Promoting self-management in lymphoedema: the role of the community nurse

Lymphoedema is a chronic and progressive disorder resulting from impaired lymphatic system function, triggering an excessive accumulation of lymph fluid in the superficial tissues that can lead to chronic swelling, localised pain, atrophic skin changes and secondary infections (Whitaker, 2016; Kayiran et al, 2017). Lymphoedema can be primary or secondary in aetiology. The former is related to developmental abnormalities of the lymphatic system, whereas the latter is attributed to the impairment of lymphatic vessels because of an acquired condition, such as trauma, tumour, surgery or infections (Kayiran et al, 2017).

To date, there is no cure for lymphoedema. The condition is associated with impaired quality of life, both in terms of psychosocial and physiological functioning, with pain, skin tightness, heaviness, numbness and reduced range of movement reported, as well as altered body image, anxiety and depression (Thomas et al, 2020). A study on the impact of lymphoedema on employment highlighted that 80% of patients were absent from work; 9% changed their employment status; 2% switched jobs; and 8% gave up work completely (Moffatt et al, 2003). Therefore, it is imperative to collaborate with the patient to create and maintain an effective management strategy.