Axillary Web Syndrome Self-Assessment Questionnaire validation and risk factors

Abstract

Background: Secondary complications after breast cancer surgery include axillary web syndrome (AWS) wound scarring (breast, axilla), nerve damage and muscle pain, numbness (breast, axilla), fatigue, lymphedema of the upper limbs, and functional disability of the upper limbs causing long-term functional impairment. In the case of AWS, the chest, armpit, elbow, and ulna bones are cord palpable, painful, and limited in shoulder flexion and abduction motion. Patient-based questionnaires for the detection of AWS in the prevention of secondary complications from breast cancer surgery are widely used internationally. Aim: To determine the reliability of the Mongolian version of a patient self-assessment questionnaire for the detection of axillary web syndrome. Materials and Methods: 62 participants were included in the self-assessment questionnaire for the detection of AWS. After the self-assessment questionnaires were evaluated by the patient with AWS, the physical therapists performed a double evaluation using the “physical therapy checklist”. Results: The average age of the study participants was 48 (±10), body mass index was 26 (±4) kg/m2, the average days of physical therapy after surgery was 15 (±38) days, chemotherapy was 6.5%, and radiation therapy was 1.6%, pain rating was 5 (±1) visual analog scale, range of motion of shoulder flexion was 135 (±44), and shoulder abduction range was 132 (±46). Internal reliability was determined by the Cronbach alpha coefÏcient of 0.8, indicating that the internal validity of the assessment was acceptable. The chi-square test assessed the differences between the questions, p < 0.05 was statistically significant. Discussion: The internal validity of the “Self-assessment Questionnaire” is acceptable with a Cronbach alpha coefÏcient of 0.8, which is the same result as the study of Luiz Felipe Nevola Teixeira et al. Through this evaluation, patients are educated about possible secondary complications after breast surgery and can self-assess, prevent, detect early, and take timely measures. Conclusions: Cronbach’s alpha coefÏcient of 0.8 for the self-assessment questionnaire of the patients of AWS shows that the internal validation of the assessment is significant.