{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T21:03:14Z","timestamp":1771275794812,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>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 \u201clast resort\u201d 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\u2019 willingness to refer patients with lymphedema for surgical consultation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u00a0 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-025-10308-z","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T03:17:29Z","timestamp":1768533449000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with lymphedema therapist willingness to refer to surgery"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2502-229X","authenticated-orcid":false,"given":"Sarah","family":"Stolker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle A.","family":"Pitzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith M.","family":"Mwobobia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla T.","family":"Washington","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"issue":"3","key":"10308_CR1","first-page":"84","volume":"36","author":"RH Charles","year":"1901","unstructured":"Charles RH (1901) The surgical treatment of elephantiasis. 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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"99"}}