title: Self-management of lymphedema: a systematic review of the literature from 2004 to 2011.
abstract: BACKGROUND
  Little is known about the effectiveness of activities used to self-manage lymphedema.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the level of evidence of peer-reviewed lymphedema self-care literature published from January 2004 to May 2011.
  
  
  METHODS
  Eleven major medical databases were searched. Articles were selected for inclusion or exclusion into the category of self-management of lymphedema by topic experts. The definition of self-management included activities that individuals initiate and perform for themselves without the assistance of others. Articles were scored according to the Oncology Nursing Society's Putting Evidence Into Practice levels of evidence.
  
  
  RESULTS
  Sixteen articles met criteria for inclusion in this review, with self-management as the independent variable. Ten categories of self-management were established subsequently and articles were classified by levels of evidence. In these categories, no self-management studies were rated as "recommended for practice," 2 studies were rated "likely to be effective," none was rated "benefits balanced with harms," 7 were rated "effectiveness not established," and 1 was rated "effectiveness unlikely."
  
  
  CONCLUSIONS
  Few studies included measures of outcomes associated with lymphedema, and there was a scarcity of randomized controlled trials in lymphedema self-management. A demonstrated need exists for the design and testing of self-management interventions that include appropriate outcome measures.
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, Tennessee 37240, USA. sheila.ridner@vanderbilt.edu
authors.forename: Sheila H
authors.initials: SH
authors.lastname: Ridner
authors.forename: Mei R
authors.initials: MR
authors.lastname: Fu
authors.forename: Ausanee
authors.initials: A
authors.lastname: Wanchai
authors.forename: Bob R
authors.initials: BR
authors.lastname: Stewart
authors.forename: Jane M
authors.initials: JM
authors.lastname: Armer
authors.forename: Janice N
authors.initials: JN
authors.lastname: Cormier
mesh_terms: D001943:Breast Neoplasms / Q000534:rehabilitation; D058128:Compression Bandages; D004038:Diet, Reducing; D015444:Exercise; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008209:Lymphedema / Q000628:therapy*; D012648:Self Care / Q000379:methods*; D017592:Skin Care