Abstract
Head and neck cancer survivors’ perception of lymphedema care
Journal of clinical oncology, Vol.42(16_suppl), pp.e24046-e24046
06/01/2024
DOI: 10.1200/JCO.2024.42.16_suppl.e24046
Abstract
e24046
Background: Secondary lymphedema and fibrosis occurs in more than 90% of HNC survivors. Given the progressive nature of lymphedema, prompt identification and treatment are essential. Treatment of HNC related lymphedema is fraught by numerous barriers. Advanced pneumatic compression devices (APCD) may address critical barriers. We conducted a phase 3 randomized multi-site trial in HNC survivors with treatment naïve lymphedema comparing usual care to APCD. Here in we report a qualitative analysis of participants treatment experience. Methods: Semi-structured interviews were audio recorded and transcribed after participants completed the 6
th
-month visit (N = 14 usual care, N = 23 APCD). Questions addressed treatment experience, perceptions of care, barriers, and facilitators. A hierarchical coding system was developed and refined using the interview guide and preliminary review of the transcripts. Transcripts were coded by experienced qualitative researchers. The coded transcripts were analyzed using an iterative inductive-deductive approach and based on our theoretical framework. Results: Participants were 65% male, 35% female and identified as 92% white, 5% black, and 5% Hispanic. The average age was 62 with a range of 32-82. We identified two distinct and one common set of barriers and facilitators. For usual care, health system (care coordination, logistics) and therapist factors (perceived skills and demeanor) were important while device characteristics (fit, comfort) were important for the APCD. Cognitive affective factors (self-efficacy, knowledge, outcome expectations, frustration) were similar for both therapies and interacted with the device/system characteristics. Conclusions: We identified distinct treatment barriers and facilitators for usual lymphedema care and treatment with APCD. Barriers identified in this study highlight practice changing opportunities to address system issues and develop interventions to enhance care and quality of life. Utilization of both treatment strategies may allow tailoring of treatments thus optimizing outcomes. Clinical trial information: NCT04797390 .
Details
- Title: Subtitle
- Head and neck cancer survivors’ perception of lymphedema care
- Creators
- Cristina Kline-Quiroz - Vanderbilt University Medical CenterBarbara A. Murphy - Vanderbilt UniversitySheila H. Ridner - Vanderbilt UniversityDerek Smith - Vanderbilt University Medical CenterDavid G. Schlundt - Vanderbilt UniversityKemberlee Bonnet - Vanderbilt University
- Resource Type
- Abstract
- Publication Details
- Journal of clinical oncology, Vol.42(16_suppl), pp.e24046-e24046
- DOI
- 10.1200/JCO.2024.42.16_suppl.e24046
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 06/01/2024
- Academic Unit
- Preventive and Community Dentistry; Dental Research
- Record Identifier
- 9984966716102771
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