Ceren ORHAN, Serap ÖZGÜL, Gülbala NAKİP, Emine BARAN, Esra ÜZELPASACI, Gamze Nalan ÇİNAR, Sercan AKSOY, Türkan AKBAYRAK

Meme Kanseri Tedavisiyle İlişkili Lenfödemi Olan Hastalarda Lenfödem Şiddetinin Yaşam Kalitesi, Üst Ekstremite Fonksiyonu ve Fiziksel Aktivite Düzeyi Üzerindeki Etkileri

Amaç: Bu çalışmanın amacı, meme kanseri tedavisi ile ilişkili hafif, orta ve şiddetli lenfödemi olan hasta grupları arasında yaşam kalitesi, üst ekstremitenin fonksiyonel durumu ve fiziksel aktivite düzeyindeki karşılaştırmaktı. Gereç ve Yöntemler: Bu çalışmaya, meme kanseri tedavisi ile ilişkili lenfödem tanısı olan 83 kadın (% 24 hafif, % 41 orta, % 35 şiddetli) katıldı. Lenfödemin varlığı ve şiddeti çevre ölçümü ile belirlendi. Lenfödem Yaşam Kalite Ölçeği (LYKÖ), Kol, Omuz ve El Sorunları Anketi’nin kısa versiyonu (DASH) ve Uluslararası Fiziksel Aktivite Anketi’nin kısa formu (UFAA-KF), sırasıyla yaşam kalitesi, üst ekstremitenin fonksiyonel durumu ve fiziksel aktivite düzeyinin değerlendirilmesi için kullanıldı. Bulgular: Hafif, orta ve şiddetli lenfödemi olan hastalar arasında yaşam kalitesi ve üst ekstremitenin fonksiyonel durumu açısından istatistiksel olarak anlamlı fark vardı (p<0.05). Ancak, fiziksel aktivite düzeyinden üç grup arasında anlamlı fark yoktu (p>0.05). İkili analizlerin sonuçlarına göre, şiddetli lenfödemi olan hastalarda, yaşam kalitesinin fonksiyon, görünüm ve semptom alt alanlarının ve üst ekstremitenin fonksiyonel durumunun hafif derecede lenfödemi olan hastalara göre daha fazla etkilendiği bulundu (p<0.016). Lenfödem şiddeti ile LYKÖ fonksiyon, görünüm ve semptom alt alanları ve DASH arasında istatistiksel olarak anlamlı ancak zayıf bir ilişki bulundu (p≤0.01). Tartışma ve Sonuç: Şiddetli lenfödemi olan hastalarda yaşam kalitesinin ve üst ekstremitenin fonksiyonel durumunun hafif lenfödemi olan hastalara göre daha fazla etkilendiği bulundu. Bu sonuçlar, meme kanseri cerrahisi geçiren bireylerde lenfödem hafif düzeyden ileri düzeye geçtiğinde yaşam kalitesi ve üst ekstremite fonksiyonelliğinin etkilenebileceğini göstermektedir. Dolayısıyla bu etkilenimi önlemek veya azaltmak için lenfödemin erken dönemde belirlenmesi ve tedavi edilmesi önemlidir.

Anahtar Kelimeler:

meme kanseri, lenfödem, üst ekstremite, yaşam kalitesi, fonksiyon, fiziksel aktivite

Effects of Lymphedema Severity on Quality of Life, Upper Limb Function, and Physical Activity Level in Patients with Breast Cancer Treatment-related Lymphedema

Aim: The aim of the present study was to compare the quality of life, the functional status of upper extremity, and physical activity level among women with mild, moderate, or severe breast cancer treatment related lymphedema. Materials and Methods: Eighty-three women with a diagnosis of lymphedema (24% mild, 41% moderate, and 35% severe) participated in the present study. The presence and severity of lymphedema were evaluated by circumferential measurement. The Turkish versions of the Lymphedema Quality of Life (LYMQOL), Quick Disability of Arm, Shoulder and Hand (DASH), International Physical Activity Questionnaire-Short Form (IPAQ-SF) were used to assess quality of life, the functional status of upper extremity, and physical activity level, respectively. Results: There were significant differences in quality of life and functional status of upper extremity among patients with mild, moderate, and severe lymphedema (p<0.05). However, there was no significant difference in physical activity level among the three groups (p>0.05). Based on the findings of pairwise analyses, function, appearance, and symptom subscales of quality of life and the functional status of upper extremity was found to be more influenced in patients with severe lymphedema than those with mild lymphedema (p<0.016). The significant, but weak associations between lymphedema severity and the LYMQOL function, and appearance, and symptom subscales, and the DASH score were found (p≤0.01). Discussion and Conclusion: It was found that quality of life and the functional status of upper extremity were more influenced in patients with severe lymphedema than those in patients with mild lymphedema. These results indicate that quality of life and upper extremity functionality may be affected when lymphoedema progress from mild to severe in patients undergoing breast cancer surgery. Therefore, it is important to determine and treat lymphedema in the early stages in order to prevent or reduce this influence.

Keywords:

breast cancer, lymphedema, upper extremity, quality of life, function, physical activity,

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