Primary Establishment Of Clinical Practice Guideline For Preventive Behavior Of Breast Cancer-related Lymphedema

BackgroundChina have become one of the fastest growing countries in the world on breast cancer and lymphedema is the serious complication.Through the implementation of related preventive behavior can reduce the incidence of lymphedema,but at present there is no evidence-based guidance of preventive behavior about breast cancer-related lymphedema.Providing standardized guidance for the health care professionals and patients is very important,thus instructive clinical practice guideline for preventive behavior of postoperative breast cancer-related lymphedema which combined with the best evidence should be built.ObjectiveInvestigating and analyzing health care professionals and breast cancer postoperative patients' awareness,implementation status,current problems about preventive behavior of breast cancer-related lymphedema.Integrating the best available evidence systematic reviews and guidelines to build evidence-based clinical practice guideline for preventive behavior of postoperative breast cancer-related lymphedema.MethodsCombining lymphedema risk-reduction behavior checklist and semi-structured interviews to analyze postoperative patients of breast cancer and medical staffs about the problems of preventive behavior of breast cancer-related lymphedema.Members in the development of guideline analyze and consolidate systematic review,Meta-analysis,guidelines to build the clinical practice guideline for preventive behavior of breast cancer-related lymphedema draft and guidebook.Results1.The general status of preventive behavior of breast cancer-related lymphedema was showed through quantitative research of 272 postoperative patients of breast cancer and qualitative research of 19 postoperative patients of breast cancer and 16 health care professionals.At present,preventive behavior of breast cancer-related lymphedema were lack of specific prescriptive guidance,patients' awareness was worse and less medical attention,different degree of recognition higher workload in medical staff.2.Searching the database comprehensively and strictly.Eventually 24 RCT met the inclusion criteria and were included and the quality of literature were in the medium level.Various lymphedema preventive behaviors were categorized which provided evidence for the establishment of guideline.Pneumatic compression,homemade soft pillow,moxibustion and customized functional exercise could reduce the incidence of lymphedema,descriptive analysis included mouth negative pressure,the affected side upper limb compression and massage therapy could reduce the degree of lymphedema and range of motion,which provided the evidence for the clinical practice guideline.3.Searching the guideline web sites and databases comprehensively,finally a total of 5guidelines for preventive behavior of breast cancer-related lymphedema were collected.16 recommendations and applications included exercise,compression garments,infection treatment,skin care and so on,which provided the evidence for the clinical practice guideline.4.The establishment of clinical practice guideline for preventive behavior of breast cancer-related lymphedema was based on quantitative research,qualitative research,systematic reviews and guidelines results of content analysis.Conclusion1.Currently preventive behavior of breast cancer-related lymphedema was lack of scientific,standardized and effective guidance.2.Clinical practice guideline for preventive behavior of breast cancer-related lymphedema was evidence-based,status of preventive behaviors of breast cancerrelated lymphedema,interviews of health care professionals and postoperative patients of breast cancer,systematic review,which has 22 recommendations included pneumatic compression,homemade soft pillow,moxibustion,compression garments,infection treatment and so on.