Ostby Pamela L, Armer Jane M, Smith Kandis, Stewart Bob R
1 University of Missouri, Columbia, MO, USA.
West J Nurs Res. 2018 Dec;40(12):1800-1817. doi: 10.1177/0193945917744351. Epub 2017 Nov 30.
Breast cancer survivors are at lifetime risk for the development of breast cancer-related lymphedema, a chronic, potentially debilitating condition that requires life-long symptom management. Suboptimal self-management rates suggest that health care providers may not be offering educative-support options that are customized to patient-perceived needs. An Institutional Review Board-approved focus group ( N = 9) and mailed surveys ( N = 15) were used to identify (a) barriers to lymphedema self-management, (b) how breast cancer survivors with lymphedema defined education and support, (c) what type of education and support they had received, and (d) what kind of education and support they wanted. Physiological, psychological, and psychosocial factors were identified as barriers to successful lymphedema self-management. One of the main barriers identified was lack of education about lymphedema treatment and risk reduction. In addition, more than half defined support as "prescriptions" and "referrals"; therefore, it is unclear whether patients were exposed to support other than medical treatment.
乳腺癌幸存者终生都有患与乳腺癌相关的淋巴水肿的风险，这是一种慢性疾病，可能使人衰弱，需要终生进行症状管理。自我管理率不理想表明，医疗保健提供者可能没有提供根据患者感知需求定制的教育支持选项。通过机构审查委员会批准的焦点小组（N = 9）和邮寄调查（N = 15）来确定：（a）淋巴水肿自我管理的障碍；（b）患有淋巴水肿的乳腺癌幸存者如何定义教育和支持；（c）他们接受过何种类型的教育和支持；（d）他们想要何种类型的教育和支持。生理、心理和社会心理因素被确定为淋巴水肿自我管理成功的障碍。所确定的主要障碍之一是缺乏关于淋巴水肿治疗和风险降低的教育。此外，超过一半的人将支持定义为“处方”和“转诊”；因此，尚不清楚患者是否接受了除医疗治疗之外的支持。
