Abstract
BackgroundBreast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality of life (QoL) of cancer survivors and can stimulate fear of cancer recurrence (FCR). Self-management education for lymphedema has been introduced as an effective method in controlling FCR. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients.MethodsThis three-arm clinical trial studied 105 patients with breast cancer-related lymphedema referred to Seyed_Khandan rehabilitation center. Sampling was done by random allocation method in blocks of 3 with 35 subjects in each group. All subjects received routine lymphedema treatments. The group-based education (GE) and social network-based education (SNE) groups received self-management education in the clinic and Telegram™ messenger channel, respectively. Impairment in QoL and mean score of FCR were assessed before, immediately after, and three months after the intervention by using the Persian version of Lymphedema Life Impact Scale (LLIS) and Fear of Progression Questionnaire-Short Form (FoPQ-SF), respectively. Mixed-model ANOVA was applied for statistical analysis.ResultsThere was a significant time effect on total LLIS (P = 0.007), psychosocial (P = 0.038) and functional (P = 0.024) subscale changes in three groups of study. Interaction between the main effect of group and time on psychosocial subscale changes was statistically significant (P = 0.017). The multicomparison results illustrated that the main effect of time, the main effect of group, and interaction of them on the mean score of FCR were P = 0.084, P = 0.380, and P = 0.568, respectively.ConclusionDespite no significant reduction in the FCR score, results showed the improvement of most QoL aspects after three months of intervention. Although the social network-based education method was effective, the group-based education method was more beneficial. Applying these educational methods in lymphedema treatment protocols needs cost-effectiveness studies.Trial registrationThis study was registered at the Iranian Registry of Clinical Trials (IRCT2017052834176N1).
Highlights
Introduction1.38 million breast cancer women are diagnosed in the world [1]. One of the most common side effects of breast cancer is lymphedema affecting about 40% of the survivors [2]
Every year, 1.38 million breast cancer women are diagnosed in the world [1]
Swelling leads to physical discomfort like pain, heaviness, tightness, numbness, fatigue, and stiffness in the affected limb, which triggers the fear of cancer recurrence (FCR) [7]
Summary
1.38 million breast cancer women are diagnosed in the world [1]. One of the most common side effects of breast cancer is lymphedema affecting about 40% of the survivors [2]. High levels of fear lead to anxiety, dysfunction and reduce QoL of cancer survivors and even their caregivers. It can disrupt the everyday life of these people as a result of creating stress, difficulty in acceptance, psychological responses, functional disorders, physical disorders, as well as exacerbation of existing mental disorders [7, 8]. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients. The social network-based education method was effective, the group-based education method was more beneficial Applying these educational methods in lymphedema treatment protocols needs cost-effectiveness studies. Trial registration This study was registered at the Iranian Registry of Clinical Trials (IRCT2017052834176N1)
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