Abstract
Objective: This study aimed to clarify the possible use of and points to improve a home-visit nursing interventional lymphedema care program (plan) we developed. Methods: The subjects were visiting nurses with at least three years of home-visit nursing experience and experience with lymphedema care for the elderly at home. Semi-structured interviews were conducted, and the collected opinions were aggregated and summarized. Results: Based on interviews with nine subjects, opinions regarding the use of the program, such as “The assessment perspective at the time of introduction helps to grasp the needs for a wide variety of subjects”, and regarding points to improve, such as “It is necessary to set the duration and timing of the section considering the frequency of visits and degree of edema at the time of introduction” and “It is necessary to have a perspective concerning efforts to maintain motivation for care of the elderly and their families”, were aggregated. Discussion: The results of the interviews were generally useful for the structure and development of the program, care methods and content, and interventions for influencing factors. Consideration of setting the timing according to the degree of lymphedema, modification of the program’s development, development of a program that fully considers the degree of edema at the time of introduction and the acceptance of edema among the elderly, and the need to consider the care content that should be given priority were suggested as points for improvement.
Highlights
Secondary lymphedema develops due to lymph node dissection, etc. associated with cancer surgery, and once it develops, it is difficult to cure and must be dealt with throughout the rest of a patient’s life [1] [2]
Development of lymphedema in the elderly reduces physical function and affects psychosocial aspects and activities of daily living (ADL) [3], and it results in a vicious cycle in which the decline in ADL causes symptoms to worsen, which has a great impact on quality of life (QOL)
The support provided by home-visit nursing for elderly people with lymphedema is not sufficient because it has a variety of restrictions due to the long-term care insurance system, such as on visit time, frequency, and maximum usage fees, and it is provided in a difficult situation in which there is a lack of visiting-nurse manpower [4]
Summary
Secondary lymphedema (hereinafter abbreviated as lymphedema) develops due to lymph node dissection, etc. associated with cancer surgery, and once it develops, it is difficult to cure and must be dealt with throughout the rest of a patient’s life [1] [2]. The prevalence of cancer is high in the elderly, and there are many elderly people at home who have developed lymphedema. Development of lymphedema in the elderly reduces physical function and affects psychosocial aspects and activities of daily living (ADL) [3], and it results in a vicious cycle in which the decline in ADL causes symptoms to worsen, which has a great impact on quality of life (QOL). The support provided by home-visit nursing for elderly people with lymphedema is not sufficient because it has a variety of restrictions due to the long-term care insurance system, such as on visit time, frequency, and maximum usage fees, and it is provided in a difficult situation in which there is a lack of visiting-nurse manpower [4]
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