Evidence Based Nursing Research: Yoga in Cancer

Running head: EVIDENCE BASED NURSING RESEARCH: YOGA AND CANCER
EVIDENCE BASED NURSING RESEARCH: EFFECT OF YOGA IN IMPROVING
QUALITY OF LIFE IN CANCER PATIENTS
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EVIDENCE BASED NURSING RESEARCH: YOGA IN CANCER1
Part 1: Introduction
As per the Standards of Practice postulated by the Nursing and Midwifery Council
(NMC), Registered Nurses are obliged to deliver patient care interventions, assessment
procedures and health educational materials which are ‘evidence-based’ or compliant with the
best and highest standards of evidence and research (NMC, 2015). ‘Evidence-based practice’
(EBP) is the name given to clinical practices, interventions and procedure which have developed
and are followed based on valid and significant scientific research. Engaging in extensive EBP
assists nurses to deliver interventions which are valid, pose the lowest risk and have been
researched to induce beneficial patient healthcare outcomes in the future (Horntvedt, Nordsteien,
Fermann & Severinsson, 2018).
Thus, considering the same, the following paper will comprise of critically evaluating the
effectiveness of a clinical practice which can improve the quality of life of adult patients, with
the help of screening and appraising an evidence-based research. The clinical practice upon
which an evidence based research will be selected is the ‘effectiveness of yoga in improving the
quality of life in adult patients with cancer.’
Part 2: Research Background and PICOT
Rationale
‘Psychosocial morbidity’ is the condition characterized by loss of psychological and
social wellbeing in individuals as a result of chronic illness, sickness, diseases and injuries.
Psychosocial morbidity is a frequent occurrence in patients who are well aware of the severity of
their disease and illness condition. It is thus common to find cancer patients encountering
psychosocial morbidity after experiencing chemotherapy, surgical and radiotherapy interventions

EVIDENCE BASED NURSING RESEARCH: YOGA IN CANCER2
resulting in frequent reporting of feelings of anxiety, depression, loss of ability to work and
dysfunction in social engagement (Caruso, Nanni, Riba, Sabato & Grassi, 2017). The adverse
metabolic consequences and associated loss in quality of life are major contributors to loss of
psychological and emotional wellbeing after cancer, which is why, cancer patients have been
evidenced to demonstrate an eagerness to regain their previous sense of empowerment, control
and responsibility over their own personal lives, their mindset and decision-making and the lives
of their loved ones and families (Matthews, Grunfeld & Turner, 2017).
With this respect, it has been evidenced that a growing number of cancer patients are
expressing an interest towards alternative and complementary therapeutic based interventions,
due to their ability to induce relaxation, spiritual wellbeing and mindfulness. Traditional
psychosocial and behavioural therapeutic interventions such as group therapy or cognitive
behavioural therapy (CBT), have been evidenced to enhance a sense of sharing, problem solving,
reasoning, support, a sense of responsibility and control, which in turn, contribute to reduced
feelings of distress and psychosocial morbidity and improved coping, mood, adjustment and
vigour in cancer patients (Eyigor, Uslu, Apaydın, Caramat & Yesil, 2018). However, despite
these benefits, such traditional psychosocial interventions do not consider factors like spiritual
wellbeing and enhancement of skills of self-awareness and mindfulness. While additional
interventions like physical exercise have also been evidence to yield improved physical as well
as psychological outcomes simultaneously, the presence of cancer related fatigue and the
debilitating physiological effects of radio or chemotherapy, imply that the effectiveness of
exercise is greatly subjective as per cancer patients’ current health and disease status
(Raghavendra Mohan Rao et al., 2017).

EVIDENCE BASED NURSING RESEARCH: YOGA IN CANCER3
Yoga is a complimentary, body and mind based therapy, which has originated in India
and rapidly gained popularity in Western countries. Yoga has been traditional considered as a
beneficial therapy in ancient Indian cultures, for the treatment of a number of health conditions
which are largely associated with psychological distress and morbidity like hypertension,
asthma, diabetes, anxiety, cardiovascular diseases, cancer and musculoskeletal diseases. With the
help of a range of postural and breathing exercises (such as ‘asanas’), yoga has been evidenced
to improve breathing regulation, induce calmness and physical as well as psychological
wellbeing (Amritanshu et al., 2017). Such factors contribute extensively in improving an
individual’s skills of mindfulness, sense of awareness as well as self-control. Such skills have
been evidenced to alter perceptions towards internal and external stimuli, induce improved sense
of self-control and lower reactivity to situation perceived as stressful, challenging and
threatening to individuals. For this reason, yoga can be considered as an efficient intervention
which can improve the quality of life in cancer patients who encounter psychosocial morbidity
and perceptions of threat regarding their illness, especially after critical treatment (Danhauer,
Addington, Sohl, Chaoul & Cohen, 2017). Thus, the prevalence of psychosocial morbidity in
cancer patients, the limitations of traditional psychosocial therapy and the beneficial impacts of
yoga form the rationale and motivation behind the exploration of yoga as an effective clinical
practice for the purpose of quality of life improvement in cancer patients.
PICOT Grid
No clinical research and underlying question can be formed without a structured ‘PICO’
format, which comprises of components like: Population, Intervention, Comparison and
Outcome. A PICO question is a structure and systematic format via which a researchable, valid
and answerable question can be developed. A PICO question, due to its specific components,