Determinants of quality of life related to lower limb lymphedema in women with gynecological cancer surgery

Yu-Yun Hsu; Chia-Yu Liu; Chien-Liang Ho; Keng-Fu Hsu

doi:10.1016/j.apjon.2022.100153

Determinants of quality of life related to lower limb lymphedema in women with gynecological cancer surgery

Asia Pac J Oncol Nurs. 2022 Oct 3;10(1):100153. doi: 10.1016/j.apjon.2022.100153. eCollection 2023 Jan.

Authors

Yu-Yun Hsu¹, Chia-Yu Liu², Chien-Liang Ho³, Keng-Fu Hsu^{4

5}

Affiliations

¹ Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Nursing Department, National Cheng Kung University Hospital, Tainan, Taiwan.
³ Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan.
⁴ Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, Tainan, Taiwan.

Abstract

Objective: This study aimed to identify the predictors of quality of life (QoL) related to lower limb lymphedema among women who had undergone gynecological cancer surgery. Additionally, the association between fatigue and the QoL was examined.

Methods: A cross-sectional design with a convenience sample was adopted. Participants included 200 women with lymphadenectomy following gynecological cancer surgery. Demographic data, QoL related to lower limb lymphedema, and fatigue symptoms were collected.

Results: Of the 200 participants, 60 percent (n = 120) reported a mild to severe impact on QoL related to lower limb lymphedema, with the main impact on the function of mobility and physical symptoms. Age less than 55 years (β = 0.706, OR = 2.027, P = 0.017), a diagnosis of ovarian cancer (β = 0.804, OR = 2.235, P = 0.048), undergoing chemotherapy (β = 0.616, OR = 1.854, P = 0.046), time after surgery (β = -0.833, OR = 0.435, P = 0.05), and fatigue (β = 0.055, OR = 1.06, P < 0.001) were independently associated with QoL related to lower limb lymphedema. Hierarchical multiple regression demonstrated that fatigue was significantly associated with QoL related to lower limb lymphedema after controlling for age, types of cancer, time after surgery, and chemotherapy. Fatigue explained 11% of the variance in the QoL.

Conclusions: More than half of the women with gynecological cancer requiring lymphadenectomy experienced an impact on QoL related to lower limb lymphedema. Effective interventions are warranted to improve the QoL related to lower limb lymphedema among women with gynecological cancer, particularly those who present with fatigue.

Keywords: Fatigue; Gynecological cancer; Lower limb lymphedema; Quality of life.