RESUMO
Background and Study Objective: Australia was one of nine participating countries in the epidemiology Phase II Lymphoedema Impact and Prevalence - International (LIMPRINT) project to determine the number of people with chronic edema (CO) in local health services. Methods and Results: Data collection occurred through questionnaire-based interviews and clinical assessment with provided LIMPRINT tools. Four different types of services across three states in Australia participated. A total of 222 adults participated with an age range from 22 to 102 years, and 60% were female. Site 1 included three residential care facilities (54% of participants had swelling), site 2 was community-delivered aged care services (24% of participants had swelling), site 3 was a hospital setting (facility-based prevalence study; 28% of participants had swelling), and site 4 was a wound treatment center (specific patient population; 100% of participants had swelling). Of those with CO or secondary lymphedema, 93% were not related to cancer, the lower limbs were affected in 51% of cases, and 18% of participants with swelling reported one or more episodes of cellulitis in the previous year. Wounds were identified in 47% (n = 105) of all participants with more than half of those with wounds coming from the dedicated wound clinic. Leg/foot ulcer was the most common type of wound (65%, n = 68). Conclusions: Distances between services, lack of specialized services, and various state funding models contribute to inequities in CO treatment. Understanding the high number of noncancer-related CO presentations will assist health services to provide timely effective care and improve referral pathways.
Assuntos
Edema/diagnóstico , Disparidades em Assistência à Saúde/estatística & dados numéricos , Sistema Linfático/patologia , Linfedema/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/fisiopatologia , Doença Crônica , Centros Comunitários de Saúde/economia , Centros Comunitários de Saúde/ética , Diagnóstico Diferencial , Edema/economia , Edema/epidemiologia , Edema/patologia , Feminino , Disparidades em Assistência à Saúde/economia , Humanos , Úlcera da Perna/diagnóstico , Úlcera da Perna/fisiopatologia , Sistema Linfático/fisiopatologia , Linfedema/economia , Linfedema/epidemiologia , Linfedema/patologia , Masculino , Pessoa de Meia-Idade , Prevalência , Instituições Residenciais/economia , Instituições Residenciais/ética , Fatores de Risco , Inquéritos e Questionários , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/fisiopatologiaRESUMO
This paper reports on a study in the UK that explored the experience of children suffering with Lymphoedema and that of their families. Qualitative data was collected from 20 children between the ages of 6 and 18 and their respective parents. Single, semi-structured interviews were used in which children and their parents were asked to share how lymphoedema impacted on their family life. Children were asked about their school experience, their dreams and their aspirations. Three categories emerged. Firstly, the negotiation of the health care system. Themes included correct diagnosis, finding robust information and reaching a knowledgeable expert. The second category explored the complex role of the parents as advocates. Themes within this category included the dilemmas of parenting and the increasing challenges as children reached adolescence. The final category involved the impact on the family unit. The first theme concerned the integration of lymphoedema into daily activities and the intrusion on family time. The second explored the impact on siblings and the final theme the changing dilemmas as children moved through the stages of childhood and faced adulthood.