Barriers to Adherence After A Self-Management Lymphedema Education Program Among Women with Breast Cancer-Related Lymphedema

Abstract

Objectives: – Lymphedema associated with breast cancer is a chronic condition that negatively affects women’s physical functioning, psychosocial well-being, and quality of life. Although self-management education is a fundamental component of lymphedema care, many women struggle to maintain recommended practices in daily life over time. To explore how women with breast cancer-related lymphedema integrate self-management education into daily life over time and to identify barriers to sustained adherence 1 year or more after completing a self-management lymphedema education program (SMLEP). Methods: – A descriptive phenomenological qualitative design was used. In-depth, semistructured interviews were conducted with 17 women diagnosed with breast cancer-related lymphedema. Data were analyzed using qualitative content analysis. Results: – Two overarching themes were identified: problems caused by lymphedema and barriers to self-management. Problems included limitations in activities of daily living, pain, restricted social participation, and body image disturbance. Barriers included economic difficulties, decreased belief in treatment effectiveness, boredom and forgetfulness, lack of family support, absence of monitoring mechanisms, use of the dominant arm, and symptom regression. Conclusions: – Women with breast cancer-related lymphedema face interconnected physical, emotional, and contextual challenges that limit long-term self-management adherence beyond knowledge deficits alone. © 2026