The Effects of Health Belief Model System Intervention on Prevention of Breast Cancer Realted Lymphedema
|School||Anhui Medical University,|
|Keywords||Breast neoplasms/surgery lymphedema health belief model quality of life self-efficacy social support|
Objectives LymPhedema is a well-known postoperative complication after axillary node dissection (ALND). This study aims to determine the efficacy of a health belief model comprehensive program of lymphedema prevention patient education, counseling vs lymphedema prevention patient education only in reducing the incidence of lymphe- dema in women with breast cancer who are underwent axillary lymph node dissection. At the same time in order to improve quality of life and the level of social support. Compare the health-related quality of life of these patients. Compare the severity of lymphedema, in terms of changes in arm circumference at the site of greatest difference as a continuous variable, in patients undergoing these interventions.Methods selecting 225 Patients who were underwent breast-conserving surgery or mastectomy into intervention group(n=114) and control group(n=111) with randomized grouping, those in the intervention group attended the health belief model system in addition routine care,while control group received routine care only. All Patients complete questionnaires prior to surgery regarding self-efficacy, social support, arm circumference, and demographics. Patients then undergo surgery, which must include axillary node dissection. One day before surgery, Patients receive a brief initial pre-operative care session describing lymphedema risk and prevention through oral instruction and written materials. Patients complete arm circumference assessments and questionnaires at 4 weeks and at 6, 12 months. Patients are also contacted by telephone at 4 and 12 months. The data collected was analysed by Descriptive statistics, x2 test ,Independent-sample t test, Spearman Bivariate analysis and Stepwise Regression analysis, Paired t-test for the normal and Wilcoxon rank-sum test for the Non-normal.Results The health belief model system intervention could reduce the morbility of lymphedema and improve their quality of life. 215 women completed the one year follow-up. Of these, 58 developed secondary lymphoedema (26.98%): 40 in the control group (37.7%) and 18 in the intervention group (16.5%). The difference was significant (P<0.01).Conclusions The health belief model intervention could be an effective intervention in the prevention of secondary lymphoedema in women for at least one year after surge- ry for breast cancer involving dissection of axillary lymph nodes, HBM are effective teaching tools, Lymphedema Risk-Reduction Behavior can be taught and can be effec- tive in managing lymphedema.It also can alleviate the lymphedema on the oPerated side of upper limb and increase long-term quality of life of the breast cancer Patients.