Effect Of Arm Exercises on the Prevention Of Lymphedema among mastectomized Women

Abstract

and (3.3%) were in unsatisfactory level and (40%) were in good level after 2 months. The second research hypothesis was supported, as a significant difference was found between study and control group subjects as regards the before discharge mean total and subtotal practice scores. All study group subjects were in unsatisfactory practice score level preoperatively then (100%) were in good level before discharge then become (86. 7%) after 2 months and (80%) after 4 months. The third research hypothesis was supported by the positive correlation between knowledge and practice scores obtained before discharge and after 2 months among the study group (r = 0.99, p = 0.001, r = 0.97. p = 0.001, respectively). The fourth research hypothesis was supported. as (56. 7%) of the control group developed lymphedema as compared to (6. 7%) of the study group. A high significant difference was found between study and control group concerning the development of the lymphedema (/ = 17.3. p = 0.001) about AIM OF WORK: To explore the impact ofthe application ofa post-mastectomy arm exercises and arm care on the prevention/reduction ofpost-mastectomy lymphedema. higher than the mean knowledge scores ofa control group. . Mean practice scores ofpatients who will apply post mastectomy arm exercises will be higher than the mean practice scores ofa control group. STUDY HYPOTHESES: . Mean knowledge scores of patients receiving instruction about arm exercises and arm care will be 3. There will be a positive correlation between knowledge and practice scores obtained by the study group subjects than that among the control group subjects. 4. Jncidence of lymphedema among patients receiving instructions about arm care and applying arm • exercises will be lower/lesser than the incidence oflymphedema among a control group. + MATERIAL AND METHODS: Sixty consecutive subjects were randomized into either study or control groups (30 each). Tools utilized for data collection were: a) Questionnaire sheet for the demographic variables and patient's knowledge about lymphedema, arm exercises and arm care. b) Checklist for practice of postmastectomy arm exercises. c) Assessment sheet for measurement of lymphedema in the affected arm. A structured interview and observation technique was utilizedfor data collection. + RESULTS: The first research hypothesis was supported as a significant difference between study and control groups as regards total and subtotal mean knowledge scores obtained before discharge and 2 months postoperatively. All study group subjects were in unsatisfactory knowledge level preoperatively, 100% were in good level postoperatively (13.3%) of the study group subjects developed mild edema, this percentage reduced to (3. 3 each) of mild and moderate edema after drain removal till 4 months. While in the control group 50% and 16. 7% developed mild and moderate lymphedema, respectively. This percentage was reduced to (30%) mild. and increase to (26. 7%) severe after drain removal till 4 months. Acute transient edema was developed by 1 3. 3% ofstudy group subjects as compared to (50%) ofthe control group subjects followed by (13. 3%) developed acute painful lymphedema as compared to (3. 3%) of the study group and (20%) of control group subjects their edema developed after one month (permanent) as compared to (3. 3%) of the study group. As regards subjects who developed lymphedema, 56. 7% were found to be in unsatisfactory knowledge and practice level while in the study group those who developed lymphedema (3. 3% each) were in unsatisfactory knowledge and practice and unsatisfactory practice only respectively. Education, occupation, residence and history of pervious cancer affection, were found to affect knowledge level among study group sample while practice level was found to be affected by marital status, occupation, and history ofpervious cancer affection. + CONCLUSIONS: enrichment of subjects knowledge and reinforcement of their performance about arm exercises and arm care were found to be highly effective in the reduction ofpostmastectomy lymphedema. \