Clarity of Purpose, Research Questions or Hypothesis

¶ … clarity of purpose, research questions or hypothesis were solid and well researched. The strength of the literature review was its focus upon multidisciplinary studies. Unfortunately, it suffered from a lack of complete. The strength of the sampling regime was its focus. Its weakness was the small size of the statistical sample. The wait control feature enhanced ethical considerations. The random assignment of patients enhanced the baseline measurement instruments. Reliability and validity of the measurement instruments in the study in the opinion of this author compromises the application of the data to a wider setting, although it did help focus. The data collection process was strong due to its use of the wait control group. Unfortunately, this reduced the number of participants in the Breast Cancer Education Intervention (BCEI) study

The threats to external and internal validity surround the small population size (256) patients. This tended in this author's opinion to negate much of the randomness of the studies due to simple probability. In addition, this compromises to some extent the BCEI studies findings and conclusions which would have been much more enhanced by a larger sample study population

The findings cam be made widely general across the nursing spectrum, but could be limited to those patients covered by adequate medical insurance. The applicability of findings to practice in nursing will prove to be profound and revolutionary, but need to be further verified in larger control groups. While the level of evidence, its strength, quality and consistency are good, it does not analyze the out of pocket costs for patients. Extensive co-pays and other costs might actually decrease overall mental quality of life (QOL) if the patient is worried too much about their finances. If this is the case, then the overall BCEI study is weakened considerably.

Article Summary

According to the authors, the BCEI was an effective intervention in improving

the QOL during the first year of breast cancer survivorship with durable treatment effects were durable over time. To examine the effectiveness of their intervention on (QOL) in breast cancer survivors, they set up a randomized controlled trial in an academic center that collaborated with a southeastern United States cancer center. They sampled 256 breast cancer survivors. The women were randomly assigned to the experimental or wait control groups and the BCE study was delivered in three face-to-face sessions with five monthly follow-up sessions (three by phone and two in person). The control group received four monthly attention control telephone calls. The BCEI did not receive these until month 6. Data was collected at the baseline, three and six months after the BCEI for the experimental group and one month after the BCEI (at month 7) for the wait control group. The purpose of the intervention was to test overall QOL with emphasis upon physical, psychological, social, and spiritual well-being.

While there were no baseline differences in QOL, the experimental group reported improved QOL at three months while the wait control group reported a significant decline in overall QOL. The experimental group in turn reported the continued maintenance of QOL at six months. While the wait control group reported improved QOL at six months, significant differences remained between the groups demonstrating the effectiveness of the BCEI.

All of this indicates that nurses are frontline members in the psychological treatment of breast cancer survivors. This article is an important contribution as there has not been a statistical study of oncology nurses in the education and support of breast cancer survivors.

Author's Reactions

While the study's findings are phenomenal, more needs to be learned as well concerning the role of nursing assistants LPNs in the regime. The CNA as a job category is now much more professionalized now with less turnover. Also junior nursing staff needs to be brought onboard in the overall treatment regime.