Prospective Nursing Study of Breast Cancer Lymphedema

描述(申请人提供)：在西方世界，乳腺癌和 它的治疗是导致淋巴水肿的主要原因。200多万女性 在这个国家，患有乳腺癌的人占到了近25% 所有癌症幸存者自始至终都有发生淋巴水肿的风险 他们的一生。淋巴水肿既有急性的，也有慢性的， 以显著的持续性肿胀为特征，与异常 受影响区域内富含蛋白质的液体堆积。网络的影响 未得到控制和未解决的淋巴水肿对生存妇女生活质量的影响 乳腺癌范围广泛，包括人际关系和家庭。 人际关系、职能能力、职业角色、自我形象和 自尊。拟议的护理研究的目标是描述 淋巴水肿的测量、发生率、管理和总体影响 被诊断为乳腺癌并接受治疗并随访超过30个月的女性。 这项研究的主要目的有两个：目标1：比较可靠性和 肢体积液量两种测量方法的临床有效性：(A) 传统的周向手臂测量与(B)红外透过率测量，在 术前、术后及常规随访点。目标2：检查 随着时间的推移，经历的症状类型和功能健康状态 伴有和不伴有淋巴水肿的乳腺癌患者。次要目标(目标3)是： 随着时间的推移，检查和比较复杂的关系(主要效果、主持人、 调解人)之间：(A)解决问题和社会支持，(B)淋巴水肿和 应对有效性；和(C)治疗后心理社会适应和 功能健康。这些目标将通过前瞻性的、纵向的 设计，它将支持测量、入射、 接受乳房治疗的女性的心理社会适应与健康状况 通过心理测量学良好的面对面采访患癌症，以及 生理指标。约200名妇女被诊断并随后接受治疗 乳腺癌将在第一年和第二年招募和登记，并在接下来的时间里 30个月。该研究将提供有关测量的新信息 淋巴水肿，这是深化准确理解的关键问题 淋巴水肿的发生、处理及其对乳房生活的影响 癌症患者。这项调查的结果也将提供重要的 有关淋巴水肿症状和体征的信息，自我护理管理，及其 对心理社会适应和功能健康的影响；这些信息将 这是后续对淋巴水肿患者进行干预的基础。这个 结果确定了生理和心理之间更复杂的关系 心理社会变量将指导护理的发展和测试 预防、检测和管理乳腺癌后治疗的干预措施 淋巴浮肿。

DESCRIPTION (provided by applicant): In the Western world, breast cancer and its treatment are the leading causes of lymphedema. More than two million women living with breast cancer in this country, accounting for nearly 25 percent of all cancer survivors, are at risk for development of lymphedema throughout their lifetimes. Lymphedema occurs as both an acute and chronic condition, characterized by significant persistent swelling associated with an abnormal accumulation of protein-rich fluid in the affected area. The impact of unmanaged and unresolved lymphedema on quality of life among women surviving breast cancer is extensive, encompassing interpersonal and family relationships, functional abilities, occupational roles, self-image, and self-esteem. The goal of the proposed nursing study is the description of measurement, incidence, management, and overall effect of lymphedema among women diagnosed with and treated for breast cancer and followed over 30 months. The primary aims of this study are two-fold: Aim 1: Compare the reliability and clinical validity of two measurement methods for limb fluid volume: (a) traditional circumferential arm measurement versus (b) infrared perometry, at pre-operative, postoperative, and routine follow-up points. Aim 2: Examine across time the type of symptoms experienced and functional health status of breast cancer patients with and without lymphedema. A secondary aim (Aim 3) is: Examine and compare over time the complex relations (main effects, moderators, mediators) between: (a) problem solving and social support, (b) lymphedema and coping effectiveness, and (c) post-treatment psychosocial adjustment and functional health. These aims will be met through a prospective, longitudinal design, which will support the examination of measurement, incidence, psychosocial adjustment, and health status among women treated for breast cancer through psychometrically sound face-to-face interviews, and physiological measures. Some 200 women diagnosed and subsequently treated for breast cancer will be recruited and enrolled in years 1 and 2 and followed over 30 months. The study will provide new information about the measurement of lymphedema, which is a critical issue in furthering an accurate understanding of the incidence, management, and effect of lymphedema on the lives of breast cancer patients. Findings from this investigation will also provide important information about lymphedema signs and symptoms, self-care management, and its impact on psychosocial adjustment and functional health; this information will form the basis of subsequent interventions with lymphedema patients. The results identifying more complex relationships between the physiological and psychosocial variables will guide development and testing of nursing interventions to prevent, detect, and manage post-breast cancer treatment lymphedema.