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J. Pers. Med. 2015, 5(4), 370-388; doi:10.3390/jpm5040370

Complexities of Adherence and Post-Cancer Lymphedema Management

1
Sinclair School of Nursing, University of Missouri, Columbia, MO 65211, USA
2
Lymphedema Research Laboratory, Sinclair School of Nursing, University of Missouri, DC 116.05, Suite 408, Mizzou North Campus, Columbia, MO 65211, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Stephen B. Liggett
Received: 17 July 2015 / Revised: 29 October 2015 / Accepted: 9 November 2015 / Published: 16 November 2015
(This article belongs to the Special Issue Long-term Cancer Survivorship)
View Full-Text   |   Download PDF [440 KB, uploaded 16 November 2015]

Abstract

Breast cancer survivors are at increased risk for breast cancer-related lymphedema (BCRL), a chronic, debilitating, condition that is progressive and requires lifelong self-management. Up to 40% of 3 million breast cancer survivors in the US will develop BCRL, which has no cure, is irreversible, and requires self-management with regimens that may include multiple components. The complexities of treatment can negatively affect adherence to BCRL self-management which is critical to preventing progressive swelling and infection. The aim of this review of contemporary literature published from 2005–2015 is to examine the complexities of BCRL self-management, to identify adherence-focused studies relevant to BCRL, and to summarize barriers to self-management of BCRL. Six electronic indices were searched from which 120 articles were retrieved; 17 were BCRL-focused; and eight met inclusion criteria. Seventeen of 120 articles identified barriers to self-management of BCRL such as complexities of treatment regimens, symptom burden, balance of time for treatment and life demands, and lack of education and support; however, only eight studies included outcome measures of adherence to BCRL treatment regimens with a subsequent improvement in reduced limb volumes and/or perceptions of self-efficacy and self-regulation. A major limitation is the few number of rigorously developed outcome measures of BCRL adherence. In addition, randomized studies are needed with larger sample sizes to establish adequate levels of evidence for establishing best practice standards for improving adherence to BCRL self-management treatment regimens. View Full-Text
Keywords: adherence; breast cancer; compliance; lymphedema; management; self-care; symptom distress; treatment burden adherence; breast cancer; compliance; lymphedema; management; self-care; symptom distress; treatment burden
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Ostby, P.L.; Armer, J.M. Complexities of Adherence and Post-Cancer Lymphedema Management. J. Pers. Med. 2015, 5, 370-388.

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