Development and evaluation of the effectiveness of lower extremity lymphedema education for women undergoing gynecologic cancer surgery

This study was conducted to development and evaluate the feasibility of a lower extremity lymphedema education program based on the Symptom Management Model (SMM) for women undergoing gynecologic cancer surgery, and to examine its effects on lymphedema development, quality of life, and self-efficacy. The randomized pilot study was carried out between September 2024 and May 2025 with 27 women (intervention group = 14, control group = 13) who underwent gynecologic cancer surgery at a training and research hospital. The women in the intervention group received SMM-based lower extremity lymphedema education. Data were collected using a Socio-demographic Information Form, Lymphedema Risk Assessment Questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the 6-Item Self-Efficacy Scale for Chronic Disease Management, the Gynecologic Cancer Lymphedema Questionnaire, and the Training Satisfaction Questionnaire. In addition, lower extremity leg circumference measurements were taken preoperatively and at the 3-month follow-up. Data were analyzed using SPSS IBM version 29. Descriptive analyses, independent samples t-test, paired samples t-test, and chi-square test were performed. All analyses were conducted at a 95% confidence interval with a significance level of p<0.05. The intervention and control groups were similar in terms of descriptive characteristics and lymphedema risk levels (p>0.05). No significant difference was found between the groups in terms of quality of life scores at the first follow-up (t=0.160, p=0.874). However, at the 3-month follow-up, the functional quality of life scores in the intervention group were significantly higher than those in the control group (t=3.289, p=0.003). The general edema and limb edema subdimension scores of the Gynecologic Cancer Lymphedema Questionnaire were significantly higher in the control group compared to the intervention group (p<0.05). Additionally, self-efficacy scores were significantly higher in the intervention group (p<0.05). The mean satisfaction score with the training was 4.54±0.16, with a participation rate of 93.3% and a completion rate of 96.42%. As a result, the SMM-based lower extremity lymphedema education was found to be feasible in clinical settings, improved self-efficacy and quality of life, and reduced lymphedema symptoms. Therefore, it is recommended that this educational program be implemented in gynecologic oncology clinics in the postoperative period to enhance quality of life, support self-efficacy, and prevent lymphedema development. Keywords Lower extremity lymphedema, gynecological cancer, symptom management model, education