Assessment of Family Caregiver Burden and Its Relationships Between Quality of Life, Arm Disability, Grip Strength, and Lymphedema Symptoms in Women with Postmastectomy Lymphedema: A Prospective Cross-Sectional Study

Esra Giray1 , Gülseren Akyüz2. Eur J Breast Health 2019; 15(2): 111-118

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Assessment of Family Caregiver Burden and Its Relationships Between Quality of Life, Arm Disability, Grip Strength, and Lymphedema Symptoms in Women with Postmastectomy Lymphedema: A Prospective Cross-Sectional Study

Esra Giray1 , Gülseren Akyüz2. Eur J Breast Health 2019; 15(2): 111-118

Objective: The aim the study is to assess relationships between caregiver burden, quality of life, arm disability, grip strength, and lymphedema symptoms in women with postmastectomy lymphedema.

Materials and Methods: Fifty-two patients with postmastectomy lymphedema were recruited. Burden Interview, Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-30 and EORTC QLQ BRE-23) were used for the assessments of caregiver burden, arm disability, and quality of life. Lymphedema symptoms were questioned by Visual Analogue Scale (VAS) for pain, heaviness, and tension. Grip strength and arm volumes of the affected and unaffected sides were measured.

Results: Statistically significant positive correlations were detected between Burden Interview scores and DASH scores, VAS for pain and EORTC QLO-30 symptom scores. There were statistically negative correlations between Burden Interview and grip strength of affected side and unaffected side and lymphedema duration. Multiple linear regression was calculated to predict Burden Interview and EORTC QLO-30 functional and symptom scores based on age, DASH, stage, and duration of lymphedema. DASH score was significant predictors of Burden Interview while DASH score and Burden Interview scores were significant predictors of quality of life.

Conclusion: Arm disability indicates caregiver burden and quality of life in patients with postmastectomy lymphedema while caregiver burden predicts the quality of life. These findings have implications for the management of lymphedema. We suggest that arm disability should be diagnosed and treated to improve caregiver burden and quality of life.

Main findings

  • Caregiver burden was associated with arm disability and quality of life of these patients while arm disability was associated with lymphedema stage, lymphedema symptoms and quality of life. Arm disability affects the caregiver burden and quality of life in these patients. We found that arm disability was higher in patients at stage 3 lymphedema than patients at milder stages.
  • There were no differences among groups regarding VAS for pain and tension while VAS heaviness was higher in patients at stage 3 lymphedema.
  • Patients at stage 0 and 1, stage 2 and stage 3 were found to be similar regarding the grip strength of the affected and the unaffected side.