Effects of Health Belief Model based nursing interventions offered at home visits on lymphedema prevention in women with breast cancer: A randomised controlled trial.

Abstract

Lymphedema is an important morbidity due to its physical and psychological restrictions and financial burden in women having breast cancer surgery. The study was performed to examine effects of Health Belief Model (HBM) based nursing interventions given at home visits on prevention of lymphedema in women having breast surgery. The study had an experimental design. The study included 72 women receiving radiotherapy after breast surgery, of whom 37 formed the intervention group and 35 formed the control group. The sample was based on Consolidated Standard of Reporting Trials (CONSORT). Data were collected with a personal information questionnaire, Quick-Disabilities of the Arm, Shoulder and Hand Score (Q-DASH), European Organization for Research and Treatment of Cancer Quality of Life for Breast Cancer 23 (EORTC QLQ-BR23), Strategies Used by Patients to Promote Health (SUPPH), Arm Circumference Form at three home visits at 3-month intervals. HBM based nursing interventions regularly offered at home visits were found to create positive changes in behaviour of lymphedema prevention and improve upper extremity functions, reduce side-effects, relieve arm and breast symptoms, enhance the quality of life, increase self-efficacy and lower the frequency of lymphedema and costs. The HBM based nursing interventions regularly offered at home visits can create positive changes in behaviour of lymphedema prevention and prevent lymphedema in women receiving radiotherapy after breast surgery. Considering costs of treatment for lymphedema, these interventions can be considered as cost-effective. Nursing interventions directed towards behaviour of preventing lymphedema and follow-ups in the long-term should be supported by home visits and reminders through phone calls. Nurses should perform HBM based interventions regularly at home visits to prevent lymphedema. These interventions were found to reduce financial burden and were cost-effective.