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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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.
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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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15. 蒋春儿, 虞亚梅, 张永芳, 等. 基于神经语言程序技术的支持性照护在乳腺癌相关淋巴水肿及负性情绪干预中的应用. 世界肿瘤研究, 2022, 12(4): 217-224.
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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.
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22. 李玉环. 基于时机理论的阶段干预方案对预防乳腺癌患者术后淋巴水肿的效果研究. 郑州: 郑州大学, 2021.
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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. 龙娟. Teach-back健康教育联合手法淋巴引流对乳腺癌术后患者上肢淋巴水肿预防效果的研究. 贵阳: 贵州中医药大学, 2020.
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27. 薛淑枝, 胡莎莎, 郭晶平, 等. 慢病自我管理模式对乳腺癌患者术后淋巴水肿的影响. 中国肿瘤临床与康复, 2020, 27(11): 1301-1304.
28. 唐友娟, 喻爱芳, 郑小玲. 基于微信的延续护理模式对乳腺癌术后淋巴水肿的预防研究. 大众科技, 2020, 22(5): 76-79.
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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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