Actual condition of lymphedema prevention behavior of postoperative breast cancer patients without lymphedema

Abstract

本研究では,リンパ浮腫未発症の乳がん術後患者におけるリンパ浮腫予防行動の実態調査を行った.対象者は乳房部分切除および腋窩リンパ節郭清を行った乳がん術後患者で,現在外来通院中のリンパ浮腫未発症患者40名に構成的質問紙調査と,その内の21名に面接調査を実施した.結果,リンパ浮腫に関する知識の「リンパ浮腫の病因」,「リンパ浮腫の治療」,「リンパ浮腫の改善方法」,「生活上の注意」,「リンパ浮腫をみた経験」の知識に関して知っているかどうかにより「リンパ浮腫予防法実施状況」で有意差が認められ,継続できるか否かに差があることが示された.また,「リンパ浮腫予防法の数」との間でも有意差が認められ,知識に関して知っているかどうかにより予防法の数に差があることが示された.リンパ浮腫に対する認識および予防行動に対する認識において,それぞれ4つのカテゴリーが抽出された.以上の結果より,未発症患者であるからこそ,自身の体に関心を向け継続していく力をいかにつけていくことが重要となる.そのためにも,患者が体験する日常生活の中から予防法を考案していくことや,実感を伴いながら,知識を意味づけられる予防行動に関する指導を考案していくことが継続の支援に必要である.In the present study, a survey of the actual condition of the lymphedema prevention behavior in postoperative breast cancer patients who had not developed lymphedema was performed.A structured questionnaire survey was conducted involving 40 postoperative breast cancer patients currently receiving outpatient care, and who had undergone partial mastectomy and axillary lymph node dissection, but had not developed lymphedema; 21 of these patients were also interviewed.The results showed significant differences in the “status of implementation of measures for preventing lymphedema” based on “knowing” or “not knowing” information regarding lymphedema, specific information regarding “etiology of lymphedema”, “ treatment of lymphedema”, “methods for improving lymphedema”, “precautions in lifestyle”, and “noticing signs of lymphedema”, with differences in whether these measures could be continued.In addition, significant differences were also observed for “number of measures for preventing lymphedema”, with differences being observed in the number of preventive measures based on “knowing” or “not knowing” the information.A total of four categories each was identified for awareness of lymphedema and awareness of preventive measures.These results indicate that finding ways to develop the ability to continue self-care is important in patients who have not developed lymphedema for the very reason that they have not yet developed lymphedema.It is also important to provide both support for continuation by devising prevention methods based on the patients’ daily lives and guidance related to prevention behavior that attaches actual feelings

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