Ridner Sheila H, Sinclair Vaughn, Deng Jie, Bonner Candace M, Kidd Nancy, Dietrich Mary S
School of Nursing, Vanderbilt University, Nashville, TN, USA.
Clin J Oncol Nurs. 2012 Dec;16(6):609-14. doi: 10.1188/12.CJON.609-614.
Breast cancer survivors with lymphedema experience physical, psychosocial, and quality-of-life difficulties. Cancer treatment-related lymphedema often is viewed as a disabling condition, and that assumption has fostered an environment in which oncology nurses are not actively involved in the care of patients with lymphedema. Little is known about how breast cancer survivors with lymphedema structure their daily lives. This article describes an effort to determine whether lymphedema truly is a disabling condition by collecting symptom data and self-generated narratives from breast cancer survivors with lymphedema regarding their eating habits, daily activities, substance use, and future plans. Although the sample experienced multiple symptoms, lymphedema duration and degree of extracellular arm fluid did not appear to influence those symptoms. In addition, participants led full, rich, busy lives. The findings do not support the notion that patients with lymphedema live as disabled people. A disability model may not be optimal to guide research design or patient care; rather, a symptom management model better explains the findings and implies that active involvement by nurses in lymphedema patient care and education is indicated.
患有淋巴水肿的乳腺癌幸存者在身体、心理社会和生活质量方面都面临困难。与癌症治疗相关的淋巴水肿通常被视为一种致残性疾病,这种假设营造了一种肿瘤护士不积极参与淋巴水肿患者护理的环境。对于患有淋巴水肿的乳腺癌幸存者如何安排他们的日常生活,人们知之甚少。本文描述了一项通过收集患有淋巴水肿的乳腺癌幸存者关于其饮食习惯、日常活动、物质使用和未来计划的症状数据和自我叙述,来确定淋巴水肿是否真的是一种致残性疾病的努力。尽管样本经历了多种症状,但淋巴水肿的持续时间和手臂细胞外液的程度似乎并未影响这些症状。此外,参与者过着充实、丰富且忙碌的生活。研究结果不支持淋巴水肿患者像残疾人一样生活的观点。残疾模型可能并非指导研究设计或患者护理的最佳选择;相反,症状管理模型能更好地解释研究结果,并意味着护士应积极参与淋巴水肿患者的护理和教育。