Patient Attitude Influences Ability to Heed Postsurgical Advice

Empowered women who can manage their stress are more likely to make necessary adaptations to avoid a postsurgery complication

A woman who feels confident in her abilities and knows how to manage stress is more likely to follow doctors’ advice regarding ways to reduce the risk of developing side effects as a result of breast cancer surgery, according to new research.

The study, funded by the US Department of Defense, focused on lymphedema, a side effect that a significant number of women develop after undergoing surgery to remove breast cancer.

Study author Suzanne M. Miller, PhD, professor and director of the Psychosocial and Biobehavioral Medicine Program at Fox Chase, says study findings suggest that clinicians must do more than just inform women of the ways they should change their behavior. Doctors and nurses should also provide patients with strategies for making those lifestyle changes and teach them skills for reducing patient stress.

Because there is no treatment for lymphedema, the best thing women can do is avoid infections, burns, muscle strain, constrictions of their arms, and weight gain in order to reduce their risk of developing it in the first place, says Miller. To truly follow these recommendations, women have to forever change and monitor their behavior. “These changes are going to be very intrusive into a woman’s everyday life,” says Miller.

For their study regarding ways to aid women in making dramatic behavioral changes, Miller and her colleagues met with 103 women immediately following breast cancer surgery. They discussed lymphedema, the patients’ attitudes about it, and they provided materials from the American Cancer Society on how to reduce the risk of developing lymphedema. Miller and her colleagues then checked in with the women 6 months later to see how well they had followed the advice.

Upon follow-up, only 50% of the women appeared to be consistently following the recommendations.

Researchers discovered that the patient’s attitude was an important factor in the rate of adherence. Women were most likely to follow the advice and reduce their risk of lymphedema if they felt confident they could physically follow the recommendations, believed these behaviors would control their risk, and had strategies to cope with stress.

Study findings indicate that care providers should offer additional tools to help women adhere to expert advice, suggests Miller. These tools may include finding ways to track what they do and reward themselves, seeking out stories of women who are coping with the same challenges, joining support groups, and learning relaxation techniques.

Furthermore, clinicians need to talk to families and ensure everyone is on board with a woman’s “new normal,” says Miller. “Managing a woman’s risk of lymphedema requires a shift in the dynamics of her relationships, so the people around her can pitch in and take over some of the tasks she should no longer do.”

Reducing the risk of lymphedema involves women taking control of the next phase of their lives, says Miller. “Being a survivor is wonderful. It’s great to get to that stage. Managing lymphedema should be seen as managing anything else in life that keeps you healthy, such as weight, or exercise.”

Source: Fox Chase Cancer Center.