Abstract
PurposeLower-extremity lymphedema (LEL) is a lifelong consequence of cancer therapy and can lead to serious physical and psychosocial complications for many cancer survivors. However, clinical knowledge and treatment of LEL remain minimal. The purpose of this study was to integrate perspectives of lymphedema patients and healthcare providers (HCPs) on LEL to develop a novel model for quality lymphedema care.MethodsA mixed-methods approach was implemented. Standardized questionnaires and semi-structured interviews were used to assess psychosocial well-being and experiences of LEL patients. Interviews were also used to evaluate the clinical experiences of HCPs working within tumour groups associated with cancer-related LEL. Thematic analysis was used to analyse qualitative data.ResultsTwenty-two patients and eleven HCPs participated in this study. Patient QOL, generalized anxiety and depressive symptom scores revealed a complex interplay between psychosocial well-being and supportive LEL care after cancer. Three themes emerged from interviews with patients (n = 19) and HCPs (n = 11): level of lymphedema knowledge, effectiveness of rehabilitation oncology services and barriers to care.Implications for Cancer SurvivorsWe developed a novel model for quality lymphedema care that emphasizes the importance of continued physical and psychosocial support for LEL patients, while illustrating the importance of HCPs in facilitating a smooth transition for patients to LEL care after cancer treatment.
Highlights
Lymphedema is a chronic lymphatic disease, affecting more than 200 million individuals worldwide [1]
Considering that cancer patients from a variety of tumour groups are at a lifelong increased risk for lymphedema, it is crucial that diagnostic tools and lymphedema knowledge are effectively used within oncology outpatient services
The aim of this study was to integrate the perspectives of lymphedema patients and Healthcare providers (HCPs) on lower-extremity lymphedema (LEL) to develop a novel model for quality lymphedema care
Summary
Lymphedema is a chronic lymphatic disease, affecting more than 200 million individuals worldwide [1]. Despite the availability of diagnostic guidelines, patients often receive inconsistent diagnoses and lymphedema-related information following cancer treatment [5,7]. Healthcare providers (HCPs) often receive minimal training on lymphatic pathologies during medical education and may not have the necessary resources and information needed to address lymphedema in clinic [9,10]. These challenges are augmented by issues associated with lymphedema tracking and continuity of care beyond active cancer treatment [9].
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