Thesis (Ph. D.)--University of Missouri--Columbia, 2003. / "August 2003." Typescript. Vita. Includes bibliographical references (leaves 240-251). Also issued on the Internet.

Breast cancer is the number one cancer in female in Hong Kong. Breast cancer-related lymphoedema causes both physical and psychological sufferings in breast cancer survivors and significantly degrades their quality of life. Medical costs for these women are substantially higher than women without lymphoedema. Effective and standardized intervention for these patients will be beneficial to both patients and healthcare institutes. The dissertation aims to evaluate the current evidence on the effectiveness of manual lymphatic drainage in managing breast cancer-related lymphoedema, to develop an evidence-based guideline for nurse-led manual lymphatic drainage in managing breast cancer-related lymphoedema as well as to assess its implementation potential and to design implementation strategies and an evaluation plan for its adoption in a local public hospital in Hong Kong. A systematic search of the literature revealed seven studies on manual lymphatic drainage for breast cancer related lymphoedema that met the selection criteria of the dissertation. Methodological quality of the selected studies was evaluated according to the method developed by the Scottish Intercollegiate Guidelines Network and data were extracted and synthesized. Five of the trials were of moderate to good methodological quality and they demonstrated that manual lymphatic drainage was safe and had additional benefits over exercise and compression alone especially in patients with early lymphoedema. A protocol on manual lymphatic drainage for breast cancer related lymphoedema was subsequently developed. The implementation potential of the protocol in the local setting was established by examining its feasibility, evaluation potential and cost-benefit. Adoption of the program was found to be able to produce a potential annual saving of HK$ 444,200 for the hospital on top of benefits to patients and staff. A three-phase implementation plan was designed in which an implementation team would initiate and guide the proposed change through a careful communication plan and a pilot study would be conducted to confirm feasibility of the protocol. An evaluation plan including patient, healthcare provider and system outcomes would then help ensure the effectiveness and sustainability of the manual lymphatic drainage protocol and guide its future refinement. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Thesis (doctoral)--Malmö University, 1998. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (doctoral)--Malmö University, 1998. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (Ph. D.)--University of Missouri--Columbia, 2003. / "August 2003." Typescript. Vita. Includes bibliographical references (leaves 240-251). Also issued on the Internet.

Background to the study: The long term maintenance of lymphoedema depends on a daily regime of these physical therapies, which lend themselves to self-management by those with the condition (Lymphoedema Framework, 2006). It has been widely recognised in the literature for many years, e.g. Rose et al (1991) to Fu (2010), that achieving a reduction in volume of the lymphoedema and ensuring the ongoing maintenance of the condition is dependent upon knowledgeable healthcare professionals and patients, who are aware of the importance of self care and self management in the long term maintenance of the condition. The challenges for effective lymphoedema management may be exacerbated when the person lives in a very remote and rural area. It has been recognised by policymakers that sparsely populated and geographically remote areas need different healthcare solutions as many of the healthcare policies designed for urban areas are not applicable or sustainable in these areas (British Medical Association, 2005). Estimating the prevalence of the condition and considering the experience of a sample of people with lymphoedema who live in a very remote and rural area will contribute to the knowledge of the requirements for a lymphoedema service to be effective in such an area. Aims: To estimate the prevalence of lymphoedema/chronic oedema and to investigate the characteristics of the condition in a very remote and rural area of Scotland and to explore the experience of a sample of people living with the condition in that area. Methods: A mixed methods research strategy was used. An initial survey of GP practices was undertaken to estimate the prevalence of lymphoedema/chronic oedema and to generate a sample for the other two stages of the study. A postal questionnaire was used to collect quantitative and qualitative information from the initial sample, and to generate a smaller sample to participate in individual semi-structured qualitative interviews exploring the experience of living with and self-managing lymphoedema/chronic oedema in a very remote and rural area in the north of Scotland. Results: The estimated prevalence rate, based on GP report, was higher than that noted in prevalence studies in large urban areas. Based on questionnaire responses, 53% of participants stated their lymphoedema made no difference to how they felt about themselves. However, interviews revealed that frustration and anger was present despite acceptance of the situation; in particular, lack of information and effective treatment was a source of frustration. Many of the sample effectively self-managed their condition, based on their own commonsense experience. However, this resort to commonsense measures seemed to be as result of an apparent lack of awareness and intervention from health care professionals. Conclusions: The findings suggest that early recognition and even minimal support from a knowledgeable source at that early stage could help to maintain the lymphoedema and reduce the need for specialist treatments. Suggestions for the ways of improving early recognition of the condition and access to self-management support in a very remote and rural area are offered.

No description available.

BACKGROUND: Breast cancer-related lymphedema (BCRL) is a negative sequela of breast cancer treatment that affects approximately one in five patients treated for breast cancer. The median time of BCRL development is three years post breast cancer treatment. The purpose of this study was to compare the incidence of specific factors between two patient populations: patients who developed BCRL within the median BCRL-onset time and patients who developed late onset BCRL (defined as after three years post breast cancer surgery). METHODS: Two cohorts, one with patients who developed BCRL within the median onset time and another with patients who developed late onset lymphedema, were examined. An in-depth chart review was conducted to identify specific factors including age, body mass index, history of cellulitis, cording, seroma, hematoma, and trauma as well as the specific breast cancer treatment each patient received. RESULTS: The results indicated that there was a higher incidence of trauma, cellulitis, and cording in the late onset BCRL group. Additionally, more patients in the late onset group received BCRL-related physical therapy prior to their BCRL diagnosis than patients in the median onset time group. CONCLUSION: Patients with late onset lymphedema had a higher incidence of trauma, cellulitis, and/or cording compared to patients who developed BCRL within three years of surgery. Given that purpose of this study was solely to examine incidence and not significance, further studies must be conducted in order to determine if these are in fact significant risk factors for late onset BCRL. / 2022-06-04T00:00:00Z

Purpose: The objectives of this pilot study for women breast cancer survivors with lymphedema was 1) to evaluate recruitment rates, retention rates, adherence to Bowenwork (a noninvasive complementary therapy involving gentle muscle movements), home exercises, safety and comfort; 2) determine the effect of Bowenwork on quality of life (QOL), functional status, perceived pain, range of motion (ROM), arm/ankle circumference (to assess for localized and systemic changes). Methods: Participants received 4 Bowenwork sessions with home exercises. Initial and post assessments included QOL, functional status, and pain. ROM, arm/ankle circumference and pain measures were recorded before each session. Results: Twenty-one women enrolled in the study; 95% completion; adherence 100%; home exercises 95%; no adverse events. The intervention improved mental health (SF-36-MCS); breast cancer-related functional (FACT-B); increased ROM; reduced arm circumferences. P value set at <0.05. Conclusions: The Bowenwork intervention was safe and acceptable for women breast cancer survivors with lymphedema.

The risk for upper extremity lymphedema post-mastectomy in women surgically treated for breast cancer is a concern since it is often painful, aesthetically displeasing, and can increase the risk of infection. However, there is a paucity of data examining if diagnostic procedures performed in the ipsilateral arm post-mastectomy increases the risk of lymphedema. The purpose of this research is to examine the relationship between diagnostic procedures performed in the ipsilateral arm post-mastectomy and the occurrence of lymphedema with or without related complications. A systematic review of the literature was conducted from multiple, online databases available from 1992 through 2014, and included CINAHL, MedLine, PsychInfo, and ERIC. Search terms included lymphedema, breast cancer, mastectomy, blood pressure, and infection. Exclusion criteria comprised articles focused on male gender, primary lymphedema, metastases, survival, quality of life studies, reoccurrence breast cancer, breast conservation, lymphedema management, lymphedema, and lymphoma. The results of this study were inconclusive concerning a relationship between upper extremity lymphedema and procedures performed in the ipsilateral arm after mastectomy. This literature review outlines gaps in the data showing a need for more focused research on the causes of secondary lymphedema after breast cancer surgery with lymph node removal. Further research on the impact of diagnostic and other invasive procedures on the ispilateral arm after mastectomy should be considered.