Abstract:
Objective To explore the application of complex decongestive therapy (CDT) combined with internet nursing guidance(ING) in the breast cancer-related lymphedema (BCRL) nursing clinic.
Methods A total of 143 patients with postoperative BCRL in the lymphedema nursing clinic, Department of Breast Diseases, Jiangsu Provincial Hospital were enrolled into a prospective study by convenience sampling. The patients who were treated from January 2019 to June 2020. There were 72 cases in control group, and 73 cases in intervention group. In the control group, the patients received CDT and routine nursing guidance; in the intervention group, the patients received ING combined with CDT and routine nursing guidance. The rank sum test was used to compare the degree of edema in the arms between two groups before treatment, at the end of treatment and 6 months after treatment. The repeated measures analysis of variance was used to compare the scores of symptom occurrence and symptom distress in the breast cancer lymphedema symptom experience index (BCLE-SEI) scale.
Results (1) At 6 months after treatment, there was a significant difference in the degree of edema between two groups (Z=-2.444, P<0.050). (2) After CDT combined with ING, the total score of symptom occurrence in the BCLE-SEI scale was decreased from 67.2±1.4 before treatment to 25.1±2.0 at the end of treatment and 38.2±1.4 at 6 months after treatment in intervention group, 66.5±1.4, 25.8±2.3 and 48.4±1.9 in control group, respectively, indicating a significant difference between two groups (F=19.338, P<0.001); the total score of symptom occurrence in the BCLE-SEI scale in the patients of the same group presented a significant difference among different time points (F=243.672, P<0.001); there was interactive effect between intervention measures and time in seven items (impaired mobility of fingers, arm swelling, chest wall swelling, tightness, heaviness and tenderness of limbs, increased temperature of skin) and the total score. At 6 months after treatment, the above-mentioned scores showed a significant difference between two groups (t=-2.945, -3.255, -3.101, -3.124, -3.187, -2.892, -3.233, -4.360, P=0.004, 0.001, 0.002, 0.002, 0.002, 0.004, 0.002, <0.001). (3) The total score of symptom distress in the BCLE-SEI scale was decreased from 62.5±14.5 before treatment to 39.4±16.5 at the end of treatment and 36.9±15.6 at 6 months after treatment in intervention group, 63.8±15.3, 39.9±16.0 and 45.1±18.2 in control group, respectively, indicating a significant difference between two groups (F=2.543, P=0.113); the total score of symptom distress in the BCLE-SEI scale in the patients of the same group presented a significant difference among different time points (F=213.523, P<0.001); there was interactive effect between intervention measures and time in the items of sexual life, emotion & psychology and total score of symptom distress. At 6 months after treatment, the above-mentioned scores showed a significant difference between two groups (t= -4.721, -2.109, -2.882, P<0.001, 0.037, 0.005).
Conclusion CDT combined with ING is feasible and effective in the BCRL nursing clinic, worthy of clinical application.
Key words:
Breast neoplasms,
Lymphedema,
Postoperative care,
Computer communication networks,
Ambulatory care
Haiping Xu, Li Sun, Kaihui Wang, Jing Lu, Chaoli Yue, Shui Wang. Application of complex decongestive therapy combined with internet nursing guidance in breast cancer-related lymphedema nursing clinic[J]. Chinese Journal of Breast Disease(Electronic Edition), 2021, 15(06): 359-365.