Journal of the Korean Data Analysis Society

Korean Data Analysis Society (한국자료분석학회)
권호 표지

Quality of Life in Female Postmastectomy Patients with Lymphedema According to the Dominant Hand

유방절제술 여성의 림프부종 우세손 일치 여부에 따른 삶의 질

  • Received : 2014.11.17
  • Accepted : 2015.01.10
  • Published : 2015.02.28
⟨ Previous Next ⟩

Abstract

This study was performed to identify the general characteristics of female postmastectomy patient groups with upper extremity lymphedema in the dominant and non-dominant hand, and comparing and analyzing the level of quality of life (QOL) between two groups. Data collection was carried out over 9 months from February to October 2014. The sample was selected from the accessible population from breast cancer patients registered at the department of rehabilitation medicine in a general hospital, Seoul and who attended regular meetings of the pink ribbon foundation. A survey was conducted on 213 female lymphedema patients, 104 with lymphedema in the dominant hand and 109 with lymphedema in non-dominant hand to analyze data gathered from questionnaires. According to the results, patients with lymphedema in the dominant hand had lower scores in overall QOL compared to those with lymphedema in non-dominant hand (t=-2.514, p=.013). They had statistically significantly higher scores in cancer-related symptoms (t=2.822, p=.005) and three subscales of fatigue (t=2.920, p=.004), pain (t=2.617, p=.010) and insomnia (t=2.996, p=.003), indicating lower QOL levels. These findings suggest that development of an integrated self-management program is crucial to provide content on maintaining and promoting social and psychological function for the use of hands in daily living activities when performing mastectomy on dominant-hand side.

본 연구는 유방절제술 후 상지 림프부종이 발생한 여성 중 우세손에 림프부종이 발생한 대상군과 비우세손에 림프부종이 발생한 대상군의 일반적 특성과 질병 관련 특성을 알아보고, 두 군 간의 삶의 질 수준을 비교 분석하여 우세손에 림프부종이 발생한 군의 자가관리를 위한 간호중재 프로그램의 개발의 기초자료로 사용하고자 시도되었다. 본 연구의 자료 수집 기간은 2014년 2월부터 10월까지 9개월간이 소요되었으며, 서울 소재 A 종합병원 재활의학과 외래에 등록된 환자 전체를 근접 모집단으로 하되, 유방암 환자의 자조집단인 '핑크 리본' 정규모임에 참여한 대상자 중 우세손에 림프부종이 발생한 자 104명, 비우세손에 림프부종이 발생한 자 109명, 총 213명에게 설문지를 이용하여 자료를 수집하였고, 최종 분석하였다. 연구결과 우세손에 림프부종이 발생한 환자가 비우세손에 림프부종이 발생한 환자에 비해 전반적인 삶의 질 영역에서 낮은 점수를 보였고(t=-2.514, p=.013), 암 관련 증상 영역(t=2.822, p=.005) 및 하위 요소인 피로(t=2.920, p=.004), 통증(t=2.617, p=.010), 불면(t=2.996, p=.003)에서 통계적으로 유의하게 높은 점수를 보여 삶의 질이 더 낮은 것으로 나타났다. 따라서 유방절제술을 시행한 측이 우세손일 경우 일상생활속에서 손의 사용 및 자가관리에 관한 사회 심리적 기능을 유지하고 증진시킬 수 있는 내용을 포함한 통합적 자가관리 프로그램이 필요할 것으로 사료된다.

Keywords

Acknowledgement

Supported by : 강동대학교

References

  1. Beaulac, S. M., McNair, L. A., Scott, T. E., LaMorte, W. W., Kavanah, M. T. (2002). Lymphedema and quality of life in survivors of early-stage breast cancer, Archives of Surgery, 137(11), 1253-1257. https://doi.org/10.1001/archsurg.137.11.1253
  2. Bower, J. E., Ganz, P. A., Desmond, K. A., Bernaards, C., Rowland, J. H., Meyerowitz, B. E., Belin, T. R. (2006). Fatigue in long-term breast carcinoma survivors, Cancer, 106(4), 751-758. https://doi.org/10.1002/cncr.21671
  3. Britton, B., Wallace, S. M. L., Wilkinson, I. B., Mortimer, P. S., Peters, A. M., Purushotham, A. D. (2009). Sympathetic nerve damage as a potential cause of lymphoedema after axillary dissection for breast cancer, British Journal of Surgery, 96(8), 865-869. https://doi.org/10.1002/bjs.6660
  4. Byar, K. L., Berger, A. M., Bakken, S. L., Cetak, M. A. (2006). Impact of adjuvant breast cancer chemotherapy on fatigue, other symptoms, and quality of life, Oncology Nursing Forum, 33(1), E18-E26.
  5. Chun, J. Y. (2008). A meta-analysis of effects on the rehabilitation programs in breast cancer patients after mastectomy, Journal of the Korean Data Analysis Society, 10(1), 183-196. (in Korean).
  6. Deutsch, M., Flickinger, J. C. (2003). Arm edema after lumpectomy and breast irradiation, American Journal of Clinical Oncology, 26(3), 229-231. https://doi.org/10.1097/01.COC.0000018177.75673.06
  7. Devoogdt, N., Van Kampen, M., Geraerts, I., Coremans, T., Christiaens, M. R. (2010). Different physical treatment modalities for lymphoedema developing after axillary lymph node dissection for breast cancer: a review, European Journal of Obstetrics & Gynecology and Reproductive Biology, 149(1), 3-9. https://doi.org/10.1016/j.ejogrb.2009.11.016
  8. EORTC (2001). EORTC-C30 Scoring Manual (3rd ed). Brussels: EORTC.
  9. Fan, G., Filipczak, L., Chow, E. (2007). Symptom clusters in cancer patients: a review of the literature, Current Oncology, 14(5), 173-179. https://doi.org/10.3747/co.2007.145
  10. Frankel, V. H. (1973). Biomechanics of the musculoskeletal system: Introduction, Archives of Surgery, 107(3), 405-405. https://doi.org/10.1001/archsurg.1973.01350210041013
  11. Han, I. Y., Rhee, Y. S., Moon, B. I., Kang, B. G. (2013). Unmet needs for health care services in patients with breast cancer, Journal of the Korean Data Analysis Society, 9(3), 1139-1152. (in Korean).
  12. Hansen, F. (1981). Hemispheral lateralization: Implications for understanding consumer behavior, Journal of Consumer Research, 8(1), 23-36. https://doi.org/10.1086/208837
  13. Jung, H. M., Cho, M. O., Jun, J. Y., Kim, Y. S., Son, K. H., Jun, E. M. (2003). The relationship among physical symptoms, ADLs, and self-care behaviors in female cancer patients with lymphedema, Journal of the Korean Data Analysis Society, 9(3), 1139-1152. (in Korean).
  14. Jung, H. S., Jung, H. S. (2009). Hand dominance and hand use behaviour reported in a survey of 2,437 Korean, Ergonomics, 52(11), 1362-1371. https://doi.org/10.1080/00140130903067805
  15. Kim, Y. S., Kim, K. C., Lee, J. W., Kim, Y. H. (2013). Effects of rehabilitation program using qigong exercise for breast cancer survivors of community, Journal of the Korean Data Analysis Society, 15(6), 3263-3277. (in Korean).
  16. Kong, Y. K., Sohn, S. T., Han, J. G. (2010). A review study for grip strength of hand, Journal of the Ergonomics Society of Korean, 29(5), 715-725. (in Korean). https://doi.org/10.5143/JESK.2010.29.5.715
  17. Kuehn, T., Klauss, W., Darsow, M., Regele, S., Flock, F., Maiterth, C., Kreienberg, R. (2000). Long-term morbidity following axillary dissection in breast cancer patients-clinical assessment, significance for life quality and the impact of demographic, oncologic and therapeutic factors, Breast Cancer Research and Treatment, 64(3), 275-286. https://doi.org/10.1023/A:1026564723698
  18. Lee, J. H., Han, H. S., Lee, E. S. (2010). A comparison of linguistic and spatial ability in left-handed and right-handed young children, Korean Journal of Human Ecology, 19(4), 601-612. (in Korean). https://doi.org/10.5934/KJHE.2010.19.4.601
  19. Lee, E. S., Kim, S. H., Kim, S. M., Sun, J. J. (2005). Effect of educational program of manual lymph massage on the arm functioning and the quality of life in breast cancer patients, Journal of Korean Academy of Nursing, 35(7), 1290-1400. (in Korean).
  20. Lee, J. S., Lee, B. K., Kim, T. S. (2012). Effects of 4wks classical decongestive physiotherapy and combined therapeutic exercise on edema, upper limb function and quality of life for middle-aged women with upper lymphedema after breast cancer surgery, Journal of Sport and Leisure Studies, 50(2), 879-889. (in Korean).
  21. Previc, F. H. (1996). Non-right-handedness, central nervous system and related pathology, and its lateralization: A reformulation and synthesis, Developmental Neuropsychology, 12(4), 443-515. https://doi.org/10.1080/87565649609540663
  22. Radina, M. E. (2009). Breast cancer related lymphedema: Implications for family leisure participation, Family Relations, 58(4), 445-459. https://doi.org/10.1111/j.1741-3729.2009.00565.x
  23. Rockson, S. G. (2004). How can lymphatic research influence lymphatic education?, Lymphatic Research and Biology, 2(2), 67-68. https://doi.org/10.1089/lrb.2004.2.67
  24. Sim, J. M. (2011). Effects of manual lymp drainage on the skin edema and the quality of life in breast cancer clients with unilateral lymphedema, The Journal of the Korean Society of Make-up Design, 7(2), 89-96. (in Korean).
  25. Stanton, A. W., Modi, S., Britton, T. M. B., Purushotham, A. D., Peters, A. M., Levick, J. R., Mortimer, P. S. (2009). Lymphatic drainage in the muscle and subcutis of the arm after breast cancer treatment, Breast Cancer Research and Treatment, 117(3), 549-557. https://doi.org/10.1007/s10549-008-0259-z
  26. Torres, L. M., Yuste, S. M. J., Zapico, G. A., Prieto, M. D., Mayoral, D. M. O., Cerezo, T. E., Minayo, M. E. (2010). Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: Randomised, single blinded, clinical trial, British Medical Journal, 340, b5396. https://doi.org/10.1136/bmj.b5396
  27. Towers, A., Carnevale, F. A., Baker, M. E. (2008). The psychosocial effects of cancer-related lymphedema, Journal of Palliative Care, 24, 134.
  28. Warren, A. G., Brorson, H., Borud, L. J., Slavin, S. A. (2007). Lymphedema: A comprehensive review, Annals of Plastic Surgery, 59(4), 464-472. https://doi.org/10.1097/01.sap.0000257149.42922.7e
  29. Yun, Y. H., Bae, S. H., Kang, I. O., Shin, K. H., Lee, R., Im, K. S., Lee, E. S. (2004). Cross-cultural application of the Korean version of the european organization for research and treatment of cancer (EORTC) breast-cancer-specific quality of life questionnaire (EORTC QLQ-BR23), Supportive Care in Cancer, 12(6), 441-445. https://doi.org/10.1007/s00520-004-0632-3
  30. Zuther J. E. (2011). Lymphedema management: the comprehensive guide for practitioners. New York: Thieme Medicine Publishers, Inc.