Predictors of arm morbidity following breast cancer surgery

Abstract

Comprehensive behavioral management and rehabilitation programs are needed to treat arm morbidity following breast cancer surgery. These programs should address the full scope of symptoms and associated psychosocial and functional sequelae.

Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies

“…We were unable to pool data for predictors from studies that used different continuous outcome measures to assess persistent pain in linear regression models. 36,39,43,50,53,55,56 However, the results from these studies were consistent with the results from studies amenable to pooling. We used the IASP criteria for the definition of persistent pain in this review; however, 14 of the included studies did not report whether their assessment of persistent postsurgical pain excluded other causes of pain; 26,[33][34][35][36]43,45,47,48,50,51,54,56,58 as such, they may have overestimated the prevalence of persistent pain.…”

“…¶Quality was not rated down on the basis of imprecision, even though the 95% CI for the pooled effect overlapped a risk difference of 0 (no effect), because clinical actions based on the estimate of the lower or upper boundary would not change, according to the predefined threshold of ≥ 20% for nonmodifiable factors. the 7 studies 37,39,42,50,53,55,56 that reported 1 or more of the 9 predictors that we subjected to metaanalysis but whose data could not be pooled were consistent with our pooled analyses (Appendix 9, available at www.cmaj.ca/lookup/ suppl/doi:10.1503/cmaj.151276/-/DC1).…”

Loss, adaptation and new directions: The impact of arm morbidity on leisure activities following breast cancer

“…Health professionals, including nurses, occupational and physical therapists, should be forthcoming with advice about potential adjustments women may need to make to accommodate these changes with the goal of enabling meaningful leisure participation, as well as the beneficial changes in perspectives and values (Silver & Gilchrist, 2011). Further, nursing administrators may be positioned to promote access to comprehensive, person-centred, psychosocial and behavioural management and rehabilitation programs, which are needed to address the multiple and varied needs of women with arm morbidity after breast cancer (Davies & Batehup, 2010;Hack et al, 2010;Quinlan et al, 2011) within the broader context of new understandings of the impact of chronic illness and disability (Livneh & Antonak, 2005). Components of such programs could include: physiotherapy, occupational therapy, spiritual care, intimacy counselling, and nutritional counselling, as part of cancer survivorship care.…”

“…Through evidence-based educational support, women who experience breast cancer need to be informed of the possibility of having to negotiate with and adapt to alterations to the body and spirit, and the lifelong requirement for their adherence to advice after surgery on arm care, exercise, diet, and other topics (Hack et al, 1999;Hack et al, 2010;Kwan et al, 2002;Radina & Fu, 2011). Health professionals, including nurses, occupational and physical therapists, should be forthcoming with advice about potential adjustments women may need to make to accommodate these changes with the goal of enabling meaningful leisure participation, as well as the beneficial changes in perspectives and values (Silver & Gilchrist, 2011).…”

Ethnodrama: An innovative knowledge translation tool in the management of lymphedema.

“…The arm morbidities of pain, impaired range of motion, and lymphedema are common among breast cancer survivors following breast cancer treatment [1,2]. Among them lymphedema is the most debilitating complication of treatment of breast cancer [1][2][3][4].…”