Understanding Post Treatment Symptoms in Patients

RRL#1 The following questions pertain to: McMillan, S.C., & Small, B.J. (2007). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients. Oncology Nursing Forum, 34(2), 313-21. What is the purpose of this research? The purpose of this research was to describe the unexpected and distressing symptom experiences that women may have after undergoing breast cancer treatment, with the goal of enhancing follow-up care through practitioner education and an increase of the knowledge base.

What is the research question (or questions)? This may be implicit or explicit. What symptoms may be experienced after breast cancer treatment that contribute to symptom distress and psychological stress that are may be temporal, situational, or attributive -- and that may be ameliorated during follow-up care? What theories, frameworks, models or concepts may have influenced the researchers' choice of a research design? The qualitative approach stems from a phenomenological philosophical background that considers the personal accounts of the study participants to be valued narrative secondary data.

In this study, the qualitative narrative data was analyzed by using constant comparative methods, in which emerging themes are teased out by an iterative process of discovery that is fostered by the categorization of data. 15) How do the authors describe the design of this study? The study is qualitative and descriptive. That is to say, the research aims to describe a phenomenon by accessing the personal accounts of patients who have had treatment for breast cancer.

16) Determine the classification of this study; is it Quantitative, qualitative or mixed method? Experimental or nonexperimental? Cross-sectional or longitudinal? The research in this study is qualitative, with in-depth interviews used to collect the narrative, personal account data from 13 participants.

17) What is the evidence that this journal is peer-reviewed? Does the journal have an editorial board? (Look for the journal's website to discover this information) The Editor of Oncology Nursing Forum provides this in her introduction to the "Submissions" section of the journal website: "The Oncology Nursing Forum (ONF) publishes manuscripts that focus on nursing achievements in the field of oncology including, but not limited to, clinical advances, research findings, educational developments, and role and theory development…Manuscripts are accepted for consideration with the understanding that they are contributed solely to this journal, that the material is original, and the articles have not been published previously…All submitted papers are subject to blind peer review.

Papers will be judged on the quality of the work and suitability for the audience." 18) Is there evidence of any conflict of interest that might introduce bias into the way the study is designed, or the way the results are viewed? Do the authors have any potential financial gain from the results of this study? The authors of this article are assistant professors in the College of Nursing at New York University in New York City.

They clearly state in the author section of the article that there are "No financial relationships to disclose." 19) Describe the population for this study. The population studied in this research consisted of 13 English-speaking women who had undergone active treatment for breast cancer from one to 18 years prior. The subjects had also volunteered with the Reach for Recovery program.

20) How was the sample selected? What are the strengths and weaknesses of this sampling strategy? The sampling procedure used was purposive, with the study participants recruited from a list of volunteers provided by Reach for Recovery, which is a cancer survivors' network sponsored by the American Cancer Society (ACS). Naturally, the participants all gave their informed consent to participate and their privacy and rights were protected by the human subjects process requirements of the college.

21) Were the subjects in this study vulnerable? Were there any risks for them as the result of participation in the research study? It is prudent to assume that the subjects in the study were vulnerable. The memories of many of the women participants would be quite fresh and the interviews would likely bring unsettling memories to the forefront, creating considerable stress anew.

The risks for these survivors would include raised levels of anxiety directly attributed to the interviews in which their feelings, perceptions, and frank discussion of symptoms were the topic. The unit of focus for the in-depth interviews was the first three years following treatment for breast cancer. [Type text] [Type text] 8 The following questions pertain to: Rosedale, M., & Fu, M.R. (2010). Confronting the unexpected: Temporal, situational, and attributive dimensions of distressing symptom experience for breast cancer survivors. Oncology Nursing Forum, 37(1), 28-33.

11) What is the purpose of this research? The purpose of the research was to test an intervention to be used by family caregivers in hospice settings with regard to better management of the symptoms that their family member patients with cancer experienced. 12) What is the research question (or questions)? This may be implicit or explicit.

What impact will improved knowledge base and the use of a problem-solving intervention by family caregivers in hospice settings have on the quality of life experienced by hospice patients? 13) What theories, frameworks, models or concepts may have influenced the researchers' choice of a research design? The researchers wondered if providing hospice caregivers different and more extensive education, and instruction in how to use a problem-solving intervention while caring for hospice patients, would result in better management of symptoms and, thereby improve the general condition of the patients and result in higher quality of life.

14) How do the authors describe the design of this study? The authors describe the study as a three-group comparative design with repeated measures. 15) Determine the classification of this secondary study; is it Quantitative, qualitative or mixed method? Experimental or nonexperimental? Prospective or retrospective? The study design is described as a repeated measures clinical trial, which is an quantitative experimental prospective design. 16) What is the evidence that this journal is peer-reviewed? Does the journal have an editorial board? (Look for the journal's website to discover this information).

The Editor of Oncology Nursing Forum provides this in her introduction to the "Submissions" section of the journal website: "The Oncology Nursing Forum (ONF) publishes manuscripts that focus on nursing achievements in the field of oncology including, but not limited to, clinical advances, research findings, educational developments, and role and theory development…Manuscripts are accepted for consideration with the understanding that they are contributed solely to this journal, that the material is original, and the articles have not been published previously…All submitted papers are subject to blind peer review.

Papers will be judged on the quality of the work and suitability for the audience." 17) Is there evidence of any conflict of interest that might introduce bias into the way the study is designed, or the way the results are viewed? Do the authors have any potential financial gain from the results of this study? There is no evidence of conflict of interest or basis for the introduction of bias.