A morbidity screening tool for identifying fatigue, pain, upper limb dysfunction and lymphedema after breast cancer treatment: a validity study

Catherine Bulley*, Fiona Coutts, Christine Blyth, Wilma Jack, Udi Chetty, Matthew Barber, Chee Wee Tan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)

Abstract

Purpose: This study aimed to investigate validity of a newly developed Morbidity Screening Tool (MST) to screen for fatigue, pain, swelling (lymphedema) and arm function after breast cancer treatment. 

Methods: A cross-sectional study included women attending reviews after completing treatment (surgery, chemotherapy and radiotherapy), without recurrence, who could read English. They completed the MST and comparator questionnaires: Disability of the Arm, Shoulder and Hand questionnaire (DASH), Chronic Pain Grade Questionnaire (CPGQ), Lymphedema and Breast Cancer Questionnaire (LBCQ) and Functional Assessment of Cancer Therapy questionnaire with subscales for fatigue (FACT F) and breast cancer (FACT B+4). Bilateral combined shoulder ranges of motion were compared (upward reach; hand behind back) and percentage upper limb volume difference (%LVD=/>10% diagnosed as lymphedema) measured with the vertical perometer (400T). 

Results: 613 of 617 participants completed questionnaires (mean age 62.3 years, SD 10.0; mean time since treatment 63.0 months, SD 46.6) and 417 completed objective testing. Morbidity prevalence was estimated as 35.8%, 21.9%, 19.8% and 34.4% for fatigue, impaired upper limb function, lymphedema and pain respectively. Comparing those self-reporting the presence or absence of each type of morbidity, statistically significant differences in comparator variables supported validity of the MST. Statistically significant correlations resulted between MST scores focussing on impact of morbidity, and comparator variables that reflect function and quality of life. 

Conclusion: Analysis supports the validity of all four short-forms of the MST as providing indications of both presence of morbidity and impacts on participants' lives. This may facilitate early and appropriate referral for intervention.

Original languageEnglish
Pages (from-to)218-227
Number of pages10
JournalEuropean Journal of Oncology Nursing
Volume18
Issue number2
Early online date18 Nov 2013
DOIs
Publication statusPublished - 1 Apr 2014

Keywords

  • fatigue
  • lymphedema
  • morbidity
  • pain
  • upper limb function
  • validity

ASJC Scopus subject areas

  • Oncology(nursing)

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