Bolette S Rafn1, Margaret L McNeely2, Pat G Camp3, Julie Midtgaard4, Kristin L Campbell5. 1. Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada. 2. Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada. 3. Department of Physical Therapy, Centre for Heart Lung Innovation, University of British Columbia. 4. Department of Public Health, University of Copenhagen, and Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. 5. Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall Vancouver, Vancouver, British Columbia V6T 1Z3, Canada.
Abstract
Background: Prospective surveillance by physical therapists enables early detection and treatment of breast cancer-related lymphedema (BCRL). Strategies to increase access to prospective surveillance could reduce the burden of BCRL on patients and the health system. One potential solution is self-managed surveillance that does not require in-person assessment by a specialized physical therapist. Objective: The objective was to develop and test the reliability and validity of a written and video-supported protocol for women with breast cancer to self-measure arm circumference. Design: This was a cross-sectional reliability and validity study. Results: The intrarater reliability between CIRself_home and CIRself_lab and the interrater reliability between CIRself_lab and CIRther was high to excellent for both arms in both groups (intraclass correlation coefficient ≥0.86). VOLself_lab correlated strongly with VOLper (r ≥ 0.95), demonstrating excellent validity. Participants reported strong intention, self-efficacy, and positive attitude toward the performance of self-managed surveillance for BCRL, which was not perceived to increase worry about having or getting BCRL. Methods: Participants with (n = 20) and without (n = 21) BCRL completed self-measurement of arm circumference on both arms at home (CIRself_home) and at the lab (CIRself_lab) (intrarater reliability). The CIRself_lab was subsequently compared to measures performed by a specialized physical therapist (CIRther) (interrater reliability). To test validity, arm volume calculated from the self-measurements (VOLself_lab) was compared to perometry measurements (VOLper). Participants completed a questionnaire to assess attitudes for performing self-managed surveillance for BCRL. Limitations: These findings need to be replicated in a clinical setting to confirm the reliability and acceptability of self-managed surveillance for BCRL among women newly diagnosed with breast cancer. Conclusions: Self-measured arm circumference is reliable and valid among women with and without BCRL. Self-managed surveillance for BCRL can support self-efficacy without increasing anxiety.
Background: Prospective surveillance by physical therapists enables early detection and treatment of breast cancer-related lymphedema (BCRL). Strategies to increase access to prospective surveillance could reduce the burden of BCRL on patients and the health system. One potential solution is self-managed surveillance that does not require in-person assessment by a specialized physical therapist. Objective: The objective was to develop and test the reliability and validity of a written and video-supported protocol for women with breast cancer to self-measure arm circumference. Design: This was a cross-sectional reliability and validity study. Results: The intrarater reliability between CIRself_home and CIRself_lab and the interrater reliability between CIRself_lab and CIRther was high to excellent for both arms in both groups (intraclass correlation coefficient ≥0.86). VOLself_lab correlated strongly with VOLper (r ≥ 0.95), demonstrating excellent validity. Participants reported strong intention, self-efficacy, and positive attitude toward the performance of self-managed surveillance for BCRL, which was not perceived to increase worry about having or getting BCRL. Methods:Participants with (n = 20) and without (n = 21) BCRL completed self-measurement of arm circumference on both arms at home (CIRself_home) and at the lab (CIRself_lab) (intrarater reliability). The CIRself_lab was subsequently compared to measures performed by a specialized physical therapist (CIRther) (interrater reliability). To test validity, arm volume calculated from the self-measurements (VOLself_lab) was compared to perometry measurements (VOLper). Participants completed a questionnaire to assess attitudes for performing self-managed surveillance for BCRL. Limitations: These findings need to be replicated in a clinical setting to confirm the reliability and acceptability of self-managed surveillance for BCRL among women newly diagnosed with breast cancer. Conclusions: Self-measured arm circumference is reliable and valid among women with and without BCRL. Self-managed surveillance for BCRL can support self-efficacy without increasing anxiety.
Authors: Judy Mastick; Betty J Smoot; Steven M Paul; Kord M Kober; Bruce A Cooper; Lori K Madden; Yvette P Conley; Niharika Dixit; Marilyn J Hammer; Mei R Fu; Merisa Piper; Sarah P Cate; John Shepherd; Christine Miaskowski Journal: Lymphat Res Biol Date: 2021-03-23 Impact factor: 2.589
Authors: Mona M Al Onazi; Kristin L Campbell; Richard B Thompson; Sunita Ghosh; John R Mackey; Anne Muir; Margaret L McNeely Journal: BMJ Open Date: 2022-04-04 Impact factor: 2.692