Breast Cancer Patients and their Support

Phase 1: Introduction
The research topic selected is the Support for Breast Cancer Patients. The purpose for the selection of this topic is to assess the impact that support for breast cancer survivors has on them. The research will investigate the type of support that has tangible positive impact on the breast cancer survivor. Surviving breast cancer can be a traumatic encounter for any patient. Having some form of support from professionals may be necessary to help the survivors in their psychological recovery process. Research shows that participating in breast cancer support groups is fundamental for the reduction of anxiety and stress that emanates from diagnosis with breast cancer. This research will investigate the legitimacy and impact of breast cancer support. The outcomes of this research are supposed to educate cancer survivors and breast cancer support groups on the importance of support.
Diagnosis with breast cancer can be a devastating experience for any person. Most people have grown up to believe that diagnosis with any type of cancer is a death sentence. There is a good chance that any breast cancer patient will suffer psychological distress, anxiety, and perhaps suffer from depression if they do not receive the necessary mental support and care. As a professional in healthcare it is important to make sure that cancer patients have the necessary support systems and medical intervention to help them recover physically and psychologically. When the support given is outstanding the cancer patient will have an easier time dealing with the breast cancer and their recovery process will be way better. It is, therefore, important to understand what goes into effective support for breast cancer patients.
Research has it that an excess of half of the breast cancer patients looking to undergo mastectomy have no adequate information concerning reconstructive surgery that is in synchrony with the personal goals they have set for themselves (UT News, 2017). According to the research suggestions surgeons are supposed to work more closely with their patients in order for them to understand their preferences and values and to ensure that there is an amicable understanding of the risks, merits and demerits of each choice. The research study measured the participants’ knowledge concerning mastectomy and reconstruction mastectomy. The research also measured the preferences of the cancer patients. Some of the primary preferences included complication risk, recovery period, and the appearance of the breast after treatment (UT News, 2017). The research findings indicated that less than 50% of the women had significant medical knowledge concerning reconstruction of their breast and therefore made choices that were in line with their preferences (UT News, 2017).
The findings of this research were concerning to the researchers because most women received mastectomy treatments they did not prefer. Breast cancer patients were concerned about the complication risks involved although they never knew anything concerning the extent of the risk involved (UT News, 2017). This research study discovered that 43% of breast cancer patients understood more than ½ of the fundamental facts concerning reconstruction and made choices that aligned to their preferences (UT News, 2017). The level of understanding concerning surgical complications among breast cancer patients was found to be quite low. Only 14% of breast cancer patients had a strong understanding of the risks associated with reconstruction (UT News, 2017). The truth is that there is always a 16% to 40% probability that the reconstruction will come with major complications within the first 2 years following a surgery (UT News, 2017). The findings are not exclusive to the reconstruction of breasts. There are gaps in the quality of decisions made by patients due to poor understanding of fundamental information concerning the treatment of choice and what they would prefer. This means that the patient support groups need to work harder in providing better patient support in order to make sure that the quality of care given is the type of care that the patient wants (UT News, 2017).
According to a CBS news article by Marcus (2016) many breast cancer patients find solace and comfort by connecting with their support groups, friends, and family after the diagnosis. However, some make the decision to conceal their illness by keeping it secret. The reason for this is that they do not want cause panic among their loved ones with the debate about prognoses and treatment. Others do not want to be considered sick at home, work or by strangers (Marcus, 2016). According to cancer experts there are many reasons why breast cancer patients choose to keep the diagnosis to themselves. According to the cancer experts, it is important for the cancer patient to have some confidants in order to make the recovery journey more manageable. Isolation will only make the recovery process difficult.
Based on the research findings documented by UT News (2017) and expert knowledge shared by Marcus (2016) breast cancer patients should have adequate information concerning their diagnosis and treatment options and have a support system in order to make their recovery process bearable. When the cancer patient understands the risks involved in their choices and the period of recover, among other things, they can make informed choices.
PICOT
Patient Problem: Breast Cancer Patients
Intervention: Provide the necessary support system to help in their diagnosis, prognosis, and recovery.
Comparison: The alternative to providing necessary support is allowing the breast cancer patient to go through treatment without any therapeutic support
Outcome: The sought after outcome is a more tolerable breast cancer recovery process through the input of support groups
Time: Through the input of support groups the recovery process is expected to take less time.
Evidence-Based Practice Question: What is the relevance and impact of providing psychological support for breast cancer patients?
Phase II: Validation (summary of your 3 articles)
Women suffering from breast cancer experience some issues associated with social, emotional, and physical adjustment. Although there is a common consensus that breast cancer treatment ought to include counseling and educational interventions aimed at alleviating symptoms related to treatment or illness, there are only a handful of theoretically based prospective randomized control trials evaluating how effective the interventions are in the promotion of adjustment (Sherman et al., 2012). Sherman et al., (2012) conducted a research study whose purpose was to examine the social, emotional, and physical adjustments undergone by women who receive some psychoeducation through the telephone counseling, videotapes, or psychoeducation as intervention measures aimed at addressing specific patient needs in the process of diagnosis, adjuvant therapy, post-surgery, and the ongoing phases of recovery from breast cancer (Sherman et al., 2012). The design of the research involved data collection from a clinical trial through randomized control. 249 cancer patients were allocated to a control group that received normal care or to 1 of the 3 intervention groups.
The research found out that patients in all the groups indicated some improvement in their overall psychological standing, social adjustment, and overall health. The normal care control group showed poor emotional adjustment in comparison to intervention groups based on the distress levels measured. The group that received counseling through telephone calls showed some decline in their psychological wellbeing in the adjuvant therapy stage into the recovery phase (Sherman et al., 2012). There was no significant difference among the groups on social adjustment. The conclusion was that the dynamic adjustment process for breast cancer patients is different for the intervention and control groups. Overall the social, emotional and physical adjustment of the breast cancer patients undergoing usual care (which is standard for women) in both intervention and control groups supported their adjustment, whether or not additional intervention was used (Sherman et al., 2012). These results are fundamental to the cost effectiveness and efficacy of intervention measures used in the improvement of the outcomes of patients.
According to Admiraal et al. (2017) there are many psychosocial and informational needs for breast cancer patients that are not met following the completion of their treatment. Psychoeducation may be suited for the support of such patients. Admiraal et al. (2017) conducted a randomized control experiment aimed at examining the effectiveness of psychoeducational program that was web based and geared towards the cancer patients. The objective was to empower breast cancer patients with better control over their prevailing problems. Close to 138 patients were involved. Almost all the patients attended the psychoeducation program named ENCOURAGE as was requested. The findings showed that there were no differences recorded between the intervention and control group both for secondary and primary outcomes. A subgroup that was unplanned was analyzed and the results showed that patients who are clinically distressed and used the ENCOURAGE program had better control and optimism over their future in 12 weeks compared to the control group patients (Admiraal et al., 2017). The conclusion was that intervention was not determined as effective. The subgroup of breast cancer patients may be supported through the ENCOURAGE program. These findings mark only the start of future development and program application in future.
The objective of the research by Setoyama, Yamazaki and Nakayama (2011) was to compare the support for 3 groups through consideration of the patterns of usage with respect to 2 resources for peer support, face to face support and online communities groups for the breast cancer patients in Japan. This was a survey involving 1039 patients suffering from breast cancer and it was a cross sectional survey. The analysis found out that all the groups revealed the support aspects including emotional support, conflict, emotional expression, universality, and advice. The group utilizing 2 resources for support had higher scores for advice and emotional expression in the online community. The face to face support group showed higher insight and emotional support score. The conclusion was that patients receiving more social support from the peers were found in the group that utilized face to face support and online community groups. The implication is that providers of healthcare ought to offer more information concerning peer support through online communities and not face to face support alone.
Phase III: Comparative Evaluation
The research is a perfect fit for the setting because it investigates the type of support that is effective for breast cancer patients through quantitative methods. The research will definitely work to inform and educate the breast cancer healthcare providers on the best form of support for their patients. The research is quite feasible given that it is a qualitative research relying on secondary sources with full administrative support. The only obstacle is availability of research resources and the validity of the data derived from the resources. Currently, support groups are not common. The routine counseling for all cancer patients is available but there is no support specifically designed for breast cancer patients.
Phase IV: Decision Stage
The breast cancer professional community including treatment specialists and nurses should be involved in making the decision on the best support system for breast cancer patients. A change in practice for the better will mean that cancer patients recover better emotionally and that they make better informed decisions in the recovery process. Current breast cancer support practices in the organization will have to be reviewed with an objective of coming up with better patient-oriented support system and programs.
Phase V: Translation/Application
c. What are the implications for practice?
The findings can be applied by breast cancer professionals in healthcare for better patient outcomes. The implementation protocol would involve redesigning the support system with a view of assisting patients with better breast cancer support systems. This may include enrolling the patients to online support groups, and face to face breast cancer intervention programs. The implication for the new support design for cancer patients is better psychological preparedness for the breast cancer patients, emotional stability, and informed choices on the recovery path.
Phase VI: Evaluation
c. What data will be used to evaluate the change in practice and patient care?
Give specific information about the evaluation process.
The anticipated outcome is better patient outcome in their emotional, psychological, and physical wellbeing. Breast cancer patients are at risk of suffering due to their unwillingness to get the support they need for better recovery. With enhanced support patients are bound to recover better. Changes in patient care and practice will be evaluated by examining patient outcome in terms of better control over their condition, adequate information concerning their situation and treatment processes, and optimism concerning their recovery journey and against distress and anxiety. Protocol will be evaluated by standardizing the diagnosis, prognosis, treatment, and support processes. The breast cancer patients will be subjected to a rigorous process of information and preparation for the recovery process through psychoeducation and appropriate psychological and physical support.



References
Admiraal, J. M., et al., (2017). Web-Based Tailored Psychoeducation for Breast Cancer Patients at the Onset of the Survivorship Phase: A Multicenter Randomized Controlled Trial. Journal of Pain and Symptom Management, 54(4), 466–475. https://doi.org/10.1016/j.jpainsymman.2017.07.009
Marcus, M.B., (2016). Private struggle: Why some with breast cancer keep it to themselves, CBS News. Retrieved 27 February, 2019 from https://www.cbsnews.com/news/breast- cancer-why-some-patients-keep-diagnosis-private/
Setoyama, Y., Yamazaki, Y., & Nakayama, K. (2011). Comparing support to breast cancer patients from online communities and face-to-face support groups. Patient Education and Counseling, 85(2). https://doi.org/10.1016/j.pec.2010.11.008
Sherman, D. W., et al., (2012). The effects of psychoeducation and telephone counseling on the adjustment of women with early-stage breast cancer. Applied Nursing Research, 25(1), 3–16. https://doi.org/10.1016/j.apnr.2009.10.003
UT News. (2017). Half of Breast Cancer Patients Get ‘Low-Quality’ Decision Support When Considering Reconstructive Surgery, The University of Texas at Austin. Retrieved 27 February, 2019 from https://news.utexas.edu/2017/05/03/study-poor-decision-support- for-breast-cancer-patients/