Nursing Scientist specialising in lymphoedema, Research Center for Implementation Nursing Science Initiative, Research Promotion Headquarters, Fujita Health University, Aichi, Japan.
Plastic and Reconstructive Surgeon specialising with microsurgery, Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Br J Nurs. 2022 Aug 11;31(15):S22-S29. doi: 10.12968/bjon.2022.31.15.S22.
Compression therapy is important in oedema control in lymphoedema. However, some patients have difficulties starting compression therapy because standard self-care education does not enable them to fully understand lymphoedema and recognise it as their problem. To overcome this, real-time image-sharing education, using a combination of indocyanine green lymphography (ICG) and ultrasonography, may be used to educate patients. In this case study, real-time image-sharing education promoted decision-making and behaviour change in a patient with lower extremity lymphoedema so she would wear elastic stockings.
A 51-year-old woman with a BMI of 31.7 kg/m and secondary lower extremity lymphoedema following cervical cancer surgery did not adhere to self-care instructions regarding wearing elastic stockings for 5 years. The oedema worsened, her limb circumference increased and she had two episodes of cellulitis within a year. Because the patient had a negative attitude towards elastic stockings, real-time image-sharing education was used to promote recognition of illness using ICG and an understanding of the condition of lymphoedema using ultrasonography. After the images were shared and explained, the patient discussed her recognition and understanding of lymphoedema, then decided to use compression stockings. She continued to wear them for 4 months, and her limb circumference decreased.
Real-time image-sharing education using ICG and ultrasonography as self-care support for a lymphoedema patient who would not start compression therapy could result in behavioural changes and the patient starting and continuing to wear elastic stockings.
在淋巴水肿的水肿控制中，压缩疗法很重要。然而，一些患者在开始压缩治疗时会遇到困难，因为标准的自我护理教育使他们无法充分了解淋巴水肿并将其视为自己的问题。为了解决这个问题，可以使用实时图像共享教育，结合吲哚菁绿淋巴造影（ICG）和超声检查，对患者进行教育。在这个病例研究中，实时图像共享教育促进了一位下肢淋巴水肿患者的决策和行为改变，使她愿意穿弹性袜子。
一位 51 岁的女性，BMI 为 31.7kg/m，因宫颈癌手术后出现继发性下肢淋巴水肿，5 年来一直不遵守穿弹性袜子的自我护理指导。水肿恶化，肢体周长增加，一年内发生了两次蜂窝织炎。由于患者对弹性袜子持消极态度，因此使用实时图像共享教育，通过 ICG 促进对疾病的认识，通过超声检查了解淋巴水肿的状况。在共享和解释图像后，患者讨论了她对淋巴水肿的认识和理解，然后决定使用压缩袜子。她继续穿了 4 个月，肢体周长减小。
对不愿意开始压缩治疗的淋巴水肿患者使用 ICG 和超声作为自我护理支持的实时图像共享教育可能会导致行为改变，使患者开始并继续穿弹性袜子。
