Background: Arm morbidity continues to impact the lives of many breast cancer survivors long after acute treatments are completed. The most debilitating symptoms of arm morbidity are pain, lymphedema and limitation with range of motion (ROM). As a chronic condition, management of arm morbidity symptoms requires survivors to engage in self-management practices that alleviate symptoms.
Objective: To explore self-management practices performed by breast cancer survivors, and the treatments women receive from healthcare practitioners in managing symptoms of arm morbidity.
Methods: A secondary analysis of quantitative and qualitative data was undertaken. A descriptive correlational design was used to analyze data from breast cancer survivors (N = 740). Logistic regression identified variables related to self-management that were associated with pain, lymphedema and ROM limitations. A descriptive qualitative design was used to analyze data from a subset of participants (n = 40). Inductive content analysis approach was applied to develop codes, categories and themes related to how women self-manage arm morbidity symptoms and the treatments they received from healthcare providers to manage their arm morbidity.
Results: Participants reported ongoing symptoms of pain (24%), lymphedema (21%), and range of motion limitation (34%) 30 to 36 months post-surgery. Pain was associated with experiencing swelling, taking pain medications, and discussing treatments for pain. Lymphedema was associated with swelling and receiving treatment for pain. ROM limitations were associated with swelling, receiving treatment for pain and taking pain medication. Two overarching qualitative themes emerged: 1) physical symptoms self-management, and 2) psychosocial self-management of uncertainty. Themes for treatments options included: rehabilitation and taking medications.
Conclusion: Findings highlight that women living with symptoms of arm morbidity require ongoing monitoring and support for self-management, and there is a need for multidisciplinary approaches. Self-management practices reported are in line with the current lymphedema guidelines, however, the complexities associated with self-management practices can be burdensome to women. Chronic pain and ROM limitation necessitates further investigation to understand their cause and develop management strategies. Oncology nurses are well positioned to implement survivorship care plans that address survivorship needs with multidisciplinary teams and primary healthcare practitioners when women with breast cancer transition from acute cancer care to home. Future research is needed to provide an in depth understanding of self-management of arm morbidity in breast cancer survivors.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/36213 |
| Date | January 2017 |
| Creators | Samuel, Vicky Rosine |
| Contributors | Gifford, Wendy Annette |
| Publisher | Université d'Ottawa / University of Ottawa |
| Source Sets | Université d’Ottawa |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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