The purpose of this article is to make a critical evaluation on the article that deals with the needs of men with prostate cancer to demonstrate their ability to integrate and apply knowledge in relation to critically evaluating published research studies as a foundation for making evidence-based practice decisions. The article will explain the role of nurses in caring for patients with prostate cancer and how to deal with the psychosocial support from the patient’s family members and friends. It will also deal with the educational needs of men diagnosed with prostate cancer and how to provide the proper psychosocial needs of men with prostate cancer by taking into account some of the previous cancer models in order to improve their quality of life.
Keywords: prostate cancer, patients, diagnosis, treatment, psychosocial support.
the needs of men with prostate cancer
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The purpose of this essay is to study role of nurses in caring for patients with prostate cancer and how to deal with the psychosocial support from the patient’s family members and friends. It will also deal with the educational needs of men diagnosed with prostate cancer and how to provide the proper psychosocial needs of men with prostate cancer by taking into account some of the previous cancer models. It is essential to analyze the psychosocial and economic impact of cancer to the person diagnosed with such disease, and to know the best treatment that will improve the quality of life of the patient. The main objective of the essay is to investigate and discover the psychosocial desires of male persons who had been diagnosed with prostate cancer by utilizing the cancer model that had been developed in the past (Wallace, 2007).
The relevance of assignment to evidence based practice (EBP) is to provide an analysis on the diagnosis of prostate cancer and its physical and emotional effects on the patients and their families. Due to the limited sources on the psychosocial and educational needs of men who had been diagnosed with prostate cancer and the existing support services for such patients. The purpose of this study is to e the psychosocial needs of men with prostate cancer.
The title of the article to be critiqued is “ The needs of men with prostate cancer: results of a focus group study” that was written by Meredith Wallace and Sherri Storms that was published in 1997 in the Applied Nursing Research Journal Volume 20 Issue No. 4, pages 181-187.
The strengths of the study shall include the authors’ increased credibility to complete the study based on the background of their education in medicine and nursing. They were able to clearly explain the need to create psychosocial support groups for men who had been diagnosed with prostate cancer to help them cope up with demands of the illness.
One of the limitations of the study that was performed by the authors is that there is lack of diversity in the sampling that was recorded. Due to the scant evidence to support the important role of nursing that will provide informational and support needs of men with prostate cancer as well as the background and history of prostate cancer. The focus group research results revealed that the diagnosis of prostate cancer had raised distinctive issues for the male individuals and their spouses who had to deal with the disease. Some of the concerns included uncertainty, how effects of treatment, how to overcome the physical and psychological trauma and asking for assistance or help to family members living with the disease.
Majority of the participants exhibited fear when they were asked to answer survey questions thinking that the cancer will spread to other parts of the body that can result to death. At the same time, the male individuals who had been diagnosed with prostate cancer are afraid that their sexual feelings may be affected due to the disease. These men has insufficient knowledge about the disease that they merely seek information from the internet, pamphlets and other people they know who were able to overcome the disease. The authors made a conclusion that these men lacked health information and psychological support at the time that they discovered that they had prostate cancer.
This article will study the current programs, reported that there is a critical lack of information on how the support groups can help the patient decide what treatment option to choose. It also discusses the insufficiency of psychosocial information on prostate cancer that had caused many men to seek other sources that will provide education on their condition. The role of the support group, coping strategies, and lack of peer support will explain why men with prostate cancer receive inadequate support the moment that they receive the news that they had been diagnosed of prostate cancer. Thus, the patients had sought the advice and support from other men had undergone and surpassed prostate cancer. However, due to the lack of research on the disease, the patients conduct their own research by using their personal computers to find out how they can endure the diseases and to seek for support groups that serve as their partner that will help them develop coping strategies, and to provide a strong peer support group as well. Due to the limited research data on prostate cancer, it essential to explain the benefits of having psychosocial support groups on men with prostate cancer.
The strengths of the literature section showed that the authors were able to clearly identify the three stages that male patients undergo through after having been diagnosed with prostate cancer. These three experiences include the taking in, taking hold, and taking on (Wallace, 2007). They were also able to explain in detail why there is a need to improve the existing health care system for the benefit of men with prostate cancer. The authors were able to expound on the essential role of the nurse to improve the knowledge of the patients prior to, during and after they had been diagnosed with the disease. One of the highlights of the article is to explain the role of the nurses and nurse practitioners to make proper referrals on how to access internet data and to educate the patients and their partners on how to cope up with the stress and challenges resulting from prostate cancer. The essay has explained that nurses have a duty in the community in organizing, developing, and implementing the group support services for patients with prostate cancer. The findings in the study can be used to enhance the present support services in order to meet the recognized requirements of men with prostate cancer such as educating the patients and how to extend the available support before, during, and after the diagnosis that can go beyond years even after treatment. Another identified strength of the article is the fact that the author emphasized on knowing the side effects and problems that the patient has to endure while managing the disease.
The limitations of the literature review section included only few participants and the study design which can be considered as very subjective in nature. At the same time, due to the lack of the benefit of quantitative analysis, the authors had a hard time to identify the incidence and pervasiveness of the concerns and requirements of the small number of participants who agreed to be part of the sample study. Another limitation in the study is the inability to include the spouses or partners of the patients, which had restricted the accuracy of the results in relation to the families who had to deal with a member who had been diagnosed with prostate cancer. Due to the scant number of sources which had examined the men’s needs who undergo prostate cancer, the article had given an exclusive insight of men who go through the emotional experience as they cope with the disease.
The problem statement that had been identified by the authors is the fear that is being experienced by male and females both deal with sexual identity. They compared the personal experience of a male who had been diagnosed with breast cancer with the conceptual model of a woman who has breast cancer. Both of the diseases experience the same fears such as losing sexual sensations. In the case of women, they experience loss of body parts, bleeding, while in the case of men, losses may refer to erectile dysfunction and sexual sensations. The main problem that was identified by the authors is the lack of research materials that deal with the psychosocial and educational needs of men who have prostate cancer. They have assessed the efficiency of current support services and the process of adjustment of old age, loss of manhood and sexual feelings, just like women who have breast cancer.
The study purpose of the study is to explore the psychosocial needs of men with prostate cancer by making use of cancer models that had been developed in the past.
The literature review, problem and purpose statements are consistent since they all dealt with the same objective for the purpose of exploring the psychosocial needs of men with prostate cancer by making use of cancer models that had been developed in the past, and the unique role of the nurses and nursing practitioners in educating the family members, particularly the spouses of the patients with prostate cancer on improving the quality of life of the patient.
The target population for study used a focus group that included sample participants of 16 men between the ages of 49 and 81. The sample population included 8 men who finished high school education, where 5 of them went to college, and 3 went to graduate school. 15 of the male participants were married and only 1 of them had filed for divorce. Only 1 of the participant was African American, while 15 of the male participants in the sample study were Caucasians.
The sampling procedure that was used in the study is by gathering and recruiting the participants using newspaper advertisements and flyers and sending direct mails to past and present support program users, that were send through affiliated urology practices.
The major characteristics of sample are that they were all male and between the ages of 49 and 81 who had been undergoing various prostate cancer treatments.
The representativeness of sample in relation to target population included two focus groups that included men whose ages ranged from 49 to 81, and are undergoing various stages of treatment for prostate cancer. The first panel consisted of 10 men, while the second panel consisted of 7 men, who had all undergone support networks in hospitals.
The research design used for the study included the conceptual model based on the work of one author named Wilmoth who explored the aftermath of breast cancer (Wallace, 2007).
The strengths of the design study in relation to its purpose is that by using a convenience sampling design, the authors were able to determine the requirements of men who had prostate cancer and obtained their personal views on how their requirements will be achieved. However, the limitation of the study design is that it used a small number of participants which is composed of only 16 men, and the study purpose may not be able to be achieved due to the small number of participants who were used in the study.
The major study variables included the relationships of the cancer patients with their families that covers the psychosocial support and by getting connected to groups who survived prostate cancer by learning to live with the disease. This will help the patient obtain the information needed before, during and after the diagnosis and how to properly deal with the effects of the treatment.
For the data collection process in the qualitative study, information was obtained from 16 participants composed of men between the ages of 49 and 81. The sample population included 8 men who finished high school education, where 5 of them went to college, and 3 went to graduate school. 15 of the male participants were married and only 1 of them had filed for divorce. Only 1 of the participant was African American, while 15 of the male participants in the sample study were Caucasians. The annual income of the participants was between the amount of $20, 000 to $100, 000.
For the gathering of data, the focus group sessions had been recorded through audio tape and the primary investigator listened to all the tapes and took down field notes as he deemed proper. After taking down the field notes, he compared his notes with the report that was submitted by the focus group facilitator and compared them using the constant comparison method. For the tabulation of the results, the previously developed cancer model of Wilmoth (2001) was used for the purpose of “ taking in” to determine the diagnosis, “ taking hold” to record the personal experience of the participants, and “ taking on” to determine the survival tips of the prostate cancer patients (Wallace, 2007). The perspectives of the participants on the present support services were also recorded. The participants were also asked to give suggestions for services that can assist in facilitating the healthiest transition between the stages as the facilitator recorded the data.
The data collection format was through focus group discussions and they were asked to answer the questions during meetings that were held off the hospital campus to prevent the participants from associating the hospital with their personal experiences as they deal with the disease.
The tools/instruments used to collect data including focus group one-on-one discussion with the facilitator by giving each of the participants the opportunity to accept or decline the invitation to participate or to schedule the session some other time. Majority of the participants accepted the invitation to participate and they agreed to be scheduled for a focus group. There were several questionnaires that the participants were required to answer which included both demographic and open-ended questions. The questions that were asked were in relation to the prostate cancer and the efficiency of the current support systems to meet the psychosocial needs of the patients.
The total number of questions that were asked was 14. The type of questions that were asked required long answers during the discussions and not just answerable by a mere “ Yes” or “ No”.
For the data collection tools, the answers were recorded by the facilitator in the form of field notes.
The data collection was very reliable and validity of data is high since the participants were met face-to-face during the meetings while attended the focus group meetings. The data shows that participants had to go through a mixture of emotions after the received the news that they had been diagnosed with prostate cancer. Majority of them were shocked an in denial of the diagnosis, and later on felt fear and anger at the same time, thinking that they will die anytime soon.
For qualitative study, the same participants composed of 16 male individuals formed the sample study and carried the same demographics and personal circumstances. The data collection was done through during meetings that were held off the hospital campus to prevent the participants from associating the hospital with their personal experiences as they deal with the disease.
The data collection format was done in focus group discussions. In order to ensure rigor of process of data collection, the participants were asked to join focus group discussion in order to obtain the answers face-to-face and noted down by the facilitator. In order to obtain the accuracy of the results the focus group sessions or one-to-one sessions and open discussion were used to be able to obtain the both psychosocial needs of the participants by using Cognitive Behavior Therapy (CBT) approaches (Cockle-Hearne and Faithfull, 2010).
The strength of the data collection process is that the participants were engaged in face-to-face discussions to discover their fears, concerns and psychosocial needs with regard their disease. The limitation of the data collection process is the number of sample participants was so small that the accuracy of the results in relation to the main purpose of the study may be compromised. Only qualitative study was used and without the benefit of quantitative anaylsis.
In order to protect the identity of the participants, the results that were obtained during the data collection process were kept confidential.
The strengths of process that was used to protect participants were based on 3 principles guiding the ethical conduct of research namely informed consent, social and clinical value and fair subject selection. All the participants were asked to make their own decision on whether to participate in the study or not. The participants who decided to join the study will benefit from it by knowing their collective psychosocial needs in coping up with their disease of prostate cancer. These men were informed that the goal of the study is to help them discover their needs that will give emotional support in dealing with cancer.
As part of the overview of data analysis process only used qualitative study, the facilitator asked the participants to attend the focus group discussions. The investigator listened to all of the recorded audio tapes and took down field notes when he deemed it was necessary. The field notes were then compared with the report completed by the focus group facilitator that utilized the same comparison method. The facilitator them tabulated the results adopting the model of developed by Wilmoth in 2001 which is divided into three stages namely: “ taking in” after knowing the diagnosis, “ taking hold” as the patients experience the emotional trauma of knowing they had the disease, and “ taking on” as the patients struggled to survive or overcome the disease (Wallace, 2007).
The processes that were used to ensure analysis and interpretation are accurate since the facilitator took down field notes while the focus discussion took place. The findings were evaluated based on the organized model that was developed by Wilmoth in 2001 to study breast cancer among women.
The qualitative method of analysis was done in the most accurate manner in order to increase the believability of the findings. During one-on-one discussions that were recorded in audio tapes made the findings more believable and accurate.
The relevant findings in the study the determining the requirements of men with prostate cancer is the best way to understand emotional and psychosocial needs of men with such kind of disease. By using the conceptual model that was previously developed for breast cancer among women was useful in identifying the three disease stages and the specific needs for every stage of the disease.
One of the major themes of the article is to explain the role of nurses in caring for patients with prostate cancer and how to deal with the psychosocial support from the patient’s family members and friends. Another theme is how to provide the proper psychosocial needs of men with prostate cancer by taking into account some of the previous cancer models in order to improve their quality of life.
The believability of study findings has been analyzed using three basic approaches such as the taking in, taking on and taking hold of the patients as they struggled to survive the disease with the help of their spouses and family members to improve their quality of life.
The major study limitation is the small number of participants and the nature of the study design was very subjective (Wallace, 2007). Thus, it can affect the scientific evidence and client perspective to provide quality services to the patients who had been diagnosed with prostate cancer.
Based on the study findings, men with prostate cancer have support needs that can only be provided by their families to be able to survive the disease and to be able to successfully manage the effects of the treatment.
It can be concluded that there are still many things to consider in order to improve the health care system and to provide the psychosocial needs of men with prostate cancer. The nurses and nurse practitioners play a special role in improving the quality of life of prostate cancer patients by educating them of what should be done before during, and after the diagnosis.
One thing that I have learned about prostate cancer is that living with the disease will also require the participation of the spouse and family members by giving them the emotional support that they need to cope up with the disease and providing them with the correct information about prostate cancer.
After the completion of this critique, I learned that the relationship getting relevant and accurate data for the research study will ensure that the goal of the EBP will be achieved after carefully reflecting on the needs and emotions of the patients to be able to provide them with quality service.
Cockle-Hearne, J. and Faithfull, S. (2010). Self-management for men surviving prostate cancer:
a review of behavioural and psychosocial interventions to understand what strategies can
work, for whom and in what circumstances. Psycho-Oncology, 19, 909–922.
Wallace, M. and Storms, S. (2007). The needs of men with prostate cancer: results of a focus
group study. Applied Nursing Research, 20(4), 181-187.