Effectiveness of a lymphedema prevention program for patients with breast cancer: A randomized controlled trial based on the Protection Motivation Theory and Information-Motivation-Behavioral Skills Model

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing Pub Date : 2025-02-09 DOI:10.1016/j.apjon.2025.100667

Yuan Wang , Ling Tong , Shan Wang , Weifeng Shi , Dewu Xu

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引用次数: 0

Abstract

Objective

This study aims to evaluate the effectiveness of a lymphedema prevention program based on the Protection Motivation Theory and Information-Motivation-Behavioral Skills Model (PMT-IMB) in patients with breast cancer.

Methods

A randomized controlled trial was conducted at a tertiary hospital, enrolling 95 patients treated between December 2022 and June 2023. Participants were randomly assigned to either the control group (n = 47), receiving standard nursing care, or the intervention group (n = 48), receiving a PMT-IMB-based lymphedema prevention program. The intervention was delivered in hospital settings, with follow-up via WeChat and phone after discharge. Outcomes were assessed using the Lymphedema Risk-Reduction Behavior Checklist (LRRB), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, upper limb circumference measurements, and self-lymphatic drainage records at baseline, 1 month, 3 months, and 6 months post-intervention.

Results

The intervention group demonstrated significantly higher lymphedema prevention behavior scores than the control group after the intervention. Upper limb dysfunction scores improved significantly in the intervention group compared to the control group at three and six months. In the control group, upper limb circumference gradually increased over time, with a significant difference observed at six months. Compliance with self-lymphatic drainage was also significantly better in the intervention group.

Conclusions

The PMT-IMB-based nursing intervention effectively enhances preventive behaviors, reduces lymphedema incidence, improves upper limb function, and increases patient adherence. These findings provide valuable insights for optimizing nursing strategies in lymphedema prevention.

Trial registration

http://www.chictr.org.cn, ChiCTR2300070705.

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乳腺癌患者淋巴水肿预防项目的有效性：基于保护动机理论和信息-动机-行为技能模型的随机对照试验

目的评价基于保护动机理论和信息-动机-行为技能模型（PMT-IMB）的乳腺癌患者淋巴水肿预防方案的效果。方法选取2022年12月至2023年6月在某三级医院接受治疗的95例患者进行随机对照试验。参与者被随机分配到对照组（n = 47），接受标准护理，或干预组（n = 48），接受基于pmt - imb的淋巴水肿预防计划。干预在医院进行，出院后通过微信和电话进行随访。结果通过淋巴水肿风险降低行为检查表（LRRB）、手臂、肩部和手部残疾（DASH）问卷、上肢周长测量和干预后基线、1个月、3个月和6个月的自我淋巴引流记录进行评估。结果干预组预防淋巴水肿行为得分明显高于对照组。与对照组相比，干预组在3个月和6个月时上肢功能障碍评分显著改善。在对照组中，上肢周长随着时间的推移逐渐增加，在6个月时观察到显著差异。干预组自身淋巴引流的依从性也明显更好。结论以pmt - imb为基础的护理干预能有效提高预防行为，降低淋巴水肿发生率，改善上肢功能，提高患者依从性。这些发现为优化预防淋巴水肿的护理策略提供了有价值的见解。试用注册http://www.chictr.org.cn, ChiCTR2300070705。

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