Evidence-Based Nursing Assessment Item Critical Questionnaire

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Sampling method -117 patients with primary breast cancer; all who had same-day surgery as part of their treatment.

Appropriateness of sample -- Appropriate for circumstances under consideration.

Results (when applicable: credibility, transferability, dependability, & conformability)

Study found significant differences between the control and experimental group in terms of post-surgery mood, confusion, tension, and home management.

Ethical considerations -- All ethical considerations; privacy, etc. followed- professional study.

Relative strengths of each publication -- Peer reviewed strong work and sense of issues surrounding pain, fatigue and emotional disturbances after surgery.

Relative weaknesses of each publication -- Larger sample than previous study, but still limited in scope, demographics, psychographics and geographic extrapolation.

Application of each article in nursing practices -- Using any intervention that helps patient's after a traumatic surgery is helpful; especially if that patient can ventilate their emotions, angst, and stages of healing. Short-term telephone intervention using the AFSMI technique proves quite helpful in most cases. This was also cooborated in other studies (Yarbo, et.al., 2010).

Conclusion of each article -- Statistical analysis showed that AFSMI was effective in reducing emotional distress and enhancing post-operative physical conditioning.

Summation and Conclusions: Same-day surgery is becoming the norm for a number of treatments in the modern medical paradigm. There are several reasons for this: it helps decrease costs to both the hospital and patient; it provides a way for the patient to get home quicker, usually signifying enhanced healing, and frees up needed resources for patients who require more personalized monitoring. However, breast cancer comprises almost 23 per cent of all cancers in women, which resulted in almost 1/2 million global deaths. Regardless of the circumstances of the surgery, though, it is an emotionally draining and highly stressful time for the patient (World Cancer report, 2008).

Outpatient, or same day surgery does not require an overnight hospital stay, and also centers around improved technology. There are a number of commonalities we see when dealing with same-day surgery on breast cancer.

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Particularly with this type of cancer, women tend to need longer, more robust support just after surgery, often feeling quite vulnerable and particularly emotional after the surgery. These women need to count on their family and friends for support, and often feel at odds with the medical community during this emotional stage. Certain psychological conditions do presuppose that women should or should not be candidates for same day surgery of this important of an issue (Greenslade, et.al., 2010).

Further, research shows that emotional distress, anger, and inability to socialize or perform normal function are mitigated by a number of approaches, one being AFSMI (Attentional Focus and Symptom Management Intervention. It does not seem to be particularly relevant whether this is done in person, in a group, or at home (or by telephone), simply that a post-operative patient is able to express individual doubt, anger, frustration, and the like during the mental and emotional healing process after cancer surgery (Allard, 2010). This is quite consistent with other studies, and posits a healing and carative paradigm to the nursing field in which allows for a more generalized emotional introduction back into family, friends, or colleagues (Mulholland, et.al., 2011).

REFERNECES

Allard, N. (2007). Day Surgery for Breast Cancer: Effects of a Psychoeducational Telephone

on Functional Status and Emotional Distress. Oncology Nursing Forum. 34 (1): 133-41.

World Cancer Report. (2008). International Agency Research on Cancer. Retrieved from the World Health Organization, http://www.iarc.fr/en/publications/pdfs-online/wcr/2008/wcr_2008.pdf

Greenslade, M., Elliott, B., Mandville-Anstey, S. (2010). Same Day Breast Cancer Surgery:

A Qualitative Study of Women's Lived Experiences. Oncology Nursing Forum. 37 (2): E92-97.

Harmer, V. (2011). Breast Cancer Nursing Care and Management. Ames, IA: Wiley.

Mulholland, M. And Doherty, G. (2011). Complications in Surgery. Philadelphia, PA:

Lippincott, Wiliamson.

Taghian, A., Smith, B., Erban, J. (2010). Breast Cancer: A Multidisciplinary

Approach to Diagnosis and Management. New York: Demos Medical Publishing.

Yarbo, C., Wujcik, D., Holmes-Gobel, B. (2010). Cancer….....

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