Exploring patient perception of success and benefit in self-management of breast cancer-related arm lymphoedema

Eur J Oncol Nurs. 2016 Feb:20:173-83. doi: 10.1016/j.ejon.2015.08.001. Epub 2015 Sep 1.

Abstract

Purpose: The aim of this study was to identify factors influencing patient perception of success and benefit with self-management of breast cancer-related lymphoedema (BCRL) and explore how patients decide whether their swollen limb has improved or deteriorated.

Methods: This qualitative study used a Grounded Theory approach. Twenty-one women in the BCRL self-management phase participated in one in-depth interview exploring their experience and perspective on self-managing their BCRL.

Findings: Seven enablers and blocks to self-management were identified: routine, recognising benefit of self-management and consequences of non-treatment, owning treatment, knowledge and understanding, problem-solving, time required for treatment and aesthetics of hosiery. Women determined treatment outcome by monitoring size, appearance, texture and internal sensations within the affected arm.

Conclusions: Women who participated in this study showed varying degrees of acceptance and adjustment to life with lymphoedema. This appears to directly impact their ability to self-manage lymphoedema. Lymphoedema practitioners and oncology nurses have a valuable role providing knowledge and support to patients transitioning to independent self-care. A better understanding of factors facilitating patients to become experts in their condition may improve longer term outcomes and reduce cost pressures on lymphoedema services.

Keywords: Breast cancer; Grounded theory; Lymphoedema; Patient compliance; Qualitative research; Self-management; Treatment adherence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Aged
  • Aged, 80 and over
  • Arm / physiopathology*
  • Breast Neoplasms / complications*
  • Breast Neoplasms / therapy
  • Female
  • Grounded Theory
  • Humans
  • Lymphedema / etiology*
  • Lymphedema / psychology
  • Lymphedema / therapy*
  • Middle Aged
  • Patients / psychology*
  • Perception
  • Qualitative Research
  • Quality of Life / psychology*
  • Self Care / psychology*