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Updated: Sep 16, 2026
Integrating Augmented Reality Tools in Breast Cancer Related Lymphedema Prognostication and Diagnosis
Published on: February 6, 2020
Lymphedema Symptom Intensity and Distress Survey-Arm in Breast Cancer-Related Lymphedema: Reliability and Validity of
Aysel Ozge Kemer1, Esra Uzelpasaci2, Turkan Akbayrak3
1Graduate School of Health Sciences, PhD Program of Physical Therapy and Rehabilitation in Pelvic and Women's Health, Hacettepe University, Ankara, Turkiye.
Background:
To assess the reliability and validity of the Turkish version of the lymphedema symptom intensity and distress survey-arm (LSIDS-A) in breast cancer-related lymphedema (BCRL).
Methods:
The LSIDS-A was translated and culturally adapted following international guidelines. Reliability was examined via internal consistency (Cronbach's alpha) and test-retest analysis (ICC). Validity was assessed in five steps: (1) face and content validity through participant feedback, (2) construct validity via confirmatory factor analysis, (3) criterion validity by correlating LSIDS-A-Tr with the Lymphoedema Functioning Disability and Health Questionnaire for Upper Limb Lymphoedema, Quality of Life Scale Upper Limb Lymphedema, and Disabilities of the Arm, Shoulder and Hand Quick Questionnaire (Lymph-ICF-UL, ULL-27, and Quick-DASH, (4) concurrent validity through correlation with bioimpedance spectroscopy (L-Dex), and (5) known-groups validity by comparing patients with and without BCRL.
Results:
The LSIDS-A-Tr demonstrated strong internal consistency (α = 0.87-0.91) and test-retest reliability (ICC = 0.91-0.95; p = 0.001). Participants found the scale easy to complete. Construct validity was confirmed, showing the same factor structure as the original scale. Moderate to strong correlations were observed with Lymph-ICF-UL, ULL-27, and Quick-DASH (r = 0.74-0.84, p = 0.001). The LSIDS-A-Tr soft tissue subscale correlated significantly with L-Dex (r = 0.46; p < 0.01). Patients with lymphedema had significantly higher LSIDS-A-Tr scores (p < 0.05).
Conclusions:
The LSIDS-A-Tr is a reliable and valid tool to evaluate the presence, intensity, and distress of the symptoms in Turkish BCRL patients. It can be used for assessing, monitoring, and screening of the symptoms of BCRL in clinical and research settings.
