Facilitators and Barriers to the Use of Outcome Measures by Certified Lymphedema Therapists

Abstract

Background: Various outcome measures (OMs) have been used with individuals with breast cancer–related lymphedema (BCRL). There have not been studies investigating the facilitators and barriers to the use of OMs by certified lymphedema therapists (CLTs) on BCRL. The purposes of this study was to (1) identify facilitators and barriers for use of OMs reported by CLTs and (2) investigate the association of personal and professional characteristics of CLTs and their knowledge or beliefs about OMs. Methods: Cross-sectional online survey research design. Electronic surveys were distributed to CLTs from various institutions. Data from 70 physical therapists and 41 occupational therapists were analyzed. Point-biserial correlations examined associations and logistic regression examined predictors to OMs facilitators and barriers. Results: Certified lymphedema therapists agreed that OMs help direct a plan of care (90.1%), improve quality of care (76.6%), and determine the efficacy of their intervention on BCRL (72.7%). Certified lymphedema therapists reported difficulty knowing the best OM to choose due to numerous options (67.3%). Barriers for OMs included lack of knowledge and time, availability in workplace, and personal preferences. Characteristics associated with barriers and facilitators were few and poorly correlated. Conclusion: Certified lymphedema therapists agree on the benefits of and to the use of OMs, however, physical therapist CLTs may value the use of OMs less than occupational therapists. Certified lymphedema therapists experience barriers to use of OMs related to lack of knowledge and implementation skills. Further guidance is needed in selecting OMs for breast cancer survivors with BCRL to reduce barriers to their use.