Critique of Oncology Nurse Counseling Study for Colorectal Cancer

Problem Statement and Study Purpose

The study seeks to address the problem of unmet health needs for colorectal cancer patients. Evidence shows that colorectal cancer patients often lack nurse counseling support to effectively manage symptoms and side effects (Reiter et al., 2021). Further, despite weight loss being a common occurrence among colorectal patients, most of them lack access to nutritional support, resulting in poor health outcomes. With the growing incidence of cancer globally, it is important to develop interventions aimed at addressing these patient care deficits. Thus, the problem the study was conducted to resolve is an important one for nurses to explore, because it seeks to address a real and major health issue that nurses should try to address through the application of evidence-based practice.

The purpose of the study was to determine the effectiveness of nutritional and oncology nurse counseling as an intervention for improving nutritional behavior and side effects management among colorectal cancer patients (Reiter et al., 2021). This is significant to nursing because colorectal cancer is the third most common type of cancer, and patients often face a long and difficult treatment journey. One of the most important things that nurses can do to support these patients is to help them maintain a healthy diet. Good nutrition can help to improve survival rates and quality of life, as well as reducing the risk of side effects from treatment. Nutritional counseling from a nurse who is specially trained in oncology can be an invaluable resource for patients striving to make healthy choices. Oncology nurses are also uniquely positioned to provide support with managing side effects from treatment, such as fatigue, pain, and nausea. By helping patients to better understand and cope with these side effects, oncology nurses can have a significant impact on their overall wellbeing.

Research Question and Study Variables

The research question was: "What differences are there in self-management among colorectal patients in a control group and two subsets of intervention groups — one which receives in- and outpatient nurse counseling support services and another that receives only inpatient counseling support?" (Reiter et al., 2021, p. 1790). The hypothesis was that systematic nutritional counseling and in- and outpatient nurse counseling significantly improved self-management in nutritional behavior and side effects management among colorectal cancer patients.

The independent variables were systematic nutritional counseling and oncology nurse counseling. The dependent variable was patient self-management regarding nutritional behavior and side effects management.

Conceptual Framework and Review of Related Literature

The conceptual framework was based on Antonovsky's salutogenesis and Collins and Rochfort's empowerment model, the goal being to promote autonomous decision-making on the part of the patient. The framework was applied via targeted knowledge transfer and practical guidance. Participating patients received instruction and resources to support them throughout the intervention. Other than this application of a framework, no specific theory was cited as a guide for the study. A structured nurse-led counseling concept was used for evaluating the in- and outpatient counseling services.

The literature supports the need for this study. The research cited in the literature review indicated specifically that more appropriate nursing interventions were needed to address the numerous care deficits apparent in the existing literature. The authors reasoned that a complex intervention should be tested experimentally in order to address the different aspects of that care deficit.

Study Design

When conducting research, scientists often face the decision of whether to use quantitative or qualitative methods. Both approaches have their own strengths and weaknesses, and the best method for any given project depends on the nature of the question being asked. Quantitative methods are well suited for measuring factors that can be counted or otherwise expressed numerically, and this approach is often used to test hypotheses about cause-and-effect relationships. Qualitative methods, on the other hand, are better suited for exploring phenomena in a more naturalistic setting and are often used to generate new hypotheses about how people think and behave. In general, quantitative methods are more suited for testing existing ideas, while qualitative methods are more suited for generating new ones.

This study by Reiter et al. (2021) adopted a quantitative design, dealing with statistics gathered from the intervention. Because quantitative research focuses on collecting data obtained through surveys or experiments, this approach aligned well with the study, since data collection occurred through experimental intervention. The data were analyzed to answer a specific research question, and the design therefore fits both the purpose and the question of the study. The researchers were not conducting exploratory research — which is typically associated with qualitative methods — but rather sought to test a specific hypothesis with known variables, using a control group and an experimental group. They examined specific hard data and tested it for correlations to determine what effects the intervention had on the experimental group compared to the control group. Thus, a quantitative design was well suited to this case.

References

Baker, M. J. (2003). Data collection — questionnaire design. The Marketing Review, 3(3), 343–370.

Reiter, M., Gerken, M., Lindberg-Scharf, P., Fuerst, A., Liebig-Horl, G., Ortmann, O., Eberl, I., & Bartholomeyczik, S. (2021). Health services research in colorectal cancer: A quasi-experimental interventional pilot study on in and out-patient oncology. Journal of Cancer Research and Clinical Oncology, 147(1), 1789–1802. https://doi.org/10.1007/s00432-020-03454-w

Rosenberg, M. (2017). Extraneous variables. Research Design: The Logic of Social Inquiry, 263.