|dc.identifier.citation||Bulley, C. & Mcphee, R. () A needs assessment of Lymphoedema services in Fife: an exploration of Physiotherapy and District Nursing Management., , , , ,||
|dc.description.abstract||Introduction: The physical and psychosocial effects of lymphoedema have
profound effects on function and quality of life. While the disease is incurable,
specific management is used to minimise and control symptoms. Strategies include
compression garments and bandaging, specialised massage, skin care, and exercise1.
A needs assessment of lymphoedema services in Fife was commissioned by
the Core Cancer Review Group in Fife and supervised by Queen Margaret Hospital.
An early finding indicated that many General Practitioners refer individuals with
lymphoedema to local Physiotherapy and District Nursing (DN) services. However,
the capability of these services in providing the required management was unknown.
Therefore, a postal survey was conducted to explore the levels of experience,
confidence and knowledge of Physiotherapy and DN staff in relation to the treatment
Method: A postal questionnaire was sent to all Physiotherapy and DN
services (n=36 and 53) in Fife. This strategy was used to obtain a broad overview of
specific issues. The local ethics committee did not require a submission for ethical
approval. Descriptive analysis of responses to both open and closed questions was
carried out in relation to the number of clinicians represented by each response.
Results: Response rates from local Physiotherapy and DN units were 58% and
53%, respectively. Findings are summarised below:
Clinicians represented: Physiotherapists (n=60) District Nurses (n=91)
% of clinicians with experience of
Mean number of patients treated
by each clinician
% of clinicans with experience
who expressed confidence in
Most frequently mentioned
management options (frequency
Limb elevation (4);
massage (3); exercise
/ bandaging (5); skin
care advice (3)
Fewer Physiotherapists than DNs had experience of lymphoedema
management, but those few had treated more patients. However, clinicians with
experience frequently lacked confidence in treating lymphoedema and the suggested
management strategies reflected incomplete knowledge regarding recommended
Conclusions: These findings represent a localised pilot investigation. The
issue requires further study to a greater depth and in different geographical regions.
Non-specialist Physiotherapists and DNs appear to lack experience, confidence and
knowledge of lymphoedema management. Therefore, specialist lymphoedema
services are recommended and increased awareness of management services and
strategies should be promoted.
References: 1. Badger, C. and Jeffs, E. (1997) Macmillan Lymphoedema
Project.- London, Macmillan Cancer Relief.||