Comparing the Effect of In-Person and Virtual Lymphedema Self-management Education on Quality of Life of Women with Breast Cancer: A Randomized Clinical Trial

Abstract

Introduction: Breast cancer-related lymphedema is a chronic swelling accompanied by physical discomfort and prolonged treatment negatively affecting patients’ quality of life (QoL). Self-management is a vital phase in managing the results of treatment. So, the study aims to compare the effect of in-person and virtual self-management education on women’s quality of life. Methods: This was a randomized clinical trial conducted on 70 women with breast cancer-related lymphedema in the last one year, attending to Seyed_Khandan rehabilitation center in Tehran. Sampling was done by random allocation method in blocks of 2 with 35 subjects in each group. All subjects received routine lymphedema treatment. The in-person and virtual groups received the education at the clinic and the Telegram messenger, respectively. QoL was assessed using the Persian version of EORTC QLQ-C30 and QLQ-BR23 questionnaires on before, immediately, and three months after the intervention. Results: The mean age of the individuals was 51.42±9.71. Most subjects were married, had a diploma or higher, and the mean duration of lymphedema was 6.88 months. At the end of the study compared to the beginning of the study, physical, role, emotional and social functions decreased significantly in the virtual group compared with the in-person group. In this way, the status of the mentioned variables in the in-person group was better than the virtual one (P=0.006, P=0.026, P=0.014, P=0.023, respectively). Three months after the intervention, median scores on global health (P=0.21), physical functioning (P=0.004), role functioning (P=0.009), emotional functioning (P<0.001), social functioning (P=0.048) were still significantly greater for the in-person group. Also, the in-person group had a greater reduction in the median scores of systemic therapy side effects (P=0.002) and arm symptoms (P=0.45) compare with the virtual group. Conclusion: Self-management education led to improved quality of life, and in the comparison between the two methods, in-person method was more effective than virtual method. However, further studies are needed to investigate the efficacy and cost-effectiveness of both methods in educating patients with lymphedema.