Psychological factors in chronic odema: a case control study

Moffatt, Christine J.; Aubeeluck, Aimee; Doherty, Debra; Mortimer, Peter; Quere, Isabella

Abstract

Objective: To examine psychological health and perceived social support in patients with chronic oedema (CO).
Methods: A random sample of patients who had been previously identified with in a chronic oedema (CO) service in an urban area of south west London were group matched for age and gender with community controls in a case control study.
Results: One hundred and seven cases and 102 controls (women 82%) were identified. CO was caused by cancer or its treatment in 51 (48%) of cases and affected the leg in 65 (61%); the arm 41(38%) and the limb and midline in 15 (14%). Length of time with CO was long with 50 (47%) suffering for > 10 years. Cases were more likely to be single or divorced/separated (p=0.041) and have reduced mobility (p less than 0.001). They had significantly poorer overall health related quality of life (HRQoL), in particular physical functioning (p = 0.003); role physical (p less than 0.001); general health (p = 0.026); vitality (p = 0.015); social function (p = 0.007); and role emotional (p = 0.041). EQ5-D health index scores were significantly reduced in cases by 13 points (p = less than 0.001, 95% confidence interval 5.8, 21.6). Cases had similar sized social networks to the control group (5.8 vs. 6.6 p = 0.49), but had lower total perceived social support scores (67.8 vs. 76.1 p = 0.018). CE patients used significantly fewer coping strategies (COPE scale) than controls with regard to the following: active coping (p = 0.024); planning (p less than 0.001); and use of instrumental support (p = 0.006). Significantly higher levels of coping were used in restraint (p = 0.031), positive reinterpretation and growth (p less than 0.001); acceptance (less than 0.001); denial (p  less than  0.001); mental disengagement (p  less than  0.001); behavioral disengagement (less than 0.001); substance abuse (p = 0.010); and humor (p  less than  0.001).
Conclusions: Patients with CE have poorer health and greater impact on many aspects of HRQoL. Perceived social support is reduced. Deficits in social function combined with perceived reduction in support, and reduced mental health and emotional scores indicate the risk of psychological issues. Systems of care should offer an environment to address these issues.

Citation

Moffatt, C. J., Aubeeluck, A., Doherty, D., Mortimer, P., & Quere, I. (2017). Psychological factors in chronic odema: a case control study. Lymphatic Research and Biology, 15(3), 252-261. https://doi.org/10.1089/lrb.2017.0022

• Journal Article Type: Article
• Acceptance Date: Aug 29, 2017
• Online Publication Date: Sep 1, 2017
• Publication Date: Sep 1, 2017
• Deposit Date: Sep 8, 2017
• Publicly Available Date: Sep 2, 2018
• Journal: Lymphatic Research and Biology
• Print ISSN: 1539-6851
• Electronic ISSN: 1557-8585
• Publisher: Mary Ann Liebert
• Peer Reviewed: Peer Reviewed
• Volume: 15
• Issue: 3
• Pages: 252-261
• DOI: https://doi.org/10.1089/lrb.2017.0022
• Public URL: https://nottingham-repository.worktribe.com/output/880176
• Publisher URL: http://online.liebertpub.com/doi/abs/10.1089/lrb.2017.0022
• Additional Information: Final publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org10.1089/lrb.2017.0022/