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乳腺癌相关淋巴水肿女性的淋巴水肿自我护理依从性与淋巴水肿结局之间的关联。

Association between lymphedema self-care adherence and lymphedema outcomes among women with breast cancer-related lymphedema.

作者信息

Brown Justin C, Kumar Anagha, Cheville Andrea L, Tchou Julia C, Troxel Andrea B, Harris Susan R, Schmitz Kathryn H

机构信息

From the University of Pennsylvania, Philadelphia, Pennsylvania (JCB, AK, JCT, ABT, KHS); Mayo Clinic, Rochester, Minnesota (ALC); and University of British Columbia, Vancouver, British Columbia, Canada (SRH).

出版信息

Am J Phys Med Rehabil. 2015 Apr;94(4):288-96. doi: 10.1097/PHM.0000000000000178.

Abstract

OBJECTIVE

The aim of this study was to determine whether adherence to self-care modalities for breast cancer-related lymphedema (BCRL) predicts BCRL outcomes among 128 breast cancer survivors who participated in the 12-mo physical activity and lymphedema trial.

DESIGN

This was a prospective cohort study. Adherence to ten BCRL self-care modalities, as recommended in the clinical practice guidelines for the management of BCRL, was assessed by a questionnaire at baseline. BCRL outcomes assessed at baseline and 12 mos included volumetry, circumferences, bioimpedence spectroscopy, the Norman lymphedema survey, and therapist-defined lymphedema exacerbations requiring treatment. Generalized linear models were used to estimate the relationship between adherence to BCRL self-care modalities and the likelihood of experiencing a BCRL outcome.

RESULTS

Adherence to BCRL self-care activities did not predict experiencing any BCRL outcomes at 12 mos. Levels of adherence to BCRL self-care modalities did not predict a 5% or greater decrease in interlimb volume (Ptrend = 0.79), 5% or greater decrease in the sum of interlimb arm circumferences (Ptrend = 0.47), 10% or greater decrease in bioimpedence spectroscopy (Ptrend = 0.83), 1 or greater decrease in self-reported lymphedema symptoms (Ptrend = 0.91), or therapist-defined lymphedema exacerbation requiring treatment (Ptrend = 0.84).

CONCLUSIONS

Our findings suggest that levels of BCRL self-care adherence do not predict BCRL outcomes among breast cancer survivors with stable lymphedema who were followed for 12 mos.

摘要

目的

本研究旨在确定128名参与为期12个月的体力活动与淋巴水肿试验的乳腺癌幸存者中,坚持乳腺癌相关淋巴水肿(BCRL)自我护理方式是否能预测BCRL的结局。

设计

这是一项前瞻性队列研究。在基线时通过问卷调查评估了对BCRL管理临床实践指南中推荐的十种BCRL自我护理方式的依从性。在基线和12个月时评估的BCRL结局包括容量测定、周长、生物电阻抗光谱、诺曼淋巴水肿调查以及治疗师定义的需要治疗的淋巴水肿加重情况。使用广义线性模型来估计坚持BCRL自我护理方式与发生BCRL结局可能性之间的关系。

结果

坚持BCRL自我护理活动并不能预测12个月时出现任何BCRL结局。对BCRL自我护理方式的依从水平不能预测肢体间体积减少5%或更多(P趋势=0.79)、肢体间手臂周长总和减少5%或更多(P趋势=0.47)、生物电阻抗光谱减少10%或更多(P趋势=0.83)、自我报告的淋巴水肿症状减少1或更多(P趋势=0.91),或治疗师定义的需要治疗的淋巴水肿加重情况(P趋势=0.84)。

结论

我们的研究结果表明,在随访12个月的稳定淋巴水肿乳腺癌幸存者中,BCRL自我护理的依从水平不能预测BCRL结局。

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