Knowledge, fatigue, and cognitive factors as predictors of lymphoedema risk-reduction behaviours in women with cancer
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To identify social–cognitive factors predicting lymphoedema risk-reduction behaviours (hereafter, self-care) after discharge among patients in Japan with breast or gynaecological cancers, using the extended model of the theory of planned behaviour.
A cross-sectional questionnaire study was conducted in an oncology hospital. Items measured were (1) knowledge about self-care; (2) the Cancer Fatigue Scale; (3) social–cognitive factors in the theory of planned behaviour (attitudes, subjective norms, and perceived behavioural control); (4) self-care (limb hygiene, observation, articular movement, recommended risk-reduction behaviours in daily life, and diet and weight control); and (5) demographics. Of 202 respondents, 147 who had not been diagnosed with lymphoedema were eligible for statistical analysis (65.3% with gynaecological cancer, 34.7% with breast cancer).
Structural equation modelling was used to examine a hypothesised model based on the theory of planned behaviour. The results revealed that a longer time since surgery, higher levels of fatigue, less knowledge, higher expected efficacy of self-care, and lower perceived behavioural control directly and significantly predicted less self-care behaviour.
Besides education about self-care behaviour, levels of fatigue and perceived behavioural control should be taken into account to encourage female patients with cancer to perform self-care after discharge. Continuous psycho-educational programmes after discharge may help to facilitate self-care behaviours among long-term female cancer survivors.
KeywordsBreast cancer Gynaecological cancer Lymphoedema Predictive factors Self-care Social–cognitive factors
We thank all patients who participated in this study.
This study was funded by the Foundation for Promotion of Cancer Research in Japan and in part by the National Cancer Center Research and Development Fund (28-A-23).
Compliance with ethical standards
Conflict of interest
Chikako Shimizu reports personal consultancy fee from Eizai and Pfizer, and grants from Pfizer, Chugai, MSD and Eli Lilly, outside the submitted work. Miyako Tsuchiya, Mariko Masujima, Tomoyasu Kato, Shun-ichi Ikeda, Takayuki Kinoshita, Sho Shiino, Makiko Suzuki, Miki Mori, and Miyako Takahashi have nothing to declare.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
Informed consent was obtained from all individual participants included in the study.
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