Effect of self-management intervention on the prevention and management of lymphedema in breast cancer patients: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Zijuan ¹ , FU Xin ¹ , HU Qian ¹ , ZHANG Lichuan ¹ , SHEN Aomei ¹ , WANG Yujie ² , CHEN Shuyu ¹ ,  LU Qian ¹

1. Peking University School of Nursing, Beijing 100191, P. R. China;
2. Department of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Henan 450003, P. R. China;

Corresponding?author：

LU Qian, Email: luqian@bjmu.edu.cn

Keywords：

Breast cancer; Self-management; Systematic review; Meta-analysis; Randomized controlled trials; Lymphedema

DOI：

10.7507/1672-2531.202311189

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the effect of self-management intervention on the prevention and management of lymphedema in breast cancer patients. Methods The Cochrane Library, Embase, PubMed, Web of Science, CINAHL, PsycINFO, SinoMed, CNKI, WanFang Data and VIP databases were electronically searched to collect studies on self-management intervention on the prevention and management of lymphedema in breast cancer patients, from inception to June 16. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed using RevMan 5.4 software. Results A total of 37 references were included, comprising 25 randomized controlled trials (RCTs), 12 controlled clinical trials (CCTs), and a total of 3 697 patients. There were 26 studies in the meta-analysis, and the results of the meta-analysis showed that, compared with the control group, patients in the intervention group exhibited better performance in lymphedema management-related behaviors (SMD=2.65, 95%CI 1.53 to 3.78, P<0.01), symptoms related to lymphedema (SMD=?2.01, 95%CI ?3.66 to ?0.37, P<0.05), occurrence of lymphedema (RR=0.37, 95%CI 0.32 to 0.45, P<0.01), upper limb function (SMD=?1.88, 95%CI ?2.83 to ?0.92, P<0.01), quality of life (SMD=2.79, 95%CI 2.05 to 3.54, P<0.01), and the difference was statistically significant. The intervention mainly included information support, material support, emotional support and decision support. Conclusion There are currently a variety of self-management interventions, but they mainly focus on information support. Self-management interventions can improve the self-management behavior of breast cancer patients with lymphedema and reduce the impact of lymphedema on patients.

Citation： ZHANG Zijuan, FU Xin, HU Qian, ZHANG Lichuan, SHEN Aomei, WANG Yujie, CHEN Shuyu, LU Qian. Effect of self-management intervention on the prevention and management of lymphedema in breast cancer patients: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2024, 24(10): 1177-1185. doi: 10.7507/1672-2531.202311189 Copy

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2. Shen A, Lu Q, Fu X, et al. Risk factors of unilateral breast cancer-related lymphedema: an updated systematic review and meta-analysis of 84 cohort studies. Support Care Cancer, 2022, 31(1): 18.
3. 劉飛, 路潛, 歐陽倩, 等. 乳腺癌患者術后淋巴水腫與其相關癥狀的關系研究. 中華護理雜志, 2016, 51(5): 518-522.
4. Eaton LH, Narkthong N, Hulett JM. Psychosocial issues associated with breast cancer-related lymphedema: a literature review. Curr Breast Cancer Rep, 2020, 12(4): 216-224.
5. McNeely ML, Dolgoy ND, Rafn BS, et al. Nighttime compression supports improved self-management of breast cancer-related lymphedema: a multicenter randomized controlled trial. Cancer, 2022, 128(3): 587-596.
6. Fu X, Lu Q, Pang D, et al. Experiences of breast cancer survivors with lymphedema self-management: a systematic review of qualitative studies. J Cancer Surviv, 2023, 17(3): 619-633.
7. Shen A, Wu P, Qiang W, et al. Factors associated with lymphedema self-management behaviours among breast cancer survivors: a cross-sectional study. J Clin Nurs, 2023, 32(19-20): 7330-7345.
8. Ahmadi M, Shahrokhi SN, Khavaninzadeh M, et al. Development of a mobile-based self-care application for patients with breast cancer-related lymphedema in Iran. Appl Clin Inform, 2022, 13(5): 935-948.
9. Omidi Z, Kheirkhah M, Abolghasemi J, et al. Effect of lymphedema self-management group-based education compared with social network-based education on quality of life and fear of cancer recurrence in women with breast cancer: a randomized controlled clinical trial. Qual Life Res, 2020, 29(7): 1789-1800.
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14. 侯鳳蘭, 肜芳, 劉亞輝, 等. 基于知信行理論的延續性護理干預對乳腺癌患者術后負性情緒及癌因性疲乏的影響. 河南醫學研究, 2022, 31(19): 3604-3606.
15. 蔣春兒, 虞亞梅, 張永芳, 等. 基于神經語言程序技術的支持性照護在乳腺癌相關淋巴水腫及負性情緒干預中的應用. 世界腫瘤研究, 2022, 12(4): 217-224.
16. 袁琛燁, 周之音. 基于智慧醫療系統的管理模式預防乳腺癌患者術后淋巴水腫的效果觀察. 國際醫藥衛生導報, 2022, 28(3): 336-340.
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20. Fu MR, Axelrod D, Guth AA, et al. A web- and mobile-based intervention for women treated for breast cancer to manage chronic pain and symptoms related to lymphedema: results of a randomized clinical trial. JMIR Cancer, 2022, 8(1): e29485.
21. 朱春蘭, 朱倩華, 楊靜. 復合護理干預對乳腺癌術后淋巴水腫的療效分析. 齊齊哈爾醫學院學報, 2021, 42(2): 165-167.
22. 李玉環. 基于時機理論的階段干預方案對預防乳腺癌患者術后淋巴水腫的效果研究. 鄭州: 鄭州大學, 2021.
23. 侯曉麗. 自我管理教育對乳腺癌根治術后患者自護能力及功能鍛煉依從性的影響. 國際護理學雜志, 2021, 40(13): 2376-2379.
24. Noura S, Kiani F, Moulaei N, et al. Effect of self-care training on upper limb function and pain after breast cancer surgery. Med Surg Nurs J, 2021, 10(2): 1-8.
25. 龍娟. Teach-back健康教育聯合手法淋巴引流對乳腺癌術后患者上肢淋巴水腫預防效果的研究. 貴陽: 貴州中醫藥大學, 2020.
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Chinese Journal of Evidence-Based Medicine

Effect of self-management intervention on the prevention and management of lymphedema in breast cancer patients: a meta-analysis

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