Managing Lymphedema and Fibrosis in Head and Neck Cancer Survivors: A Data Analysis on Self-Care Behaviors.

Abstract

Objectives: Head and neck cancer survivors (HNCS) often face lymphedema and fibrosis (LEF) post-treatment, which require long-term self-management to minimize LEF progression and its negative impact on quality of life. This secondary data analysis aims to evaluate self-care, LEF status, and symptom burden among HNCS, and to examine the associations among self-care status, LEF status, and symptom burden in HNCS.

Methods: Descriptive statistics summarized the sample and variable distributions. Bivariate analysis assessed associations between variables. Multiple linear regression tested for associations, incorporating moderators including health literacy, self-efficacy, anxiety, and depression.

Results: Most participants (N = 59) were non-Hispanic (98.3%), White (89.8%), and males (83.1%). On average, participants had 2.68 anatomical sites affected by LEF in the head and neck region and spent 20.29 minutes daily on self-care. Participants spent more time (minutes per day) on self-care when their LEF was more severe (P < .05). Participants with worse symptom burden spent more time (minutes per day) conducting self-care activities (P < .05). Self-efficacy moderated the relationship between time spent on self-care and the number of sites involved with LEF. Furthermore, anxiety and depression moderated the relationship between time spent on self-care and symptom burden.

Conclusions: HNCS with more severe LEF and worse symptom burden spent more time on self-care. Self-efficacy, anxiety, and depression may moderate self-care behaviors. Findings highlight the importance of self-care management strategies to address self-efficacy and psychological factors to maximize engagement and LEF outcomes. Further investigation is warranted.

Implications for nursing practice: Nurses play a critical role in supporting HNCS with LEF. This study highlights the importance of assessing both the physical and psychological aspects of survivorship care. Nurses should routinely evaluate LEF severity, symptom burden, and psychological well-being (anxiety, depression, and self-efficacy) to personalize self-care guidance.