Jane Armer

University of Missouri, Columbia, Missouri, United States

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Publications (46)53.28 Total impact

  • M.R. Fu · J. Deng · J.M. Armer
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    ABSTRACT: Cancer-related lymphedema is a progressive and chronic syndrome of abnormal swelling and multiple symptoms resulting from cancer treatment. Even with modern medical advances, lymphedema remains a major health problem affecting thousands of cancer survivors. To provide healthcare professionals with evidence-based clinical practice guidelines for lymphedema treatment and management, a systematic review was conducted to evaluate 75 selected articles from 2009–2014 by the Oncology Nursing Society Putting Evidence Into Practice lymphedema team. Findings of the systematic review support complete decongestive therapy, compression bandages, and compression garments with highest evidence for best clinical practice. Weight management, full-body exercise, information provision, prevention, and early intervention protocols are likely to be effective for clinical practice. Historic recommendations for activity restriction and avoidance of aerobic and resistive exercises that limit cancer survivors’ daily lives have been challenged with more evidence. Cancer survivors may not need to restrict activities such as resistive or aerobic exercises and weightlifting with gradual exercise progression. Future research should focus on providing high-level evidence using randomized clinical trials with larger samples and studying lymphedema beyond breast cancer.
    No preview · Article · Jan 2015
  • G. Lu · K. Han · G.N. DeSouza · J. Armer · C.-R. Shyu
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    ABSTRACT: Early detection and management of lymphedema (LE) can significantly reduce the potential of new symptoms and complications. In fact, effective diagnostic of LE can potentially affect the lives in the U.S. of nearly 500 000 current LE patients and over 2.4 million breast cancer survivors who are at-risk for developing this disease at some point in their lives. However, many cancer patients fail to seek medical assistance at the first sign of the disease in part due to the additional burden that constant monitoring imposes on patients. In that sense, a self-monitoring system could represent a major improvement in health-care management and delivery.The main challenges in self monitoring limb volume are in the design of a system that is at the same time inexpensive, easy to use, and accurate, despite being operated by a person without any training. In this paper, we present such a system. The proposed framework relies on off-the-shelf video gaming devices – the Kinect infrared device with a set of inertial sensors. In order to achieve high accuracy despite the typical low-texture and smoothness of the human skin, a new algorithm for 3D registration of clouds of points – Iterative Clustered Closest Points (ICCP) – is also proposed. The final result is a device that can be operated in the comfort of the patient's homes – i.e. it can be operated by professionals as well as non-professionals.In order to validate the system, we first tested its individual parts, more specifically the proposed ICCP algorithm for 3D registration and reconstruction of challenging objects. Then, we tested the complete system for the target application of limb-volume measurement by comparing our system against the gold standards: water displacement and perometer.
    No preview · Article · Nov 2014 · IRBM
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    Full-text · Dataset · Jul 2014
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    Full-text · Dataset · Jul 2014
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    Full-text · Dataset · Jul 2014
  • Jane M Armer · Bob R Steward

    No preview · Article · Feb 2014 · Seminars in Oncology Nursing
  • Sherri G Homan · Bob R Steward · Jane M Armer
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    ABSTRACT: To describe the development of a multi-component colorectal cancer educational tool for female breast cancer survivors through a cooperative group and public health partnership. PubMed, World Wide Web, guidelines from professional organizations, surveys and focus groups with breast cancer survivors. Collaboration is at the core of cooperative group and public health research. This partnership led to the development of a colorectal cancer educational tool for breast cancer survivors. Focus groups revealed that female breast cancer survivors were receptive to education on colorectal cancer screening. Nurses are instrumental in research collaborations between cooperative groups and public health. The colorectal educational intervention for breast cancer survivors serves as an exemplar of partnerships leading to innovative research planning and implementation outcomes.
    No preview · Article · Feb 2014 · Seminars in Oncology Nursing
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    ABSTRACT: To describe the Community Clinical Oncology Programs (CCOPs), identify the roles and functions of CCOP nurses in clinical trials, and discuss the future contributions of nurses in the National Cancer Institute (NCI) Community Oncology Research Program. Research and review articles, Web sites, and government reports. The contribution of nurses in the community clinical research setting has not been defined or quantified; however, examination of the literature reveals substantial contributions from nurses in the conduct and dissemination of oncology research. Nurses outside of academic settings must be as well versed in new research as those in large institutions. Education on clinical trials and oncology research is necessary in the treatment and care of cancer patients. Experienced community-based nurses are essential to the success of the NCI Community Oncology Research Program.
    No preview · Article · Feb 2014 · Seminars in Oncology Nursing
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    ABSTRACT: Currently, a limited number of studies have been conducted that examine sources of information and knowledge level in individuals with lymphedema. This study aimed (1) to examine self-reported information sources and perceived lymphedema knowledge among individuals with lymphedema; and (2) to examine differences in self-reported information sources and perceived lymphedema knowledge among individuals with primary or secondary lymphedema; and with upper or lower extremity lymphedema. The National Lymphedema Network (NLN) conducted a survey to collect self-report data from March 2006 to January 2010. Overall, participants preferred a variety of sources of information. Participants reported low levels of knowledge about the types of lymphedema, treatment approaches and methods, and self-administrated therapies. In comparison to participants with secondary or upper extremity lymphedema, participants with primary or lower extremity lymphedema reported lower knowledge level regarding causes of lymphedema, risks for and complications of lymphedema, treatment approaches and methods for lymphedema, and self-administered therapies. Opportunities exist to expand lymphedema information sources. Healthcare professionals should focus on delivering high quality information about treatment and self-care management to individuals with lymphedema.
    No preview · Article · Dec 2013 · Lymphology
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    ABSTRACT: Lymphedema, a chronic disease caused by failure in the lymphatic system, affects nearly 500,000 people in the U.S., and over 2.4 million breast cancer survivors are at-risk for developing this disease at some point in their life. Early detection and management can significantly reduce the potential for symptoms and complications; however, many patients fail to seek medical assistance at the first sign of the disease. In this paper, we present a method for measuring limb volume and for detecting early swelling associated with lymphedema. The system relies on IR imaging sensors, such as in the Microsoft Kinect. This technique will allow for the future development of tools for self-management and specialist monitoring, and when compared to other commercially available devices, our system is less expensive, equally or more reliable/accurate, and much more user friendly.
    Full-text · Conference Paper · Apr 2013
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    ABSTRACT: A project of the American Lymphedema Framework Project (ALFP), this review seeks to examine the policy and economic impact of caring for patients with lymphedema, a common side effect of cancer treatment. This review is the first of its kind undertaken to investigate, coordinate, and streamline lymphedema policy initiatives in the United States with potential applicability worldwide. As part of a large scale literature review aiming to systematically evaluate the level of evidence of contemporary peer-reviewed lymphedema literature (2004 to 2011), publications on care delivery models, health policy, and economic impact were retrieved, summarized, and evaluated by a team of investigators and clinical experts. The review substantiates lymphedema education models and clinical models implemented at the community, health care provider, and individual level that improve delivery of care. The review exposes the lack of economic analysis related to lymphedema. Despite a dearth of evidence, efforts towards policy initiatives at the federal and state level are underway. These initiatives and the evidence to support them are examined and recommendations for translating these findings into clinical practice are made. Medical and community-based disease management interventions, taking on a public approach, are effective delivery models for lymphedema care and demonstrate great potential to improve cancer survivorship care. Efforts to create policy at the federal, state, and local level should target implementation of these models. More research is needed to identify costs associated with the treatment of lymphedema and to model the cost outlays and potential cost savings associated with comprehensive management of chronic lymphedema.
    Full-text · Article · Mar 2013 · Lymphology
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    ABSTRACT: Objectives To describe the place of CCOPs in oncology research, identify the roles and functions of CCOP nurses in clinical trials, and discuss the future contributions of nurses in the National Cancer Institute Community (NCI) Oncology Research Program (NCORP) setting. Data Sources Research and review articles, web sites, and government reports. Conclusion The contribution of nurses in the community clinical research setting has not been well-documented or quantified; however, examination of the literature reveals substantial contributions from nurses in the conduct and dissemination of oncology research. Implications for nursing practice Nurses outside of academic settings need to be as well versed in new research as those in large institutions. Education regarding clinical trials and oncology research is necessary in the treatment and care of cancer patients. Experienced community-based nurses are essential to the success of the NCI Community Oncology Research Program (NCORP).
    No preview · Article · Jan 2013 · Seminars in Oncology Nursing
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    ABSTRACT: Breast cancer-related lymphedema (LE) is one type of incurable progressive chronic disease caused by cancer treatment or surgery that damages a patient's lymphatic system. Many patients are unaware of available treatment and places to seek for help with LE. This paper introduces a framework for a mobile application package for LE patients or patients at-risk to 1) locate available trained therapists using embedded Google Map technology; 2) monitor disease progression using profile match and rules mining; and 3) acquire up-to-date LE research findings based on patient characteristics. It aims to increase patients' accessibility to available resources and improve patient's quality of life by a mHealth-driven disease management approach.
    No preview · Conference Paper · Oct 2012
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    ABSTRACT: Currently, there is a lack of data related to differences in symptoms and infection across different types and anatomical sites of lymphedema. The objective of this study was to examine differences in symptoms and infection status among individuals with lymphedema of the upper or lower extremities. The National Lymphedema Network initiated an online survey of self-report lymphedema data from March 2006 through January 2010. Descriptive statistics, Mann-Whitney tests, and Chi-square tests were used to analyze data. 723 individuals with upper extremity lymphedema and 1114 individuals with lower extremity lymphedema completed the survey. Individuals with extremity lymphedema experienced high symptom burden and infectious complications. Compared with individuals with upper extremity lymphedema, individuals with lower extremity lymphedema experienced more frequent and more severe symptoms (p<.001), infection episodes (p<.001), and infection-related hospitalizations (p<.001). No statistically significant differences of symptom burden and infection status were identified between individuals with lower extremity primary and secondary lymphedema. Individuals with extremity lymphedema experience substantial symptom burden and infectious complications; however, those with lower extremity lymphedema have more severe symptoms and more infections than those with upper extremity lymphedema.
    No preview · Article · Sep 2012 · Lymphology
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    ABSTRACT: Intermittent pneumatic compression (IPC) therapy is an effective modality to reduce the volume of the lymphedematous limbs alone or in conjunction with other modalities of therapy such as decongestive therapy. However, there is no consensus on the frequency or treatment parameters for IPC devices. We undertook a systematic review of contemporary peer-reviewed literature (2004-2011) to evaluate the evidence for use of IPC in the treatment of lymphedema. In select patients, IPC use may provide an acceptable home-based treatment modality in addition to wearing compression garments.
    Full-text · Article · Mar 2012 · Lymphology
  • A. Wanchai · B.R. Stewart · J.M. Armer
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    ABSTRACT: WANCHAI A., STEWART B.R. & ARMER J.M. (2011) Experiences and management of breast cancer-related lymphoedema: a comparison between South Africa and the United States of America. International Nursing Review59, 117–124 Purpose: Approximately one third of breast cancer survivors are estimated to develop lymphoedema. This study was conducted in the midwestern region of the USA and in Western Cape, South Africa. The purpose of this study was to compare and contrast lymphoedema experiences and lymphoedema managements between breast cancer survivors from the two countries. Methods: Using a qualitative research design, data were collected from 29 women with a history of breast cancer-related lymphoedema (18 women from the USA and 11 women from South Africa) who consented to semi-structured interviews. Findings: Six themes regarding effects of lymphoedema emerged from the study including difficulties with daily activities, unmet lymphoedema preparations, facing public curiosity, time-consuming wrapping, trouble with fitted clothes and a reminder of breast cancer. Four themes regarding lymphoedema management included compression garments, physical activities and faith, as well as other strategies such as compression pumps or antibiotics for infection. Conclusion: Experiences about lymphoedema and its management for breast cancer survivors from both countries were somewhat similar and somewhat different. Collaboration between healthcare providers from both countries should be planned to develop culturally appropriate lymphoedema symptom management interventions for each country.
    No preview · Article · Mar 2012 · International Nursing Review
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    Brent Mallinckrodt · Jane M Armer · P Paul Heppner
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    ABSTRACT: This study examined a threshold model that proposes that social support exhibits a curvilinear association with adjustment and distress, such that support in excess of a critical threshold level has decreasing incremental benefits. Women diagnosed with a first occurrence of breast cancer (N = 154) completed survey measures of perceived support (Social Provisions Scale), quality of life (Functional Living Index--Cancer), adjustment (Psychological Adjustment to Illness Scale) and psychological distress (Brief Symptom Inventory) approximately 3 weeks after surgical treatment and 8-16 months later. Consistent with a threshold model, multiple regression analyses suggested a significant curvilinear relationship between social support and distress at Time 1 and Time 2 and between social support and adjustment at Time 2. Consistent with this model, the significant bivariate correlations between social support and outcomes were accounted for almost entirely by women in the lowest quartile of support. Social support among women in the highest 3 quartiles was unrelated or only marginally related to adjustment and distress.
    Full-text · Article · Jan 2012 · Journal of Counseling Psychology
  • J.M. Armer · J.N. Cormier

    No preview · Article · Dec 2011 · Breast Diseases A Year Book Quarterly
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    ABSTRACT: Breast cancer is the leading cause of cancer in South African women. Without comprehensive national and provincial breast health programs, survivorship issues are in need of being addressed. Lymphedema secondary to breast cancer treatment (BCLE) is one of the most physically and psychologically devastating outcomes of treatment. Nurses at a South African oncology clinic educated survivors with BCLE in cost-effective self-management and self-monitoring techniques. The purpose of this paper is to describe these techniques and their relevance to diverse South African survivors. A case study analysis was performed. The need for cost-effective survivorship programs is discussed.
    No preview · Article · Dec 2011 · Journal of cultural diversity
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    ABSTRACT: A systematic review of the literature was performed to examine contemporary peer-reviewed literature (2004-2010) evaluating the surgical treatment of lymphedema. A comprehensive search of 11 major medical indices was performed. Selected articles were sorted to identify those related to the surgical treatment of lymphedema. Extracted data included the number of patients, specific surgical procedure performed, length of follow-up, criteria for defining lymphedema, measurement methods, volume or circumference reduction, and reported complications. A total of 20 studies met inclusion criteria; procedures were categorized as excisional procedures (n = 8), lymphatic reconstruction (n = 8), and tissue transfer (n = 4). The reported incidence of volume reduction of lymphedema in these studies varied from 118% reduction to a 13% increase over the follow-up intervals ranging from 6 months to 15 years. The largest reported reductions were noted after excisional procedures (91.1%), lymphatic reconstruction (54.9%), and tissue transfer procedures (47.6%). Procedure complications were rarely reported. A number of surgical approaches have demonstrated beneficial effects for select patients with lymphedema. Most of these reports, however, are based on small numbers of patients, use nonstandardized or inconsistent measurement techniques, and lack long-term follow-up. The proposed benefits of any surgical approach should be evaluated in the context of the potential morbidity to the individual patient and the availability of surgical expertise. In addition, although these surgical techniques have shown promising results, nearly all note that the procedures do not obviate the need for continued use of conventional therapies, including compression, for long-term maintenance.
    No preview · Article · Aug 2011 · Annals of Surgical Oncology