The Important Treatment Modalities For Treating Cancers Nursing Essay
Based on the GLOBOCAN 2008 estimates, breast cancer is one of the leading causes of cancer deaths in females across the globe as it accounts for 23% (1.38 million) of new cases and 14% (458000) of new cancer deaths (Jemal, 2011, p.71). Although breast cancer incidence rates are lower in Eastern countries compared to the Western world, it is estimated that it will rise in future (Takiar & Srivastav as cited by Moore, 2009, p. 57). Looking at the Pakistani scenario, according to the population-based cancer registry for Pakistan and India, 69% of breast cancer cases have been reported in Karachi city which is the highest among other cities in Pakistan (Moore, 2009, p.51). Despite of its accelerating growth, it is among one such type of cancers which can be managed effectively with the advancement of technology over time (Machin, Day, & Green, 2006).
Chemotherapy is one of the important treatment modalities for treating cancers (Turgay, Khorshi & Eser, 2008) and is used with and/or without surgery and radiation therapy (the report National Cancer Institute Fact sheet, 2009). Although it aims to reduce the tumor burden, it brings with itself various side effects. These side effects are extensive; they may begin soon after the therapy and may persist long after the completion of the modality. Thus, it creates difficulty for the patients and their families to manage (Corner & Bailey, 2008; Akin, Can, Durna & Aydiner, 2008). The empirical evidence suggests that cancer patients and their families suffer through a dual burden (Corner & Bailey, 2008; Akin et al., 2008; Turgay et al., 2008; Salonen, Tarkka, Kellokumpu-Lehtinen, Kaunonen, & Astedt-Kurki, 2009). According to them, on the one hand, the disease itself is troublesome because of its extended treatment-time in years and its aggressiveness. On the other hand, the treatment modalities such as chemotherapy and its side effects are upsetting as they are many in number and they reduce the patient’s self-efficacy to fight against the disease. Ultimately the patient’s quality of life is poorly affected (Corner & Bailey, 2008; Akin et al., 2008; Turgay et al., 2008; Salonen, Tarkka, Kellokumpu-Lehtinen, Kaunonen, & Astedt-Kurki, 2009). Considering this, in order to maintain patient’s health and wellbeing, the goal of the treatment is not only to reduce the tumor burden, but also, to target the bothersome symptoms and alleviate them. The health care teams, including nurses, play their respective roles in the attainment of this goal.
Nurses; however, being at the front line of providing direct patient care, can significantly contribute in caring for their patients, supporting them throughout the cancer trajectory, improving their patient’s wellbeing, and alleviating these distressing symptoms. By virtue of the profession, nurses are taught to be caring and patient education is one of its dimensions (Rankin & Stallings, 2001). Moreover, it is "recognized as a professional role of nurses (Rankin & Stallings, 2001, p. 6)".
Patient education can be provided as one-to-one individual teaching and collective-or-group teaching. The significance of one to one teaching over group teaching is that it is based on individualized needs, it provides more ownership, greater patient participation and motivation, and it offers opportunity for frequent feedback (Rankin & Stallings, 2001). Emotional support together with individualized patient education, to a cancer patient, can help them get adapted to the disease in the initial phase of the chemotherapy and even after that. When education and support is provided, then patients are more aware about their illness, gain self-confidence and know the ways to manage it with minimal assistance (Salonen et al., 2009; Rankin & Stallings, 2001). This self-confidence increases their self-efficacy (Rankin & Stallings, 2001). Once their self-efficacy is improved, it will have a positive effect on the "health behaviors, symptom control, compliance with cancer treatment, and quality of life" (Akin et al., 2008, p. 449).
Literature emphasizes the use of various instructional methods for patient education and stresses the significance of tailoring them according to individualized patient needs (Rankin & Stallings, 2001). The use of written instructions along with the use of telephone for individualized patient education has been explored in a number of studies and its effect is reported to be effective (Compaci, Ysebaert, Oberie, Derumeaux, & Laurent, 2011; Salonen et al., 2009). However, almost all studies have been conducted in western countries, for multiple patient population including oncology patients, and no such study, to the best of my knowledge, has been conducted in Pakistan which has explored the effectiveness of the individualized patient education and emotional support to breast cancer patients undergoing chemotherapy. The individualized needs of Pakistani breast cancer patients might be different then the western world patients with respect to their cultural differences, and the effectiveness of the intervention on their quality of life and self-efficacy might reveal different results. Therefore, the study was designed to explore this area The effect of individualized patient education and emotional support on the quality of life among breast cancer patients undergoing chemotherapy in this part of the world.
Research Purpose and Hypothesis
The aim of the study was to determine the effect of individualized patient education with emotional support by a nurse on the quality of life among breast cancer patients undergoing chemotherapy. Specifically, the proposed study examined the following research hypotheses.
Hypothesis I There is a difference in the quality of life of breast cancer patients undergoing chemotherapy who receive individualized patient education with emotional support from a nurse as compared to the patients who receive only routine care.
Hypothesis II There is a positive association between the patient’s quality of life and self-efficacy among breast cancer patients.
An understanding of the educative-supportive intervention has helped will help in a number of ways. First, it will advance has advanced the available knowledge about the nurses’ role in educating and supporting their breast cancer patients for improving their quality of life and self-efficacy. This would help not only in empowering nurses to play such an important role for their patient’s better quality of life, but also will illustrate significance of nurses as a meaningful contributor in improving patient’s health and well-being within a health care team. Additionally, the health care team member, including the physicians will recognize the importance of non-conventional methods of cure and care i.e. education and support as part of their treatment plan.
Second, it will help has helped in assessing the effectiveness of this educative-supportive intervention baed on which . On the basis of the effectiveness, this the intervention can be used as part of the treatment plan for similar patients. Additionally, this intervention can be adopted by nursing systems as their policy for effective patient care.
Third, the findings will help has helped to identify the QOL of patients in pertinent domains such as physical, psychological, social, and spiritual which are being affected the most by the chemotherapy regimen. As a result, it will be intervened accordingly. Accordingly, interventions can be provided.
Also, Fourth, the locally developed self-efficacy tool will be has been tested. Then, the This tool could be utilized for different oncology patient population.
Moreover, this intervention will benefit has benefitted the patients as well. Pakistan is a low-Gross Domestic Product (GDP) developing country where majority of the people are illiterate, have least awareness about health care, are poor, cant access to receive health care and where their treatment is planned according to the western literature available rather than considering local perspectives (Afsar et al., 2010, p.825). In such a case, this educative-supportive intervention will play a key role to identify and fulfill patient’s has identified and fulfilled individualized patient needs. Also, the patients will find have found an opportunity to receive specific information both at the hospital and at their homes. Further, they will be were able to self-manage the side effects at home with minimal assistance. Additionally, it may reduce might have reduced their re-hospitalizations which, at times, resulted only for the management of the side effects. Thus, their economic burden might reduce have reduced.