ZHANG Zijuan 1 , FU Xin 1 , HU Qian 1 , ZHANG Lichuan 1 , SHEN Aomei 1 , WANG Yujie 2 , CHEN Shuyu 1 , LU Qian 1
  • 1. Peking University School of Nursing, Beijing 10091, P. R. China;
  • 2. Department of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Henan 450003, P. R. China;
LU Qian, Email: luqian@bjmu.edu.cn
Breast cancer; Self-management; Systematic review; Meta-analysis; Randomized controlled trials; Lymphedema
10.7507/1672-2531.202311189
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Objective To systematically review the effect of self-management intervention on the prevention and management of lymphedema in breast cancer patients. Methods Cochrane Library, Embase, PubMed, Web of Science, CINAHL, PsycINFO, SinoMed, CNKI, WanFang Data and VIP databases were electronically searched to collect studies on self-management intervention on the prevention and management of lymphedema in breast cancer patients, from database inception to June 16. Two reviewers independently screened the literature, extracted data and assessed the risk of biasof the included studies. Meta-analysis was performed using RevMan 5.4 software. Results A total of 37 references were included, comprising 25 randomized controlled trials (RCTs), 12 controlled clinical trials (CCTs), and a total of 3 697 patients. There were 26 studies in the meta-analysis, and the results of the meta-analysis showed that, compared with the control group, patients in the intervention group exhibited better performance in lymphedema management-related behaviors SMD=2.65, 95%CI(1.53 to 3.78), P<0.01, symptoms related to lymphedema SMD=−2.01, 95%CI (−3.66 to −0.37), P<0.05, occurrence of lymphedema RR=0.37, 95%CI (0.32 to 0.45), P<0.01, upper limb function SMD=−1.88, 95%CI (−2.83 to −0.92), P<0.01, quality of life SMD=2.79, 95%CI (2.05 to 3.54), P<0.01, and the difference was statistically significant. The intervention mainly included information support, material support, emotional support and decision support. Conclusion There are currently a variety of self-management interventions, but they mainly focus on information support. Self-management interventions can improve the self-management behavior of breast cancer patients with lymphedema and reduce the impact of lymphedema on patients.