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Meme Kanserli Hastaların Cerrahi Tedavi Sonrası Kollarını Fonksiyonel Olarak Kullanma Durumları ve Lenfödemi Önlemeye Yönelik Davranışları

Yıl 2024, Cilt: 19 Sayı: 1, 67 - 76, 28.03.2024
https://doi.org/10.17517/ksutfd.1193674

Öz

Amaç: Tanımlayıcı tipte olan bu çalışmanın amacı meme kanserli hastaların cerrahi tedavi sonrası kollarının fonksiyonel kullanma ve lenfödemi önleme davranışlarını belirlemektir.
Gereç ve Yöntem: Çalışma 125 hasta ile gerçekleştirildi. Veriler Hasta Tanıtım Formu ve Kol, Omuz ve El Sorunları Anketi-DASH’ın Türkçe versiyonu kullanılarak toplandı. Verilerin istatistiksel değerlendirilmesinde ki kare, Fisher exact ve Independent-Samples t testi kullanıldı.
Bulgular: Cerrahi tedavi sonrası meme kanserli kadınların %21,6’sında lenfödem tespit edildi. Hastaların egzersiz durumu ile lenfödem gelişimi arasında anlamlı fark bulunmazken, egzersiz süresi ile lenfödem varlığı arasında anlamlı fark olduğu belirlendi (p<0,05). Araştırmaya katılan kadınların DASH puan ortalaması 25,57 ± 15,86 olarak bulundu. Lenfödemi olan kadınların DASH skoru daha yüksek ve kol güçsüzlüğü daha fazlaydı.
Sonuç: Hemşirelerin meme kanserli kadınlara eğitim ve danışmanlık vermeleri, cerrahi tedavi sonrası düzenli takip edilerek hastaları önerilen egzersizleri yapmaları konusunda bilgilendirmeleri önerildi.

Kaynakça

  • World Health Organization. World Health Statistic 2018: Monitoring Health For The Sdgs, Sustainable Development Goals. Geneva. 2018
  • Türkiye İstatistik Kurumu. Ölüm Nedeni İstatistikleri 2018. TÜİK Haber Bülteni, Sayı: 30626. 2019
  • Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre AT, Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Cancer J Clin. 2018; 68:394–424.
  • Sağlık İstatistikleri Yıllığı 2017. Available From: URL:Https://Dosyasb.Saglik.Gov.Tr/Eklenti/31096,Turkcesiydijiv1pdf.Pdf?0 31.10.2020
  • Büyükakıncak Ö, Akyol Y, Özen N, Ulus Y, Cantürk F, Tander B, ve ark. Meme Kanseri Cerrahisi: Üst Ekstremite İçin Bir Problem Midir? Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 2013; 59:304-309.
  • Güler DS. Meme Kanseri Nedeniyle Ameliyat Olan Hastalarda Kendi Kendine Lenfödem Yönetimi. Meme Sağlığı Dergisi 2008; 4(2): 62-69.
  • Zaralı O, Karaman N, Özaslan C, Hüseyinova S, Altınok M. Long-Term Complications Associated with Mastectomy and Axillary Dissection. Acta Oncologıca Turcıca 2009; 42: 17-23.
  • Doğan L, Akıncı M, Çetin B, Kızıltan G, Karaman N, Altınok M. Mastektomi Sonrası Kol ve Omuzun Pozisyonu Önemli midir? Acta Oncologıca Turcıca 2009; 42:114-117.
  • Ewertz M, Bonde JA. Late Effects of Breast Cancer Treatment and Potentials for Rehabilitation. Acta Oncologica 2011; 50: 187–193.
  • Clark B, Sitzia J, Harlow W. Incidence and Risk of Arm Oedema Following Treatment for Breast Cancer: A Three-Year Follow-Up Study. QJM: An International Journal of Medicine 2005; 98(5): 343–348.
  • Harris SR, Hugi MR, Olivtto IA, Levine, M. Clinical Practice Guidelines for The Care and Treatment of Breast Cancer: 11. Lymphedema. Canadian Medical Association or Its Licensors CMAJ 2001; 164: 191-199.
  • Deo SVS, Ray S, Rath GK, Shukla NK, Kar M, Asthana S, et al. Prevalence and Risk Factors for Development of Lymphedema Following Breast Cancer Treatment. Indian Journal of Cancer 2004; 41(1): 8-12.
  • Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema After Breast Cancer: Incidence, Risk Factors, and Effect on Upper Body Function. Journal of Clınıcal Oncology 2008; 26(21):3536-3542.
  • Akkaş GA. Meme Kanseri Tedavisine Bağlı Lenfödem ve Hemşirelik Bakımı. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi 2005; 9(2): 18-25.
  • Yavuz KA, Gök ÜF. Mastektomili Hastalarda Evde Bakım. Meme Sağlığı Dergisi 2008; 4(1): 3-8.
  • Hawash MAE, Alaa Elden S, El Shatby A, El Moghazy, H, Hamida M. Effect of Nursing Rehabilitation Program on The Prevention of Lymphedema among Post Mastectomy Women. IOSR Journal of Nursing and Health Science (IOSR-JNHS) 2018; 7(86):68-87.
  • Çavdar İ, Kostanoğlu A, Karayurt Ö, Yıldız FÜ, Turan A, Kanan N. Genel Semptomların Yönetimi-Lenfödem. Onkoloji Hemşireliğinde Kanıttan Uygulamaya-Konsensus. 2014; 25-39. İstanbul.
  • Şişman H, Şahin B, Duman BB, Tanrıverdi G. Nurse-Assisted Education and Exercise Decrease The Prevalence and Morbidity of Lymphedema Following Breast Cancer Surgery. JBUON2012; 17:565–569.
  • Nemli A, Tekinsoy Kartin P. Effects of Exercise Training and Follow-Up Calls at Home on Physical Activity and Quality of Life after a Mastectomy. Jpn J Nurs Sci. 2019 Jul;16(3):322-328. Doi: 10.1111/Jjns.12243.
  • Türk G, Atalay M. Mastektomi Sonrası Yaptırılan Egzersizlerin Kol Ödemini Önlemeye Etkisi. Meme Sağlığı Dergisi 2007; 3(3):143-149.
  • Hudak PL, Amadio PC, Bombardier C. Upper Extrenity Collaborative Group, “Development of an Upper Extremity Outcome Measure: The DASH (Disabilities of The Arm, Shoulder, And Hand). Amerıcan Journal of Industrial Medicine 1996; 29:602-608.
  • Düger T, Yakut E, Öksüz Ç, Yörükan S, Milgüta BS, Ayhan Ç. Kol, Omuz, El Sorunları (Disabilities Of The Arm, Shoulder And Hand-DASH) Anketi Türkçe Uyarlamasının Güvenirliği ve Geçerliği. Fizyoterapi Rehabilitasyon 2006; 17(3), 99- 107.
  • Yılmaz E, Coşkun T. Meme Kanserli Hastalarda Üst Ekstremite Sorunları ve Yaşam Kalitesi. Bakırköy Tıp Dergisi 2019; 15:29-37.
  • Hayes SC. Review of Research Evidence on Secondary Lymphoedema: İncidence, Prevention, Risk Factors and Treatment. National Breast and Ovarian Cancer Centre Australia 2008; 19-25.
  • Armer JM, Stewart BR. Post-Breast Cancer Lymphedema: Incidence Increases from 12 To 30 To 60 Months. Lymphology 2010; 43:118-127.
  • Shih YT, Xu Y, Cormier JN, Giordano S, Ridner SH, Buchholz TA, et al. Incidence, Treatment Costs, and Complications of Lymphedema After Breast Cancer Among Women of Working Age: A 2-Year Follow- Up Study. Journal Clinical Oncology 2009; 27(12): 2007-2014.
  • Tsai RJ, Dennis LK, Lynch CF, Snetselaar LG, Zamba GKD, Scott-Conner C. Lymphedema Following Breast Cancer: The Importance of Surgical Methods and Obesity. Front Womens Health 2018; 3(2):1-17.
  • Assis MR, Marx AG, Magna LA, Ferrigno ISV. Late Morbidity in Upper Limb Function and Quality of Life in Women After Breast Cancer Surgery. Braz J Phys Ther. 2013; 17(3):236-243.
  • Norman SA, Localio AR, Kallan MJ, Weber AL, Simoes THA, Potashnik SL, et al. Risk Factors for Lymphedema after Breast Cancer Treatment. Cancer Epidemiol Biomarkers Prev. 2010; 19(11) :2734-2746.
  • Safwat Y, Shaalan M, Mokhtar M, Hamood M. Risk Factors of Upper‑Arm Lymphedema After Breast Cancer Treatment. Journal of Current Medical Research and Practice 2017; 2:73-78.
  • Zhang L, Fan A, Yan J, He Y, Zhang H, Zhong Q, et al. Combining Manual Lymph Drainage with Physical Exercise after Modified Radical Mastectomy Effectively Prevents Upper Limb Lymphedema. Lymphat Res Biol. 2016; 14(2):104-108.
  • Arıkan DA, Kapucu S. Management of Breast Cancer-Related Lymphedema. Turk J Oncol. 2016;31(4):138-148.
  • Arıkan DA, Özdemir L. Lenfödemde Cilt Bakımı ve Koruyucu Yaklaşımlar. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi 2016; 54–64.
  • Fu MR, Axelrod D, Guth AA, Cartwright F, Qiu Z, Goldberg JD, et al. Proactive Approach to Lymphedema Risk Reduction: A Prospective Study. Ann Surg Oncol. 2014; 21(11): 3481–3489.
  • Ferguson CM, Swaroop MN, Horick N, Skolny MN, Miller CL, Jammallo LS, et al. Impact of Ipsilateral Blood Draws, Injections, Blood Pressure Measurements, and Air Travel on The Risk of Lymphedema for Patients Treated for Breast Cancer. Journal of Clinical Oncology 2016; 34(7):691-699.
  • Kilbreath SL, Refshauge KM, Beith JM, Ward LC, Ung OA, Dylke ES, et al. Risk Factors for Lymphoedema in Women with Breast Cancer : A Large Prospective Cohort. The Breast 2016; 28:29-36.
  • Lu SR, Hong RB, Chou W, Hsiao PC. Role of Physiotherapy and Patient Education in Lymphedema Control Following Breast Cancer Surgery. Therapeutics And Clinical Risk Management 2015; 11: 319–327.
  • Brown JC, Kumar A, Cheville AL, Tchou JC, Troxe, AB, Harris SR, Schmitz KH. Association Between Lymphedema Self-Care Adherence and Lymphedema Outcomes among Women with Breast Cancer-Related Lymphedema. Am J Phys Med Rehabil. 2015; 94(4):288–296.
  • Recchia TL, Prim AC, Luz CM. Upper Limb Functionality and Quality of Life in Women With Five-Year Survival After Breast Cancer Surgery. Rev Bras Ginecol Obstet. 2017; 39:115–122.
  • Dawes DJ, Meterissian S, Goldberg M, Mayo N. Impact of Lymphoedema on Arm Function and Health-Related Qualıty of Life in Women Followıng Breast Cancer Surgery. J Rehabil. Med. 2008; 40: 651–658.

Behaviors to Prevent Lymphedema and Functional Use of Arms of Patients with Breast Cancer after Surgery

Yıl 2024, Cilt: 19 Sayı: 1, 67 - 76, 28.03.2024
https://doi.org/10.17517/ksutfd.1193674

Öz

Objective: The aim of this descriptive study was to determine the behaviors to prevent lymphedema and functional use of arms patients with breast cancer after surgery.
Material and Methods: The study was conducted with 125 patients. The data were collected using the Patient Information Form and the Turkish version of the Disabilities of the Arm, Shoulder and Hand Questionnaire-DASH. Chi square, Fisher exact and Independent-Samples t test were used for statistical evaluation of the data.
Results: Lymphedema was detected in 21.6% of the women with breast cancer after surgical treatment. There was no significant difference between exercise status and lymphedema development of the women, but there was a significant difference between exercise duration and the presence of lymphedema (p<0.05). The DASH mean score of the women in the study was found to be 25.57 ± 15.86. The patients with lymphedema had higher DASH scores and had more arm weakness.
Conclusion: It is recommended that nurses give training and consultancy to women with breast cancer and inform patients to do the recommended exercises by regular followups after surgical treatment.

Kaynakça

  • World Health Organization. World Health Statistic 2018: Monitoring Health For The Sdgs, Sustainable Development Goals. Geneva. 2018
  • Türkiye İstatistik Kurumu. Ölüm Nedeni İstatistikleri 2018. TÜİK Haber Bülteni, Sayı: 30626. 2019
  • Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre AT, Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Cancer J Clin. 2018; 68:394–424.
  • Sağlık İstatistikleri Yıllığı 2017. Available From: URL:Https://Dosyasb.Saglik.Gov.Tr/Eklenti/31096,Turkcesiydijiv1pdf.Pdf?0 31.10.2020
  • Büyükakıncak Ö, Akyol Y, Özen N, Ulus Y, Cantürk F, Tander B, ve ark. Meme Kanseri Cerrahisi: Üst Ekstremite İçin Bir Problem Midir? Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 2013; 59:304-309.
  • Güler DS. Meme Kanseri Nedeniyle Ameliyat Olan Hastalarda Kendi Kendine Lenfödem Yönetimi. Meme Sağlığı Dergisi 2008; 4(2): 62-69.
  • Zaralı O, Karaman N, Özaslan C, Hüseyinova S, Altınok M. Long-Term Complications Associated with Mastectomy and Axillary Dissection. Acta Oncologıca Turcıca 2009; 42: 17-23.
  • Doğan L, Akıncı M, Çetin B, Kızıltan G, Karaman N, Altınok M. Mastektomi Sonrası Kol ve Omuzun Pozisyonu Önemli midir? Acta Oncologıca Turcıca 2009; 42:114-117.
  • Ewertz M, Bonde JA. Late Effects of Breast Cancer Treatment and Potentials for Rehabilitation. Acta Oncologica 2011; 50: 187–193.
  • Clark B, Sitzia J, Harlow W. Incidence and Risk of Arm Oedema Following Treatment for Breast Cancer: A Three-Year Follow-Up Study. QJM: An International Journal of Medicine 2005; 98(5): 343–348.
  • Harris SR, Hugi MR, Olivtto IA, Levine, M. Clinical Practice Guidelines for The Care and Treatment of Breast Cancer: 11. Lymphedema. Canadian Medical Association or Its Licensors CMAJ 2001; 164: 191-199.
  • Deo SVS, Ray S, Rath GK, Shukla NK, Kar M, Asthana S, et al. Prevalence and Risk Factors for Development of Lymphedema Following Breast Cancer Treatment. Indian Journal of Cancer 2004; 41(1): 8-12.
  • Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema After Breast Cancer: Incidence, Risk Factors, and Effect on Upper Body Function. Journal of Clınıcal Oncology 2008; 26(21):3536-3542.
  • Akkaş GA. Meme Kanseri Tedavisine Bağlı Lenfödem ve Hemşirelik Bakımı. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi 2005; 9(2): 18-25.
  • Yavuz KA, Gök ÜF. Mastektomili Hastalarda Evde Bakım. Meme Sağlığı Dergisi 2008; 4(1): 3-8.
  • Hawash MAE, Alaa Elden S, El Shatby A, El Moghazy, H, Hamida M. Effect of Nursing Rehabilitation Program on The Prevention of Lymphedema among Post Mastectomy Women. IOSR Journal of Nursing and Health Science (IOSR-JNHS) 2018; 7(86):68-87.
  • Çavdar İ, Kostanoğlu A, Karayurt Ö, Yıldız FÜ, Turan A, Kanan N. Genel Semptomların Yönetimi-Lenfödem. Onkoloji Hemşireliğinde Kanıttan Uygulamaya-Konsensus. 2014; 25-39. İstanbul.
  • Şişman H, Şahin B, Duman BB, Tanrıverdi G. Nurse-Assisted Education and Exercise Decrease The Prevalence and Morbidity of Lymphedema Following Breast Cancer Surgery. JBUON2012; 17:565–569.
  • Nemli A, Tekinsoy Kartin P. Effects of Exercise Training and Follow-Up Calls at Home on Physical Activity and Quality of Life after a Mastectomy. Jpn J Nurs Sci. 2019 Jul;16(3):322-328. Doi: 10.1111/Jjns.12243.
  • Türk G, Atalay M. Mastektomi Sonrası Yaptırılan Egzersizlerin Kol Ödemini Önlemeye Etkisi. Meme Sağlığı Dergisi 2007; 3(3):143-149.
  • Hudak PL, Amadio PC, Bombardier C. Upper Extrenity Collaborative Group, “Development of an Upper Extremity Outcome Measure: The DASH (Disabilities of The Arm, Shoulder, And Hand). Amerıcan Journal of Industrial Medicine 1996; 29:602-608.
  • Düger T, Yakut E, Öksüz Ç, Yörükan S, Milgüta BS, Ayhan Ç. Kol, Omuz, El Sorunları (Disabilities Of The Arm, Shoulder And Hand-DASH) Anketi Türkçe Uyarlamasının Güvenirliği ve Geçerliği. Fizyoterapi Rehabilitasyon 2006; 17(3), 99- 107.
  • Yılmaz E, Coşkun T. Meme Kanserli Hastalarda Üst Ekstremite Sorunları ve Yaşam Kalitesi. Bakırköy Tıp Dergisi 2019; 15:29-37.
  • Hayes SC. Review of Research Evidence on Secondary Lymphoedema: İncidence, Prevention, Risk Factors and Treatment. National Breast and Ovarian Cancer Centre Australia 2008; 19-25.
  • Armer JM, Stewart BR. Post-Breast Cancer Lymphedema: Incidence Increases from 12 To 30 To 60 Months. Lymphology 2010; 43:118-127.
  • Shih YT, Xu Y, Cormier JN, Giordano S, Ridner SH, Buchholz TA, et al. Incidence, Treatment Costs, and Complications of Lymphedema After Breast Cancer Among Women of Working Age: A 2-Year Follow- Up Study. Journal Clinical Oncology 2009; 27(12): 2007-2014.
  • Tsai RJ, Dennis LK, Lynch CF, Snetselaar LG, Zamba GKD, Scott-Conner C. Lymphedema Following Breast Cancer: The Importance of Surgical Methods and Obesity. Front Womens Health 2018; 3(2):1-17.
  • Assis MR, Marx AG, Magna LA, Ferrigno ISV. Late Morbidity in Upper Limb Function and Quality of Life in Women After Breast Cancer Surgery. Braz J Phys Ther. 2013; 17(3):236-243.
  • Norman SA, Localio AR, Kallan MJ, Weber AL, Simoes THA, Potashnik SL, et al. Risk Factors for Lymphedema after Breast Cancer Treatment. Cancer Epidemiol Biomarkers Prev. 2010; 19(11) :2734-2746.
  • Safwat Y, Shaalan M, Mokhtar M, Hamood M. Risk Factors of Upper‑Arm Lymphedema After Breast Cancer Treatment. Journal of Current Medical Research and Practice 2017; 2:73-78.
  • Zhang L, Fan A, Yan J, He Y, Zhang H, Zhong Q, et al. Combining Manual Lymph Drainage with Physical Exercise after Modified Radical Mastectomy Effectively Prevents Upper Limb Lymphedema. Lymphat Res Biol. 2016; 14(2):104-108.
  • Arıkan DA, Kapucu S. Management of Breast Cancer-Related Lymphedema. Turk J Oncol. 2016;31(4):138-148.
  • Arıkan DA, Özdemir L. Lenfödemde Cilt Bakımı ve Koruyucu Yaklaşımlar. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi 2016; 54–64.
  • Fu MR, Axelrod D, Guth AA, Cartwright F, Qiu Z, Goldberg JD, et al. Proactive Approach to Lymphedema Risk Reduction: A Prospective Study. Ann Surg Oncol. 2014; 21(11): 3481–3489.
  • Ferguson CM, Swaroop MN, Horick N, Skolny MN, Miller CL, Jammallo LS, et al. Impact of Ipsilateral Blood Draws, Injections, Blood Pressure Measurements, and Air Travel on The Risk of Lymphedema for Patients Treated for Breast Cancer. Journal of Clinical Oncology 2016; 34(7):691-699.
  • Kilbreath SL, Refshauge KM, Beith JM, Ward LC, Ung OA, Dylke ES, et al. Risk Factors for Lymphoedema in Women with Breast Cancer : A Large Prospective Cohort. The Breast 2016; 28:29-36.
  • Lu SR, Hong RB, Chou W, Hsiao PC. Role of Physiotherapy and Patient Education in Lymphedema Control Following Breast Cancer Surgery. Therapeutics And Clinical Risk Management 2015; 11: 319–327.
  • Brown JC, Kumar A, Cheville AL, Tchou JC, Troxe, AB, Harris SR, Schmitz KH. Association Between Lymphedema Self-Care Adherence and Lymphedema Outcomes among Women with Breast Cancer-Related Lymphedema. Am J Phys Med Rehabil. 2015; 94(4):288–296.
  • Recchia TL, Prim AC, Luz CM. Upper Limb Functionality and Quality of Life in Women With Five-Year Survival After Breast Cancer Surgery. Rev Bras Ginecol Obstet. 2017; 39:115–122.
  • Dawes DJ, Meterissian S, Goldberg M, Mayo N. Impact of Lymphoedema on Arm Function and Health-Related Qualıty of Life in Women Followıng Breast Cancer Surgery. J Rehabil. Med. 2008; 40: 651–658.
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Hava Çolak 0000-0002-2174-8371

Aynur Kızılırmak 0000-0002-5032-7234

Songül Karadağ 0000-0003-0604-8008

Erken Görünüm Tarihi 28 Mart 2024
Yayımlanma Tarihi 28 Mart 2024
Gönderilme Tarihi 24 Ekim 2022
Kabul Tarihi 7 Mart 2023
Yayımlandığı Sayı Yıl 2024 Cilt: 19 Sayı: 1

Kaynak Göster

AMA Çolak H, Kızılırmak A, Karadağ S. Behaviors to Prevent Lymphedema and Functional Use of Arms of Patients with Breast Cancer after Surgery. KSÜ Tıp Fak Der. Mart 2024;19(1):67-76. doi:10.17517/ksutfd.1193674