Early Physiotherapy to Prevent Lymphoedema after Surgery - Assignment Example

Early Physiotherapy to Prevent Lymphoedema after Surgery Critical appraisal of literature is a vital part of medical research. Critical research appraisal is indispensable in the identification of the most relevant studies in clinical practice. Research appraisal assesses the relevance of the research question to the field of work. Most scientific research studies aim at creating new knowledge based on existing literature or the latest discoveries (Greenhalgh and Taylor 1997). An appraisal determines the extent to which a research study adds substantive new knowledge to existing concepts. Research appraisal is conducted to determine whether a study extends validity of previous studies or introduces a new idea in the field of study. In most research studies, there exist biases that may cause possible deviation of results. Choosing the most appropriate study methods is important to avoid instances of bias in research (Greenhalgh and Tylor 1997). Research appraisals assist in establishing the question posed by the author(s). It is vital for research studies to possess well-developed study questions relevant to the topic under study (LoBiondo-Wood and Haber 2010). In addition, the identified study questions must have applicable parameters and study populations and discern relevant outcomes. Statistical testing should be based on study hypotheses because they are fundamental in research studies (Greenhalgh and Tylor 1997). Appraisals assist in ascertaining the relevance of hypothesis testing the techniques used in a given study. Appraisal also contributes to determining whether research is based on practice (Brown 2014). How good or bad the research is Lacomba et al. (2010) carried out a study aiming at ascertaining the efficacy of early physiotherapy in post cancer surgery. An appraisal of the study carried out by Lacomba et al. (2010) reveals that there exist proper applications of interventions for physiotherapy sessions during post cancer surgery. Notably, the research conducted by Lacomba et al. (2010) is indispensable in promoting prevention of secondary lymphedema immediately after surgery. Even though the study was successful in addressing the hypothesis question, it had various limitations such as the recruiting of subjects from a single hospital. It is noteworthy that most single hospital recruitment may result in systematic variations during provision of care between other regions and the hospital. Introduction Lacomba et al. (2010) provide a vivid description of secondary lymphoedema within the first paragraph that clearly introduces the study. It is important to understand that the descriptive introduction is appealing to readers and elaborates the research objectives. The sentences written by Lacomba et al. (2010) in the first paragraph assist in attracting the readers’ attention to the research questions. In addition to being descriptive, the introduction provides an extensive explanation of the conditions of the study. It is important that the introductory sentences of research satisfy the standards of research in nursing care. Lacomba et al. (2010) give descriptions of the methods applied in finding plausible results and interventions to research questions. As well as the aforementioned concise introduction, there exist various limitations mainly in terms of focus. Introduction does not provide an indication for the research focus. The study results but is not concise to address all parameters. Moreover, the introduction has not presented clearly the study’s stance on the effectiveness of physiotherapy in lymphoedema evidently due to doubts about its effectiveness and associated complications (Lacomba et al. 2010). Methodology The research has used an effective method in conducting the study about the effectiveness of physiotherapy in the prevention of lymphoedema. Notably, the study has recruited a reasonable number of female participants with breast cancer. Lacomba et al. (2010) engaged approximately one hundred and twenty (120) female participants who had undergone axillary lymph nodes surgery. Moreover, the study involved a plausible period entailed in observation of participants within the scope of the study. Women who participated in the study had undergone surgery between 2005 and 2007. It is notable that the research did not recruit participants with varied health conditions. The study employed effective methods in conducting research. The research involved the use of a variety of physiotherapy programmes in testing its effectiveness among respondents. Other methods employed by the study in conducting the different physiotherapy programmes included shoulder exercises, manual drainage of lymph, and scar tissue massage. The research conforms to provisions by participant-administered instruments. Data collection should be through analysis of potential subjects (Grove and Burns 2013). It is vital to understand that using different programmes provided the research with a wide scope of study also enabling confirmation of the effectiveness of interventions. Apart from the physiotherapy programmes, the study employed control groups relevant in monitoring evidence changes among research subjects. Incorporation of control groups was central to enabling researchers to make inferences during research. It is notable that the research did not provide the methods used for analysing collected data despite highlighting this. It is essential to note that this absence of methods for data analysis resulted in problems in correlating collected data to the research topic (Lacomba et al. 2010). Critical analysis of reducing the risk of secondary lymphoedema During a critical analysis of secondary lymphoedema development after surgery among women with breast cancer, it was effective to perform measurement of arm circumference within the specific year of surgery. Measurements of arm circumference gave a vivid indication of secondary lymphoedema development after cancer surgery among women compared to postoperative assessments that involve measurement of BMI. It is critical to understand that circumferential measurements indicate this more accurately mainly because they show actual changes in the volume ratio of arm fluids. Consequently, it is essential for medical assessment procedures not to rely on information provided by subjects but rather ensure use of measurements for accurate outcomes. Therefore, the study was right to use circumferential measurements as these displayed actual medical information about the subject. It was evident from the study that subjects with significant secondary lymphoedema had an arm circumference increment of two centimeters compared with the unaffected arm (Lacomba et al. 2010). Study Design The research utilised an appropriate research design in collecting medical data from study groups. The research used randomised single-blind methods in conducting quantitative research. It was indispensable for the quantitative study to employ the randomised single-blind method mainly due to the ability of the technique to prevent subject bias. The single-blind technique ensured elimination of bias among control groups and study subjects. According to Weathington, Cunningham and Pittenger (2010), in the single-blind method involves participants who are not knowledgeable of the researcher’s hypothesis. It was also significant for the study to assign subjects randomly to specific treatments with a single-blinded control. Use of follow-up studies on the subject and control groups offers a gold standard treatment for testing the efficacy of therapy. It was critical in addressing potential problems within the study. Interpretation of Results Based on the study data and results, it is apparent that early physiotherapy is effective in reducing inherent risks of secondary lymphoedema. Physiotherapy is essential in reducing development of lymphoedema among surgery subjects. The results indicate that the aforementioned techniques of physiotherapy programmes including shoulder exercise are essential in reducing development of secondary lymphoedema among subjects. The study results also indicate that performing physiotherapy among surgery subjects has minimal effects on development of associated risks. Therefore, it is advisable for health professionals to provide physiotherapy sessions for cancer patients, who have undergone breast surgery, to avoid development of secondary lymphoedema (Lacomba et al. 2010). Acceptance of Evidence Fain (2013) emphasises that evidence in research is important and should be from scholarly sources. The evidence in the research was adequate in understanding the risks involved in breast cancer surgery and provision of medical solutions to secondary lymphoedema. Lacomba et al. (2010) present secondary lymphoedema as an essential chronic impediment after conducting breast cancer surgery with proximal dissection of axillary lymph nodes. However, it is essential to understand that post-surgery rehabilitation does not provide a comprehensive technique for preventing secondary lymphoedema. Lacomba et al. (2010) identified that incorporated physiotherapy and educational techniques assisted in reducing the inherent risks of secondary lymphoedema within twelve months after conducting breast surgery with axillary dissection among women with cancer. The research, therefore, supports the ideas of Polit and Beck (2008) on evidence used in research. Practical Aspect of Evidence Macnee and Mccabe (2007) elaborate on the importance of evidence in nursing research. The inherent evidence from this research remains significant for health institutions and practitioners with respect to performing physiotherapy after surgery in an effort to manage potential secondary lymphoedema development. However, the applicability of the evidence remains questionable mainly due to the control environment setting for the study (Lacomba et al. 2010). In addition, research evidence depends on the nature of services within a specific hospital and thus may not hold for all health facilities. Moreover, the procedures outlined in the research require trained physiotherapists, a factor that may limit the application of the technique. Conclusion Appraisal of research remains the most vital aspect of determining relevance of research based on study results, methods, and hypothetical questions. The study by Lacomba et al. (2010) aimed at establishing techniques that can enhance prevention of secondary lymphoedema immediately after surgery. The research introduction was concise and satisfactory as it was appealing to readers, as well as providing an overview of the study objectives. The study did not provide techniques used for analysing collected data to address the research questions (Moule and Hek 2011). However, the study used various methods including physiotherapy programmes in collecting research data and establishing the applicability of the hypothesis question. Based on the study results, it should be mandatory for women who have undergone breast cancer surgery, to embrace early physiotherapy one year after the operation. Physiotherapy sessions could be important in reducing potential risks of secondary lymphoedema development. In addition, incorporation of education sessions on self-management, in addition to post-surgery physiotherapy, is essential in reducing lymphoedema development. However, the applicability of the research results has no fundamental basis due to lack of similarity in the control environment for this research among health facilities. Nevertheless, the study by Lacomba et al. (2010) is vital in enhancing knowledge relevant for management of secondary lymphoedema, and the promotion of recovery among breast cancer women that have undergone surgery. References BROWN, S. J., 2014. Evidence-based nursing: the research-practice connection. Burlington, MA: Jones & Bartlett Learning. FAIN, J. A., 2013. Reading, understanding, and applying nursing research. Philadelphia: F. A. Davis Company. GREENHALGH, T. and TYLOR, R., 1997. How to read a paper: papers that go beyond numbers (quantitative research). British Medical Journal vol. 315, pp. 740–743. GROVE, S. K. and BURNS, N. 2013. The practice of nursing research: appraisal, synthesis, and generation of evidence. Elsevier: St. Louis: Missouri. LACOMBA, T., YUTSE SANCHEZ, M.J., ZAPICO GONI, A., PRIETO MERINO, D., MAYORAL DEL MORAL, O., CEREZO TELLER, E. and MINAYO MOGOLLON, E., 2010. Effectives of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomized, single blinded, clinical trial. British Medical Journal [online] vol. 340, p. b5396 [viewed 30 December 2014]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2806631/pdf/bmj.b5396.pdf. MACNEE, C. L. and MCCABE, S., 2007. Understanding nursing research: using research in evidence-based practice. Philadelphia, PA: Lippincott Williams & Wilkins. MOULE, P. and HEK, G., 2011. Making sense of research: an introduction for health and social care practitioners. London: Sage Publications. POLIT, D. F. and BECK, C. T., 2008. Nursing research: generating and assessing evidence for nursing practice. Philadelphia, PA: Lippincott Williams & Wilkins. WEATHINGTON, B. L., CUNNINGHAM, C. J. L. and PITTENGER, D. J. 2010. Research methods for the behavioral and social sciences. Hoboken, N.J.: John Wiley & Sons. Read More