Study On The Application Of Self-management Intervention Based On The Theory Of Empowerment In Patients With Breast Cancer Associated Lymphedema

ObjectivesGuided by the empowerment theory,formulate an intervention plan for the self-management of patients with Breast cancer-related lymphedema,and explore its effects on patients’ limbs through knowledge empowerment,technical empowerment,psychological adjustment empowerment,and functional exercise empowerment.To explore its effect on reducing the symptoms and signs of lymphedema of the affected limbs,improving the patients’ unhealthy psychological condition,and improving the ability of disease management,so as to provide references for the medium and long-term management of lymphedema in patients with breast cancer-related lymphedema.MethodSelected patients with breast cancer-related lymphedema who attended the lymphedema clinic,radiotherapy department,and breast surgery department of two tertiary A hospitals in Zhengzhou from January to November 2020 and had a course of treatment(4 weeks)for Comprehensive detumescence therapy as the study Object.Patients from one hospital were randomly selected as the control group,and the other as the intervention group.The control group received routine health education on breast cancer-related lymphedema,and the intervention group implemented self-management intervention based on the empowerment theory.Breast Cancer &Lymphedema Symptom Experience Index(BCLE-SEI),Profile of Mood States-Short Form,(POMS-SF),and the Strategies Used by People to Promote Health(SUPPH)were used for evaluation,and the circumference of both upper limbs was measured.Use Microsoft Office Excel 2016 and SPSS 21.0 for data entry and processing.Results1.A total of 72 patients with BCRL were included in the study.During the intervention,2 patients in the intervention group were lost to follow-up and 4 patients in the control group were lost to follow-up.Finally,66 valid data were collected.There was no significant difference between the two groups of patients in general data such as age,family monthly income,surgical methods,adjuvant treatment methods,breast cancer-related lymphedema staging,and lymphedema occurrence time(P>0.05).2.The t-test was used to compare the difference in upper limb circumference and the average value of the upper limb circumference difference between the two groups of patients at baseline,at discharge,one month and three months after discharge.The results showed that at baseline,there was no significant difference between the upper limb circumference difference and the average upper limb circumference difference at each measurement point between the two groups of patients(P>0.05).There was a significant difference in the average value of the upper limb circumference difference between the two groups of patients at one month and three months after discharge(P<0.05).Repeated measurement analysis of ANOVA found that with the intervention,the average value of the upper limb circumference difference of the two groups of patients gradually decreased,the decline was the fastest before discharge,and then the rate of decline slowed down,and the average upper limb circumference difference of the intervention group decreased and decreased.The amplitude is always greater than the control group.3.The rank sum test was used to analyze the BCLE-SEI scores,and it was found that the total BCLE-SEI scores and scores of each dimension were not significantly different between the two groups at baseline(P>0.05).As the intervention progressed,the number of symptoms,the severity of symptoms and the degree of distress of the two groups of patients were reduced,and the total scores of BCLE-SEI and the scores of various dimensions of the intervention group were significantly lower than those of the control group for one month and three months after discharge(P<0.05).Repeated measures analysis of ANOVA was used to explore the changes in the symptom index of the two groups over time.It was found that as the intervention progressed,the total scores of the two groups of patients on the BCLE-SEI scale gradually decreased,and the decline was the fastest after the intervention began to one month after discharge,and then the rate of decline slowed down.The total score of the BCLE-SEI scale in the intervention group was always smaller than that in the control group.4.The t-test was used to compare the POMS-SF scores of the two groups before and after intervention.It was found that the total POMS-SF scores of the intervention group and the control group at baseline were(45.88 ± 9.82)and(46.75 ± 10.04)points,respectively.The total score of POMS-SF and the scores of each dimension were not significantly different(P>0.05).Three months after discharge,the total POMS-SF score and the scores of all dimensions of the intervention group were significantly lower than those of the control group(P<0.05).5.The t-test was used to compare the SUPPH scores of the two groups before and after the intervention.And it was found that the total SUPPH score and the scores of each dimension at baseline were not significantly different(P>0.05).Three months after discharge from the hospital,the total score of SUPPH and the scores of all dimensions in the intervention group were significantly higher than those in the control group(P<0.05).ConclusionStudies have shown that self-management programs based on the Empowerment theory can effectively reduce the degree of lymphedema in patients with Breast cancer-related lymphedema,reduce related symptoms caused by lymphedema,alleviate patients’ unhealthy psychological conditions,improve patient self-management efficiency,and promote the effectiveness of lymphedema control.