Kirshbaum M
Greenlea Oncology Unit, Huddersfield Royal Infirmary, UK.
Eur J Cancer Care (Engl). 1996 Dec;5(4):246-51. doi: 10.1111/j.1365-2354.1996.tb00243.x.
A project was funded by the UK's Department of Health to develop national guidelines for breast cancer related lymphoedema using a Consensus Strategy. This involved the organization of a consensus conference with a multidisciplinary panel of experts, an extensive literature review, the production of clinical guidelines and the implementation of the guidelines at three pilot sites (breast unit, hospice and community). The EORTC QLQ-30, MOS SF-36 and a standard assessment form were used to evaluate patient outcome. Diaries and semi-structured interviews were used to elicit data on practitioner compliance and practical issues of implementing change using clinical practice guidelines. Results showed stable or improved scores in all categories of physical, social and emotional functioning and a stable or measured decrease in limb volume for 75% of the sample. Qualitative data obtained from practitioners demonstrated high levels of compliance from practitioners and patients and offers useful recommendations. This project highlights the importance of raising awareness of lymphoedema through the development and utilization of research-based, patient-centred guidelines.
英国卫生部资助了一个项目，采用共识策略制定乳腺癌相关淋巴水肿的国家指南。这包括组织一次由多学科专家小组参与的共识会议、进行广泛的文献综述、制定临床指南以及在三个试点地点（乳腺科、临终关怀机构和社区）实施这些指南。使用欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ - 30）、医学结局研究简短健康调查（MOS SF - 36）和一份标准评估表来评估患者的预后。通过日记和半结构化访谈来收集关于从业者依从性以及使用临床实践指南实施变革的实际问题的数据。结果显示，在身体、社会和情感功能的所有类别中，得分稳定或有所提高，并且样本中75%的患者肢体体积稳定或测量值有所下降。从从业者那里获得的定性数据表明，从业者和患者的依从性很高，并提供了有用的建议。该项目强调了通过制定和利用基于研究、以患者为中心的指南来提高对淋巴水肿认识的重要性。
