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• W2916900131 abstract "Lower limb lymphoedema (LLL) following surgery for stage III metastatic melanoma (MM) of the groin/pelvis is a common occurrence and can impact on all domains of occupational performance. Gaps in literature exist regarding the experiences, impacts and needs of people with stage III MM who require groin/pelvic node dissection.n Additionally, the impact of monitoring, preventative approaches or treatment for lymphoedema on occupational performance is unknown. Occupational therapists working in this area must have specialist knowledge and understanding of both melanoma and lymphoedema to facilitate appropriate, evidence-based care within an occupational therapy model of care.This study aimed to explore the experiences, needs and occupational performance impacts of people who are at risk, or have developed LLL following inguinal (groin) or ilio-inguinal (groin/pelvic) node dissection for stage III metastatic melanoma. The research questions were:1. What are the experiences, impacts and needs of people with stage III MM following surgery to the groin/pelvis?2. What are peoplers perceptions of monitoring and proactive, preventative approaches to LLL following surgery for stage III MM?Using an interpretive descriptive (ID) methodology, twenty interviews were conducted with a purposive sample of eleven people from a major tertiary hospital in Australia. Interviews were conducted between 8-18 months following surgery, recorded and transcribed verbatim. Data were analysed using ID methods to inductively generate themes.n Of the eleven participants being prospectively monitored, (5=male; 6=female), six developed LLL (2=male; 4=female). This was a very difficult time that had significant impact on participantsr lives. Five themes were inductively generated from the data and included: 1) reactions to metastatic melanoma; 2) the possibility of lymphoedema; 3) impacts on occupation, personal relationships and identity; 4) professional relationships; and 5) from crisis to coping and reframing.Understanding the experiences, impacts and needs of this group and how stage III MM of the groin/pelvis, subsequent surgery, monitoring and/or preventative treatments for LLL impact on occupational performance, can inform the planning and delivery of specialist occupational therapy services for these people. The results of this study suggest that there are benefits from inter-professional team follow-up and that more attention could be paid to the impacts of MM and LLL on a personrs occupational performance.nn Prospective monitoring for LLL was well received by people who had undergone ilioinguinal node dissection for stage III MM and it is recommended that prospective monitoring for LLL be considered by lymphoedema trained occupational therapists in conjunction with standard surgical follow-up treatments that routinely exist in current models of care. Increased monitoring and support throughout the journey of adjustment with MM would ensure early detection, facilitate ongoing education of LLL and skill acquisition to maximise self-efficacy in self-care for either risk reduction or management of the condition should LLL occur.n Occupational performance and occupational roles following stage III MM and LLL are affected and the implications on identity should also be considered during care. The experience of being involved in a proactive, preventative program was reported as positive and whilst formal quantitative outcomes are not reported in this thesis, reports in this study were that the prophylactic wearing of compression garments and conducting lymphatic drainage for 6-months following surgery was not considered a burden for those involved.n It provided people with a choice and a feeling of control, which they perceived assisted their recovery.Findings from this study indicated that a collaborative approach is necessary to support people with MM and LLL throughout the continuum of care. Occupational therapists are well placed to assess, manage and guide a person through the physical and psychosocial sequelae that may negatively impact occupational performance. Clinical implications and recommendations are made in this thesis to assist in providing care to people who are at high risk of LLL following surgery for stage III MM of the groin/pelvis.nn" @default.
• W2916900131 created "2019-03-02" @default.
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• W2916900131 date "2018-11-09" @default.
• W2916900131 modified "2023-09-26" @default.
• W2916900131 title "The experiences, occupational performance impacts and needs of people who are at risk of, or have developed lymphoedema following groin or pelvic node dissection for Metastatic Melanoma: an interpretive descriptive study" @default.
• W2916900131 doi "https://doi.org/10.14264/uql.2018.675" @default.
• W2916900131 hasPublicationYear "2018" @default.
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