Healthcare Practitioners’ Knowledge of Lymphedema

Abstract

Objectives. Lymphedema is neglected in medical education, and a review on healthcare practitioners’ (HCPs) knowledge is necessary to shed light on gaps and to provide evidence for establishing educational programs on lymphedema. Methods. This systematic review was performed based on the PRISMA guideline in PubMed, Scopus, Web of Science, and Google Scholar databases. There was no limitation on the type of lymphedema or HCPs. The quality assessment was performed based on QATSDD. Data regarding study characteristics, questionnaire context, and findings of the study were summarized from each article. Results. After the screening, 16 articles were included that 12 were cross-sectional, two were qualitative, and two were interventional pilot studies. Breast cancer and other cancer-related lymphedema, lymphatic filariasis, and podoconiosis were included, and the majority of articles were focused on primary HCPs. The overall knowledge was low and average in five and 11 articles, respectively, and prior education was a significant factor related to higher knowledge of lymphedema in two studies. Conclusion. Structured education of lymphedema is needed to increase the knowledge of HCPs and to enhance their collaboration in multidisciplinary care teams. Improvement of HCPs’ knowledge may lead to better outcomes of lymphedema patients’ management which are neglected.

Competence of Healthcare Providers in Managing Lymphedema Post Breast Cancer Treatment: A study in western Kenya hospitals

“…These tallies to a study by Bayisenge et al (15) that reported a lack of knowledge regarding assessment, examination, patient education and follow-up appointments. This was consistent with a study by Hossein et al (20) in Iran that showed the educational needs of healthcare providers regarding the care of patients were reported either as adequate or poor. These may be due to lack of commitment, shortage of staff and time allocated for each patient.…”

Cancer-Related Lymphedema: Clinical and Epidemiological Features in Mexico

“…It was not surprising to identify as one of the principal causes of disability and limited physical activity for all patients with CRL, in all clinical stages, the fear-avoidance behaviors related to health care practitioners and patients' support groups explicitly indicating and recommending avoiding every physical effort, activity, exercise, and daily chores that involve the use of the affected limb to either prevent lymphedema development or to avoid its worsening once onset. These are not evidence-based recommendations, and in fact, there is strong evidence contradicting them; also exists worldwide evidence that shows there is a general lack of information of lymphedema prevention and management, and of appropriate clinical practice standards in the healthcare professionals [22][23][24]. The health care providers and support groups spreading these recommendations may be representing a factor that complicates this scenario, this favors lymphedema progression, disability, and a barrier to the rehabilitation of these patients.…”

The Lymphatic System, Lymphoedema, and Medical Curricula–Survey of Australian Medical Graduates

“…While previous studies have suggested that knowledge of the lymphatic system and lymphoedema among healthcare professionals is not favorable [ 20 ], and curricula frameworks within medical degrees are deficient in these areas [ 22 , 24 ], this is the first study to specifically survey medical graduates about their understanding of the lymphatic system and lymphoedema, and the comprehensiveness of curricula specific to the lymphatic system and lymphoedema within their Australian medical degree. For this study, we merged survey items under subscales of (i) understanding, (ii) medical curricula, and (iii) appropriateness for clinical practice, with each demonstrating acceptable to good internal consistency [ 29 ].…”

“…Knowledge of lymphoedema among healthcare professionals, including doctors, is generally considered to be low [ 20 ], and access to doctors with the knowledge and expertise to diagnose and manage (or refer for management) lymphoedema is an established problem [ 21 , 22 , 23 ]. While the cause of this knowledge gap is unknown, some studies have suggested that it may be due to insufficient time within medical curricula allocated to the lymphatic system and lymphoedema, and failure to update curriculum frameworks in line with advancements in medical research [ 22 , 24 ].…”