2.50
Hdl Handle:
http://hdl.handle.net/10755/338328
Category:
Full-text
Type:
Presentation
Title:
Breast Cancer Related Lymphedema: An Algorithm for Self-Care
Author(s):
Tedin-Moschovas, Paula D.
Lead Author STTI Affiliation:
Beta Phi
Author Details:
Paula D. Tedin-Moschovas, MSN, RN, pmoschovas@yahoo.com
Abstract:
Session presented on Thursday, September 25, 2014: In 2013, there were 2.8 million breast cancer survivors in America and Armer, et al, (2008) reveal that 20-40% will develop breast cancer-related lymphedema (BCRL). BCRL is an accumulation of lymph fluid in the interstitial spaces, of the arm or chest wall, where normal lymphatic flow has been disrupted by axillary node dissection, mastectomy, radiation or chemotherapy. Once lymphedema (LE) develops it becomes a chronic condition requiring medical and therapeutic support. The purpose of this scholarly activity is to create then study an algorithm to assist the patient in self-care. Knowledgeable nurses, physicians and lymphedema therapists using the algorithm, will be able to plan, educate and support the patients self-care activities. The PICOT question is: For patients who have breast cancer surgery or treatment, would the patient increase BCRL self-care activities if provided a personalized self-care algorithm for BCRL versus being provided education materials without a personalized algorithm over a period of 6 months? The literature reviewed included seven primary research articles and one guideline. There is strong evidence for complete decongestive therapy (CDT) initial phase, which is performed by lymphedema therapists. Studies are few and sample sizes small for CDT maintenance phase or the care following the initial phase of CDT. During the CDT maintenance phase the patient manages their symptoms of lymphedema at home. Other findings in the literature search revealed, exercise and weight reduction provide a decrease in symptoms and a decreased arm volume. Patient educational information produces more risk-reduction activities, yet limitations of self-care are many. A gold standard for assessing lymphedema has not been established within the literature. The Chronic Illness Trajectory Framework by Corbin and Strauss (1991) consists of concepts for understanding the management, perceptions, reciprocal impact and goals of the trajectory, or course, of a chronic illness. The trajectory of BCRL is unpredictable thus making it unique to each patient. Nurses are in a position to provide support during the patients journey along this trajectory. Nurses educate patients regarding prevention and self-care for chronic disease processes. Communicating with the patient and a multidisciplinary team to identify patient goals, limiting factors, burden of treatment and self-care activities, are nursing roles. More specifically, assessment of the chronic illness trajectory phase and identifying appropriate healthcare referrals and self-care could possibly avert hospitalization or development of BCRL. The nurse is positioned to assist the patient in meeting self-care goals, management and challenges of the patients lifetime risk and unique trajectory of BCRL. The BCRL Algorithm describes healthcare provider and patient activities in the management of BCRL throughout the trajectory. The research question could be answered by using the algorithm to identify the phase in which the patient presents. BCRL requires complex management and by assessing patient goals, planning interventions and evaluating patient limitations related to the phase of the trajectory, the nurse is able to support the patient through their life with BCRL. Future study of the algorithm is planned.
Keywords:
Breast cancer; Lymphedema
Repository Posting Date:
15-Jan-2015
Date of Publication:
15-Jan-2015
Other Identifiers:
LEAD14PST70
Conference Date:
2014
Conference Name:
Leadership Summit 2014
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
Leadership Summit 2014 Theme: Personal. Professional. Global. Held at the Indianapolis Marriott Downtown, Indianapolis.
Note:
Items submitted to a conference/event were evaluated/peer-reviewed at the time of abstract submission to the event. No other peer-review was provided prior to submission to the Henderson Repository.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleBreast Cancer Related Lymphedema: An Algorithm for Self-Careen_US
dc.contributor.authorTedin-Moschovas, Paula D.en
dc.contributor.departmentBeta Phien
dc.author.detailsPaula D. Tedin-Moschovas, MSN, RN, pmoschovas@yahoo.comen
dc.identifier.urihttp://hdl.handle.net/10755/338328-
dc.description.abstractSession presented on Thursday, September 25, 2014: In 2013, there were 2.8 million breast cancer survivors in America and Armer, et al, (2008) reveal that 20-40% will develop breast cancer-related lymphedema (BCRL). BCRL is an accumulation of lymph fluid in the interstitial spaces, of the arm or chest wall, where normal lymphatic flow has been disrupted by axillary node dissection, mastectomy, radiation or chemotherapy. Once lymphedema (LE) develops it becomes a chronic condition requiring medical and therapeutic support. The purpose of this scholarly activity is to create then study an algorithm to assist the patient in self-care. Knowledgeable nurses, physicians and lymphedema therapists using the algorithm, will be able to plan, educate and support the patients self-care activities. The PICOT question is: For patients who have breast cancer surgery or treatment, would the patient increase BCRL self-care activities if provided a personalized self-care algorithm for BCRL versus being provided education materials without a personalized algorithm over a period of 6 months? The literature reviewed included seven primary research articles and one guideline. There is strong evidence for complete decongestive therapy (CDT) initial phase, which is performed by lymphedema therapists. Studies are few and sample sizes small for CDT maintenance phase or the care following the initial phase of CDT. During the CDT maintenance phase the patient manages their symptoms of lymphedema at home. Other findings in the literature search revealed, exercise and weight reduction provide a decrease in symptoms and a decreased arm volume. Patient educational information produces more risk-reduction activities, yet limitations of self-care are many. A gold standard for assessing lymphedema has not been established within the literature. The Chronic Illness Trajectory Framework by Corbin and Strauss (1991) consists of concepts for understanding the management, perceptions, reciprocal impact and goals of the trajectory, or course, of a chronic illness. The trajectory of BCRL is unpredictable thus making it unique to each patient. Nurses are in a position to provide support during the patients journey along this trajectory. Nurses educate patients regarding prevention and self-care for chronic disease processes. Communicating with the patient and a multidisciplinary team to identify patient goals, limiting factors, burden of treatment and self-care activities, are nursing roles. More specifically, assessment of the chronic illness trajectory phase and identifying appropriate healthcare referrals and self-care could possibly avert hospitalization or development of BCRL. The nurse is positioned to assist the patient in meeting self-care goals, management and challenges of the patients lifetime risk and unique trajectory of BCRL. The BCRL Algorithm describes healthcare provider and patient activities in the management of BCRL throughout the trajectory. The research question could be answered by using the algorithm to identify the phase in which the patient presents. BCRL requires complex management and by assessing patient goals, planning interventions and evaluating patient limitations related to the phase of the trajectory, the nurse is able to support the patient through their life with BCRL. Future study of the algorithm is planned.en
dc.subjectBreast canceren
dc.subjectLymphedemaen
dc.date.available2015-01-15T13:35:38Z-
dc.date.issued2015-01-15-
dc.date.accessioned2015-01-15T13:35:38Z-
dc.conference.date2014en
dc.conference.nameLeadership Summit 2014en
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationIndianapolis, Indiana, USAen
dc.descriptionLeadership Summit 2014 Theme: Personal. Professional. Global. Held at the Indianapolis Marriott Downtown, Indianapolis.en
dc.description.noteItems submitted to a conference/event were evaluated/peer-reviewed at the time of abstract submission to the event. No other peer-review was provided prior to submission to the Henderson Repository.-
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