Abstract

Background

Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality of life (QoL) of cancer survivors and can stimulate fear of cancer recurrence (FCR). Self-management education for lymphedema has been introduced as an effective method in controlling FCR. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients.

Methods

This three-arm clinical trial studied 105 patients with breast cancer-related lymphedema referred to Seyed_Khandan rehabilitation center. Sampling was done by random allocation method in blocks of 3 with 35 subjects in each group. All subjects received routine lymphedema treatments. The group-based education (GE) and social network-based education (SNE) groups received self-management education in the clinic and Telegram™ messenger channel, respectively. Impairment in QoL and mean score of FCR were assessed before, immediately after, and three months after the intervention by using the Persian version of Lymphedema Life Impact Scale (LLIS) and Fear of Progression Questionnaire-Short Form (FoPQ-SF), respectively. Mixed-model ANOVA was applied for statistical analysis.

Results

There was a significant time effect on total LLIS (P = 0.007), psychosocial (P = 0.038) and functional (P = 0.024) subscale changes in three groups of study. Interaction between the main effect of group and time on psychosocial subscale changes was statistically significant (P = 0.017). The multicomparison results illustrated that the main effect of time, the main effect of group, and interaction of them on the mean score of FCR were P = 0.084, P = 0.380, and P = 0.568, respectively.

Conclusion

Despite no significant reduction in the FCR score, results showed the improvement of most QoL aspects after three months of intervention. Although the social network-based education method was effective, the group-based education method was more beneficial. Applying these educational methods in lymphedema treatment protocols needs cost-effectiveness studies.

Trial registration

This study was registered at the Iranian Registry of Clinical Trials (IRCT2017052834176N1).

中文翻译：

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淋巴水肿自我管理小组教育与社交网络教育相比对乳腺癌女性生活质量和癌症复发恐惧的影响：一项随机对照临床试验。

摘要

背景

乳腺癌相关淋巴水肿（BCRL）及其相关症状损害了癌症幸存者的生活质量（QoL），并可能激发人们对癌症复发（FCR）的恐惧。自我管理的淋巴水肿教育已被引入作为控制FCR的有效方法。这项研究调查了与基于社交网络的对照组相比，基于淋巴水肿的教育对乳腺癌患者的QoL和FCR的影响。

方法

这项三臂临床试验研究了105例与乳腺癌相关的淋巴水肿的患者，转诊至Seyed_Khandan康复中心。通过随机分配方法以3个为一组，每组35个受试者进行抽样。所有受试者均接受常规淋巴水肿治疗。基于团体的教育（GE）和基于社交网络的教育（SNE）团体分别在诊所和Telegram™Messenger渠道中接受了自我管理教育。在干预之前，之后和三个月后，分别使用波斯语版的淋巴水肿生活影响量表（LLIS）和对进展的恐惧问卷-简短表格（FoPQ-SF）评估了QoL的损伤和FCR的平均评分。混合模型方差分析用于统计分析。

结果

 在三组研究中 ，对总的LLIS（P = 0.007），社会心理（P  = 0.038）和功能性（P = 0.024）分量表变化有明显的时间影响。小组与时间对心理社会分量表变化的主要影响之间的相互作用具有统计学意义（P  = 0.017）。多重比较结果表明，时间的主要影响，组的主要影响以及它们之间的交互作用对FCR的平均得分分别为P  = 0.084，P  = 0.380和P  = 0.568。

结论

尽管FCR评分没有明显降低，但结果显示，干预三个月后，大多数QoL方面均得到改善。尽管基于社交网络的教育方法是有效的，但基于群体的教育方法却更为有益。在淋巴水肿治疗方案中应用这些教育方法需要成本效益研究。

试用注册

该研究已在伊朗临床试验注册中心（IRCT2017052834176N1）注册。