Effect of lymphedema self-management group-based education compared with social network-based education on quality of life and fear of cancer recurrence in women with breast cancer: a randomized controlled clinical trial

Abstract

Background Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality of life (QoL) of cancer survivors and can stimulate fear of cancer recurrence (FCR). Self-management education for lymphedema has been introduced as an effective method in controlling FCR. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients. Methods This three-arm clinical trial studied 105 patients with breast cancer-related lymphedema referred to Seyed_Khandan rehabilitation center. Sampling was done by random allocation method in blocks of 3 with 35 subjects in each group. All subjects received routine lymphedema treatments. The group-based education (GE) and social network-based education (SNE) groups received self-management education in the clinic and Telegram™ messenger channel, respectively. Impairment in QoL and mean score of FCR were assessed before, immediately after, and three months after the intervention by using the Persian version of Lymphedema Life Impact Scale (LLIS) and Fear of Progression Questionnaire-Short Form (FoPQ-SF), respectively. Mixed-model ANOVA was applied for statistical analysis. Results There was a significant time effect on total LLIS (P = 0.007), psychosocial (P = 0.038) and functional (P = 0.024) subscale changes in three groups of study. Interaction between the main effect of group and time on psychosocial subscale changes was statistically significant (P = 0.017). The multicomparison results illustrated that the main effect of time, the main effect of group, and interaction of them on the mean score of FCR were P = 0.084, P = 0.380, and P = 0.568, respectively. Conclusion Despite no significant reduction in the FCR score, results showed the improvement of most QoL aspects after three months of intervention. Although the social network-based education method was effective, the group-based education method was more beneficial. Applying these educational methods in lymphedema treatment protocols needs cost-effectiveness studies. Trial registration This study was registered at the Iranian Registry of Clinical Trials (IRCT2017052834176N1). KeywordsSelf-management · Lymphedema · Quality of life · Fear of cancer recurrence · Breast cancer Abbreviations BCRL Breast cancer-related lymphedema QoL Quality of life FCR Fear of cancer recurrence GE Group-based education SNE Social network-based education CO Control group CDT

The Quality of Life and Psychosocial Implications of Cancer-Related Lower-Extremity Lymphedema: A Systematic Review of the Literature

“…The literature has demonstrated that heightened psychological distress, depression, and anxiety are associated with the development of lymphedema after cancer [ 3 , 4 ]. These psychological sequelae are often linked to feelings of hopelessness, fear of the future and isolation due to immobility, social avoidance, and/or sexual dysfunction [ 4 , 5 , 6 ]. As a result of the skin changes and swelling associated with lymphedema, cancer survivors have also reported the negative impact of this condition on their appearance [ 3 ].…”

Educational Processes for Health and Disease Self-Management in Public Health: A Systematic Review

“…This review showed that 29% of the texts studied [ 20 , 22 , 28 , 29 , 34 , 37 , 40 , 47 , 54 , 55 , 57 ] reported technological tools as a digital literacy alternative for people with health conditions, as well as for professionals, family members, and caregivers. Technological tools accessible to the community were identified using free applications, such as WhatsApp and WeChat, accessible via smartphone, and disseminating content through websites and social networks, defined as Digital Health Interventions (DHI).…”

Recommendations for Physiotherapy in Breast and Gynecological Cancer during COVID-19 Pandemic: Literature Review

“…Physiotherapy in Breast and Gynecological Cancer self-dressing for cases of absence of cutaneous lesion on the limb or when the patient or caregiver is insecure or unable to perform bandaging. The prescription of compression garments should be done with strict control of limb measurements [23][24][25] . d. Provide guidance regarding signs of worsening of lymphedema (pain, increased limb volume, altered sensitivity and changes in the skin) and the presence of inflammatory signs.…”

“…All the articles used the Disability Arm, Shoulder and Hand (DASH) Questionnaire to evaluate functionality. a. Assess the presence of postural changes, such as asymmetry of shoulders (elevation, depression and protrusion) and hip (inclination, rotation, ante or retroversion); and the range of motion of the upper or lower limbs 24 . b.…”