Nancy Kidd

Vanderbilt University, Nashville, MI, United States

Are you Nancy Kidd?

Claim your profile

Publications (5)11.22 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Breast cancer survivors with lymphedema experience physical, psychosocial, and quality-of-life difficulties. Cancer treatment-related lymphedema often is viewed as a disabling condition, and that assumption has fostered an environment in which oncology nurses are not actively involved in the care of patients with lymphedema. Little is known about how breast cancer survivors with lymphedema structure their daily lives. This article describes an effort to determine whether lymphedema truly is a disabling condition by collecting symptom data and self-generated narratives from breast cancer survivors with lymphedema regarding their eating habits, daily activities, substance use, and future plans. Although the sample experienced multiple symptoms, lymphedema duration and degree of extracellular arm fluid did not appear to influence those symptoms. In addition, participants led full, rich, busy lives. The findings do not support the notion that patients with lymphedema live as disabled people. A disability model may not be optimal to guide research design or patient care; rather, a symptom management model better explains the findings and implies that active involvement by nurses in lymphedema patient care and education is indicated.
    Clinical Journal of Oncology Nursing 12/2012; 16(6):609-14.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Treatment of the truncal lymphatics prior to treatment of the lymphedematous arm is an accepted, although not empirically tested, therapeutic intervention delivered during decongestive lymphatic therapy (DLT). Breast cancer survivors with arm lymphedema are encouraged to use these techniques when performing simple lymphatic drainage as part of their life-long lymphedema self-care. Self-massage is at times difficult and pneumatic compression devices are used by many patients to assist with self-care. One such device, the Flexitouch(®) System, replicates the techniques used during DLT; however, the need for application of pneumatic compression in unaffected truncal areas to improve self-care outcomes in arm only lymphedema is not established. The objective of this study was to compare the therapeutic benefit of truncal/chest/arm advanced pneumatic compression therapy (experimental group) verses arm only pneumatic compression (control group) in self-care for arm lymphedema without truncal involvement using the Flexitouch(®) System. Outcomes of interest were self-reported symptoms, function, arm impedance ratios, circumference, volume, and trunk circumference. Forty-two breast cancer survivors, (21 per group), with Stage II lymphedema completed 30 days of home self-care using the Flexitouch(®) System. Findings revealed a statistically significant reduction in both the number of symptoms and overall symptom burden within each group; however, there were no statistically significant differences in these outcomes between the groups. There was no statistically significant overall change or differential pattern of change between the groups in function. A statistically significant reduction in bioelectrical impedance and arm circumference within both of the groups was achieved; however, there was no statistically significant difference in reduction between groups. These findings indicate that both configurations are effective, but that there may be no added benefit to advanced pneumatic treatment of the truncal lymphatics prior to arm massage when the trunk is not also affected. Further research is indicated in a larger sample.
    Breast Cancer Research and Treatment 09/2011; 131(1):147-58. · 4.47 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The primary purpose of this study was to cross-sectionally examine breast cancer treatment-related lymphedema self-care education, self-care practices, and perceived self-care barriers, burdens, and benefits. We also explored the associations among self-care education, practices, symptoms, and quality of life (QOL) in breast cancer survivors with known lymphedema. A cross-sectional design was used to obtain data about lymphedema self-care education, self-care practices, perceived self-care barriers, burdens, and benefits, symptoms, and QOL. Frequency distributions and Spearman rank-order correlations were used to analyze quantitative data. Thematic qualitative analysis of perceived barriers, benefits, and burdens of self-care was also undertaken. Surveys were completed and returned by 51 of 58 eligible individuals. Of the 51 responding, 48 had received some self-care education, but three did not think it was adequate. Wearing a compression garment was the most frequently cited self-care activity, and 18 of the 51 required help with self-care. Thirty-three percent, 17/51, spent 15 minutes or less per day on self-care. Multiple barriers to self-care were identified. Those with more symptoms spent more time on self-care activities and had a poorer QOL. Opportunities exist to improve lymphedema self-care education. Breast cancer survivors with lymphedema experience symptoms beyond that of simple swelling of the affected limb. Self-care is burdensome. Barriers to providing lymphedema self-care exist and may vary across patients. A multidisciplinary approach to lymphedema management, including self-care education and monitoring, is likely needed to improve QOL in this population.
    Supportive Care in Cancer 05/2011; 19(5):631-7. · 2.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to conduct a preliminary, post-market, home study of the Flexitouch(®) system to examine the potential efficacy of the device as a component of self-care in breast cancer survivors with truncal lymphedema. A quasi-experimental, pre-treatment, post-treatment design was used. Twelve participants received a total of ten self-administered, consecutive, one hour per day treatments. Treatments one and two were observed by study staff and the remaining eight were unobserved. Assessments were conducted at baseline, after the first two treatments, mid-way through therapy, and at the end-of-study. Logs revealed 100% compliance with the eight prescribed unobserved home treatments. Symptoms were assessed by self-report symptom surveys. Signs, objectively observed physical phenomenon, were assessed by staff-initiated skin examination and circumferential truncal measurements. Statistically significant improvement in truncal symptoms and sleep were found. Changes in function and girth were not statistically significant in this initial study. Breast cancer survivors with truncal lymphedema may benefit from using an advanced pneumatic compression devices with truncal treatment as part of their self-care program. Participants were highly compliant in device use. Further research of this intervention is warranted. To facilitate future research, clinically meaningful reductions in truncal girth should be defined.
    Lymphatic Research and Biology 12/2010; 8(4):209-15. · 2.33 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Single-frequency bioelectrical impedance has been used in clinical and research settings to measure extracellular fluid in arms. Its ease of use and low risk of user error suggests this measurement method may have advantages for use in nonlaboratory (community-based) environments when compared to other measurement methods. The purpose of this study was to evaluate the feasibility of using single-frequency bioelectrical impedance to detect upper limb lymphedema in nonlaboratory settings. Using a standardized protocol, impedance ratios among healthy normal women, breast cancer survivors with lymphedema, and breast cancer survivors without lymphedema were compared with participants seated in an upright position conducive for use outside laboratory settings (community-based environments). Ratios of healthy normal controls and breast cancer survivor groups without lymphedema were very similar, with almost complete overlap in confidence intervals. However, those values were markedly different from the values assessed in the survivor group with lymphedema (p<0.001). These findings suggest impedance ratios determined by single-frequency bioelectrical impedance can be used as markers for lymphedema in nonlaboratory settings when a standardized protocol is used.
    Lymphatic Research and Biology 03/2009; 7(1):11-5. · 2.33 Impact Factor