Cognitive-Affective Predictors of the Uptake of, and Sustained Adherence to, Lymphedema Symptom Minimization Practices in Breast Cancer Survivors

摘要

Approximately 20-30% of women develop lymphedema (LE) following breast cancer treatment. Effective symptom management requires that women recognize early signs of lymphedema, and maintain precautionary practices over time. Data indicates that knowledge and use of symptom minimization precautions are poor. Little is known about how breast cancer survivors perceive their LE risk, and the cognitive-affective factors that promote the uptake and adherence to LE symptom minimization precautions. Guided by the Cognitive-Social Health Information Processing (C-SHIP) model, we are conducting a longitudinal study, to assess barriers and facilitators associated with knowledge and adherence to LE symptom-minimization practices among breast cancer survivors. We are exploring the mediating role of cognitive-affective variables, and the moderating role of attentional style, on knowledge, uptake and adherence. Our preliminary analysis shows a correlation between high monitoring and more knowledge of lymphedema risks compared to low-monitoring styles. We are surveying levels of knowledge, and practice of symptom minimization precautions at baseline, 6-, and 12-month follow-up. Although many women are aware of LE minimization practices, data suggest that they are not incorporating the recommendations into their daily lives. Further, psychosocial factors play a role in the uptake of LE symptom-minimization practices, and sustained adherence over time.