greater self-efficacy for managing emotions.

Time frame: Baseline (week 0), post-intervention (week 8), and 3 month follow-up (week 20)

NCI Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (NCI-PRO-CTCAE)

The NCI-PRO-CTCAE will be used to assess patient-reported symptom frequency, severity, and interference related to lung cancer and its treatment. Items are rated on a 5-point Likert scale, with higher scores indicating greater symptom burden.

Time frame: Baseline (week 0), post-intervention (week 8), and 3 month follow-up (week 20)

Functional Assessment of Cancer Therapy - Lung (FACT-L)

The FACT-L will be used to assess patient-reported quality of life across physical, social/family, emotional, and functional domains, as well as lung cancer-specific concerns. Items are rated on a 5-point Likert scale (0 = Not at all to 4 = Very much) and summed to form subscale and total scores. Higher subscale and total scores indicate better quality of life.

Time frame: Baseline (week 0), post-intervention (week 8), and 3 month follow-up (week 20)

DBT Ways of Coping Checklist (DBT-WCCL) - DBT Skills Subscale (DSS)

The DBT Ways of Coping Checklist (DBT-WCCL) -DBT Skills Subscale (DSS) will be used to assess patient-reported frequency of skill use to manage difficult situations. The DBT-WCCL has a score range of 0 to 4, where a higher score indicates greater DBT skill use.

Time frame: Baseline (week 0), post-intervention (week 8), and 3 month follow-up (week 20)