University Case Studies: Midwifery Care and Breast Cancer Treatments

This document presents two case studies. The first, focuses on the experiences and wishes of women regarding systemic aspects of midwifery care in Germany, exploring their perspectives on access, availability, and the overall healthcare system. The study utilized qualitative research methods, including focus groups, to gather data from pregnant women and mothers. The second case study investigates mindfulness meditation for younger breast cancer survivors, examining its impact on stress, depression, and inflammatory activity. This randomized controlled trial assessed the effectiveness of a 6-week mindfulness-based intervention. The study analyzed the psychological, physiological, and biological outcomes, highlighting the potential benefits of mindfulness practices for this vulnerable group. The results of both studies are discussed in detail, providing valuable insights into women's health and healthcare practices.

Running head: CRITICAL EVALUATION
Critical Evaluation
Name of the student
Name of the university
Author’s name

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CASE STUDY 1 - Experiences and wishes of women regarding systemic
aspects of midwifery care in Germany (625)
This case study is focused on the view of the midwifery treatment of pregnant women and
adolescents that is essential for their proper service and research. In Germany, there is a thorough
strategy to higher knowing the requirements of women in pregnancy, labour, maternity and
postpartum cycle until weaning is missing. International studies provide some understanding of
the perceptions of women, their decisions, and individual requirements that indicate excellent
midwife practice. The objective of the research element described here was to define the
behaviours, wants and desires of pregnant females and mothers concerning the structural aspects
of midwife treatment in Germany.
DESIGN
This qualitative exploratory research proposal was intended per the hermeneutic strategy of
Gadamer, which seeks at a broader, more profound comprehension of other people's views.
Pregnant women and mothers who had given birth in Germany in the previous year were
"participants" in the research; no other requirements were implemented as respondents with a
broad range of features were deliberately requested. Women would only be barred if they could
not talk and comprehend German adequately. This was achieved through an accessible strategy,
focusing on the other as a topic of practice, a constructive dialogue between the study group, and
an explanation of each phase in the compilation and evaluation of information. First, the
conceptual discussion focused on the opinions of each group member on midwifery treatment in
Germany for pregnant females, labour and newborn females, and postpartum mothers. This gave
a "picture," and thus the consciousness of personal preconceptions, and enabled clear reflection

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and analysis of the feelings of the respondents. Secondly, during the research session meetings,
perception and approachability were called for: the investigator permitted the females to relate
their opinions without disruption and to interact with each other without constraints. Third,
through a thorough iterative method in data analysis, comprehensive and context-related
knowledge of the feelings, behaviours and beliefs of the respondents was directed at.
METHODOLOGY
The objective of the full research study was to define the perspectives, desires and needs of
pregnant women and mothers in Germany that were of top priority for them in terms of midwife
care. Thus, empirical information was to be produced in an accessible and comprehensive
methodical strategy that could function as a point of reference for the growth of a women-
oriented national midwifery study strategy in Germany in the future. The entire initiative
included women's target communities (as midwife practice participants) and midwives (midwife
care professionals). As a significant quantity of information has been gathered and analyzed, this
will concentrate on structural elements of midwife treatment as elevated by pregnant females and
mothers. Systemic facets involve midwife care methods within the German medical system, such
as exposure, accessibility and midwife care design, decisions provided based on national rules
and regulations, and midwife care facilities as a component of interprofessional maternity
coverage.
ANALYSES
Interviews with the focus group and data analysis were conducted in parallel after four focus
groups were conducted and analyzed. A team member translated the focus group panel
discussions, and each focus group mediator then paid attention to the digital recording file to

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double-check the tape recording. It was found that the most appropriate passages were those in
which women psychologically linked their midwife care perspectives, had fascinating
discussions about some respects or extended on them in more context. The aim was to condense
the accounts of the respondents without missing important contextual information of the
associated events. The quality management measures initiated to enhance the ’outcomes’
relevance were: autonomous analytical measures, group discernment procedures, and many
verifications. For two purposes, in comparison to individual interviews, the rhythm of
presentation in a focus group was collaborative and more haphazard and citing lengthier
scriptures were beyond the bounds of this analysis, and that’s why the study participants were
not mentioned in the results of the study. The assessment led in three prevalent conceptual topics
involving the perspectives and desires of women and their apparent shortcomings and
discrepancies concerning structural elements of midwife practice in Germany. They were the
midwifery care expertise or absence of awareness, entry and accessibility of midwives, and
midwifery practice in the health care system. No acknowledgement of "frequency" (e.g. "some"
women) was offered in the following case study, and the particular word "women" was used as
the inherent emphasis was not on individual people but perceptual information in regards to
background.

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CASE STUDY 2 - Mindfulness meditation for younger breast cancer
survivors (625)
This case study is based on the group of premenopausal women who have been diagnosed with
breast cancer. This study tries to analyze the risks of psychological and behavioral disturbances
after the cancer treatment. A short carefulness-based action demonstrated preliminary short-term
effectiveness in decreasing stress, cognitive signs, and pro-inflammatory signals in older victims
of breast cancer. Breast cancer is the most prevalent form of cancer seen in females and the
major trigger of mortality in females under the age of 55. About 25 per cent of cases of breast
cancer occurs premenopausal. Younger females report enhanced psychological pressure and
anxiety, exhaustion, sleep disruption, and vasomotor symptoms following diagnosis of cancer
compared to elderly females in empirical research. Despite the fact that a high level of distress is
happening in the young females, a limited amount of interventions have been found for the
adolescent survivors fighting the breast cancer. In fact, only two nonpharmacological
randomized controlled trials focused on young females were recognized. Therefore, approaches
are needed that directly address this susceptible group's emotional and physical requirements.
DESIGN (200)
This study was conducted in the UCLA Medical Center, Los Angeles, CA between the March
2011 and October 2012. The UCLA Institutional Review Board approved study procedures, and
written informed consent was obtained from participants.
Participants were enlisted via requests to women registered in an initial study, 28 invitations to
physicians, and recruitment on the Internet. To ascertain eligibility, interested females finished a
telephone test. Some incorporation conditions were used to select initial respondents, such as

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females who were identified with stage 0 – III breast cancer at or before age 50, and who
finished local or adjuvant disease treatment (except hormonal treatment) at least three months
earlier. The researchers selected women up to 10 years after cancer treatment, as there was no
chosen time limit to the requirements and advantages of stress administration. There have also
been some rejection standards such as reoccurrence of breast cancer, metastasis, or other
diagnoses of cancer (except for non-melanoma skin cancer); effective, an unregulated medical
disease that could affect inflammation; and are unable to contribute to action.
METHODOLOGY (200)
A randomized controlled trial was used in this case study that offered an assessment of a brief
carefulness-based intervention for young breast cancer survivors aimed at reducing stress,
depressed mood, and inflammatory event. A 6-week duration Mindful Awareness Practices
(MAPS) approach (n = 39) or a wait-list control (n = 32) was randomly selected to women who
have early-stage breast cancer before age 50 who had undertaken treatment for cancer.
Respondents conducted pre- and post-intervention surveys to evaluate pressure and depression
symptoms (initial conditions) as well as physical ailments, cancer-related discomfort, and
positive results. Blood tests were obtained to investigate inflammation indicators that are
genomic and flowing. At a three-month follow-up, respondents also finished surveys.
ANALYSES (200)
This study aimed to assess the viability and effectiveness of a brief carefulness approach on
mental, physiological and biological consequences between many survivors of breast cancer
diagnosed at or before age 50 years. The procedure was well adhered to, with an attendance rate
of 87%. The 6-week operation, relative to wait-list command, resulted in significant changes in

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apparent stress and a tendency towards enhancement in depressive behaviours, both active in this
community. The operation also resulted in improvements in fatigue, sleep disruption, signs of
menopause, and beneficial psychological procedures. Mindfulness also resulted in substantial
decreases in the activity of pro-inflammatory genes and pro-inflammatory binding
bioinformatics. Although the operation did not lead in modifications in inflammation plasma
concentrations, post-treatment females in the mindfulness category who exercised more often
demonstrated reduced levels of interleukin 6 (IL-6). This study's constraints include the
comparatively tiny sample, which reduces statistical validity to detect statistically relevant
connections between the expression and the approach of any gene transcript.

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REFERENCES
Bower, J.E., Crosswell, A.D., Stanton, A.L., Crespi, C.M., Winston, D., Arevalo, J., Ma, J., Cole,
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S.W. and Ganz, P.A., 2015. Mindfulness meditation for younger breast cancer survivors: a
randomized controlled trial. Cancer, 121(8), pp.1231-1240.
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