A Randomized Trial of the Effect of Self-care Booklet Plus Routine Care Compared with Routine Care Alone in Breast Cancer-related Lymphedema Patients

A Randomized Trial of the Effect of Self-care Booklet Plus Routine Care Compared with Routine Care Alone in Breast Cancer-related Lymphedema Patients


  • Sithawatdecha T ภาควิชาเวชศาสตร์ฟื้นฟู
  • Chotiyarnwong C
  • Pajareya K


breast cancer related lymphedema, self-care booklet, patient education



Objectives: To investigate the effectiveness of the self-care booklet plus routine care on reducing arm volume in patients with breast cancer related lymphedema (BCRL).

Setting: Outpatient department, Department of Rehabilitation Medicine, Siriraj Hospital.

Study design: Prospective, randomized single-blinded controlled trial.

Subjects: Fifty-one patients with stage 1 or 2 BCRL were enrolled during December 2017 and December 2018.

Methods: Patients were randomized into 2 groups, the intervention group received self-care booklet plus routine care and the control group receives routine care alone for 12 weeks. Patients in the intervention group were asked to follow the instructions in the booklets and record their self-monitor routine in the booklet weekly.  Arm volume, quality of life, arm range of motions, patients’ knowledge, and overall satisfactions were recorded at baseline, 4 weeks and 12 weeks.

Results: After using the self-care booklet for 4 weeks, patients in the intervention group demonstrated significantly higher score in the physical sub-scale of the Lymph-ICF questionnaire when compared between groups (p=0.046) but there were no significant differences regarding the arm volume reduction and knowledge score. After 12 weeks, there were significant increases in shoulder forward flexion and shoulder abduction ROM (p= 0.033, 0.025 respectively) in the intervention group but no difference between groups was found in terms of arm ROM, volume reduction, knowledge score, overall satisfaction and adverse events.

Conclusion: The self-care booklet plus routine care demonstrated some benefit for women with stage 1 or 2 BCRL in terms of improving the physical subscale QOL score after using for 4 weeks. But after 12 weeks, there were no difference from the routine care alone.


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