A lymphedema self-management programme: report on 30 cases.
OBJECTIVE
Compression therapy is the most important element in the treatment and long-term management of moderate and severe lymphedema, but it is not universally accessible in Canada. For those unable to access private lymphedema treatment, physiotherapists at the McGill University Health Centre (MUHC) Lymphedema Clinic began teaching patients and caregivers how to use compression bandages safely and effectively.


METHODS
A retrospective chart review was combined with structured telephone or in-person interviews with 30 people who had attended a self-bandaging clinic in the MUHC Lymphedema Clinic between 2011 and 2012. Patients were monitored weekly until limb volume plateaued, and a compression garment was then fitted for ongoing maintenance. Monthly or quarterly surveillance continued for 1 year. Follow-up interviews were conducted 3 to 18 months after patients had received their garments.


RESULTS
The majority of participants had moderate to severe lymphedema; all achieved reduction of edema in the range of 48% to 92%. More than three-quarters of participants reported a global rate of change (GRC) of ≥80%. Themes derived from the interviews included the importance of bandaging, the feeling of being in control, and difficulties with compression garments. Participants spontaneously expressed satisfaction about having tools to manage their condition themselves.


CONCLUSIONS
For selected patients with lymphedema, a self-bandaging programme can be a route to lymphedema reduction, independence, and self-efficacy.
Department of Physical Therapy, Maccabi Healthcare Services, Sderot, Israel.
Dorit
D
Tidhar
Lymphedema Program, McGill University Health Centre.
Pamela
P
Hodgson
Lymphedema Program, McGill University Health Centre.
Carol
C
Shay
Department of Oncology, McGill University, Montreal.
Anna
A
Towers
compression bandages; lymphedema, self-care