# Factors associated with lymphedema therapist willingness to refer to surgery

## TL;DR

The study explores which factors influence lymphedema therapists' willingness to refer patients for surgery, finding that urban settings, certification, and research knowledge are key.

## Contribution

Identifies therapist and practice factors associated with willingness to refer lymphedema patients for surgical consultation.

## Key findings

- Willingness to refer is linked to urbanicity, LANA certification, and higher lymphedema caseload.
- Therapists with higher research knowledge are more likely to refer patients for surgery.
- Practice setting and caseload composition influence referral behavior.

## Abstract

Treatment options for lymphedema have expanded in the last decade through the development of complex surgical interventions, whose innovations have transformed these options from a “last resort” to a potential way to restore lymphatic function, cosmesis, and reduce daily patient burden. Lymphedema therapists, who serve as a primary contact point for many individuals with lymphedema, may exhibit varying levels of acceptance of surgical intervention, potentially impacting patient education and access to these procedures. The current study seeks to identify factors associated with therapists’ willingness to refer patients with lymphedema for surgical consultation.

Researchers conducted a cross-sectional exploratory study of 463 lymphedema therapists in the USA to determine factors associated with willingness to refer to surgery. Associations were examined between demographic variables, therapist characteristics (professional discipline, Lymphology Association of North America (LANA) certification, percent of caseload  with lymphedema, and self-reported research knowledge), practice factors (clinical setting, urbanicity, and number of practitioners at treatment site), and willingness to refer to surgery using bivariate and multivariate approaches.

Results identified significant associations between willingness to refer to surgery and practice setting, urbanicity, LANA certification, percent of caseload with lymphedema, and research knowledge. Specifically, willingness to refer was associated with urbanicity, LANA certification, over 50% lymphedema caseload, and therapists with higher self-reported research knowledge.

Study results shed light on therapist and practice factors that may be influential in acceptance of innovations within lymphedema treatment, which could impact timeliness of referrals and quality of surgical outcomes.