Reducing Psychological Distress in patients undergoing Chemotherapy

The heading of the article offers an overview of the issue that the paper intends to look at in the entirely. The title summarizes the primary objective of the paper and the audiences who are in this case, cancer patients who undergo chemotherapy. Also, the title serves as a brief introduction, and at a glance, the reader can determine the themes analyzed in the article as the title is informative and specific. However, the title of the article does not mention anything about chemotherapy treatments but only focuses on the psychological distress that chemotherapy patients undergo.

Research Problem 

As the article begins, the author clearly states the research problem whereby the first paragraph clearly states the general problem and the audience. The introductory part of the article is evidence-based with a theses statement in the last sentence thereby introducing the issue of chemotherapy treatment for cancer patients. The statement dramatically assists in building a strong argument as well as an excellent rationale for reducing distress in patients undertaking chemotherapy treatment.

The issue of reducing psychological distress in patients undertaking Chemotherapy treatment is essential in improving the treatment as well as reducing adverse side effects associated with cancer treatment. Out of the current problem discussed in the article, the healthcare researchers can formulate clinical interventions appropriate in reducing psychological distress in patients taking chemotherapy. The significance of the clinical interventions for alleviating psychological distress after a chemotherapy treatment is also stated in this part of the article. Nurse-led interventions that promote patient care, as well as nursing support on a cancer patient, are also reviewed in this section. The research problem of reducing psychological distress in patients undertaking chemotherapy is done within the acceptable and scientific based paradigm.

Purpose 

At the introduction part of the article, the purpose of the research study is stated as well as the limitations that contributes to psychological distress. The scope of the review that makes the research evidence-based and the unique psycho-social nursing intervention that further determines the purpose of the study is also briefly explained. The author or the article wisely use the best choice of words to bring forth the main ideas about the research study in a simple way to comprehend. Also, the author suggests that a special training should be done for nurses who wish to specialize in cancer patient care as well as psycho-social support. The author further gives a possible advantage of nurse-delivered psychological support as it may lower the psychological distress in patients undertaking chemotherapy.

Theoretical Framework 

The author of the article in his research study utilizes the self-cognitive theory applicable in psychology, communication as well as in education. The theoretical framework insists that a person’s knowledge as its directly linked to an observation of other people in the context of social, experience and media influences. The author concisely discusses in the framework the observation models that cancer patients experience during a chemotherapy treatment and often associate the behavior with the consequences (Milanti, Metsälä & Hannula, 2016). Also, the author further explains the how the framework can be used in developing competent interventions that can assist in reducing psychological distress of cancer patients after undergoing a chemotherapy (Milanti, Metsälä & Hannula, 2016). The theoretical framework was integrated into the entire study process. This includes the methodology as well as the hypothetical assumptions. The use of 42-minute psycho-educational video served to affect the cognitive behavior of the cancer patients receiving chemotherapy. The framework perfectly fits the research study as well as its application in clinical interventions.

Literature review 

The literature review as evidenced by the article is well organized and easy to understand. The fundamental idea of reducing psychological distress is well developed with scientific support evidence to back-up the idea study. The research problem has been associated with numerous clinical instances as well as the nursing intervention that can assist in reducing the distress (Milanti, Metsälä & Hannula, 2016). The reference materials used by the author are current and therefore form a substantial evidence that the interventions are applicable and relevant. The author tactfully refers to previous research findings to build on the study and also considers what other associations such as the American Society of Clinical Oncology as well as the American Cancer Society say about cancer treatment (Milanti, Metsälä & Hannula, 2016).

Hypothesis 

The article is written based on a reasonable hypothesis that is both figurative as well as literally. The hypothesis is primarily based on the present literature about cancer chemotherapy treatment and predicts the most likely interventions that can be applied to reduce the distress. The video which offers the previous study that is aimed at lowering psychological distress in patients that undergoes cancer chemotherapy.

Methodology 

Ethical Aspect of the Study 

During the research study, the ethics committee in Indonesia approved the procedures applicable to the study. Since the experiment involved human beings as well as sample, the issue of ethics was mandatory to be adhered to throughout the process. Ethical approval was done by the ethics committee of Indonesia as one of the legal ways to ensure that the healthcare rules are followed to the letter. As per the ethical requirements, the individuals involved in the experiment were spared from any harm such as physical, emotional as well as psychological (Milanti, Metsälä & Hannula, 2016). It was also essential and ethical to ensure that the patients already suffering from psychological distress as a result of cancer chemotherapy were prevented from more suffering emanating from the research. It was also ethical to respect the rights of all the participants especially their right to informed consent. The participants must also be briefed on the research study as well as the outcomes and the objective of the study.

Design 

The design method used during the study as it is written in the article is a quasi-experimental as well as the pre-test and post-test experimental design with a parallel group. The relative group is left untreated during the research, but it is given standard care. Furthermore, the trial group approved based on the ethical grounds applicable to healthcare.

Sampling 

The researchers of the study aimed at reducing psychological distress for cancer patients after receiving chemotherapy treatment identified and also described the participants before collecting any samples. After identification of the individuals, the researchers purposely sampled for breast cancer as well as cervical cancer patients receiving chemotherapy treatment. The patients used in the study were receiving treatment at Dharmais National Cancer Centre which is among the top referral health care centers in Indonesia. For the purpose of eligibility, all the patients had to be within the age of informed consent which was taken to be 18 years old (Milanti, Metsälä & Hannula, 2016). The patients were diagnosed with either the breast cancer or cervical cancer. The participants were scheduled for intravenous injections for chemotherapy as stipulated in the study time frame. It was notable from the article that the participants used in chemotherapy study had to be literate, that is, they were able to read and write just in case there were agreements to be signed regarding the study. Different psychological methods are required for Oral chemotherapy, and therefore it was not applicable to the research study (Milanti, Metsälä & Hannula, 2016). The conclusion criteria of the sampling methods stated in the article were either historical or the current techniques, the psychiatric issues and the psychological interventions.

Data Collection 

In data collection, the medical records of the patients were used to provide the socio-demographic statistical data. The author suggests in a review the medical chart as seen from the article was an efficient way of gathering patient information about the medical status of the patient, the type, and stage of cancer. Also, the review of the medical chart shows if the patient is having metastatic, the specific for chemotherapy treatment cycle the time since the patient was diagnosed with cancer and also the prior chemotherapies. Also, the article states that the patients were assessed for the presence of cancer using the DT (Distress Thermometer) as a way of data collection (Milanti, Metsälä & Hannula, 2016).

The D.T scale range from 0-10 whereby 0 represents a figure for no distress while the ten digit represents the extreme upper case of psychological distress. The D.T was further accompanied by a Problem List (PL) which included a total of 39 problem items that commonly accompany psychological distress. The Problem Items as in the article were divided into five categories, that is, the practical, emotional, spiritual, family as well as the physical issue (Milanti, Metsälä & Hannula, 2016). The D.T is scientifically accurate as it is validated and also has a perfect sensitivity and even specificity. Therefore, the errors are minimal as compared to other methods of data collection.

Results 

The author of the article regarding the study found out that among all the 113 patients eligible for the breast and cervical cancer, only 100 of them participated in the research study. In the intervention group, 50 patients were assigned while just 13 patients declined for the survey as a result of physical reason. These were the overall characteristics of all the individuals who took part in the study (Milanti, Metsälä & Hannula, 2016). The figures that the researcher come-up with regarding the turn-up figures showed that the research was free and fair to all the patients.

From the investigation, the author noted that the interventions, as well as the control groups used in the study, diagnosed with breast cancer stage-II which was less than 12 months old. Also, the author noted that many participants in the study recently had their first-time cancer chemotherapy. The chemotherapy regimen frequently given to a patient who has breast cancer stood at 43%. On the other hand, the regimen given to patients with cervical cancer was at 36.84% based on the chemotherapy done (Milanti, Metsälä & Hannula, 2016). The researcher also noted that the homogeneity test on the characteristics of all the individual patients did not reveal any essential differences between the control groups and the interventions. The assumption made between the two groups is that they were equal regarding health and chemotherapy treatments.

Further results that the researcher came up with regarding the distress were a mean score of 3.9, a median of 4.0, and a Standard Deviation of 2.58 of all the findings. There was also an assumption that the distress level of the participants was equal until an intervention of p=0.506 was eventually given at the end (Milanti, Metsälä & Hannula, 2016).

Limitation 

The author of the article reveals out that the one limitation that faced the research study was that the validity, as well as the reliability, were not obtained from the study. Some measurements were taken lower than expected leading to bias in the data. The limitation is stated in the starting sentence of the article in the limitation section. However, the author fails to indicate how the defect can be overcome in case a similar research is done in future. It would be more appropriate if the author of the article told the readers how to handle same limitations in other related research projects in healthcare settings. In the interpretation of the research, the limitation does not significantly come into account in addressing why the data collected from the research is still relevant despite the limitation.

Significance 

The author of the article addresses the issue of statistical figures as very essential in the interpretation of research findings. In the article, he advises on a careful interpretation of the results findings as their clinical significance determines the interventions to be used in reducing psychological distress in cancer patients undergoing chemotherapy. However, the author also suggests that the significant limitation that affects the results findings s the sampling methods used by the researcher. In the non-probability techniques of sampling as well as the small sample sizes that are used to explore the research far beyond the population of patients under study (Milanti, Metsälä & Hannula, 2016). Finally, the author gives the clinical consequences that are as a result of the appropriate use of clinical data from clinical research.

In conclusion, introductory part of the article is evidence-based with a theses statement in the last sentence thereby introducing the issue of chemotherapy treatment of cancer patients. Out of the current problem discussed in the article, the healthcare researchers can formulate clinical interventions appropriate in reducing psychological distress in patients taking chemotherapy. The scope of the study that makes the research evidence-based and the unique psycho-social nursing intervention that further determines the purpose of the study is also briefly explained.

Based on the author’s research findings, it can also be concluded that the issue of psycho-education as an intervention reported from the article reduced significantly for 50 patients who took the breast and cervical cancer chemotherapy. The author concluded that the number of patients had higher chances of reporting the psychological distress as compared to patients with lower levels of distress. Personal reasons and fear of discrimination from friends and family members force some patients suffering from low levels of distress to hide the feeling. Unlike the patients with high levels of psychological distress who according to statistics report their cases to their loved ones.

The author further concludes that the study is essential and has numerous benefits for the psycho-educational interventions and particularly in clinical practices. The interventions also help other patients suffering from cancer irrespective of the body organs affected. When undergoing chemotherapy, these types of interventions are applicable. However, the author does not conclude if the intervention can be entirely used for patients with other types of cancer but insists on further research to prove them. Also, the author concluded by further explaining that the intervention offers basic information as well as psychological support applicable by patients suffering from cancer disease. As a way of conclusion, the author signals a critical aspect that the psycho-educational interventions need to be incorporated into the learning system and as an intervention for patients who have cancer.

Recommendations 

The author recommends on further research to be conducted making good use of more robust research design to develop the psycho-educational materials. Also, the author suggests a triangulation study design with more repeated interventions because it takes longer, but the results are more reliable and accurate. The author also recommends a multiple and randomized research study whereby a large sample is required to allow more generalization of the research findings. In the case of the large sample used in the study, there will also be a wide range of data for comparison and most important, to the formulation of interventions. Additionally, the author recommends that the media used as the intervention for the patients need to be well developed and refined so that it suits the characteristics and the needs of the client. The primary focus of the study aimed at reducing psychological distress is arguing the needs of the female patients suffering from breast or even cervical cancer. As the author concludes the article, he recommends on the necessity of the collaboration between the healthcare institution s and the educational institution. The collaboration between the two will significantly optimize the sustainable psycho-social patient care development.

Reference 

Milanti, A., Metsälä, E., & Hannula, L. (2016). Reducing psychological distress in patients undergoing chemotherapy. British Journal of Nursing, 25(4), S25-S30.