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Rehabilitation Practice and Science

Translated Title

婦癌婦女預防下肢淋巴水腫臨床照護指引

Abstract

Background: Women receiving gynecological cancer surgery with lymph node dissection may experience lower limb lymphedema, resulting in physical discomfort and poor quality of life (QOL). Purpose: This study developed and assessed the effectiveness of a clinical guideline for preventing lower limb lymphedema in women with gynecological cancer following surgery. Methods: The guideline was created through the following processes: defining the topic and generating clinical questions by using the PICO process, conducting a systematic literature reviewarticle and evidence appraisal, drafting the clinical guideline for Preventing Lower Limb Lymphedema in Patients with Gynecological Cancer (CGP-3L-in-GC), performing two rounds of Delphi consensus, and evaluating the clinical guidelines in practice. Subsequently, the guideline was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE). Results: A total of 12 evidence-based papers and one published guideline were retrieved to draft the CGP-3L- in- GC, which was then approved through two rounds of Delphi consensus. Finally, an experiment was performed to test the effectiveness of the CGP-3L- in- GC in practice. The CGP-3L- in- GC was applied to 15 women experimental group, and regular care was applied to 14 women control group. The experimental group had a lower number of mild to severe limb edema cases than did the control group (p = .049). Additionally, the QOL of women in the experimental group significantly improved after implementation of the CGP-3L- in- GC, especially in subjective health (Z = −2.33, p = .02) and physiological domains (Z = −2.0, p = .047). An external evaluation using the AGREE indicated that the GCP-3L-in-GC can be recommended to health care providers who care for women with gynecological cancer following lymph node dissection surgery. Conclusions: Because of the limitations of study time and the numbers of subjects, the CGP-3L-in-GC cannot be proved to significantly decrease the prevalence of lower limb lymphedema. However, health care practitioners can apply the guideline to clinical practice when they treat women with gynecological cancer after surgery.

Language

Traditional Chinese

First Page

29

Last Page

42

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