Experiences of breast cancer survivors with lymphedema self-management: a systematic review of qualitative studies

Fu, Xin; Lü, Qian; Pang, Dong; Shen, Aomei; Shih, Yi An; Wei, Xiaoxia

doi:10.1007/s11764-022-01225-9

Cited by 20 publications

(18 citation statements)

References 46 publications

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“…Is important to highlight that breast cancer-related lymphedema is a chronic complication that occurs in one of five patients who have undergone breast cancer treatment [2] . Lymphedema can cause physical, psychological and social harm [3 , 4] and negatively affects a patient's quality of life [5] . Therefore, a holistic assessment is essential for clinicians and researchers to understand, diagnose and prevent lymphedema.…”

Section: Experimental Design Materials and Methodsmentioning

confidence: 99%

Data for the Spanish adaptation of Breast Cancer and Lymphedema Symptom Experience Index (BCLE SEI Esp)

et al. 2022

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Section: Experimental Design Materials and Methodsmentioning

confidence: 99%

Data for the Spanish adaptation of Breast Cancer and Lymphedema Symptom Experience Index (BCLE SEI Esp)

et al. 2022

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“…A systematic review of research on lymphedema self‐management summarized ten categories of self‐management and found that whole‐body exercise, second‐stage CDT, including compression garments, exercise, careful skin care, and compression bandages, might be effective in preventing BCRL 11 . A summary of 24 studies by Fu et al found that breast cancer survivors faced challenges in lymphedema self‐management and needed to reestablish a new role balance as well as internal and external resources to regulate negative emotions 12 . Although most of the related studies have assessed the effectiveness of a single intervention, there is a lack of systematic lymphedema prevention programs for postoperative breast cancer patients.…”

Section: Introductionmentioning

confidence: 99%

“…11 A summary of 24 studies by Fu et al found that breast cancer survivors faced challenges in lymphedema selfmanagement and needed to reestablish a new role balance as well as internal and external resources to regulate negative emotions. 12 Although most of the related studies have assessed the effectiveness of a single intervention, there is a lack of systematic lymphedema prevention programs for postoperative breast cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of a lymphedema prevention program based on the theory of knowledge–attitude–practice on postoperative breast cancer patients: A randomized clinical trial

et al. 2023

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BackgroundBreast cancer‐related lymphedema (BCRL) is one of the common postoperative complications that severely affects the functions of the arm and quality of life. Since lymphedema is difficult to treat and prone to recurrence, early prevention of lymphedema is crucial.MethodsPatient diagnosed with breast cancer (N = 108) were randomized to the intervention (n = 52) or control group (n = 56). In the intervention group, patients were provided the lymphedema prevention program based on the theory of knowledge–attitude–practice during the perioperative period and the first three chemotherapy sessions (mainly includes health education, seminars, knowledge manuals, sports guidance, peer education, and WeChat group).The limb volume, handgrip strength, arm function, and quality of life were measured in all patients at the baseline, 9 weeks (T1), and 18 weeks (T2) after surgery.ResultsThe incidence of lymphedema in the Intervention group was numerically lower than in the control group after implementing the lymphedema prevention program, but the difference was not statistically significant (T1: 1.9% vs. 3.8%, p = 1.000; T2: 3.6% vs. 7.1%, p = 0.744). However, compared with the control group, the intervention group showed there was less deterioration in handgrip strength (T1 [t = −2.512, p < 0.05] and T2 [t = −2.538, p < 0.05]), improved postoperative upper limb dysfunction (T1 [t = 3.087, p < 0.05] and T2 [t = 5.399, p < 0.05]) and less deterioration in quality of life (T1 [p < 0.05] and T2 [p < 0.05]).ConclusionAlthough the investigated lymphedema prevention program improved arm function and quality of life, it did not reduce the incidence of lymphedema in postoperative breast cancer patients.

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“…For those diagnosed with BCRL, self‐management is necessary for maintenance and preventing progression and needs lifelong persistence. Daily lymphedema self‐management required to prevent occurrence, slow the progression and minimize complications is necessary, yet time‐consuming, burdensome and ongoing (Fu et al, 2022). Earlier studies have consistently revealed that the compliance level of lymphedema self‐management behaviours (LSMB) was low (Alcorso et al, 2016; Fu et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

“…Daily lymphedema self-management required to prevent occurrence, slow the progression and minimize complications is necessary, yet time-consuming, burdensome and ongoing (Fu et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Predicting lymphedema self‐management behaviours in breast cancer patients: A structural equation model with the Integrated Theory of Health Behaviour Change

Shen

Qiang

et al. 2023

Journal of Advanced Nursing

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AimsTo explore predictors of lymphedema self‐management behaviours among Chinese breast cancer survivors based on the Integrated Theory of Health Behaviour Change, and to clarify the interrelationship among these variables.DesignFurther analysis of a multicentre cross‐sectional and survey‐based study.MethodsA total of 586 participants with breast cancer were recruited from December 2021 to April 2022 in different cities in China. We used self‐reported questionnaires to collect data. Descriptive analysis, bivariate analysis and structural equation model were performed.ResultsThe Integrated Theory of Health Behaviour Change is suitable for predicting lymphedema self‐management behaviours. The final structural model showed good model fit. Social support, self‐efficacy and lymphedema knowledge positively affected lymphedema self‐management behaviours, directly and indirectly. Self‐regulation acted as a crucial mediator between these variables and self‐management. The direct path between social support and self‐regulation was not significant. Lymphedema knowledge and social support also influenced self‐management via illness perception, self‐efficacy and self‐regulation, sequentially. These variables explained 55.9% of the variance in lymphedema self‐management behaviours.ConclusionsThe modified model based on the Integrated Theory of Health Behaviour Change fitted well in predicting lymphedema self‐management behaviours among breast cancer patients. Lymphedema knowledge, illness perception, self‐efficacy, social support and self‐regulation directly and indirectly influenced lymphedema self‐management behaviours.ImpactThis study provides a theoretical basis for the assessment and interventions of lymphedema self‐management behaviours in breast cancer patients. Lymphedema self‐management behaviours should be assessed regularly and comprehensively, taking these predictors into consideration to identify potential barriers. Further research is needed to explore effective interventions integrating these significant predictors.Reporting MethodThis study was reported following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross‐sectional studies.Patient or Public ContributionNo patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript.What Does This Paper Contribute to the Wider Global Clinical Community?This study focused on identifying and predicting mechanism of self‐management based on a theory of behaviour change. The results can be applied among patients with other chronic diseases or high‐risk populations, and inspire the assessment and interventions facilitating self‐management behaviours.Study RegistrationThis study was registered as an observational study at Chinese Clinical Trial Registry: http://www.chictr.org.cn (ChiCTR2200057084).Implications for the Profession and/or Patient CareFor breast cancer patients with poor lymphedema self‐management behaviour, attention should be raised among nurses and involved healthcare staffs that lymphedema self‐management is multi‐faced. Strategies targeted at improving social support, self‐regulation, knowledge, self‐efficacy and illness perception should be also addressed in lymphedema self‐management programs, to facilitate more effective improvement of lymphedema self‐management behaviours.

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Experiences of breast cancer survivors with lymphedema self-management: a systematic review of qualitative studies

Cited by 20 publications

References 46 publications

Data for the Spanish adaptation of Breast Cancer and Lymphedema Symptom Experience Index (BCLE SEI Esp)

Data for the Spanish adaptation of Breast Cancer and Lymphedema Symptom Experience Index (BCLE SEI Esp)

Effects of a lymphedema prevention program based on the theory of knowledge–attitude–practice on postoperative breast cancer patients: A randomized clinical trial

Predicting lymphedema self‐management behaviours in breast cancer patients: A structural equation model with the Integrated Theory of Health Behaviour Change

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