Breast Cancer and its Impact for Younger Women - Research Paper Example

CRITIQUE OF PUBLISHED LITERATURE ESSAY Name: Student Number: Course Code: Word Count: () CRITIQUE OF PUBLISHED LITERATURE ESSAY Introduction The nursing profession is challenging and greatly demands physical and mental wherewithal of both the nurses and the patients in order to continuously cope with the ever changing and challenging health care environment. In a patient care setting, a nurse is expected to abide by the doctor’s orders and at the same time make personal decisions that will ensure the wellbeing of the patients. In the same breathe; they interact with the patients to find what is expected of them by the patients. It is important to note that the expectations of the nurses from the patient’s perspectives are enormous and a clear understand of the patients expectations aids the nurses in offering their best services. To do this effectively, nurses need to be disciplined, punctual and make informed and evidence based decisions as well as be professionally competent in terms of practical and research skills. The nurses should be able to research widely and to know what information is there on the situation they are dealing with at a particular time. Nurses taking care of patients with a particular condition should for example seek to know the impacts the condition has on the patients. This can only be achieved by reviewing available literature on already carried out studies on the effect the condition has on the lives of different people. To do this, there is also need to know the elements that make a good research study. It would not be advisable to the nurses to just get information from any source and use it in finality. They can achieve this through applying systematic approaches to gathering, confirming and building upon available information so that they can develop a body of knowledge which is fundamental to their practice. This body of knowledge will enable these nurses to apply up-to-date relevant evidence to their area of clinical expertise. In order to achieve these Nurses and other Health Professionals must be able to support, participate in, apply and evaluate research findings related within their field. This paper essay seeks to display the skills of Nursing in identifying different kinds of evidence along with the strengths and weaknesses of this through their ability to critically read and analyze published research literature through the implementation of appraisal tools. Elmir, et al, (2010) have attempted to address the effects breast-cancer based breast surgery has on the lives of young women in their qualitative study. They have followed a well designed qualitative approach to investigate four main themes of the study identifies from the narratives given by the respondents as the life-changing experiences they went through the process of treatment (Daniel, et al, 2004). They have conducted a precise and an incisive qualitative analysis of the experiences of the cancer survivors which helps nurses to gain insight in to the experiences the patients have of recovery from breast cancer. This was done by obtaining the patients’ personal views. The structure for the analysis of this research article will identify the problem the authors were addressing, the main aim of study in the area of breast cancer and the general ideas they got from previous and current studies on the same issue in order to achieve a reasonable and qualitatively valid conclusion (Marjorie, et al, 2010). The theoretical structure will be clearly analyzed to find out it clarity of statement and whether the selected sample size will be sufficient enough to validate the results and the conclusion. The study has satisfied the criteria needed for a qualitative research study within the limits inflicted by the small sample size used. A detailed analysis of the research is discussed below. Critical Appraisal Elmir, R., Jackson, D., Beale, B., & Schmied, V. (2010). Against all odds: Australian women’s experiences of recovery from breast cancer. Journal of Clinical Nursing, 19(17-18), 2531–2538. The critical appraisal is done on a study by Elmir, et al, (2007) addressing the main experiences younger women go through when recovering from breast cancer-related breast surgery a qualitative lens by investigating the way patients coped with life during the treatment process. The title “Australian women’s experiences of recovery from breast cancer” (Elmir, et al, 2007) of the research study is self explanatory which suggests that the experiences of women recovering from breast cancer can only be established from personal experiences of the survivors and the attempt of the researchers of investigating insights of the experiences from the lived experiences of the carefully selected women who were themselves breast cancer survivors in their own capacities. There is a brief summary of the main aim of the research in the abstract which also projects the points of the conclusion as from the findings. The abstract contains a brief background on the amount of literature available on the effects breast cancer has on women older than 50 years of age. It records the need for research on the same in younger women whose experiences are expected to be different from those of the older women. This makes the basis of the research study that is under analysis in this paper. The abstract also reveals the research methodology that has been clearly stated to be phenomenological qualitative methodology was used to evaluate the true essence and lived experience of four carefully selected Australian women under the age of 50, who had undergone breast cancer based breast surgery. The findings are also enumerated in the abstract which were arrived at from thematic analysis of the narratives given by the respondents. The introductory part starts by an opening line listing breast cancer as one of the leading causes of death among women in Australia with a lot of citations showing the analyses of the percentage number of women dying from the condition. The authors have clearly pointed out that even though breast cancer is statistically low in younger women, a significant number of them are diagnosed with it every year. The diagnosis in younger women is usually delayed since young women are not expected to be found at risk with breast cancer. A number of previous studies have been cited to show delayed or late diagnosis of breast cancer usually takes place in younger women. They however assert that there is little or scanty literature available on the experiences of younger women recovering from cancer-related breast surgery. This was a valid introduction since a good qualitative research a quality analysis of the current situation concerning the issue under study. This section was however short with very little information given on the actual background of the study although, however, this can be attributed to lack of previous studies on the same. This section would have given the benefits of the study as well as give the theoretical framework of the study which the authors failed to do. The literature review is well detailed review of available information on the survivorship of cancer patients and the experiences they undergo. The authors have recorded the findings of researches done by such researchers as Coyne and Borbasi (2006), (Avis et al. 2004) and (Lee 2002) among others who have conducted studies on the impacts cancer diagnosis and cancer as a condition has on the lives and self image of young women under 50 years of age. This is a well written literature review the put together researches from both qualitative and quantitative researches giving an insight into what other authors have written about the same issue. This is what is needed for good qualitative research but a lot of emphasis could have been put on the gap between the available information and the lack of information on the issue so as to validate the current study. The main aim of the study has also been included at the end of the literature review. This was to investigate the experiences of Australian younger women recovering from breast cancer-related breast surgery and contribution to the knowledge base of clinicians practicing in this field. This was well placed because in a qualitative research study, it is supposed to let the readers know why the study is different from those that have already be done before and the study will help bridge the gap between the available information and the lacking information. The study was initiated by the recruitment of women who had been diagnosed with breast cancer that had led to breast surgery, under the age of 50 years and English speaking. The recruitment was done through advertisements in the local newspapers, information posters and announcements made on the local radio stations. The authors employed one of the most common sampling strategies in qualitative research methodology because there is an already pre-selected criterion that is used to sample the participants relevant to the research question. The authors of this research paper also record that the recruitment followed the ethics that are required of a qualitative research study. According to the information pointed out in the Recruitment section of the paper (Elmir, et al, 2010, p 2533), the study has met all the three core principles of universally accepted basis for research ethics (Belmont, 1979). These are respect for persons, beneficence and justice which were met by the participants being granted an opportunity to ask questions so that they can give their informed consent. The participants were informed of the fact that the interview would be audio-taped and were made to understand that they could withdraw whenever they felt uncomfortable with the whole process. They were also granted the right to refuse to answer any questions if their autonomy was at risk. The research methodology took a phenomenological design that was the most suitable for this qualitative study which focused on lived experience of the breast cancer survivors (LoBiondo-Wood & Haber 2002). In qualitative studies, such a study of experience takes an holistic perspective that served as the foundation of this study. The study exposes the subjective phenomena from the direct experiences of the participants with the belief that vital truth about the reality of the study is based in the experiences of the participants. This was exactly what the researchers did, getting the facts and the results from the participants’ narratives. The sample size that was used in this case was 4 which seems so small for the phenomenological study design. The study might have not entirely got the reality of the experiences of all the cancer survivors just from the responses of 4 women. They however defend their sample size claiming that it will illuminate the richness of the experiences of the women. According to Holloway and Wheeler (2002) asserts that a small sample size of about 4-40 is considered to be sufficient for qualitative research methodologies. The collection and analysis of data was done in form of richly narrated descriptions gathered through phenomenological one-on-one taped interviews between the interviewing researchers and the participants with attention paid to individual respect and privacy. The interviews involved general questions that asked them to describe and discuss their recovery from breast surgery resulting from breast cancer. The interviews also sought to highlight their feelings and concerns that came as a result of the recovery process. The audio-taped data was transcribed and analyzed thematically. The transcripts were read several times and tapes listened to simultaneously with gaps being filled and phone calls made to the participants for clarifications. The thematic analysis of data was done using three approaches; the line by line approach, the holistic approach and the selective approach (Pelucchi, et al, 2007). Thematic analysis of the narratives revealed four primary themes and a number of sub-themes. These themes were “Being overwhelmed’, ‘Being absolutely encompassed’, ‘Living with fear and uncertainty’, and ‘Finding strength within’. These themes have been full explained in the report one by one with various quotations from the interviews which were considered as important for arriving at the conclusion which assisted in bringing out the theme classifications. Surviving against all odds appeared to be the major allegory describing the overall experience of the life changing breast cancer recovery. Finding the strength within increased their chances of survival because the recovery made then strong and their lives were directly influenced assisting them to attain the finest quality of life. The path to recovery was however impeded by several feelings of defeat that were described as ‘living with fear and uncertainty’, ‘fear of losing attractiveness and desirability’ (Katz, 2011, and Westrup, et al, 2006), ‘being overwhelmed’, and ‘coping with external workforce’ made the recovering women appreciate the weight of the situations and drove them to overcome the recovery process through finding strength within and support from friends and family. In the discussion section, the effects of the breast cancer-related breast surgery on the lives of younger women in the centre of focus. The findings showed that the women experienced emotional turmoil and were usually concerned with their sexuality, body image and femininity after the surgery. The concerns and the feelings became a routing in their lives from the day they were diagnosed to the time of surgery and the aftermath. Support from family members, friends and health professionals has been considered in the discussion as the most important factor that would help the cancer patients to go through the recovery process with brevity and there after have a positive look on life in general (Sernekos, 2008). The discussion also supports the findings of the thematic analysis with other researches that suggest that younger women with breast cancer and recovering from breast surgery resulting from breast cancer undergo a multitude of issues. This is required of a qualitative research. Its validity should be shown by the concurrence of its findings with other studies done previously. This is exactly what the authors have recorded in the discussion. Conclusion The research paper analyzed above highlights the lived experience and recovery of women under the age of 50 years who were diagnosed with breast cancer and undergone breast surgery as a result (Wright, et al, 2008). This research adds value to the nursing profession because nurses provide a vital support to the patients and therefore, they have gained insight in to the lives of the younger woman patients. This study has also increased awareness of the specific needs of the younger women especially if they are working and they have families to take care of as seen in the lives of participants taking part I this research. The research has also shown its validity and reliability as a qualitative research since it provides future guidelines to be followed by nursing professionals when providing care and support to younger women recovering from breast surgery. Nurses should deliver individualized care to such patients and understand that that there exists a big difference between psychological and physical disparities among older and younger women who have undergone breast cancer-related breast surgery and so all women with breast cancer should not be treated the same (Ellen, 2006). References Avis EN, Crawford S & Manuel J (2004) Psychological problems among younger women with breast cancer. Psycho-Oncology 13, 295–308 Belmont, (2002). Ethical Principles and Guidelines for the Protection of Human Subjects of Research. Washington, DC: National Institutes of Health, 1979. Available: http://ohsr.od.nih.gov/guidelines/belmont.html. Coyne, E and Borbasi, S., (2006) Holding it all together: breast cancer and its impact for younger women. Contemporary Nurse 23, 157–169. Elmir, R., Jackson, D., Beale, B., & Schmied, V. (2010). Against all odds: Australian women’s experiences of recovery from breast cancer. Journal of Clinical Nursing, 19(17-18), 2531–2538. Holloway I & Wheeler S (2002) Qualitative research in Nursing, 2nd edn. Blackwell Science, Oxford. Lee, W., (2002), Frequent loss of BRCA1 nuclear expression in young women with breast cancer: an immunohistochemical study from an area of low incidence but early onset. Applied Immunohistochemistry and Molecular Morphology 10, 310–315. LoBiondo-Wood, G. and Haber, J. (2002), Nursing research: methods, critical appraisal and utilisation. European Journal Medical research, 12: 56-60 Pelucchi, C., Negri, E., Talamini, R., La Vecchia, C. and S. Franceschi (2007) Researching lived experience: human science or an action sensitive pedagogy. European Journal Cancer Preview 11: 543–545  Katz, A.R.N. PhD, (2011), Breast Cancer and Women's Sexuality, AJN, American Journal of Nursing April 2011 - Volume 111 - Issue 4 - pp 63-67 Sernekos, L., (2008) Hypnosis Complements Breast Cancer Treatment and Breast Surgery, Journal of Clinical Nursing, Volume 12: (4), pp23-25 Ellen, P. M., Long, H.N., Richard, G.R., Thomas, N. C., Donglin Li, Reed, E.D. and L.I., Iezzoni, (2006), Disparities in Breast Cancer Treatment and Survival for Women with Disabilities, American International Medical JournalI November 7, 145:637-645 Daniel, W.C, M.D., George, B.H., William, R.W., M.D., Robert E. Scully, M.D., and Robert C. Knapp, M.D. (2004), Factors Affecting the Association of recovery from breast cancer and patient’s personality, English Journal of Medicine 307:1047-1051 Wright, J. D., Doan, T., McBride, J., Jacobson, J.S. and D. L. Hershman, (2008), Variability in breast cancer surgery for elderly women with advanced stage and its impact on survival, British Journal of Cancer 98, 1197–120 Marjorie K. McClure, Richard J. McClure, Richard Day and Adam M. Brufsky, (2010), Randomized Controlled Trial of the Breast Cancer-related breast surgery Recovery Program for Women, Australian Medical Journal, vol. 64 no. 1 59-72 Westrup J. L., Lash T. L., Thwin S. S., and Silliman R. A. (2006), Risk of destruction in upper-body function and symptoms among younger breast cancer patients. Journal of European Internal Medicine 21:327–333. Read More