Quality of Life of Primary Caregivers of Women with Breast Cancer

Student Name: Analyzing Published Research Article Summary Table (25) Articles (2) #1. Study Type: Reference: Study Purpose (2) Participants (2) Numbers Inclusion & Exclusion Criteria Interventions (5) Intervention Contents & Procedures OR Description of Procedure for Descriptive Study Data Collection with Measurement Tools (4) Sociodemographic Findings) (5) All Other Results/Findings (5) 1 Individual: Analyzing Published Research Articles (APRA) Paper Purpose • The purpose of this paper is to interpret the article as most relevant to the group topic. • Analyze ONE PRIMARY DATA RESEARCH ARTICLE most relevant to your group topic and research question. Course Outcomes This assignment enables the student to meet the following course outcomes: CO 2: Apply research principles to the interpretation of the content of published research studies (PO#4 & 8). CO 4: Evaluate published nursing research for credibility and clinical significance related to evidence-based practice (PO#4 & 8). Points Possible: 220 Points Paper Preparation: • Please describe the literature review in paragraphs and complete sentences with appropriate APA citations. ▪ It is NOT acceptable to use bullet-points in the body of text review paper. ▪ All review contents must be PARAPHRASED with your OWN words with in-text citations. ▪ It is NOT acceptable to QUOTE article contents EXCEPT the Purpose of Study as required. • Paper MUST be written using PAPER FORMAT (page #3). • Paper must include all required APA-Style/Format elements as designated. • Do NOT leave blank for any of these review elements. • Any review element left blank will get 0 point: If authors did not provide information or it was not applicable for certain elements, make note such as “No information was given” or “Not applicable” PLAGIARISM: “Turnitin” Percentage • Less than 25 percentage: Acceptable percentage. • Turnitin Draft Submission Box ▪ Submit your draft of paper into Turnitin Draft Submission Box to check your percentage as many times as needed before you submit your final paper to designated Unit. • If your Final paper has 25% or higher percentage, you must revise/modify your paper contents BEFORE you submit your paper due date and time. • If your Final paper has 25% or higher percentage AT/AFTER you submit your final paper due date and time, Academic Integrity Violation Procedures will be initiated Academic Integrity Violation Procedure • Academic Integrity Violation letter will be sent to student • Assignment Grade will be 0 point • The violation case will be reviewed, and a further sanction will be determined by the Administrators. Analyzing Published Research Article (IAPRA) Part I Research Question 2 • Clearly and concisely state your group research question. Purpose of the Study • Describe the purpose/aim of the study as the author stated in the article: may do cut & paste • Do NOT change or modify the purpose statement on the article Variables: Identify study variables from the above stated Purpose of Study Quantitative Study: Dependent & Independent Variables OR Descriptive, Qualitative Study: Variables of Interest Participants: Enrollment: How did they recruit/enroll eligible participants in the study? Inclusion & Exclusion Criteria: Describe Inclusion & Exclusion Criteria Total Participant Numbers: Total numbers of participants in the study Part II: Intervention Procedures OR Obtaining Information Procedures Quantitative Study: Intervention/Treatment Group • Describe the intervention contents given to Intervention group • Describe how the contents were given to Intervention group • Identify the person who provided Intervention contents to Intervention group Control Group: If the study has Control Group • Describe the contents given to Control group • Describe how the contents were given to Control group • Identify the person who provided contents to Control group OR Descriptive/Qualitative Study: Obtaining Information Procedure • Describe the detailed procedure for obtaining information/data (i.e. made appointment to meet each participant, visited home/met in clinical setting……etc) Part III: Data Collection Procedures & Measurement Tools/Instruments • Describe ALL methods to collect data in detail (i.e. interview, survey, observation……etc.) • Describe each measurement tool/instrument used to measure/assess outcomes in the study in detail. Part IV: Results/Findings Participant Characteristics/Sociodemographic Findings • Describe participant characteristics or sociodemographic status • Must be objective, descriptive, and comprehensive • Must describe the findings of Tables/Figures to provide comprehensive information about participant characteristics as article provided. Study Results/Findings • Describe ALL Other Results/Findings besides above Participant Characteristics in detail. ▪ Each result item must include Headings/Subheadings as the article provided. 3 ▪ Must describe the findings of Tables and Figures as the article provided. ▪ Do NOT simply saying “pain level was decreased,” “adherence was increased”… etc ▪ Do NOT include contents from Discussion and/or Conclusion in the article. Part V Synthesis of Findings • Describe the Rationale/Mechanism for how/why Finding of each intervention/factor helps your Research Question (i.e. how/what mechanism does music therapy help pain, how does sucking stimulation increase oral intake for pre-term infants, or how each identified factor decrease quality of life….etc) • Should NOT repeat same contents you had on Findings section and/or article • May include citations from the analyzed article or from other sources for above described rationale/mechanism (i.e. textbooks, CDC…etc) Nursing Implications • How the nurses can implement the research findings into nursing practice? Part VI: Article Summary Table • Describe article on Research Article Summary Table. • Use bullet points for each review content Grading Rubric& Description for Analyzing Published Research/Individual Literature Review Part I (40) 4 Format (5) • Accurately/Clearly state group’s Research Question as your group formulated and in PICO format 5 • Describe the purpose of the study as the author stated in the article. ▪ Do NOT change or modify the statement on the article 10 • Identify study variables from the above stated Purpose of Study ▪ Quantitative Study: Dependent & Independent variables OR ▪ Descriptive, Qualitative Study: Variables of Interest 5 • Enrollment: How did they recruit eligible participants in the study? 5 • Eligibility: Describe Inclusion & Exclusion Criteria 5 • Numbers: Total numbers of participants in the study 5 Followed APA format for paper and in-text citations Part II (40) 40 Quantitative Study: • Intervention Group: Describe the detailed Intervention contents, procedures, and person who provided Intervention for Intervention group. • Control Group: Describe the detailed contents, procedures, and person who provided contents for Control group OR Descriptive Study: • Describe the detailed procedure for obtaining information/data (i.e. made appointment to meet each participant, visited home/met clinical……etc) 5 Followed APA format for paper and in-text citations Part III (40) 5

• Describe ALL data collection Methods in detail (i.e. survey, interview, blood test, observation….etc) 30 • Describe ALL Measurement tools/instruments in detail 5 Followed APA format for paper and in-text citations Part IV (50) 15 Participant Characteristics/Sociodemographic Findings • Describe participant characteristics or sociodemographic status • Must be descriptive and comprehensive • You must describe the findings of Tables/Figures to provide comprehensive information about participant characteristics as article provided 30 All Other Results/Findings • Describe ALL Other Results/Findings besides above participant characteristics in the article in detail for each Result item • Each Result item must include Headings/Subheadings of Results as the article provided. • Must describe the contents of Tables and Figures as the article provided. • Do NOT simply saying “pain level was decreased,” “adherence was increased”…etc • Do NOT include contents from Discussion and/or Conclusion in the article. 5 Followed APA format for paper and in-text citations Synthesis of Findings (10) Part V (20) 10 • Describe the Rationale/Mechanism for how/why Finding of each intervention/factor helps your Research Question (i.e. how/what mechanism Research Question (5) Purpose of Study (5) Variables (10) Participants (15) Format (5) Intervention Procedures OR Obtaining Information Procedures Format (5) Data Collection & Measurement Tools Format (5) Results/Findings (45) 5 5 Nursing Implication (7) Format (3) Article Summary Table (25) 7 does music therapy help pain, how does sucking stimulation increase oral intake for pre-term infants, or how each identified factor decrease quality of life….etc) • Should NOT repeat same contents you had on Findings section and/or article • Should • have citation of analyzed article(s) • May include citations from other sources for above described rationale and mechanism (i.e. textbooks, CDC…etc) Quality of Life of Primary Caregivers of Women with Breast Cancer

• How the nurses can implement the research findings into nursing practice? • Followed APA format for paper, in-text citation, references. Part VI (25) 25 • Describe article on Research Article Summary Table • Use bullet points for each column in the Table • Submit Table as separate document 3 Grand Total Points: 220 Points European Journal of Oncology Nursing 38 (2019) 85–91 Contents lists available at ScienceDirect European Journal of Oncology Nursing journal homepage: www.elsevier.com/locate/ejon Effects of a psychosocial intervention on the quality of life of primary caregivers of women with breast cancer T Israel Olatunji Gabriela,b, Pat M. Mayersc,∗ a School of Post Basic Nursing Programmes (Anaesthesia), Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria Division of Nursing and Midwifery, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, South Africa c Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, South Africa b A R T I C LE I N FO A B S T R A C T Keywords: Breast cancer Caregiver burden Nigeria Psycho-education intervention Psychosocial Quality of life Purpose: Breast cancer is the leading form of cancer among women in Nigeria. The care of such patients has shifted from hospital-based care to home and community care, with the resultant increase in responsibility and burden on caregivers. The study aimed to implement and evaluate the effectiveness of a psychosocial intervention programme on the quality of life (QOL) and caregiver burden of the primary caregivers of women with breast cancer. Method: This was a quasi-experimental study with 108 primary caregivers (54 in both intervention and control groups). Quality of Life of Primary Caregivers of Women with Breast Cancer

The intervention comprised six 90-min educational sessions, held weekly. Topics included information about breast cancer, the emotional aspect of caring, adjustment to the role of caregiver and communication strategies. The intervention group received the psychosocial intervention programme in addition to routine care, and the control group received routine care. Primary outcome (caregiver burden) and caregiver QOL were measured using the Zarit Burden Interview (ZBI) and Caregiver Quality of Life Index-Cancer (CQOLC) at baseline, week six and week 12. Results: The psychosocial intervention reduced caregiver burden at both T1 and T2 (p = 0.000, p = 0.018 respectively) and improved the caregiver QOL (p = 0.000, p = 0.020 respectively) in the intervention group compared to the control group. Conclusion: The psychosocial intervention programme had a positive effect on caregiver burden and QOL. Issues such as sustainability of such programmes and advocacy relating to caregiver burden need further research. 1. Introduction Breast cancer is the leading form of cancer among women in Nigeria, affecting primarily women over 40 years of age (Ntekim et al., 2009). The incidence of the disease has risen significantly between 1960 and 2010 in Nigeria; from 13.7 per 100000 in 1960–1969 to 54.3 per 100000 between 2009 and 2010 (Jedy-Agba et al., 2012).

Although there is an increased incidence of breast cancer, diagnosis and management has also improved, with the majority of patients in developed countries remaining alive five years after diagnosis (Youlden et al., 2012). Another development in breast cancer management is the shift from the acute care cancer centre (hospital in-patient care) to outpatient and community settings for continued care (Northouse, 2012; Wadhwa et al., 2013). Consequently, the burden of care has shifted from health workers to family members, who often serve as primary caregivers (Frambes et al., 2018). ∗ Primary caregivers have assumed many of the care roles and functions of hospital-based health workers; this includes involvement in treatment planning, decision making and implementing ongoing treatment and care at home (Lkhoyaali et al., 2015; Waldron et al., 2013). Many caregivers are ill-prepared for the caregiving role and have limited knowledge which may impact on the nature and quality of care provided (Chih et al., 2013; Northouse, 2012). Quality of Life of Primary Caregivers of Women with Breast Cancer

In caring for their family member, caregivers often neglect their own health care needs (Lapid et al., 2016), with risk of a deterioration in their own quality of life (QOL). Hodges et al. (2005) reported that there was a significant relationship between the distress reported by cancer patients and the distress reported by their caregivers; distress of the cancer patient is shared by the caregiver. Although research into the QOL of primary caregivers of women with breast cancer has been conducted worldwide (McMillan et al., 2006; McMillan and Small, 2007; Wadhwa et al., 2013; Waldron et al., Corresponding author. E-mail addresses: israelchristson@gmail.com (I.O. Gabriel), pat.mayers@uct.ac.za (P.M. Mayers). https://doi.org/10.1016/j.ejon.2018.12.003 Received 10 April 2018; Received in revised form 6 December 2018; Accepted 10 December 2018 1462-3889/ © 2018 Elsevier Ltd. All rights reserved. European Journal of Oncology Nursing 38 (2019) 85–91 I.O. Gabriel, P.M. Mayers 2.1. Control group 2013), research into this aspect of care in Nigeria is limited. Studies conducted in first world countries have reported that the primary caregivers of persons with breast cancer benefit from psycho-educational interventions (O’Hara et al., 2010; Stenberg et al., 2010; Yoon et al., 2014).

A variety of interventions have been implemented to assist caregivers in managing the effects of the caregiving burden on QOL (Dolbeault et al., 2009; Tan et al., 2015). The aim of this study was to implement and evaluate the effectiveness of a psychosocial intervention programme on caregiving burden and self-reported QOL of primary caregivers of women with breast cancer in Abuja, Nigeria. The main objective was to evaluate the effect of the psychosocial intervention on caregiver burden and caregiver QOL. The control group received routine care which was offered by the hospital, such as 24-h phone calls, if required by the caregivers. The nurse on duty also provided psychosocial support, such as counselling. The psychosocial support was ad hoc and as needed but not regular. 2.2. Quality of Life of Primary Caregivers of Women with Breast Cancer

Intervention group The intervention group received the psychosocial intervention programme in addition to routine care, which included counselling, if required by the caregivers. The routine care did not overlap with the psychosocial educational programme being tested in the study. The intervention was adapted with permission from the following materials: Supporting a person who needs palliative care: a guide for family and friends (Hudson and Hudson, 2012) and the National Cancer Institute, United States Department of Health and Human Services (National Cancer Institute, 2012). 1.1. Conceptual framework This study was guided by Lazarus and Folkman’s transactional model of stress and coping, which has been advocated as a useful framework to guide caregiver research (Hudson et al., 2004). The model is useful, as when people are faced with a stressor such as breast cancer, they experience appraisal processes which, in turn, direct their adaptation to the stressor. If they cannot adapt, it affects their QOL. This framework provides a testable theoretical approach to assessing change in QOL. The theoretical model depicted in Fig. 1 was used to clarify and predict changes in perceived QOL that Results from the interaction of these factors. The variables identified in the model are significant predictors of outcomes in primary caregivers, and therefore provide a strong conceptual basis for an intervention designed to improve QOL. 2.3. Psychosocial intervention programme The intervention programme, held at a venue in the Oncology Unit of the hospital, was coordinated by the researcher. It comprised six face-to-face sessions (once a week for six weeks) delivered by four research assistants (registered nurses who were trained by the researcher in the ethical conduct of research, and their roles in the study process). Each session was 90 min in length; a presentation of thematic content followed by questions and discussion. Each session had a specific theme: • Introduction and essential information about breast cancer • Adjustment to the role of caregiver • Communication strategies to prevent misunderstanding and promote positive interaction between caregiver and patient • Dealing with the emotional aspect of caring • Self-care: its importance and strategies to promote self-care • Practical care information relating to the management of common 2.Quality of Life of Primary Caregivers of Women with Breast Cancer

Methods A quasi-experimental study with pre- and post-test measures was conducted from August to November 2016, at the National Hospital, Abuja, Nigeria. Two post-test measures were obtained at six and 12 weeks from baseline. A convenience sample of primary caregivers was recruited in the outpatient clinic at the National Hospital in Abuja, Nigeria. The inclusion criteria were: adults of age 18 years or older, caring for a person with breast cancer and literate with a minimum of nine years of schooling. The care recipient (referred to as the patient in this study) was expected to have at least a six-month survival prognosis. Exclusion criteria were: professional health caregivers, as their knowledge and information could influence their participation and caregivers who, at the time of the study, were receiving treatment for breast cancer or a condition which increased their physical and/or psychological vulnerability. symptoms and dealing with the patient’s emotions. Questions from caregivers focused mainly on hereditary aspects of breast cancer, prognosis and the types and processes of treatment. At the end of each session participants were provided with an information package relating to the session theme. Fifty-one participants in the intervention group completed programme. Due to the severity of their patient’s illness, three intervention group participants did not complete the programme. Fifty-two participants in the control group completed the post intervention assessments. Caregiver burden and the caregiver QOL were assessed at baseline (before the commencement of the psychosocial intervention programme), at week six (at completion of the Fig. 1. Theoretical model of factors affecting primary caregiver QOL. In the above model, bold arrows indicate direct effects of psychosocial intervention on the appraisal factor and QOL, while lines indicate significant relationships among …Quality of Life of Primary Caregivers of Women with Breast Cancer