UK survey on experiences of men with non-cancer-related lymphoedema: part one.

This initial article delves into the methodology, methods and theories, while the subsequent article will centre on the discoveries, discussion and conclusion. The study aimed to address the research question: how do men perceive their engagement in the self-management of non-cancer-related lymphoedema? An interpretivist qualitative methodology was employed, utilising an online survey based on the validated lymphoedema quality of life tool (LYMQoL). The data underwent inductive narrative inquiry. The study incorporated theories such as hegemonic masculinity and the health, illness, men and masculinities (HIMM) framework. The findings will be detailed in the second article in this series. This article has delineated the objective, methodologyand methods, employing a qualitative interpretivist approach through narrative inquiry. The study incorporated masculinity theories, including hegemonic masculinity and HIMM. The second article will present the findings and their significance within the broader literature.

Compression therapy and heart failure: a scoping review of the existing evidence.

The completion of a scoping review within the area of compression therapy and heart failure offers an insight into the present literature in this area, alongside offering the ability to connect this existing knowledge to chronic oedema/lymphoedema when both conditions co-exist. The evidence obtained included national agreed guidelines, consensus documents and existing primary/secondary research. The review identified existing evidence that suggests that the application of compression therapy in those with heart failure may be appropriate, but is dependent upon staging and stability. However, this needs to be contextualised against other co-morbidities, such as lymphoedema, which may impact upon the exact compression therapy and level applied. Further research within the area of heart failure in combination with chronic oedema/lymphoedema would expand the existing evidence base. This is set against a need for further consensus guidance to bridge the gap that exists within the literature.

PhD: what is it and where to start? Personal reflections of a doctoral researcher.

A PhD starts with a passion in a subject area, which may occur through reading literature, or professional or personal experience. This journey is one that is taken over years, with multiple steps to support the person to grow and develop their own knowledge within research. The intention for any PhD is to produce original research. This should add to the existing evidence base through the production of a thesis, and subsequent article publications. The experience can be beneficial and rewarding but needs planning to ensure there are supportive strategies, funding, time, resources, and motivation.

Best practice for chronic oedema in community settings: what can we learn?

There are various opportunities and challenges in the delivery of care to those diagnosed with chronic oedema/lymphoedema. Service provision is not consistent within the UK, and non-specialist nurses and other health professionals may be called on to fill the gaps in this area. The latest best practice guidance on chronic oedema is directed at community services that care for people within their own homes in primary care. This guide was developed in order to increase awareness, knowledge and access to an evidence base. Those involved in its creation cross specialist fields (lymphoedema and tissue viability), resulting in the document covering a number of areas, including an explanation of chronic oedema, its assessment and management and the association between chronic oedema and wet legs. The document complements existing frameworks on the condition and its management and also increases the available tools within chronic oedema management in the community. The present article provides an overview of the guidance document and discusses its salient features.

Chronic oedema and lymphoedema: what is the difference?

Chronic oedema is a term that encompasses several causes that lead to oedema formation in any part of the body. This includes lymphoedema and its subcategories. Despite the assumption that these are different, there are more commonalities amongst them. This makes the transfer of knowledge and experience, from chronic oedema conditions to lymphoedema, and vice versa easier to achieve. However, this takes both time and support, to achieve the ultimate patient outcome of self-care, with generalist able to support this process and journey.

Chronic oedema and the older person.

Chronic oedema (CO) and lymphoedema (LO) are long-term conditions that can become more complicated or are more likely to develop with age. The ageing process can involve alterations in the structures that support the normal function of the lymphatic system or put it at greater risk of damage. The main three components (skin care, exercise and compression therapy) within the management of CO/LO can become more difficult to apply with age. This is because of reduced healing rates, decreased cardiovascular capacity and deterioration in vascular and arterial structures. The impact of ageing and how this can affect patients and treatment outcomes requires careful consideration.

Real-time simulation: first-hand experience of the challenges of community nursing for students.

The Community Challenge is a simulated community event for pre-registration nursing students across all four fields. Through the provision of real-time simulation, the Community Challenge has combined a deeper learning for both nursing students and the drama students who were involved in making the scenarios real and interactive. The event was run over 5 days, with positive evaluations from students and staff. Furthermore, Community Challenge has been found to be successful in expanding opportunities for students that align with national drivers, curriculum planning and interprofessional learning. The event has allowed students to engage in learning with other fields, enhancing their own practice. The Community Challenge has been found to enhance the link between theory and practice within primary care, promoting the relevance and importance of community care within nursing.

Compression therapy and exercise: enhancing outcomes.

Compression therapy is the main method used within the treatment and management of lymphoedema and chronic oedema. The increasing prevalence of the condition, which has multiple causes, such as genetic factors, age and external factors, require the effective management of the condition, and to enhance the management methods used to contain the condition. The use of exercise alongside the mainstay method of treatment (compression therapy) has been an underutilised area. The application of a structured exercise programme in conjunction with multi-layer lymphoedema bandaging combined with an adjustable velcro wrap based systems led to a decrease in limb volume in one case study. The results of the programme indicate that the approach is beneficial and requires embedding further within Walsall lymphoedema service, due to improved patient outcomes, and cost effectiveness in terms of resources.

A qualitative systematic review and meta-aggregation of the experiences of men diagnosed with chronic lymphoedema.

Background: Lymphoedema is a chronic condition that is estimated to affect up to four people per 1000 of the UK population with this increasing with age. Men account for up to 20% of lymphoedema service caseloads with research focussing upon women affected. Aims: To retrieve primary qualitative research on the experiences of men with chronic lymphoedema. Methods: A qualitative review was undertaken using the Joanna Briggs Institute (JBI) meta-aggregation method. A search strategy was applied to 12 databases, from inception to February 2021, with 22 studies identified and appraised. The findings were extracted and synthesised via the JBI approach. Results: Four synthesised findings were identified: (1) The 'New Norm', how diagnosis led to men being faced with a 'new version' of themselves; (2) 'Journey into the Unknown' relates to the unforeseen diagnosis of the condition; (3) 'Access' - challenge in receiving a diagnosis, and support; and (4) 'Personhood' - the impact of the condition upon external constructs and relationships. Conclusions: Men are faced with similar challenges as women coupled with societal expectations with respect to gender identity and expression. This leads to those wishing to engage with men to adopt 'gender-based tailoring' within healthcare services, information and support.