Browsing by Person "Williams, Anne F."

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A review of the evidence for adjustable compression wrap devices
(MA Healthcare, 2016-05-12) Williams, Anne F.
Compression therapy is a key component in the effective management of people with lower limb problems associated with venous, lymphatic and fat disorders such as lipoedema. Individuals with lymphoedema, venous ulceration and lipoedema often require long-term compression therapy to prevent and manage problems such as chronic ulceration and skin changes, persistent swelling and shape distortion. Challenges remain in achieving acceptable, safe, effective and cost-efficient compression therapy choices. Adjustable compression wrap devices using hook and loop fasteners, commonly called VELCRO brand fasteners, present new opportunities for improving treatment outcomes, supporting patient independence and self-management in the use of compression therapy. This paper reports the findings of an evidence review of adjustable compression wrap devices in people with lymphoedema, chronic oedema, venous ulceration and lipoedema. MA Healthcare Limited 2016.
Accurate diagnosis and self-care support for women with lipoedema
(Mark Allen Healthcare, 2016-07-01) Williams, Anne F.; MacEwan, Isobel
Lipoedema is a long term, progressive condition usually presenting as symmetrical enlargement of the legs and buttocks, and mainly affecting women. Distinct from obesity and lymphoedema, lipoedema is associated with an unusual distribution of diet-resistant inflammatory fat tissue. This article provides background to lipoedema diagnosis, and discusses self-care support for women with lipoedema.
An updated review of the evidence for adjustable compression wrap devices in the lower limb
(Mark Allen Group, 2018-04-15) Williams, Anne F.
Compression therapy is a key component in the effective management of people with lower limb problems associated with venous, lymphatic and fat disorders such as lipoedema. Individuals with lymphoedema, venous ulceration and lipoedema often require long-term compression therapy to prevent and manage problems such as chronic ulceration and skin changes, persistent swelling and shape distortion. There are challenges in achieving acceptable, safe, effective and cost-efficient compression therapy choices. Adjustable, compression-wrap devices incorporating hook-and-loop systems present new opportunities for improving treatment outcomes, supporting patient independence and self-management in the use of compression therapy.
Best practice guidelines for the management of lipoedema
(MA Healthcare Limited, 2017-09-29) Hardy, Denise; Williams, Anne F.
The Best Practice Guidelines for the management of lipoedema were published earlier this year by Wounds UK, following a collaborative development and peer review process. This paper provides an overview of the development process, and a summary of key messages from the guidelines. The idea of establishing UK-specific guidelines was first discussed by a group of clinicians in 2015. Supported by Wounds UK, industry and third sector partners, an Expert Working Group was brought together in September 2016. This initial meeting was the start of a creative process, and provided a framework for the subsequent development of the evidence-based guidelines.
Lipoedema — a fat disorder: Considerations for GPNs
(Wound Care People, 2018-09) Williams, Anne F.
Lipoedema is a fat and connective tissue disorder associated with proliferation of diet-resistant inflammatory fat tissue. It predominantly affects women and commonly manifests as symmetrical enlargement of the legs, buttocks and arms. Lipoedema often develops or worsens at key stages of life, such as puberty, pregnancy and menopause, and is associated with a variety of physical and psychosocial problems. It is poorly understood and women may be wrongly diagnosed as having lymphoedema or ‘obesity’, leading to a delay in accessing appropriate treatment and support. Lipoedema aetiology appears to include genetic, immune and endocrine factors, although the science is evolving and research is ongoing and, in the future, a clearer picture of lipoedema pathophysiology will emerge. This paper examines evidence relating to lipoedema pathophysiology, diagnosis, and the psychological impact of lipoedema, providing an overview of current treatment and selfmanagement approaches, and key considerations for general practice nurses (GPNs).
Lipoedema complicated by secondary lymphoedema
(Mark Allen Group, 2017-07-13) Williams, Anne F.; MacEwan, Isobel
Anne Williams and Isobel MacEwan of Talk Lipoedema supply an overview of an often misunderstood disorder and the effects of additional complications - and provide guidance for supporting self-management in patients This article explores the pathophysiology of lipoedema, and the changes to the lymphatic system in someone with lipoedema. It aims to identify some of the challenges for individuals who live with lipoedema complicated by secondary lymphoedema, and provides information for health professionals in managing associated problems such as cellulitis.
Lymphoedema
(Cambridge University Press, 2019-05-16) Williams, Anne F.; Llewellyn, Carrie; Ayers, Susan; McManus, Chris; Newman, Stanton; Petrie, Keith J.; Revenson, Tracey A.; Weinman, John
This chapter provides an overview of the lymphatic system, causes, diagnosis and psychosocial impacts of lymphoedema, and describes treatment and self-management approaches for people living with lymphoedema.
Manual lymphatic drainage for lymphedema following breast cancer treatment
(The Cochrane Collaboration, 2015-05-21) Ezzo, Jeanette; Manheimer, Eric; McNeely, Margaret L.; Howell, Doris M.; Weiss, Robert; Johansson, Karin I.; Bao, Ting; Bily, Linda; Tuppo, Catherine M.; Williams, Anne F.; Karadibak, Didem
Background More than one in five of breast cancer patients will develop breast cancer-related lymphedema (BCRL). BCRL is a swelling that can occur in the arm, breast, or chest wall as a result of breast cancer surgery and/or radiation therapy. BCRL can negatively impact comfort, function, and quality of life Manual lymphatic drainage (MLD) is a hands-on therapy that is commonly used for BCRL and often as part of complex decongestive therapy (CDT). CDT consists of MLD, compression bandaging, lymph-reducing exercises (LREs), and skin care. The Review Questions Is MLD safe and effective in treating BCRL? Study Characteristics We found six trials published through May, 2013, totaling 208 participants. Key Results When women were treated with a course of intensive compression bandaging, their swelling went down about 30% to 37%. When MLD was added to the intensive course of compression bandaging, their swelling went down another 7.11%. Thus, MLD may offer benefit when added to compression bandaging. Examining this finding more closely showed that this significant reduction benefit was observed in people with mild-to-moderate lymphedema when compared to participants with moderate-to-severe lymphedema. Thus, our findings suggest that individuals with mild-to-moderate BCRL are the ones who may benefit from adding MLD to an intensive course of treatment with compression bandaging. This finding, however, needs to be confirmed by further research. When women were given a standard elastic compression sleeve plus MLD and compared to women who received a standard compression sleeve plus a nonMLD treatment, results were mixed (sometimes favoring MLD and sometimes favoring neither treatment.) One-year follow-up suggests that once swelling had been reduced, participants were likely to keep their swelling down if they continued to use a custom-made sleeve. MLD is safe and well tolerated. Findings were contradictory for function (range of motion), with one trial showing benefit and the other not. Two trials measured quality of life, but neither trial presented results comparing the treatment group to the control, so findings are inconclusive. No trial measured cost of care. Quality of the Evidence Trials were small ranging from 24 to 45 participants. Most trials appeared to randomize participants adequately. However, in four trials the person measuring the swelling knew what treatment the participants were receiving, and this could have biased results. Authors' conclusions: MLD is safe and may offer additional benefit to compression bandaging for swelling reduction. Compared to individuals with moderate-to-severe BCRL, those with mild-to-moderate BCRL may be the ones who benefit from adding MLD to an intensive course of treatment with compression bandaging. This finding, however, needs to be confirmed by randomized data. In trials where MLD and sleeve were compared with a nonMLD treatment and sleeve, volumetric outcomes were inconsistent within the same trial. Research is needed to identify the most clinically meaningful volumetric measurement, to incorporate newer technologies in LE assessment, and to assess other clinically relevant outcomes such as fibrotic tissue formation. Findings were contradictory for function (range of motion), and inconclusive for quality of life. For symptoms such as pain and heaviness, 60% to 80% of participants reported feeling better regardless of which treatment they received. One-year follow-up suggests that once swelling had been reduced, participants were likely to keep their swelling down if they continued to use a custom-made sleeve.
Measuring change in limb volume to evaluate lymphoedema treatment outcome
(European Wound Management Association, 2015-04) Williams, Anne F.; Whitaker, J.
The accurate, non-invasive measurement of limb volume in patients with lymphoedema is important in the clinical and research setting. Aim This paper provides an overview of the practical approaches to assessing limb volume and calculating changes in limb volume after treatments in patients with unilateral lymphoedema. Methods Techniques for assessing limb volume are described, and a case study example is presented. A compression bandaging system comprised of a foam roll and cohesive, inelastic bandages was applied to 9 patients with unilateral lymphoedema on 6 occasions over a 12-day treatment period. Two parameters for measuring the changes in limb volume after the course of treatment were used to evaluate treatment outcomes. n Parameter 1: percentage change in excess limb volume over time. n Parameter 2: percentage change in absolute limb volume over time. Results In 9 patients, the mean percentage change in excess limb volume at Day 12 was 35%, and the mean percentage change in absolute limb volume was 8%. Conclusions The two parameters for calculating changes in limb volume are not interchangeable. Parameter 1 is only suitable for patients with unilateral lymphoedema, but provides the information on the reduction of lymphoedema (excess) volume. Parameter 2 can be used for patients with bilateral lymphoedema, where no comparator or unaffected limb is available. Both parameters should be reported in research, and both limbs should be measured, if possible. However, Parameter 2 should be used with caution, as the percentage change is based on the whole limb volume, rather than the more accurate excess limb volume as a measure of lymphoedema.
Obesity matters: The skills that strengthen midwifery practice when caring for obese pregnant women
(Mark Allen Group, 2021-05-02) Greig, Yvonne; Williams, Anne F.; Smith, Margaret Coulter
Obese pregnant women (BMI>30 kg/m²) are at an increased risk of developing complications during pregnancy, labour and birth. Furthermore, their offspring are at risk of short- and long-term health complications. Midwives are ideally situated to inform women about risks and to support them in optimising their health. How midwives raise and maintain dialogue with women about this health issue is not well understood. A qualitative research study was conducted drawing on the principles of social constructionism to explore how midwives practiced and maintained dialogue with women about the risks of living with obesity. Data were analysed thematically, three themes emerged: ‘situational context of practice’, ‘constructing partnerships with women’, ‘midwife as a public health agent’. Midwives appeared to have learnt their communication skills informally ‘on the job’ but utilised institutional questionnaires as a mechanism for opening ‘sensitive’ conversations. This approach appeared to guide appointment dialogue and risked providing woman-centred care to individuals while concurrently inhibiting development of professional autonomy. Providing educational opportunities for midwives with respect to consultation education in midwifery curricula may strengthen midwifery practice with respect to discussing sensitive topics.
A qualitative study of the experiences of women with lipoedema in Scotland
(International Lymphoedema Framework, 2019-06-13) Williams, Anne F.; MacEwan, Isobel
Lipoedema is a fat and connective tissue disorder associated with symmetrical proliferation of diet-resistant inflammatory fat tissue, mainly in the limbs and buttocks. Effective self-care is key to improving symptoms, and minimising lipoedema progression (Wounds UK 2017). Evidence from online surveys has shown that living with lipoedema presents many challenges (Fetzer and Fetzer 2016). There has been limited exploration of the qualitative experiences of living with lipoedema, how women perceive and self-manage their condition, and what support is required.
A review of the literature relating to liposuction in women with lipoedema and Dercum’s disease
(Wounds Group, 2019-06-24) Williams, Anne F.
This paper reports on a review of the literature in liposuction for women with lipoedema and those with Dercum’s disease. The aims were: to identify the outcomes from liposuction in these two groups and describe adverse effects reported in the studies. A total of 10 studies met the inclusion and exclusion criteria, dated between 2006-2019. Improvements in pain, quality of life and mobility were common outcomes. There were indications that reliance on conservative treatments reduced after liposuction. The incidence of adverse effects appeared modest, including minor haematomas, postoperative swelling, orthostatic reactions, temporary bruising and burning sensations. However, the numbers studied were relatively small, particularly relating to Dercum’s disease. Findings were limited by retrospective evaluations, use of poorly validated tools, and relatively short follow-up periods in some studies. There were no randomised controlled trials. Lack of standardisation made it challenging to analyse and compare outcomes across different studies. Liposuction appears to play a role as a treatment option for some women in managing symptoms, however, further research is required to better explore efficacy and cost-effectiveness, monitor adverse effects, inform decision-making and identify key advice for women who undergo liposuction.
Support with nutrition for women receiving chemotherapy for breast cancer
(Mark Allen Group, 2018-02-19) Gilmour, Fiona; Williams, Anne F.
Nurses are in a unique position to provide nutritional support and information to women with breast cancer who are undergoing chemotherapy, supporting them with making decisions regarding nutrition and diet. This narrative review evaluated the research evidence relating to: the nutritional challenges experienced during chemotherapy; and the most effective approaches for supporting women with dietary choice. Weight gain was identified as a specific problem for women undergoing chemotherapy. The evidence indicated that information about nutrition and food preparation support may go some way to assisting women in overcoming some of the nutrition related challenges experienced during chemotherapy treatment for breast cancer. However, further research is required to better inform person-centred nursing practice in this area.
Understanding the challenges of lipoedema
(Wound Care People, 2018-04) Williams, Anne F.
Lipoedema is a challenging condition for patients, health and social care professionals. Lack of understanding about the condition leads to delayed diagnosis and poor support with self-management. This paper draws on key evidence, best practice guidelines for the management of lipoedema, and a patient story, to provide insights into the presentation, diagnosis, impact and management of the condition. It also identifies key points for practice for community nurses.