Effectiveness of a lymphedema prevention program for patients with breast cancer: A randomized controlled trial based on the Protection Motivation Theory and Information-Motivation-Behavioral Skills Model.

OBJECTIVE

This study aims to evaluate the effectiveness of a lymphedema prevention program based on the Protection Motivation Theory and Information-Motivation-Behavioral Skills Model (PMT-IMB) in patients with breast cancer.

METHODS

A randomized controlled trial was conducted at a tertiary hospital, enrolling 95 patients treated between December 2022 and June 2023. Participants were randomly assigned to either the control group ( ​= ​47), receiving standard nursing care, or the intervention group ( ​= ​48), receiving a PMT-IMB-based lymphedema prevention program. The intervention was delivered in hospital settings, with follow-up via WeChat and phone after discharge. Outcomes were assessed using the Lymphedema Risk-Reduction Behavior Checklist (LRRB), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, upper limb circumference measurements, and self-lymphatic drainage records at baseline, 1 month, 3 months, and 6 months post-intervention.

RESULTS

The intervention group demonstrated significantly higher lymphedema prevention behavior scores than the control group after the intervention. Upper limb dysfunction scores improved significantly in the intervention group compared to the control group at three and six months. In the control group, upper limb circumference gradually increased over time, with a significant difference observed at six months. Compliance with self-lymphatic drainage was also significantly better in the intervention group.

CONCLUSIONS

The PMT-IMB-based nursing intervention effectively enhances preventive behaviors, reduces lymphedema incidence, improves upper limb function, and increases patient adherence. These findings provide valuable insights for optimizing nursing strategies in lymphedema prevention.

TRIAL REGISTRATION

http://www.chictr.org.cn, ChiCTR2300070705.