接受乳癌相關手術婦女之患肩功能變化及相關因素探討

Background: Recovery of affected shoulder function in females receiving breast cancer-related surgery is inadequate. Information related to the changes and correlates of affected shoulder function for females receiving breast cancer-related surgery is lacking. Feasible recommendations to improve affected shoulder function for females receiving breast cancer-related surgery are limited. Aims: The purpose of the study was to examine the changes in shoulder function at the affected side, cancer-related symptoms and perceptions of arm exercise, and to explore possible correlates of affected shoulder function during the first three months after surgery in a sample of females receiving breast cancer-related surgery. Methods: This study was a longitudinal study consisting of 71 females all newly diagnosed with breast cancer (I-III) and receiving their initial breast cancer-related surgeries. Related information was collected by a structured questionnaire at four time points: at one day before surgery, and at the ends of the 1st, 2nd, and 3rd months after surgery. At the four data collection points, participants' shoulder abduction angles (shoulder function) at the affected side were measured. Data analyses included descriptive statistics, repeated measures ANOVA, t-test, Pearson correlation, and Generalized Estimating Equation (GEE) model. Results: During the first three months after surgery, participants' shoulder abduction levels (shoulder function) improved over time. However, participants' shoulder function at the 3rd month after surgery could not achieve to pre-surgery levels. Overall cancer-related symptoms peaked at the 3rd month after surgery. The perceived benefits of arm exercise at the 3rd month after surgery was significantly more positive than that at the 2nd month after surgery. Participants who did not receive chemotherapy, who experienced less fatigue, who perceived more benefits of arm exercise, and who performed arm exercise regularly were more likely to have positive changes in the affected shoulder function during the first 3 months after surgery. Conclusions: For females receiving breast cancer-related surgery and undergoing active treatment, healthcare providers need to cautiously monitor and manage participants' shoulder function at the affected side, cancer-related symptoms, perceptions of arm exercise, and conditions of performing arm exercise. Related interventions focusing on modifiable correlates could be provided to improve the recovery of the affected shoulder function.