Fu MR, Ridner SH, Hu SH, Stewart BR, Cormier JN, Armer JM, et al.
Psycho-oncology. Date of publication 2013 Jul 1;volume 22(7):1466-84.
1. Psychooncology. 2013 Jul;22(7):1466-84. doi: 10.1002/pon.3201. Epub 2012 Oct 9.
Psychosocial impact of lymphedema: a systematic review of literature from 2004 to
2011.
Fu MR(1), Ridner SH, Hu SH, Stewart BR, Cormier JN, Armer JM.
Author information:
(1)New York University College of Nursing, New York, NY 10003, USA. mf67@nyu.edu
OBJECTIVE: This systematic review aimed to evaluate the level of evidence of
contemporary peer-reviewed literature published from 2004 to 2011 on the
psychosocial impact of lymphedema.
METHODS: Eleven electronic databases were searched and 1311 articles retrieved;
23 met inclusion criteria. Twelve articles utilized qualitative methodology and
11 used quantitative methodology. An established quality assessment tool was used
to assess the quality of the included studies.
RESULTS: The overall quality of the 23 included studies was adequate. A critical
limitation of current literature is the lack of conceptual or operational
definitions for the concept of psychosocial impact. Quantitative studies showed
statistically significant poorer social well-being in persons with lymphedema,
including perceptions related to body image, appearance, sexuality, and social
barriers. No statistically significant differences were found between persons
with and without lymphedema in the domains of emotional well-being (happy or sad)
and psychological distress (depression and anxiety). All 12 of the qualitative
studies consistently described negative psychological impact (negative
self-identity, emotional disturbance, and psychological distress) and negative
social impact (marginalization, financial burden, perceived diminished sexuality,
social isolation, perceived social abandonment, public insensitivity, and
non-supportive work environment). Factors associated with psychosocial impact
were also identified.
CONCLUSIONS: Lymphedema has a negative psychosocial impact on affected
individuals. The current review sheds light on the conceptualization and
operationalization of the definitions of psychosocial impact with respect to
lymphedema. Development of a lymphedema-specific instrument is needed to better
characterize the impact of lymphedema and to examine the factors contributing to
these outcomes in cancer and non-cancer-related populations.
Copyright © 2012 John Wiley & Sons, Ltd.
DOI: 10.1002/pon.3201
PMCID: PMC4153404
PMID: 23044512 [Indexed for MEDLINE]