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Al Onazi et al. Plast Aesthet Res 2020;7:23 Plastic and
DOI: 10.20517/2347-9264.2019.74 Aesthetic Research

Original Article Open Access

Exploring adherence to daytime compression in
women with breast cancer related lymphedema: a

multi-methods study

Mona Al Onazi , Naomi Dolgoy , Joanna Parkinson , Margaret L. McNeely
1
1
2
1
1 Department of Physical Therapy, University of Alberta, Edmonton T6G 2G4, Canada.
2 Department of Physical Therapy, University of Alberta & Cross Cancer Institute, Edmonton T6G 1Z2, Canada.
Correspondence to: Prof. Margaret L. McNeely, Department of Physical Therapy, University of Alberta & Cross Cancer Institute,
2-50 Corbett Hall, Edmonton T6G 2G4, Canada. E-mail: mmcneely@ualberta.ca

How to cite this article: Al Onazi M, Dolgoy N, Parkinson J, McNeely ML. Exploring adherence to daytime compression in women
with breast cancer related lymphedema: a multi-methods study. Plast Aesthet Res 2020;7:23.
http://dx.doi.org/10.20517/2347-9264.2019.74

Received: 16 Dec 2019 First Decision: 27 Mar 2020 Revised: 3 Apr 2020 Accepted: 15 Apr 2020 Published: 11 May 2020

Science Editor: Xiao Long Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Abstract
Aim: The objective of this follow-up study was to explore the barriers and facilitators to use of daytime compression
among women with breast cancer related lymphedema who previously took part in a trial examining the efficacy
of night compression.

Methods: We used a multi-methods approach involving a survey and subsequent focus group sessions. The survey
questions were developed based on clinical experience and findings from the literature. Questions were framed
to align with the Theoretical Domains Framework. For the focus group data, we applied an interpretive description
qualitative methodology to understand participants’ experiences and views on use of daytime compression.
Qualitative findings were mapped to the Theoretical Domains Framework.

Results: Questionnaires were completed by 48 of 52 participants. Only 15 participants (31%) reported adhering
to wearing the garment for greater than 12 h each day. Better adherence was positively associated with perceived
control of lymphedema (r = 0.304; 95%CI: 0.051-0.564 ; P = 0.021). Survey findings suggest that participants
have good knowledge about the rationale for, and the benefits of, wearing the compression sleeve. Twenty-
three survey respondents took part in one of the five subsequent focus group sessions. Five key themes were
identified representing the primary barriers to regular use of daytime compression: discomfort, negative emotions,
interference with function, social situations and visibility, and use of alternative management strategies.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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