פיתוח קווים מנחים לפיזיותרפיסטים המטפלים בנשים שעברו ניתוח סרטן השד, וניסוח הנחיות מעודכנות עבור מטופלות - תיאור פרויקט: [מבט על מנקודת ראות מקצועית]

Background and objectives: Women undergoing breast cancer (BC) surgery may suffer from a wide range of short- or long-term side effects, beyond lymphedema.The consensus in the literature is that these women need postoperative guidance in order to reduce the risk of developing side effects. Therefore, updated guidelines for therapists and instructions for patients were recently developed and made available online in Israel. The present article aims to describe the development process of these guidelines and instructions.Methods: The development project included the following steps: 1. A case study was presented to increase public awareness as to the various side effects of BC surgery other than lymphedema. 2. A qualitative study evaluated how twenty physical therapists treating patients with lymphedema perceived the presence of side effects following BC, and their recommendations for side effect risk reduction. 3. Guidelines for physical therapists as to how to reduce the risk of side effects following BC surgery were formulated on the basis of a Delphi survey among 130 lymphatic physical therapists. 4. Existing instructions for women after BC surgery were reviewed. 5. Based on the conclusions of the Delphi survey and a review of the literature,updated instructions for patients post BC surgery were developed. 6. A videos films were produced and posted on YouTube. The guidelines for therapists and instructions for patients were distributed on a number of online websites and sent by email to the directors of the physical therapy services and to all lymphatic physiotherapists in the country. 7. A survey was conducted among the managers of physical therapy services in Israeli hospitals to assess the implementation of the updated instructions and their recommendations for further improvements. 8. In accordance with there commendations, corrections were integrated in the guidelines and a new version of the instructions was formulated and distributed.Conclusions: The development of uniform and up-to-date guidelines for physical therapists and instructions for patients after BC surgery is an important step that should be offered as part of the care. However, in order to implement the guidelines in the immediate period following surgery and during the subsequent period of rehabilitation, their marketing should be expanded through as many channels as possible.