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淋巴水肿自我管理在预防乳腺癌相关淋巴水肿和生活质量方面的有效性:一项随机对照试验。

The effectiveness of lymphedema self-management in the prevention of breast cancer-related lymphedema and quality of life: A randomized controlled trial.

机构信息

Hacettepe University Adult Hospital, Department of General Surgery Wards, Ankara, Turkey.

Hacettepe University Nursing Faculty, Department of Medical Nursing, Ankara, Turkey.

出版信息

Eur J Oncol Nurs. 2019 Jun;40:22-35. doi: 10.1016/j.ejon.2019.02.006. Epub 2019 Feb 25.

Abstract

PURPOSE

The aim of our randomized controlled study is to determine the effect of lymphedema self-management in the prevention of breast cancer-related lymphedema and quality of life.

METHOD

Sixty-one breast cancer patients were included in the study. In the intervention group, patients were provided training and given a training booklet describing "exercise, massage and prevention methods" by the researchers, as part of the Self-Management of Lymphedema Program. Patients were followed by telephone for 6 months and through monthly clinical check-ups. Patients in the intervention and control groups were evaluated in both the pre-operative and post-operative periods (at one, three and six months) using the "DASH", "Measurement of Upper Extremity", " EORTC QLQ-30 and BR-23 questionnaire". The Mann Whitney U test, the Kruskal-Wallis H test, the Wilcoxon test, and the Friedman test were used for the statistical analysis of the data.

RESULTS

At the end of the study, while lymphedema development was not observed in the intervention group, 61.2% of the control patients developed lymphedema. The difference between the intervention and control groups for the development of lymphedema was found to be statistically significant (χ2 = 25,943; p = 0,000). The quality of life of the intervention group was higher than that of the control group. Moreover, the symptom scores of the intervention group were found to be significantly lower than those of the control group.

CONCLUSIONS

As a result of our research, it can be concluded that the Self-Management of Lymphedema Program is effective at preventing lymphedema development following breast cancer treatment.

摘要

目的

我们的随机对照研究旨在确定淋巴水肿自我管理对预防乳腺癌相关淋巴水肿和生活质量的影响。

方法

本研究纳入了 61 例乳腺癌患者。在干预组中,研究者为患者提供培训并发放培训手册,介绍“运动、按摩和预防方法”,作为淋巴水肿自我管理计划的一部分。通过电话对患者进行 6 个月的随访,并进行每月的临床检查。干预组和对照组患者分别在术前和术后(术后 1、3 和 6 个月)进行“DASH”、“上肢测量”、“EORTC QLQ-30 和 BR-23 问卷”评估。采用 Mann Whitney U 检验、Kruskal-Wallis H 检验、Wilcoxon 检验和 Friedman 检验对数据进行统计学分析。

结果

研究结束时,干预组未观察到淋巴水肿发展,而对照组有 61.2%的患者发生了淋巴水肿。干预组和对照组之间发生淋巴水肿的差异具有统计学意义(χ2=25.943,p=0.000)。干预组的生活质量高于对照组。此外,干预组的症状评分明显低于对照组。

结论

我们的研究结果表明,淋巴水肿自我管理计划可有效预防乳腺癌治疗后淋巴水肿的发生。

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