Competence of Healthcare Providers in Managing Lymphedema Post Breast Cancer Treatment: A study in western Kenya hospitals

Abstract

BACKGROUND Globally, breast cancer, the most diagnosed cancer, affects around 2.3 million individuals. Approximately 28% to 38% of breast cancer patients develop lymphedema post-treatment, impacting one in five patients. Without intervention, the condition leads to serious complications, affecting daily tasks. Sub-Saharan Africa reports increasing comorbidities related to lymphedema, yet no data exists on its prevalence in Kenya. This study assessed clinical management strategies for breast cancer treatment-induced lymphedema in selected Western Kenya hospitals. MATERIAL AND METHODS This was a cross-sectional analytic study. Simple random sampling was used to select healthcare facilities offering cancer screening and treatment. Healthcare providers were randomly selected from five health facilities depending on the number required at each health facility. 192 healthcare providers were selected to participate in the study. Data collection was by structured questionnaires, observation checklist and focus group discussion, analysed by SPSS version 23.1 and Qualitative data thematically analysed guided by questions on knowledge, skills and management strategies. RESULTS The results showed healthcare providers' knowledge ranging from low to average with a deficit in important areas of practice such as skincare (OR=0.56, p=0.01). stocking pressure (OR=1.841, P=0.004, positive stemmer's sign test (OR=2.217, p=0.001) with over 50% getting incorrect answers. Good history and assessment Skills were demonstrated (0R=1.6; CI;1.0-24; P=0.037) but patient education was poorly done. Focus group discussion showed a deficit in knowledge by failure to clearly define lymphedema. CONCLUSION Structured education of lymphedema is needed to increase the knowledge of healthcare providers and improving knowledge may fill the gaps in knowledge and demonstrate good practical skills in patient management.