| Summary: | 碩士 === 長庚大學 === 護理學系 === 98 === The purposes of this study were to explore the incidence and change pattern of restriction in shoulder movement and arm lymphedema and to identify the risk factors and the relationship between restriction of shoulder movement and arm lymphedema in women after breast cancer surgery. Shoulder ranges of motion and arm circumference were measured at pre-surgery, 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, and 24 months after surgery. Norman questionnaire measuring subjective lymphedema was also administered at the same schedule. Descriptive statistics, Hierarchical Liner Model (HLM), and Chi-square test were used to analyze the study data.
Data from 189 patients showed that: (1) The incidence of restriction of shoulder movement during two years after surgery was 72.8%. The majority of this problem was occurred at the first or second month after surgery and 40% of them could recover later. Only 4.2-12.2% patients still had restriction of shoulder movement after six months post surgery. The incidence of arm lymphedema ranged from 43.1% to 52.2%, depending on the measurement methods. The persistent lymphedema was often first observed six months after surgery and the occurrence was gradually increased after one year post-surgery. (2) In terms of change pattern, both the trend of degree of shoulder movement and the severity of lymphedema demonstrated a reversed U shape. (3) Handedness being the surgical side, type of surgery, and the number of lymph node removed had significant effect on the change of shoulder movement degree. BMI, handedness being the surgical side, disease stage, and the number of lymph node involved had significant effect on the change of lymphedema severity. (4) There was no significant relationship between the persistent restriction of shoulder movement and the occurrence of arm lymphedema.
Keyword: breast cancer, shoulder range of motion restricted, arm lymphedema, Hierarchical Liner Model
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