National Clinical Lead for Lymphoedema in Wales, Swansea Bay University Health Board, Wales, United Kingdom.
National Lymphoedema Specialist, Swansea Bay University Health Board, Wales, United Kingdom.
Eur J Oncol Nurs. 2020 Feb;44:101720. doi: 10.1016/j.ejon.2019.101720. Epub 2019 Dec 26.
Lymphoedema is a chronic condition, a cancer consequence and causes physical, psychological, and social implications. A new super-micro surgical treatment Lymphatic Venous Anastomosis (LVA) may improve the symptoms of lymphoedema. This study aims to explore the impact of lymphoedema on individuals and if LVA Surgery changes perceptions on quality of life.
Semi-structured interviews were conducted with sixteen individual's pre-LVA surgery and repeated six months later post-LVA with ten of the participants. Transcripts were analysed using thematic analysis.
Themes identified pre-LVA included: Impact of Living with Lymphoedema, Being Different, and Future Hopes and Emotions. Participants reported making significant changes to 'normal' life due to living with lymphoedema. Changes included alteration in shopping, cleaning, hobbies, familial roles, employment and sexual intimacy. The wearing of compression garments engendered feelings of being unattractive. Themes found post-LVA were: I am one of the Lucky Ones and Returning to Former Self. Post-LVA, participants described how life had become more normalised with fear and apprehension of developing cellulitis reduced. Positive changes had enabled usual activities of daily living to recommence. Some participants had decreased pain, aching, heaviness, stiffness and were wearing their compression garments less.
The findings suggest that the real impact of living with lymphoedema is much more challenging than previously identified. The findings suggest that LVA can give a future of greater choice for some of its recipients, but further research should explore longer-term benefits. LVA could offer hope to some people with lymphoedema, but a realistic expectation is essential.
淋巴水肿是一种慢性疾病,是癌症的后果,会导致身体、心理和社会方面的影响。一种新的超微创手术治疗淋巴静脉吻合术(LVA)可能会改善淋巴水肿的症状。本研究旨在探讨淋巴水肿对个体的影响,以及 LVA 手术是否会改变对生活质量的看法。
对 16 名患者在 LVA 手术前进行半结构访谈,并在术后 6 个月对其中 10 名患者进行重复访谈。使用主题分析对转录本进行分析。
LVA 术前确定的主题包括:淋巴水肿对生活的影响、与众不同、未来的希望和情绪。参与者报告说,由于患有淋巴水肿,他们的“正常”生活发生了重大变化。这些变化包括购物、清洁、爱好、家庭角色、就业和性亲密的改变。穿着压缩服装会产生不吸引人的感觉。LVA 术后发现的主题包括:我是幸运的人之一和恢复到以前的自我。术后,参与者描述了生活如何变得更加正常,对发展蜂窝织炎的恐惧和担忧减少。积极的变化使他们能够重新开始日常生活活动。一些参与者疼痛、酸痛、沉重、僵硬减轻,穿压缩服的次数也减少了。
研究结果表明,与以前确定的相比,患有淋巴水肿的实际影响更加具有挑战性。研究结果表明,对于某些患者来说,LVA 可以为他们提供更多的选择未来,但需要进一步研究来探索长期效益。LVA 可以为一些患有淋巴水肿的人带来希望,但必须要有现实的期望。