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- Lymphedema management: Manual Lymph Drainage for upper extremities
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- Roamabout 4102 manual lymphatic drainage
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E-mail address: john. Email: john. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. Our study examines the financial cost of lymphedema following a diagnosis of breast cancer and addresses a significant knowledge gap regarding the additional impact of lymphedema on breast cancer survivors.
The cost of compression garments formed a large proportion of these costs The average number of attendances to a therapist each year was 5. The incidence of cellulitis was 7. This study identifies an additional detrimental effect of lymphedema on women in terms of financial costs.
However, research into lymphedema is still limited, regarding not only diagnosis and treatment but also the impact on a patient's quality of life and costs to the economy.
Patients with BCRL have higher treatment costs: for example, compression therapy, the most crucial element in the management of chronic lymphedema, involves wearing compression garments on the affected limb. In many countries, including Australia, there is little government support for lymphedema, and private health insurance reimbursement depends on the patient's level of cover. In addition, patients with lymphedema are more likely to spend more time in hospital owing to lymphangitis or cellulitis, known to contribute to a more advanced condition and compound medical costs.
Scholars are beginning to examine these financial costs. However, studies of this type are constrained because of the use of administrative claims data, which are likely to underestimate true incidence rates and costs.
This report specifically addresses the impact of lymphedema over and above breast cancer on the financial costs borne by women. Owing to limited knowledge about the socioeconomic impact of lymphedema, an exploratory qualitative methods approach was used that entailed interviews with 30 individuals—10 with primary lymphedema and 20 with secondary lymphedema.
During the second phase, reported here, we used survey methodology to collect extensive data on the impact that living with secondary lymphedema has on breast cancer survivors. The survey instrument is available on request.
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A complexity addressed in the study was how to differentiate the impact of a diagnosis of lymphedema over and above a diagnosis of breast cancer. The survey instrument therefore had 2 sections looking at the impact of lymphedema first if present and then breast cancer for all patients. Individuals who fulfilled these criteria alone became the control group. Participants completed the study questionnaire online. Women previously diagnosed with breast cancer were approached for study participation through an Australian community—based breast cancer consumer organization, the Breast Cancer Network Australia BCNA.
Patients with lymphedema were also asked to consider the study through the Australasian Lymphology Association ALA and through notices in the clinics of the authors J. A total of women agreed to participate. We asked a screening question so as to classify our respondents' lymphedema stage Sheila Ridner, personal communication.
We asked participants to reflect on their condition for the last month and report on its severity by choosing one of the following categories. No problem: no noticeable swelling. Mild lymphedema: soft swelling that is not obvious to others and comes and goes. Moderate lymphedema: swelling with occasional hardness in some areas that is obvious to others and is always present.
Enterasys RoamAbout AP4102 - wireless access point Series Specs & Prices
Severe lymphedema: profuse swelling with thickened skin, constant hardness, and a very large, heavy arm that is extremely obvious to others and is always present. For patients given a diagnosis of lymphedema, information about the impact of lymphedema on employment, cost of seeing therapists, and cost of compression sleeves was collected in addition to the above domains. All P values are 2 sided using the statistical tests for differences as specified. As expected, the number, complexity, and associated costs of therapies used increased as the stage of lymphedema increased.
The use of laser therapy and kinesiology tape also significantly varied by stage, but nearly all patients had previously had lymphatic drainage massage, and very few had used compression pumps or had undergone liposuction surgery.
The cost of compression garments formed a large proportion of the financial costs Visits to therapists, garment use, and costs increased as the severity of lymphedema increased. Although limited by small numbers in the severe group, the one exception was that the average number of visits to a therapist was only 3. This probably reflects the fact that severe lymphedema is often fatty and fibrotic and is nonresponsive to conservative therapies.
Specific comments given about the financial impact of lymphedema are shown in Table 5 Supporting Information. Twelve of patients 7. The total number of admission days was 57 for the 12 patients admitted. The incidence of cellulitis was 7 7.
Enterasys RoamAbout RBT-4102-BG Manuals
However, existing scholarship is in the early stages of development regarding many aspects of this condition. There have been some studies conducted in the United Kingdom and the United States that estimate the health care costs of lymphedema, but none of these studies estimated the financial cost borne by women.
This is comparable with our study, in which 25 patients Further, the incidence of cellulitis was 7. In , the average cost per admission for cellulitis was divided into less severe A qualitative study from Canada reported aspects of abandonment described by some participants because of the lack of financial support available to cover the costs of treatment strategies.
Compression garments were expensive to buy, and a number of participants did not have insurance. Those with insurance policies stated that there was insufficient coverage for sleeve replacement costs. Participants stated that the need for frequent cleaning caused compression garments to lose elasticity and require regular replacement. Several participants found the cost of compression pumps and massage therapy prohibitive.
A common theme among patients was the expense of garments and the lack of financial reimbursement from the government or private health insurance funds. There have been limited studies on the impact of lymphedema on financial costs borne by the patient.
This burden was more common among cancer survivors compared with those without a diagnosis of cancer, those without private insurance, and those not working.
Lymphedema management: Manual Lymph Drainage for upper extremities
Our experience is that many patients still wear a compression sleeve even when it has significantly diminished pressure to delay the expenditure for a replacement.
As a result, we could not explore whether these financial costs have increased over time. We also only included patients who had seen a lymphedema therapist.
Cheville et al 24 argued that lymphedema is best estimated as a chronic disease by utility values given its chronic nature and treatment that enhances rather than extends patients' lives.
To adequately review these factors, we are planning a prospective study to further differentiate the impact on finances from lymphedema versus the impact from breast cancer. Thanks also to Philippa Sutton for her expert editorial assistance.
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The authors have no conflicts of interest to declare. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors.
Any queries other than missing content should be directed to the corresponding author for the article. Volume 26 , Issue 6.
Roamabout 4102 manual lymphatic drainage
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Share Give access Share full text access. Share full text access. Please review our Terms and Conditions of Use and check box below to share full-text version of article. Abstract Objective Our study examines the financial cost of lymphedema following a diagnosis of breast cancer and addresses a significant knowledge gap regarding the additional impact of lymphedema on breast cancer survivors.
Conclusions This study identifies an additional detrimental effect of lymphedema on women in terms of financial costs.
How to convert an RBT-4102 access point to work with a HiPath controller
Abbreviation: NS, not significant. Visit to therapist Average visits to lymphedema therapist per year 5. Supporting Information. Filename Description ponsupSI.
J Psychosoc Oncol.
Google Scholar. Crossref Google Scholar. Crossref PubMed Google Scholar. Citing Literature. Volume 26 , Issue 6 June Pages References Related Information.
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