Title : A scoping review of the current status of adherence to lymphedema prevention behaviors and factors influencing them in postoperative breast cancer patients
Abstract:
Objective: To conduct a scoping review of the status of behavioural adherence to lymphoedema prevention and its influencing factors in postoperative breast cancer patients, in order to provide a scientific basis for future intervention studies.
Methods: Following the scoping review methodology, a systematic search was conducted for relevant studies in Chinese and English databases, with a search timeframe of the period from the establishment of the database to 31 August 2024, and the retrieved literature was screened and information extracted to analyse the status of patients' behavioural adherence, and the extracted influencing factors were mapped to the various domains of the theoretical domains, identifying and analysing the key factors for behavioural change.
Results: A total of 15 papers were included, with nine quantitative studies, including seven cross-sectional studies, one cohort study, one longitudinal study, and six qualitative studies. The results of the analyses showed an overall low level of adherence to lymphoedema prevention behaviours in postoperative breast cancer patients, and 25 influencing factors were integrated and summarised across eight theoretical domains, including knowledge (level of knowledge about lymphoedema), skills (coping styles, postoperative time), competence beliefs (self-efficacy, disease perception, unclear tumour stage, surgical modality, symptom distress), outcome beliefs (outcome expectations, attitudes ), emotions (negative emotions, fatigue level, age), behavioural regulation (self-regulation, exercise habits, behavioural control), social influences (social support, family support, marital status, behavioural cues), and environment and resources (healthcare resources, ethnicity, healthcare staff supervision, economic status, work status).
Conclusion: Patient behavioural adherence is not promising and the influencing factors are differential, multi-source and cross-cutting. Future focus should be on dissecting the potential associations and mechanisms between different influencing factors in order to improve patient behavioural adherence.
