Meme kanseri hastalarında kompresyon giysisi uyum faktörlerinin değerlendirilmesi

Öz

Amaç: Kompleks dekonjestif tedavi (KDT) postmastektomi lenfödemin standart tedavisidir. Çalışmamızın amacı KDT'nin ana aşamalarından biri olan kompresyon giysisine uyumu bozan faktörleri belirlemek ve lenfödem hastalarının tedaviye uyumunu artırarak lenfödemin sınırlayıcı etkilerini azaltmaktır. Gereç ve Yöntem: Bu prospektif çalışmada, hastaların demografik ve klinik bilgileri, Lenfödem evresi (International Society of Lymphology (ISL)) ve daha önce lenfödem tedavisi alıp almadıkları sorgulandı. Kompresyon giysisi kullanım deneyimi ve kompresyon giysisi kullanımında hasta uyumunu etkileyen faktörler; 5'li Likert tipi ölçekli bir anket ile değerlendirildi. Bulgular: Postmastektomi sonrası 71 lenfödem hastasının yaş ortalaması 56.3±8.6 yıldı. Hastaların 29'u (%40.8) kompresyon giysilerini her gün düzenli olarak kullanırken, 42'si (%59.1) düzenli olarak kullanmıyordu. Ortalama puan değerlerine bakıldığında, kompresyon giysisine uyumu bozan kısıtlayıcı faktörlerin ilk 3 nedeni şöyleydi: hastalar en çok kompresyon giysisini giyip çıkarmakta sorun yaşıyordu (3,94±1,30), kompresyon giysisini kullanırken günlük yaşamda ev işlerini yaparken (3,92±1,36) ve spor ve hobi aktivitelerine katılmakta zorlanıyorlardı (3,84±1,41). Sonuç: Hastaların spesifik özellikleri, yaşam tarzı ve öyküsü kompresyon giysilerinin seçiminde önemlidir. Kompresyon giysisine uyumu bozan faktörleri belirlemek, hastaları lenfödem önleyici tedbirler hakkında bilgilendirmek ve kompresyon giysisi ile günlük yaşama daha iyi uyum sağlamalarını sağlamak, kendi kendine tedavi yönetimini iyileştirebilir ve bakıcılara olan ihtiyacı azaltabilir.

Anahtar Kelimeler

• Postmastektomi lenfödem
• kompleks dekonjestif tedavi
• kompresyon giysisi
• gece kompresyon bandajı.

Evaluation Of Compression Garment Compliance Factors İn Breast Cancer Patients

Öz

Aim: Complete decongestive therapy (CDT) is the standard treatment of postmastectomy lymphedema. Our study aimed to determine the factors that impair compliance with the compression garment, one of the main phases of CDT, and to reduce the limiting effects of lymphedema by increasing the treatment compliance of lymphedema patients. Material and Methods: In this prospective study, demographic and clinical information of the patients were recorded. The stage of lymphedema (International Society of Lymphology (ISL)) and whether they had received lymphedema treatment before were questioned. The experience of pressure garment use was evaluated with a 5-point Likert-type scale questionnaire covering factors affecting patient compliance. Results: The mean age of 71 postmastectomy lymphedema patients was 56.3±8.6 years. 29 patients (40.8%) used their compression garments regularly every day, while 42 (59.1%) patients did not use them regularly. Regarding the mean score values, the top 3 reasons for limiting factors impairing compliance with the pressure garment were as follows: the patients had the most problems putting on and taking off the garment (3.94±1.30), had difficulty in housework in daily life (3.92±1.36), and had difficulty in participating in sports and hobby activities (3.84±1.41). Conclusion: Patients' specific characteristics, lifestyle, and history are important in the selection of compression garments. It is important to identify factors that impair compliance with the compression garment, to inform patients about lymphedema preventive measures, and to enable them to better adapt to daily life with the compression garment may improve self-treatment management and reduce the need for caregivers

Anahtar Kelimeler

• Postmastectomylymphedema
• completedecongestivetherapy
• compressiongarment
• night compressionbandage

Kaynakça

1. Shamoun, S. and M. Ahmad, Complete Decongestive Therapy Effect on Breast Cancer Related to Lymphedema: A Systemic Review and Meta-Analysis of Randomized Controlled Trials. Asian Pac J Cancer Prev, 2023. 24(7): p. 2225-2238.
2. Torgbenu, E., T. Luckett, M.A. Buhagiar, and J.L. Phillips, Guidelines relevant to diagnosis, assessment, and management of lymphedema: a systematic review. Advances in Wound Care, 2023. 12(1): p. 15-27.
3. McGlynn, K.A., J.L. Petrick, and H.B. El-Serag, Epidemiology of Hepatocellular Carcinoma. Hepatology, 2021. 73 Suppl 1(Suppl 1): p. 4-13.
4. Hobday, A., Continuing Professional Development. Use of compression therapy in patients with lymphoedema. Nursing Standard, 2016. 30(27).
5. Witte, M. and M. Bernas, Evolution of the 2020 International Society of Lymphology Consensus document parallels advances in Lymphology: An Historical Perspective. Lymphology, 2020. 53(1).
6. Keeley, V., S. Crooks, J. Locke, D. Veigas, K. Riches, and R. Hilliam, A quality of life measure for limb lymphoedema (LYMQOL). Journal of Lymphoedema, 2010. 5(1): p. 26-37.
7. Rockson, S.G., P. Karaca-Mandic, R. Skoracki, et al., Clinical Evaluation of a Novel Wearable Compression Technology in the Treatment of Lymphedema, an Open-Label Controlled Study. Lymphat Res Biol, 2022. 20(2): p. 125-132.
8. Monteiro, A.J., C. de Labra, M.E. Losa-Iglesias, et al., Depressive symptoms and their severity in a sample with lymphedema: a case-control investigation. Front Psychiatry, 2023. 14: p. 1202940.

9. Ochalek, K., H. Partsch, T. Gradalski, and Z. Szygula, Do Compression Sleeves Reduce the Incidence of Arm Lymphedema and Improve Quality of Life? Two-Year Results from a Prospective Randomized Trial in Breast Cancer Survivors. Lymphat Res Biol, 2019. 17(1): p. 70-77.
10. Lee, N. and J. Wigg, Selecting compression garments for treating chronic oedema. British Journal of Community Nursing, 2012. 17(Sup10): p. S26-S31.
11. Johansson, K., K. Blom, L. Nilsson-Wikmar, and C. Brogårdh, Early Intervention with a Compression Sleeve in Mild Breast Cancer-Related Arm Lymphedema: A 12-Month Prospective Observational Study. Cancers (Basel), 2023. 15(10).
12. Cinar, N., Ü. Seckin, D. Keskin, H. Bodur, B. Bozkurt, and Ö. Cengiz, The effectiveness of early rehabilitation in patients with modified radical mastectomy. Cancer nursing, 2008. 31(2): p. 160-165.
13. Singh, B., T. Disipio, J. Peake, and S.C. Hayes, Systematic Review and Meta-Analysis of the Effects of Exercise for Those With Cancer-Related Lymphedema. Arch Phys Med Rehabil, 2016. 97(2): p. 302-315.e13.
14. Nadal Castells, M.J., E. Ramirez Mirabal, J. Cuartero Archs, et al., Effectiveness of Lymphedema Prevention Programs With Compression Garment After Lymphatic Node Dissection in Breast Cancer: A Randomized Controlled Clinical Trial. Front Rehabil Sci, 2021. 2: p. 727256.
15. Karlsson, K., G. Biguet, K. Johansson, and L. Nilsson‐Wikmar, Perceptions of lymphoedema treatment in patients with breast cancer–a patient perspective. Scandinavian journal of caring sciences, 2015. 29(1): p. 110-117.
16. ohansson, K., H. Holmström, I. Nilsson, C. Ingvar, M. Albertsson, and C. Ekdahl, Breast cancer patients' experiences of lymphoedema. Scand J Caring Sci, 2003. 17(1): p. 35-42.
17. Barański, K. and J. Chudek, Factors affecting patients' self- management in chronic venous disorders: a single-center study. Patient Prefer Adherence, 2016. 10: p. 1623-9.
18. Van Hecke, A., M. Grypdonck, H. Beele, K. Vanderwee, and T. Defloor, Adherence to leg ulcer lifestyle advice: qualitative and quantitative outcomes associated with a nurse-led intervention. J Clin Nurs, 2011. 20(3-4): p. 429-43.
19. Hampton, S., Elvarex compression garments in the management of lymphoedema. Br J Nurs, 2003. 12(15): p. 925-6, 928-9.
20. Blom, K.Y., K.I. Johansson, L.B. Nilsson-Wikmar, P.E. Klernäs, and C.B. Brogårdh, Impact on Health-Related quality of life after wearing compression garment or not for six months in women with mild breast cancer-related arm lymphedema. A cross- sectional study. Acta Oncol, 2023. 62(5): p. 528-534.
21. Vignes, S. and M. Arrault, Adverse effects of compression in treatment of limb lymphedema. Journal des Maladies Vasculaires, 2009. 34(5): p. 338-345.
22. Barlow, S., R. Dixey, J. Todd, V. Taylor, S. Carney, and R. Newell, 'Abandoned by medicine'? A qualitative study of women's experiences with lymphoedema secondary to cancer, and the implications for care. Prim Health Care Res Dev, 2014. 15(4): p. 452-63.
23. Fu, M.R., S.H. Ridner, S.H. Hu, B.R. Stewart, J.N. Cormier, and J.M. Armer, Psychosocial impact of lymphedema: a systematic review of literature from 2004 to 2011. Psychooncology, 2013. 22(7): p. 1466-84.
24. Bertsch, T., Evaluation of a novel night-time compression garment: a prospective observational study. Br J Community Nurs, 2018. 23(11): p. 535-541.
25. Ramadan, F., Night-time compression: a valuable addition to the lymphoedema management toolkit. Br J Community Nurs, 2023. 28(6): p. 293-296.
26. Framework, L., Best practice for the management of lymphoedema. International consensus. London: MEP Ltd, 2006: p. 3-52.
27. Linnitt, N. and J. Jones, Indications for deciding compression in the treatment of chronic oedema. British Journal of Community Nursing, 2012. 17(Sup4): p. S11-S15.