Lower limb lymphedema (LLL) is a common but neglected problem in palliative cancer patients. No studies have focused on these patients’ experiences of lymphedema. The aims of this study were to explore patients’ experiences regarding LLL and how they manage to deal with this in the late palliative stage. Methods: Thirteen patients with cancer-related LLL were included to satisfy a maximum variation sampling strategy. Interviews were analyzed using a qualitative phenomenographic method. Results: LLL influenced the patients’ thoughts about the future. Body image was often strongly influenced. Interactions with other persons were perceived as both positive and negative, and a range of coping strategies were expressed. Conclusion: LLL can exert a considerable influence on the physical experiences and the psychosocial situation of cancer patients in palliative care. Areas in need of increased education, attention, and further research are highlighted.
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References
1.
SzubaA., RocksonS.G.Lymphedema: classification, diagnosis and therapy. Vasc Med1998; 3(2): 145–156.
2.
RyanM., StaintonM.C., SlaytorE.K., JaconelliC., WattsS., MacKenzieR.Aetiology and prevalence of lower limb lymphoedema following treatment for gynaecological cancer. Aust N 2 J Obstet Gynecol2003; 43: 148–151.
3.
CavanaghD., FioricaJ.V., HoffmanM.S., RobertsW.S., BrysonS.C., LaPollaJ.P.Invasive carcinoma of the vulva. Changing trends in surgical management. Am J Obstet Gynecol1990; 163(3): 1007–1015.
4.
MortimerP., BadgerC., HallJ.Lymphedema. In: DoyleD., HanksG., MacDonaldN. (eds). Oxford Textbook of Palliative Medicine. 2nd edition.London: Oxford University Press Inc., 1999; pp. 657–666.
5.
FarncombeM., RobertsonE.Lymphedema. In: BergerA., PortenoyR., WeismanD. (eds). Principles and Practice of Palliative Care and Supportive Oncology. 2nd edition.Philadelphia: Lippincott Williams and Wilkins, 2002; pp. 333–343.
6.
BainV.Jaundice, ascites and hepatic encephalopathy. In: DoyleD., HanksG., MacDonaldN. (eds). Oxford Textbook of Palliative Medicine. 2nd edition.London: Oxford University Press Inc., 1999; pp. 557–570.
7.
OlszewskiW.L., EngesetA.Intrinsic contractility of prenodal lymph vessels and lymph flow in human leg. Am J Physiol1980; 239(6): H775–H783.
8.
BrorsonH.Liposuction gives complete reduction of chronic large arm lymphedema after breast cancer. Acta Oncol2000; 39(3): 407–420.
9.
SwedborgI., BorgG., SarnelidM.Somatic sensation and discomfort in the arm of post-mastectomy patients. Scand J Rehabil Med1981; 13(1): 23–29.
10.
HullM.M.Lymphedema in women treated for breast cancer. Semin Oncol Nurs2000; 16(3): 226–237.
11.
TobinM.B., LaceyH.J., MeyerL., MortimerP.S.The psychological morbidity of breast cancer-related arm swelling. Psychological morbidity of lymphedema. Cancer1993; 72(11): 3248–3252.
12.
CarterB.J.Women's experiences of lymphedema. Oncol Nurs Forum1997; 24(5): 875–882.
13.
PassikS.D., McDonaldM.V.Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma. Cancer1998; 83(12 suppl American): 2817–2820.
14.
JohanssonK., HolmstromH., NilssonI., IngvarC., AlbertssonM., EkdahlC.Breast cancer patients’ experiences of lymphedema. Scand J Caring Sci2003; 17(1): 35–42.
15.
RyanM., StaintonM.C., JaconelliC., WattsS., MacKenzieP., MansbergT.The experience of lower limb lymphedema for women after treatment for gynecologic cancer. Oncol Nurs Forum2003; 30(3): 417–423.
16.
PattonM.Qualitative research and evaluation methods. 3rd edition.London: Sage Publications, 2002.
17.
MalterudK.Qualitative research: standards, challenges, and guidelines. Lancet2001; 358(9280): 483–488.
HerthK.Fostering hope in terminally-ill people. J Adv Nurs1990; 15(11): 1250–1259.
23.
WeismanA.Coping With Cancer.New York: McGraw-Hill, 1979.
24.
SalanderP., WindahlG.Does ‘denial’ really cover our everyday experiences in clinical oncology? A critical view from a psychoanalytic perspective on the use of ‘denial'. Br J Med Psychol1999; 72(Pt 2): 267–279.
25.
AdelbrattS., StrangP.Death anxiety in brain tumour patients and their spouses. Palliat Med2000; 14(6): 499–507.
26.
GerberL.H.A review of measures of lymphedema. Cancer1998; 83(12 suppl American): 2803–2804.
27.
JohanssonK., LieE., EkdahlC.Lindfeldt J. A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema. Lymphology1998; 31(2): 56–64.
28.
SitziaJ., StantonA.W., BadgerC.A review of outcome indicators in the treatment of chronic limb oedema. Clin Rehabil1997; 11(3): 181–191.
