Free Article Review On Briefly Describe The Health Issue Of The Study’s Focus?

Critical Review on article

Background of the study
Women with breast cancer are required to go for regular check-ups post-surgery or treatment. Post-surgery follow-up helps in detecting and treating recurrent diseases. The follow-up also ensures asymptomatic patients are diagnosed at an early stage. According to the National Institute of Clinical Excellence, routine outpatient follow-up of breast cancer patients by specialists and nurses ensures that the educational and psychological needs of these patients are met. However, not many patients are comfortable in sharing personal information which may lead to delayed diagnosis of disease recurrence. Follow-up is the only method through which patients can share their personal views and level of satisfaction from the treatment. However, the methods for patient follow-up needs improvement. (Li G, et al. 2011).

Breast cancer patients have a high risk of disease recurrence. According to nursing guidelines, all patients who underwent any kind of treatment/intervention are supposed to report to outpatient clinics or healthcare centers for follow-up. This method helps healthcare professionals to assess the patient’s quality of life and detect diseases recurrence (if any). The study was aimed to review different follow-up techniques, especially telephonic follow-up.

What is the significance of the study?

Since, not many studies have assess or evaluated the significance of patient follow-up in breast cancer cases, this study would be of prime importance. There are studies that report various techniques of patient follow-up, but this study primarily focuses on the views of experts and patients from a telephonic follow-up. This study would be able to analyze the importance of follow-up by nurses and specialist in this field and relate the same with patient satisfaction. The nurse and patient interaction during the follow-up is the most critical aspect which will be the primary focus of this study and hence it is of significant importance.

Overview of research design

What was the aim of the research?
The researchers aimed to investigate the views of experts, nurses, specialists, and patients on telephonic follow-up after breast cancer treatment. The research was based on a previous randomized control study that evaluated the significance of nurse-based telephonic call on patient satisfaction such as emotional, psychological, and social context.

What research design did the researchers use? Was it appropriate? Why/why not?

The researchers opted for a qualitative design in order to evaluate the significance of telephonic follow-up on patient satisfaction. Qualitative analysis is considered as the best method to understand and critique a research study/method/intervention. Some of the major advantages of selecting a qualitative analysis are: (a) It provides an in-depth and detailed review on the study (b) it is linked with openness and (c) it enhances the knowledge of experts in the same field. (Taggart, F., Donnelly, P., & Dunn, J. 2012).

Sampling

Who were the study participants?
The study (qualitative) comprised of 4 experts (special breast cancer nursing professionals) and 28 patients with a history of breast cancer who underwent some kind of treatment or intervention.
What are the inclusion and exclusion criteria of the sample? Why is it important to have these criteria identified before recruitment?
Since the qualitative study was based on a previous randomized-control study with over 374 patients, there were no specific exclusion and inclusion criteria for the current research. After a comprehensive review of all the patient, 28 patients were finally interviewed for the study.

What sampling technique was employed in this study? Was the sampling technique appropriate for the research design? Why/why not?

The sampling of participants from a previous study was based on simple randomization. The Beaver et al. (2009a) comprised of 374 patients. However, in the entire study, 191 patients were subject to telephonic follow-up which was the basis for the current research. A total of 22 participants were lost to follow-up which led to small number of patients. After randomization of 39 patients, only 34 patients had agreed to participate from which 28 were confirmed for the study after a written consent. This may not be the most appropriate sampling technique since it involved a small number of patients. Secondly, the report that would be analyzed from these patients may not necessarily provide a significant consensus to the healthcare industry, especially nurses and specialist care nurses. The best method for such a hypothesis would be a meta-analysis on over 100 published studies which will provide a reliable and concrete conclusion to the hypothesis.

How was the sample size determined? Was it appropriate and why?

The sample size was based on interviews of all patients who were available from the previous study. All patients were telephonically contacted and asked to participate in the study. After a comprehensive interview of all participants, only 28 participants were conformed. Since this a small number for a research, the sample size was inappropriate to draw a significant conclusion. Large studies with many participants may provide a more precise, reliable, and reproducible conclusion to the objective of the study.

Data collection

How was the data collected?
The format for data collection was based on a semi-format that covered various aspects of patients who participated in the study. The data collection was reviewed by two experts (nursing professionals). The data collection was unique since it replaced the doctor interview by a nursing professional. The interview was based on a conversational format that comprised of questions. The questions included sections such as likes and dislikes of the interview and satisfaction level of the telephonic interview. Clinical and socio-demographical variables were taken into account for data collection. Each interview lasted for about half to one hour.

Was the data collection method appropriate for the study question and the research design? Why/why not?

Qualitative analysis is of critical importance to evaluate a minor section of a research study. The data collection was appropriate since it included all possible participants, situations, and varying factors that would affect the study. The data collection was unique since it involved two experts and a team of expert researchers in the same field. Lastly, there was no publication bias/human-error in the process of data collection which is an added advantage.

What measures were or were not taken to ensure rigor?

The research, review, data collection, data synthesis, and data interpretation was based on the views of experts in this field. In order to avoid rigor for the qualitative research, an expert research team, nurses (BCN and RCN), specialists nurse, and reviewers were taken into consideration. Appropriate research tools such as randomization, questionnaire, and interviews, were utilized to avoid rigor. Some of the key aspects to avoid rigor also included line-by-line analysis, de-briefing, and consistent review. (Dickinson, R., et al. 2014)

Data analysis/results: Identify and describe the data analysis? Was it appropriate?

Procedures such as manifest content analysis were applied by expert researchers. Independent coding was applied in all cases to ensure reliability of the coding during transcription. This is by far, the most appropriate technique for data analysis of small number of participants.

What were the findings?

The findings of this study were of significant importance. The study findings comprised of both patient and nurse views on telephonic follow-up. Based on a thorough discussion, the patients stated that the telephonic interview was linked to convenience, continuity, normalizing, well-formatted structure, and better fact-to-voice consultation. On the other hand, the nurses stated that the telephonic follow-up was liked to patient benefits, developed skills, meeting needs, and better choice. Both nurses and patients reported that the telephonic follow-up was well-structured with no errors. The telephonic intervention is associated with improved patient satisfaction and increased number of outpatient interaction.

Can the study findings be used in other settings? Why/why not?

Yes. The findings from this study can be used since most clinical and outpatient would comprise of the same patient, similar nurse specialists, and strategy for follow-up. Since this study provided a positive role of telephonic follow-up intervention in a small population, the same could be used in a large setting with similar results. Many outpatient clinics lack the knowledge and expertise to organize such post-treatment analysis. This study would help to build a base to implement such a thoughtful interventions. (Beaver, K., et al. 2010).

Evidence utilization

Would you implement the findings of this study in clinical practice? Why/why not?
Telephonic follow-up is a complex task and requires the right knowledge and expertise in the field. This study provides the necessary requirements for nursing professionals to inculcate and implement the same during their practice. Telephonic follow-up would also require training and communication skills in order to improve patient satisfaction. This modality is considered as the best in breast cancer follow-up cases. (Kimman, M. L., et al. 2010).

Reference

Taggart, F., Donnelly, P., & Dunn, J. (2012). Options for early breast cancer follow-up in primary and secondary care - a systematic review. BMC Cancer, 12, 238. doi:10.1186/1471-2407-12-238.
Beaver K, Hollingworth W, McDonald R, Dunn G, Tysver-Robinson D, Thomson L, Hindley A, Susnerwala S & Luker K (2009b) Economic evaluation of hospital versus telephone follow-up after treatment for breast cancer: evidence from a randomised trial. British Journal of Surgery 96, 1406–1415.
Dickinson, R., Hall, S., Sinclair, J. E., Bond, C., & Murchie, P. (2014). Using technology to deliver cancer follow-up: a systematic review. BMC Cancer, 14, 311. doi:10.1186/1471-2407-14-311.
Kimman, M. L., Bloebaum, M. M., Dirksen, C. D., Houben, R. M., Lambin, P., & Boersma, L. J. (2010). Patient satisfaction with nurse-led telephone follow-up after curative treatment for breast cancer. BMC Cancer, 10, 174. doi:10.1186/1471-2407-10-174.
Beaver, K., Williamson, S. and Chalmers, K. (2010), Telephone follow-up after treatment for breast cancer: views and experiences of patients and specialist breast care nurses. Journal of Clinical Nursing, 19: 2916–2924. doi: 10.1111/j.1365-2702.2010.03197.x.
Li G, Zhang SX, Xu B. Effects of nurse-led telephone follow-up for discharged patients treated with chemotherapy. Asia Pac J Oncol Nurs 2014;1:46-9