PREDICTORS OF PSYCHOLOGICAL DISTRESS, SEXUAL DYSFUNCTION AND PHYSICALFUNCTIONING AMONG WOMEN WITH UPPER EXTREMITY LYMPHEDEMA RELATED TO BREAST-CANCER

Sixty-nine women presenting for rehabilitation treatment for upper ext remity lymphedema (UEL) were assessed by physical examination and vali dated self-report assessment instruments measuring demographics, psych ological distress, sexual functioning, social support, coping style, p ain and functional status. Statistical analyses revealed that women wi th UEL had high levels of psychological distress, and high levels of s exual, functional and social dysfunction. There were no linear relatio nships between severity of UEL and levels of distress. Women with UEL in their dominant hand, however, had more distress and less overall se xual satisfaction than those with UEL in their non-dominant limb. Wome n with pain of any intensity were the most distressed, and had the mos t significant difficulties in psychological and physical functioning. Women with pain also perceived significantly less interpersonal suppor t than those without pain. Virtually none were receiving pain treatmen t. An avoidant coping style and low perceived social support were sign ificant correlates of psychological distress. UEL poses significant fu nctional, social and sexual functioning problems in women following br east cancer treatment. An assessment of pain, as well as social suppor t and coping, might help identify those in need of consultation by psy chiatry and pain specialists. Patients may also benefit from psycholog ical support and sexual therapy in addition to physical rehabilitation . A psyche-educational and support group within the clinic may prevent the worsening of UEL through the adoption of preventive strategies, m aximizing compliance with rehabilitative efforts, augmenting better co ping methods through group support, decreasing isolation that accompan ies the condition, and facilitating the identification of patients in need of formal consultation.