Experiences of breast cancer survivors with lymphedema self-management: a systematic review of qualitative studies

Abstract

Purpose: This study systematically identified, evaluated, and synthesized qualitative literature on the experiences of breast cancer survivors with lymphedema self-management.

Methods: This systematic review followed the Joanna Briggs Institute meta-aggregation approach and was guided by the ENTREQ, graded according to the ConQual approach, and evaluated using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Qualitative studies related to the experiences in lymphedema self-management among breast cancer survivors conducted until March 9, 2022, were searched. The selected studies were reviewed independently, and the data were synthesized collaboratively into core themes.

Results: A total of 24 studies were included, and 85 findings resulted in three synthesis findings: (a) breast cancer survivors face challenges in lymphedema self-management, (b) breast cancer survivors are entangled in rebuilding a new balance between different roles, and (c) breast cancer survivors seek internal and external resources to regulate negative emotions.

Conclusions: Lymphedema self-management is a lifetime commitment and a challenge for breast cancer survivors, who find it difficult to adhere to self-management and cope with their problems. They require timely and continuous effective self-management education, and instrumental and emotional support from others, particularly healthcare providers and family members.

Implications for cancer survivors: Timely self-management education and access to lymphedema treatment and related resources are important for survivors to prevent and manage lymphedema. Breast cancer survivors should develop coping skills, and family members should participate in survivors' lymphedema self-management.

Keywords: Breast cancer survivors; Lymphedema; Meta-aggregation; Qualitative studies; Self-management.