Quality of life with lmyphedema : post breast cancer patients in Karachi, Pakistan
Date of Award
Master of Science in Nursing (MScN)
School of Nursing and Midwifery, Pakistan
Background Lymphedema is a dreadful, prolonged, and non-life threatening side effect of breast cancer surgeries and radiation. Lymphedema impacts patients' quality of life with wide range of physical arm pain and mobility and psychosocial problems stress, depression, anxiety, impaired body image, and social isolation. Objective The study aimed to identify the impact of lymphedema on patients' quality of life aspects including symptoms, physical, and psychosocial functioning, pain, mood, and body image. In addition, the study aimed to discover the association of lymphedema with the socio-demographic variables and the health related factors of the study participants. Design and Methodology An analytical cross sectional study was conducted on breast cancer patients at the Aga Khan University Hospital and the Institute of Radiotherapy and Nuclear Medicine, between March and May, 2012. Data was collected using the modified LYMQOL Limb Lymphedema Quality of life tool among lymphedema and non lymphedema group. Arm circumference at different levels was measured to determine the presence and severity of lymphedema. Data were analyzed by t-test, chi-square test and multiple logistic regressions. Result Among the 336 of breast cancer, 41.1% women had developed lymphedema. There were significantly increased risks of lymphedema if women were with higher such as; axillary lymph node dissection (p value : <.01), radiation therapy (p value : <.007), hypertension (p value : <.04), and lack information of lymphedema (p value : <.001).The lymphedema group was significantly affected quality of life having high odds ratios for pain in neck (OR=1.8), in shoulder (OR=1.67), in arm (OR=1.63), numbness (OR=2.07) , and heaviness(2.39). Moreover, on sub scale of physical functions effected quality of life having high odds ratios during eating (OR=3.10), occupation (017=3.08), and in body image feeling self (OR-2.69), appearance (OR=2.31), wearing jewelries (OR=2.31).Whereas, social domain was analyzed by using in qualitative approach and five themes were emerged restrict socialization, poor body Image, physical limitation, appearance and coping strategies. Conclusion Lymphedema is recognized as an unpleasant and uncomfortable condition which is associated with lower quality of life, due to, severity of arm symptoms. These symptoms associated with decrease physical, psycho social life lymphedema group. In summary the study suggested that patient education should start soon after breast cancer treatment .A long term lymphedema program to be prepared and implemented by a multidisciplinary approach including nurses, doctors, and physiotherapists.
Waheed, H. Y. (2012). Quality of life with lmyphedema : post breast cancer patients in Karachi, Pakistan (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.