Lymphedema Risk Reduction for Chinese Breast Cancer Survivors

降低中国乳腺癌幸存者的淋巴水肿风险

• 批准号: 8504500
• 负责人: Mei Rosemary Fu
• 金额: $ 1.94万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至 2017-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8504500
• 关键词: Adherence; Adverse effects; Affect; Area; Asian Americans; Attention; Behavior Therapy; Behavioral; Body Composition; Body mass index; Breast; Breast Cancer Treatment; Cancer Survivor; Cellulitis; Chinese People; Clinical Trials; Cognitive; Data; Devices; Diagnosis; Disease; Distress; Doctor of Philosophy; Early Diagnosis; Early treatment; Economic Burden; Education; Educational Intervention; Effectiveness; Effectiveness of Interventions; English Language; Evaluation; Excision; Focus Groups; Foundations; Funding; Health; Healthcare; Healthcare Systems; Immigrant; Infection; Inflammation; Intervention; Knowledge; Language; Limb structure; Linguistics; Liquid substance; Lymph; Lymphangitis; Lymphedema; Morbidity - disease rate; Numbness; Nurses; Outcome; Pain; Patient Care; Patients; Physiological; Process; Quality of life; Radiation therapy; Randomized Controlled Clinical Trials; Reporting; Risk; Risk Reduction; Risk Reduction Behavior; Services; Severities; Staging; Survivors; Swelling; Symptoms; Syndrome; Techniques; Testing; Translating; Woman; advanced disease; cancer diagnosis; chemotherapy; clinical practice; cost; ethnic minority population; follow-up; health care cost/financing; health disparity; hormone therapy; improved; indexing; interstitial; lymph flow; lymph nodes; malignant breast neoplasm; minority health; patient oriented; prevent; programs; psychologic; psychosocial; satisfaction; social; trial comparing

Lymphedema (LE) remains a major health problem affecting thousands of breast cancer survivors. Significantly lower quality of life is observed in survivors with LE than those without. LE following breast cancer treatment is characterized by an accumulation of lymph fluid in the interstitial spaces of the affected limb and areas, leading to a syndrome of abnormal swelling and multiple distressing symptoms. Survivors with fluid accumulation are at greater risk for repeated cellulitis, infections, and lymphangitis, which creates financial and economic burdens not only to survivors but also to the healthcare system. Preoperative assessment, educational and behavioral interventions are showing effectiveness to maintain limb volume, ameliorate LE symptoms and promote early detection. This project proposes to improve clinical practice by implementing and preliminarily evaluating an educational and behavioral intervention (The Optimal YOU) to enhance LE risk reduction among Chinese-speaking breast cancer survivors. The Optimal YOU intervention focuses on promoting lymph flow, preventing inflammation-infection, and maintaining optimal body mass index. Evaluation of the feasibility, acceptability, and effectiveness of the intervention has been demonstrated in English-speaking breast cancer survivors. Yet in its current form, this very promising program is not available to non-English-speaking women. The aims of the project are to: (1) translate and adapt The Optimal YOU intervention from English language into Chinese language; (2) Preliminarily evaluate the feasibility and acceptability of implementation of the intervention through focus group approach; and (3) preliminarily examine the intervention on the process of participation, attrition, satisfaction, cost, and intervention fidelity as well as the effectiveness by conducting a randomized controlled clinical trial and comparing the intervention outcomes at preoperative baseline, 4-8 weeks, 6 months, and 12 months follow-up. Special attention will be on the identification of cultural and linguistic factors that promote or impede the implementation of the intervention.

淋巴水肿（LE）仍然是影响数千个乳腺癌幸存者的主要健康问题。 LE幸存者观察到的生活质量明显低于没有的生活质量。乳腺癌治疗后的LE的特征是在受影响的肢体和区域的间隙空间中积聚淋巴液，导致异常肿胀和多种令人痛苦的症状综合征。流体积累的幸存者面临重复的蜂窝炎，感染和淋巴管炎的风险，这不仅会给幸存者，而且给医疗保健系统带来财务和经济负担。术前评估，教育和行为干预措施显示出有效的肢体体积，缓解LE症状并促进早期发现。 该项目建议通过实施和初步评估教育和行为干预（最佳您）来改善临床实践，以增强中文乳腺癌幸存者的风险降低。最佳干预措施的重点是促进淋巴流，防止炎症感染和保持最佳体重指数。在讲英语的乳腺癌幸存者中，已经证明了对干预措施的可行性，可接受性和有效性的评估。然而，以目前的形式，这个非常有前途的计划无法使用非英语女性。 该项目的目的是：（1）将您从英语的最佳干预转化为中文； （2）初步评估通过焦点小组方法实施干预的可行性和可接受性； （3）初步检查参与，损耗，满意度，成本和干预保真度以及通过进行随机对照临床试验的有效性，并比较术前基线，4-8周，6个月和12个月的随访，并进行比较。特别关注的是鉴定促进或阻碍干预实施的文化和语言因素。