scholarly journals Swelling Among Women Who Need Education About Leg Lymphedema: A Descriptive Study of Lymphedema in Women Undergoing Surgery for Endometrial Cancer

2014 ◽  
Vol 24 (8) ◽  
pp. 1507-1512 ◽  
Author(s):  
Ritu Salani ◽  
Megan M. Preston ◽  
Erinn M. Hade ◽  
Jessica Johns ◽  
Jeffrey M. Fowler ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Body Mass ◽  
Lower Limb ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Prolonged Standing ◽  
True Incidence ◽  
Patient Reported

ObjectivesIn addition to hysterectomy and bilateral salpingo-oophorectomy, comprehensive surgical staging for endometrial cancer includes pelvic and para-aortic lymphadenectomy. Clarifying and addressing the morbidity from these surgical procedures is imperative. The goal of this study was to assess the prevalence of lower extremity swelling after surgery for endometrial cancer.Materials and MethodsWe performed a descriptive, cross-sectional survey study of women who underwent surgery for endometrial cancer at our institution from 2006 to 2008. Survey information included symptoms, management, and education regarding lymphedema. Demographic information such as race and education was collected in addition to clinical data such as body mass index and age.ResultsOf the 482 patients identified, 440 were determined eligible and 305 (69.3%) responded to the survey with information on lower limb swelling (LLS). Of the 108 (35%) responders who reported swelling, only 68 (22%) participants reported a diagnosis of lower limb lymphedema (LLL). The most commonly experienced symptoms among those who reported LLS were tightness, pain/tenderness, and heaviness. Among those with a diagnosis of LLL, most (60%) stated it affected their daily activities and noted exacerbating factors such as prolonged standing, heat, and walking. The most common therapies used to reduce symptoms included leg elevation (96%), compression stockings (65%), diuretics (46%), massage therapy (35%), and bandaging (25%). There was no association between LLS or LLL diagnosis and body mass index, age, race, and tobacco use. Only 8% of responders reported receiving preoperative education regarding risks for LLS and a desire for more comprehensive education was frequently noted.ConclusionsThe patient-reported incidence of LLS occurred in approximately 35% of survey participants who underwent surgery for endometrial cancer. However, only 22% reported a diagnosis of LLL. Efforts to obtain the true incidence of LLL and to develop effective educational materials and programs to improve the management of lymphedema are warranted.

scholarly journals Development and Validation of a Self-Report Lower-Extremity Lymphedema Screening Questionnaire in Women

2013 ◽  
Vol 93 (5) ◽  
pp. 694-703 ◽  
Author(s):  
Kathleen J. Yost ◽  
Andrea L. Cheville ◽  
Amy L. Weaver ◽  
Mariam Al Hilli ◽  
Sean C. Dowdy
Keyword(s):  
Body Mass Index ◽  
Lower Extremity ◽  
Body Mass ◽  
Sensitivity And Specificity ◽  
Self Report ◽  
Survey Study ◽  
Cutoff Score ◽  
Cross Sectional Survey ◽  
Screening Questionnaire ◽  
Patient Reported

Background Patient-reported signs and symptoms are often the first indication of clinically relevant lymphedema. Objective The purpose of this study was to develop and assess the diagnostic accuracy of a screening questionnaire to detect lower-extremity lymphedema (LEL) among normal-weight women and women with obesity. Design This was a cross-sectional survey study. Methods The authors reviewed existing questionnaires assessing upper-extremity lymphedema (UEL) for potential questions and worked with content experts to generate new items. A draft questionnaire with 59 items was reviewed by 5 physicians and 5 physical therapists who specialized in lymphedema management and 5 female patients with clinically confirmed secondary LEL. A revised questionnaire with 45 items was administered by mail to 186 women with clinically confirmed LEL (n=116) or UEL (n=70). A total of 99 women (53.2% of 186) completed the mailed survey, and 28 women with lymphedema who were recruited directly in a lymphedema clinic waiting area also completed the survey. A parsimonious subset of items that best discriminated patients with and without LEL was identified using chi-square tests and logistic regression. Sensitivity and specificity for detecting LEL and positive and negative likelihood ratios (LR+, LR−) were estimated for the entire sample and for subsamples defined by obesity (body mass index ≥30 versus <30 kg/m2), which may confound the accurate diagnosis of LEL. Results Questionnaires were completed by 127 women (LEL group, n=88; UEL group, n=39). A sum of 13 items (score range=0–52) was the most discriminating. Using a cutoff score of ≥5 points, the sensitivity and specificity for detecting LEL among all participants were 95.5% and 86.5%, respectively (LR+=7.1, LR−=0.05), and 94.8% and 76.5%, respectively (LR+=4.0, LR−=0.07), for participants who were obese. Limitations By enumerating a sample with a high prevalence of LEL, a spectrum bias may have been introduced, which may have affected the accuracy of the screening questionnaire. Conclusions The brief, 13-item self-report questionnaire is a sensitive and specific tool for detecting clinically relevant LEL among women, including those with a body mass index of ≥30 kg/m2.

scholarly journals Examining patient distress and unmet need for support across UK renal units with varying models of psychosocial care delivery: a cross-sectional survey study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036931
Author(s):  
Maaike Seekles ◽  
Paula Ormandy ◽  
Daiga Kamerāde
Keyword(s):  
Logistic Regression ◽  
Service Provision ◽  
Care Delivery ◽  
Unmet Need ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Psychosocial Service ◽  
Patient Reported ◽  
Need For Support

ObjectiveTo examine in-centre haemodialysis patients’ emotional distress and need for support across UK renal units with varying models of psychosocial service provision.DesignThe study used a cross-sectional survey design. Logistic regression analysis was used to examine patient distress, as captured by the Distress Thermometer, and need for support, across different renal units.SettingSeven renal units across England, Wales and Scotland. The units were purposively selected so that varying workforce models of renal psychosocial services were represented.ParticipantsIn total, 752 patients were on dialysis in the participating centres on the days of data collection. All adult patients, who could understand English, and with capacity (as determined by the nurse in charge), were eligible to participate in the study. The questionnaire was completed by 509 patients, resulting in an overall response rate of 67.7%.Outcome measuresThe prevalence of distress and patient-reported need for support.ResultsThe results showed that 48.9% (95% CI 44.5 to 53.4) of respondents experienced distress. A significant association between distress and models of renal psychosocial service provision was found (χ2(6)=15.05, p=0.019). Multivariable logistic regression showed that patients in units with higher total psychosocial staffing ratios (OR 0.65 (95% CI 0.47 to 0.89); p=0.008) and specifically higher social work ratios (OR 0.49 (95% CI 0.33 to 0.74); p=0.001) were less likely to experience distress, even after controlling for demographic variables. In addition, a higher patient-reported unmet need for support was found in units where psychosocial staffing numbers are low or non-existent (χ2(6)=37.80, p<0.001).ConclusionsThe novel findings emphasise a need for increased incorporation of dedicated renal psychosocial staff into the renal care pathway. Importantly, these members of staff should be able to offer support for psychological as well as practical and social care-related issues.

scholarly journals Prevalence, Awareness, Treatment, and Control of Hypertension among Chinese First-Generation Migrants and Italians in Prato, Italy: The CHIP Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Pietro A. Modesti ◽  
Maria Calabrese ◽  
Ilaria Marzotti ◽  
Hushao Bing ◽  
Danilo Malandrino ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
First Generation ◽  
Primary Outcome Measure ◽  
Cross Sectional Survey ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Parental History ◽  
Chinese Migrants ◽  
First Generation Migrants

Data on health needs of Chinese living in the South of Europe are lacking. To compare prevalence, awareness, treatment, control, and risk factors for hypertension between Chinese migrants and Italian adults, a sample of 1200 first-generation Chinese migrants and 291 native Italians aged 35–59 years living in Prato (Italy) was recruited in a community-based participatory cross-sectional survey. Primary outcome measure was hypertension, diagnosed for blood pressure values ≥ 140/90 mmHg or current use of antihypertensive medications. Associations with exposures (including age, gender, body mass index, waist, education level, total cholesterol, and triglycerides) were examined using logistic regression. When compared with Italians, Chinese had higher hypertension prevalence (27.2% versus 21.3%,p<0.01), with comparable levels of awareness (57.4% and 48.4%) but lower treatment rates (70.6% and 90.0%, resp.). In both ethnic groups age and parental history of hypertension were predictors of awareness and treatment, body mass index being predictor of hypertension diagnosis. In Chinese participants, where the optimum cut-off point for body mass index was ≥23.9 kg/m2, the sensibility and specificity prediction for hypertension were 61.7% and 59.8%, respectively (area under the ROC curve = 0.629). Implementation of specific, culturally adapted health programs for the Chinese community is now needed.

scholarly journals Assessment of respiratory muscle strength in children according to the classification of body mass index

2014 ◽  
Vol 32 (2) ◽  
pp. 250-255 ◽  
Author(s):  
George Jung da Rosa ◽  
Camila Isabel S. Schivinski
Keyword(s):  
Body Mass Index ◽  
Muscle Strength ◽  
Body Mass ◽  
School Children ◽  
Respiratory Muscle ◽  
Forced Expiratory Volume ◽  
The Body ◽  
Respiratory Muscle Strength ◽  
Cross Sectional Survey ◽  
Cross Sectional

OBJECTIVE: To assess and compare the respiratory muscle strength among eutrophic, overweight and obese school children, as well as to identify anthropometric and respiratory variables related to the results.METHODS: Cross-sectional survey with healthy schoolchildren aged 7-9 years old, divided into three groups: Normal weight, Overweight and Obese. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was applied. The body mass index (BMI) was evaluated, as well as the forced expiratory volume in one second (FEV1) with a portable digital device. The maximal inspiratory and expiratory pressures (MIP and MEP) were measured by a digital manometer. Comparisons between the groups were made by Kruskal-Wallis test. Spearman's correlation coefficient was used to analyze the correlations among the variables.RESULTS: MIP of eutrophic school children was higher than MIP found in overweight (p=0.043) and obese (p=0.013) children. MIP was correlated with BMI percentile and weight classification (r=-0.214 and r=-0.256) and MEP was correlated with height (r=0.328). Both pressures showed strong correlation with each other in all analyses (r≥0.773), and less correlation with FEV1 (MIP - r=0.362 and MEP - r=0.494). FEV1 correlated with MEP in all groups (r: 0.429 - 0.569) and with MIP in Obese Group (r=0.565). Age was correlated with FEV1 (r=0.578), MIP (r=0.281) and MEP (r=0.328).CONCLUSIONS: Overweight and obese children showed lower MIP values, compared to eutrophic ones. The findings point to the influence of anthropometric variables on respiratory muscle strength in children.

scholarly journals Patient-reported Outcomes of Patients With Breast Cancer During the COVID-19 Outbreak in the Epicenter of China: A Cross-sectional Survey Study

2020 ◽  
Vol 20 (5) ◽  
pp. e651-e662 ◽  
Author(s):  
Li Juanjuan ◽  
Cesar Augusto Santa-Maria ◽  
Feng Hongfang ◽  
Wang Lingcheng ◽  
Zhang Pengcheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Reported Outcomes ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Reported
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