self management of lymphedema a systematic review of the literature from 2004 to 2011

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Self-management of lymphedema: a systematic review of the literature from 2004 to 2011

Background: Little is known about the effectiveness of activities used to self-manage lymphedema.

Objective: The aim of this study was to evaluate the level of evidence of peer-reviewed lymphedema self-care literature published from January 2004 to May 2011.

Methods: Eleven major medical databases were searched. Articles were selected for inclusion or exclusion into the category of self-management of lymphedema by topic experts. The definition of self-management included activities that individuals initiate and perform for themselves without the assistance of others. Articles were scored according to the Oncology Nursing Society's Putting Evidence Into Practice levels of evidence.

Results: Sixteen articles met criteria for inclusion in this review, with self-management as the independent variable. Ten categories of self-management were established subsequently and articles were classified by levels of evidence. In these categories, no self-management studies were rated as "recommended for practice," 2 studies were rated "likely to be effective," none was rated "benefits balanced with harms," 7 were rated "effectiveness not established," and 1 was rated "effectiveness unlikely."

Discussion: Few studies included measures of outcomes associated with lymphedema, and there was a scarcity of randomized controlled trials in lymphedema self-management. A demonstrated need exists for the design and testing of self-management interventions that include appropriate outcome measures.

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Self-management of lymphedema: A systematic review of the literature from 2004 to 2011

Research output : Contribution to journal › Review article › peer-review

BACKGROUND:: Little is known about the effectiveness of activities used to self-manage lymphedema. OBJECTIVE:: The aim of this study was to evaluate the level of evidence of peer-reviewed lymphedema self-care literature published from January 2004 to May 2011. METHODS:: Eleven major medical databases were searched. Articles were selected for inclusion or exclusion into the category of self-management of lymphedema by topic experts. The definition of self-management included activities that individuals initiate and perform for themselves without the assistance of others. Articles were scored according to the Oncology Nursing Society's Putting Evidence Into Practice levels of evidence. RESULTS:: Sixteen articles met criteria for inclusion in this review, with self-management as the independent variable. Ten categories of self-management were established subsequently and articles were classified by levels of evidence. In these categories, no self-management studies were rated as "recommended for practice," 2 studies were rated "likely to be effective," none was rated "benefits balanced with harms," 7were rated "effectiveness not established," and 1 was rated "effectiveness unlikely." DISCUSSION:: Few studies included measures of outcomes associated with lymphedema, and there was a scarcity of randomized controlled trials in lymphedema self-management. A demonstrated need exists for the design and testing of self-management interventions that include appropriate outcome measures.

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10.1097/NNR.0b013e31824f82b2

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Self-management of lymphedema : A systematic review of the literature from 2004 to 2011. / Ridner, Sheila H. ; Fu, Mei R. ; Wanchai, Ausanee et al.

T1 - Self-management of lymphedema

T2 - A systematic review of the literature from 2004 to 2011

AU - Ridner, Sheila H.

AU - Fu, Mei R.

AU - Wanchai, Ausanee

AU - Stewart, Bob R.

AU - Armer, Jane M.

AU - Cormier, Janice N.

N2 - BACKGROUND:: Little is known about the effectiveness of activities used to self-manage lymphedema. OBJECTIVE:: The aim of this study was to evaluate the level of evidence of peer-reviewed lymphedema self-care literature published from January 2004 to May 2011. METHODS:: Eleven major medical databases were searched. Articles were selected for inclusion or exclusion into the category of self-management of lymphedema by topic experts. The definition of self-management included activities that individuals initiate and perform for themselves without the assistance of others. Articles were scored according to the Oncology Nursing Society's Putting Evidence Into Practice levels of evidence. RESULTS:: Sixteen articles met criteria for inclusion in this review, with self-management as the independent variable. Ten categories of self-management were established subsequently and articles were classified by levels of evidence. In these categories, no self-management studies were rated as "recommended for practice," 2 studies were rated "likely to be effective," none was rated "benefits balanced with harms," 7were rated "effectiveness not established," and 1 was rated "effectiveness unlikely." DISCUSSION:: Few studies included measures of outcomes associated with lymphedema, and there was a scarcity of randomized controlled trials in lymphedema self-management. A demonstrated need exists for the design and testing of self-management interventions that include appropriate outcome measures.

AB - BACKGROUND:: Little is known about the effectiveness of activities used to self-manage lymphedema. OBJECTIVE:: The aim of this study was to evaluate the level of evidence of peer-reviewed lymphedema self-care literature published from January 2004 to May 2011. METHODS:: Eleven major medical databases were searched. Articles were selected for inclusion or exclusion into the category of self-management of lymphedema by topic experts. The definition of self-management included activities that individuals initiate and perform for themselves without the assistance of others. Articles were scored according to the Oncology Nursing Society's Putting Evidence Into Practice levels of evidence. RESULTS:: Sixteen articles met criteria for inclusion in this review, with self-management as the independent variable. Ten categories of self-management were established subsequently and articles were classified by levels of evidence. In these categories, no self-management studies were rated as "recommended for practice," 2 studies were rated "likely to be effective," none was rated "benefits balanced with harms," 7were rated "effectiveness not established," and 1 was rated "effectiveness unlikely." DISCUSSION:: Few studies included measures of outcomes associated with lymphedema, and there was a scarcity of randomized controlled trials in lymphedema self-management. A demonstrated need exists for the design and testing of self-management interventions that include appropriate outcome measures.

KW - literature review

KW - lymphedema

KW - self-management

KW - systematic review

UR - http://www.scopus.com/inward/record.url?scp=85027942373&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027942373&partnerID=8YFLogxK

U2 - 10.1097/NNR.0b013e31824f82b2

DO - 10.1097/NNR.0b013e31824f82b2

M3 - Review article

AN - SCOPUS:85027942373

JO - Nursing Research

JF - Nursing Research

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Self-Management of Lymphedema

A systematic review of the literature from 2004 to 2011.

Ridner, Sheila H.; Fu, Mei R.; Wanchai, Ausanee; Stewart, Bob R.; Armer, Jane M.; Cormier, Janice N.

Sheila H. Ridner, PhD, RN, FAAN, is Associate Professor, School of Nursing, Vanderbilt University, Nashville, Tennessee.

Mei R. Fu, PhD, RN, ACNS-BC, is Assistant Professor, College of Nursing, New York University.

Ausanee Wanchai, RN, is Graduate Research Assistant; Bob R. Stewart, EdD, is Professor Emeritus; and Jane M. Armer, PhD, RN, FAAN, is Professor, Sinclair School of Nursing, University of Missouri, Columbia.

Janice N. Cormier, MD, MPH, is Associate Professor, MD Anderson Cancer Center, University of Texas, Houston.

Accepted for publication February 7, 2012.

On behalf of the American Lymphedema Framework Project, thank you to the Vanderbilt University School of Nursing staff Joey O’Dell and Kandis Smith, Melanie Schneider Austin, and the reference librarians of the University of Missouri for their assistance.

The authors have no funding or conflicts of interest to disclose.

Corresponding author: Sheila H. Ridner, PhD, RN, FAAN, Vanderbilt University, 526 Godchaux Hall, Nashville, TN 37240 (e-mail: [email protected] ).

Background:

Little is known about the effectiveness of activities used to self-manage lymphedema.

Objective:

The aim of this study was to evaluate the level of evidence of peer-reviewed lymphedema self-care literature published from January 2004 to May 2011.

Methods:

Eleven major medical databases were searched. Articles were selected for inclusion or exclusion into the category of self-management of lymphedema by topic experts. The definition of self-management included activities that individuals initiate and perform for themselves without the assistance of others. Articles were scored according to the Oncology Nursing Society’s Putting Evidence Into Practice levels of evidence.

Results:

Sixteen articles met criteria for inclusion in this review, with self-management as the independent variable. Ten categories of self-management were established subsequently and articles were classified by levels of evidence. In these categories, no self-management studies were rated as “recommended for practice,” 2 studies were rated “likely to be effective,” none was rated “benefits balanced with harms,” 7were rated “effectiveness not established,” and 1 was rated “effectiveness unlikely.”

Discussion:

Few studies included measures of outcomes associated with lymphedema, and there was a scarcity of randomized controlled trials in lymphedema self-management. A demonstrated need exists for the design and testing of self-management interventions that include appropriate outcome measures.

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Putting Evidence Into Practice: Cancer-Related Lymphedema: Evolving Evidence for Treatment and Management From 2009-2014

Cancer-related lymphedema is a progressive and chronic syndrome of abnormal swelling and multiple symptoms resulting from cancer treatment. Even with modern medical advances, lymphedema remains a major health problem affecting thousands of cancer survivors. To provide healthcare professionals with evidence-based clinical practice guidelines for lymphedema treatment and management, a systematic review was conducted to evaluate 75 selected articles from 2009-2014 by the Oncology Nursing Society Putting Evidence Into Practice lymphedema team. Findings of the systematic review support complete decongestive therapy, compression bandages, and compression garments with highest evidence for best clinical practice. Weight management, full-body exercise, information provision, prevention, and early intervention protocols are likely to be effective for clinical practice. Historic recommendations for activity restriction and avoidance of aerobic and resistive exercises that limit cancer survivors' daily lives have been challenged with more evidence. Cancer survivors may not need to restrict activities such as resistive or aerobic exercises and weightlifting with gradual exercise progression. Future research should focus on providing high-level evidence using randomized clinical trials with larger samples and studying lymphedema beyond breast cancer.

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self management of lymphedema a systematic review of the literature from 2004 to 2011

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Journal of Vascular Nursing

What do lymphedema patients expect from a treatment and what do they achieve a descriptive study.

It is important to question patient's expectation and benefit from treatment.

Access to clear diagnosis and treatment should be ensured for lymphedema patients.

Function is more important than appearance for most of the lymphedema patient.

Patient education should be considered as a part of the effective treatment to take under control of disease.

Regulations for health insurance are also needed to cover cost of treatment.

Lymphedema is characterized by swelling and fibroadipose tissue deposition that is a physically, psychologically, and socially debilitating condition due to chronic and progressive nature of the disease. Treatment benefit evaluation from the patient's perspective is important for medical decision-making. The aim of this study is to investigate important treatment goals and benefits of treatment from the patients’ perspective.

Eighty-one patients with lymphedema, lipoedema, or lipolymphoedema who are currenlty treated or who underwent previous treatment were included in the study. Socio-demographic data was recorded. Important goals and benefit from treatment were assessed with Patients Needs Questionnaire and Patient Benefit Questionnaire which are sub-questionnaires of Patient Benefit Index-Lymphedema.

The most important expectation and needed item was “To find a clear diagnosis and therapy” (n:59, 72%). The least important item for the lymphedema patients was “To feel more attractive” (n:9, 11%). Most beneficial effect of treatment was “To have no fear that the disease will become worse” (n:37, 45.7%). “To have fewer out of pocket treatment expenses” was rated as the least beneficial effect of treatment (n:24, 29.6%).

Conclusions

It is important to identify patients' needs and expectations. Patients should be referred for treatment according to their needs. The effectiveness of the treatment should be evaluated objectively. Patient education should be considered as a part of the effective treatment to teach patients how to control their lymphedema. A clear diagnosis and access to treatment should be ensured for lymphedema patients. Regulations for health insurance benefit coverage are needed to cover cost of compression garments.

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Self-management of lymphedema: a systematic review of ...
Objective: The aim of this study was to evaluate the level of evidence of peer-reviewed lymphedema self-care literature published from January 2004 to May 2011.
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Self-management of lymphedema: A systematic review of the
OBJECTIVE:: The aim of this study was to evaluate the level of evidence of peer-reviewed lymphedema self-care literature published from January 2004 to May 2011
Self-management of lymphedema: a systematic ...
The aim of this study was to evaluate the level of evidence of peer-reviewed lymphedema self-care literature published from January 2004 to May 2011.
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