Self-regulation in patients with cancer-related lymphedema: A concept analysis

PURPOSE: Although sustained self-management behaviors are important for improving or preventing the worsening of cancer-related lymphedema (CRL), the definition of self-regulation, a core element of self-management behavior, remains unclear. These findings provide a foundation for the development of self-management behavior measurement scales, research advancements, and the development of effective interventions. This study aimed to define the concept of self-regulation in patients with CRL. METHODS: Walker and Avant's eight-step concept analysis method was used to clarify the attributes, antecedents, and consequences of self-regulation in patients with CRL. Literature searches were conducted using PubMed, CINAHL, Scopus, and Ichushi-Web (Japan Medical Abstracts Society Database). Related articles were searched using the search terms self-management, self-care, lymphedema, and self-regulation. RESULTS: The attributes defining self-regulation in patients with CRL were Motivational and emotional internal regulation, utilization of social resources, self-monitoring, Adjusting self-management behaviors, and Integrating self-management behaviors. Antecedents were the presence of emotional motivation and goals, Acceptance of lymphedema as a chronic condition, recognition of the necessity for self-management, understanding of self-management strategies and their effectiveness. The consequences were gaining a sense of control, symptom control, and life reconstruction and stabilization. CONCLUSION: This concept analysis clarifies self-regulation in patients with CRL and provides a theoretical foundation for the development of measurement tools and support strategies that reflect the continuity of self-management behaviors. The findings may facilitate future research and interventions aimed at improving the quality of life of patients with CRL.