Nieuwe zoekopdracht

Borstkanker [evidence statement]

Inleiding

Zie ook noot 8 en noot 9 - Een essentieel onderdeel van evidence based fysiotherapie is het gebruik van meetinstrumenten. Het doel van het gebruik van meetinstrumenten is tweeledig. Meetinstrumenten worden inventariserend / diagnostisch gebruikt, waarbij het van belang is om de hulpvraag van de patiënt te objectiveren en te specificeren en het behandeldoel vast te leggen. Daarnaast worden meetinstrumenten evaluatief gebruikt. Om de effecten van de interventie te meten, kan gebruik worden gemaakt van het verschil in de begin- (baseline) en de vervolg(eind)score.

Waar mogelijk moeten valide, betrouwbare en meetinstrumenten worden gekozen, die voldoende sensitief zijn. Als er iets bekend is over de meetfout en de verschilscore, wordt het minimale relevante verschil aangegeven.

Waar mogelijk moeten valide, betrouwbare en meetinstrumenten worden gekozen, die voldoende sensitief zijn. Als er iets bekend is over de meetfout en de verschilscore, wordt het minimale relevante verschil aangegeven.

De meetinstrumenten die werden gebruikt in de voor deze statement geselecteerde onderzoeken zijn opgenomen in noot 8.

Deze meetinstrumenten werden in de verschillende studies op verschillende momenten ingezet. Een beschrijving van de meetmomenten in de gevonden studies is opgenomen in noot 9.

Noot 8 Meetinstrumenten uit de geselecteerde studies

Noot 8 In de studies werden 82 verschillende meetinstrumenten gebruikt, waaronder 9 specifiek voor borstkanker en 6 specifiek voor lymfoedeem.

De gevonden vragenlijsten omvatten meestal meerdere ICF-domeinen. In diverse studies (n = 43) werden dergelijke gecombineerde vragenlijsten door de onderzoekers zelf ontwikkeld, met als nadeel dat er weinig bekend is over de betrouwbaarheid en validiteit van deze vragenlijsten. Deze vragenlijsten zijn daarom buiten beschouwing gelaten, evenals meetinstrumenten die niet gericht waren op patiëntkenmerken. 
De meetinstrumenten die veelvuldig werden onderzocht en toegepast in de gevonden studies staan vermeld in de volgende tabel, met hun uitkomstmaten en de stoornissen in functies en structuren, beperkingen in activiteiten en participatieproblemen van de ICF-domeinen waarop ze betrekking hebben.

Tailleomvang.

  mannen vrouwen
gezond 94 cm 80 cm
ongezond 94-99 cm 80-89 cm
heel ongezond > 100 cm > 90 cm

 

Noot 9 Meetmomenten

Noot 9 Uit het literatuuronderzoek bleek dat verschillende metingen op verschillende momenten werden uitgevoerd. In 2 SR’s (Devoogdt et al., 2010; Tsai et al., 2009) vonden metingen preoperatief en tussen 5 dagen tot 1 jaar postoperatief plaats. Bij patiënten met lymfoedeem bleek dat regelmatig meten tijdens de behandeling zinvol was om het therapeutisch proces te evalueren (mede in verband met het aanmeten van een therapeutisch elastische kous (TEK)). De beschreven meetmomenten waren na 2, 3, 4, 8 weken; de controlemetingen na 3, 6, 12 en 18 maanden. De in de studies beschreven fysiotherapeutische behandelinterventies duurden 2-8 weken. In retrospectief cohortonderzoek werd beschreven dat patiënten eens per halfjaar werden gezien en tot 20 jaar werden gevolgd (Johansson & Branje, 2010; Petrek, et al. 2001).

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