Critical Review: Nursing's Role in Holistic Cancer Patient Support

This literature review critically appraises ten primary research articles focusing on healthcare, specifically the role of nurses in providing effective care and support to cancer patients. The review identifies a common theme of patient-centered care using a holistic approach, emphasizing quality care from the perspectives of patients and caregivers. It examines various settings, primarily hospitals in the UK and Singapore, and considers ethical issues such as patient confidentiality and voluntary participation. The analysis covers qualitative and quantitative studies, including randomized control trials and systematic reviews, highlighting the importance of addressing unmet needs in supportive care, including psychological, sexual, and health-related concerns. The findings underscore the significance of psychosocial care, family support, and the multifaceted role of nurses in palliative care, emphasizing the need for improved communication, decision-making involvement, and symptom control to enhance the overall quality of life for cancer patients and their families.

Running head: HEALTHCARE
Topic: HEALTHCARE
Name of the Student:
Name of the University:
Author Note:

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Introduction
Literature review
This assignment would highlight the various issues related with the provision of
effective care and support to patients suffering from cancer. The first article involve a
comparison of the hospice in patient care along with hospital care among the cancer patients
in the areas of UK (Hall and Callaghan 2009). This study have been done on the viewpoint of
bereaved relatives. The main aim of the author have been directed at comparing the various
types of hospice care as well as hospital care for the cancer patients. The author has done a
comparative study based on the clinical settings in UK based on the responses of the relatives
who have lost their members. The research methodology have been qualitative, based on the
responses of the patients through a manually prepared questionnaire. The inclusion criteria
has been the patients who have received inpatient care as well as hospital care. The analysis
of the responses have been done through SPSS. The first article focuses on the fact that there
have been significant differences in the responses of the patient who have received hospice
care and both forms of care. The second article would be directed at discovery of the care
needs of the patient which has not been met especially those suffering from prostate cancer.
In the second article, a quantitative design has been followed taking the sample of 1000
people coming from various European countries (Hearne et al. 2013). There has been a
usually quantitative analysis study involving primary data sources. The conclusion given by
the author claims that supportive care have been unmet among the patients suffering from
prostate cancer and this is in alignment with the research findings of the first author which
also establishes a marked difference in the kind of care given to the cancer patients. The third
and fourth article explore the various role of nurses in the provision of implementing an
effective care plan and support for deleting or reducing the barriers faced by the patients in
the kind of care given (Dilwrth et al. 2014). For establishing the variegated role of nurses in

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cancer care, multicenter as well as randomized non inferiority trial as well as non-inferiority
trails have been done while the fourth article have done a qualitative study (Fan et al. 2014).
Both the articles have found loopholes in the care delivery system and have given
recommendations for improvised nursing care. Although the third article suggest a telephonic
way of conversation for follow up, the fourth author have found a significant barrier among
the unmet needs of the people suffering from cancer and the kind of care given to patients in
hospital settings. The fifth article in as exploratory descriptive study for investigating the
experiences of the nurses in the concept of palliative care especially among the acute care
units in Singapore (Chuah et al. 2016). Among the sample of only 24 nurses, an inductive
concept analysis have been done through the implementation of focused group interviews. In
this study, the author have found that the research topic including provision of care has been
supported by the nurses.
The sixth and seventh articles have been compared and included in a similar issue of
provision of care to oncology patients. The sixth article includes the varied role of nurses for
overcoming various issue among patients at the end of care before dying. Moreover the
seventh article is revolving around the enhancement of nursing care among the oncology
units for the provision of quality services pertaining to healthcare to patients (Boele et al.
2013). Ethno graphic studies have been done along with randomized control trials for the two
articles. The comparison between the research statements by the authors come to the
conclusion that nurse led chemotherapy could be a contributing factor which would
ultimately reduce the impact of the care given to the patients. Moreover, in contrast to the
negative effect of the care given to the patients, the seventh article have led to the conclusion
that there is job satisfaction among the nurses where there is the presence of clinical skills
along with awareness. The eighth, ninth and tenth articles have been revolving around the
roles of the nurses based on the counselling techniques and interventions given by them based

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on the health of HNC patients. Moreover it would deal with the identification for the desire
of the patients for overcoming the various issue faced by cancer patients. From the
amalgamated findings of the three authors it can be understood that the three articles focus on
the role of nurses regarding the curative care of the patients especially during the need of care
(Vander meulen et al. 2014). From the literature review of the ten articles, the common theme
of patient center care using holistic approach for nurses can be determined for the provision
of effective care and support for the patients suffering from cancer. Moreover the concept of
quality care from the viewpoint of the patients and the caregivers have been discussed in the
article for providing effective quality care to the patients.
Setting/ Design-
Most of the articles have been done in clinical settings among hospitals in UK. The
fifth article has been base among the hospital settings of Singapore. Among the palliative
care unit. Among the various areas in UK the last articles have been based among a palliative
setting. The third article have been conducted in a palliative care unit. The seventh article has
been among various oncology units in UK. Thus it can be understood that the studies
pertaining to cancer has been done in various hospital setting specializing in either palliative
care or vivid medical conditions of the patients (Kelly and Morrison 2015). Fifth, sixth, ninth
articles have been based on the qualitative studies regarding the research done in UK.
Qualitative articles are important in article analysis as they would help in providing useful as
well as valuable data regarding the use of various designs of products. Moreover qualitative
studies would help people in provision of various behavior patterns the needs of the user
along with the use of various cases (Wilson et al. 2016). Qualitative researches are usually
important for the attainment of deep understanding of specific organization of events.
Moreover it provides detailed information rather than superficial description of a population
(Silverman 2016). Moreover it is useful in the provision of useful order structure as well as

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broader patterns among the studies done in a particular population group (Brannen 2017).
Thus the authors have been successful in providing a detailed description of the research
thesis revolving around the provision of care to cancer patients among hospital settings
(Bahrami and Arbon 2012).
Population/Sample
From the paper which has been reviewed it can be understood that authors have
mainly recruited various nurses in nursing programs. In most of the papers the sample,
patients suffering from cancer has been chosen. In the first article studies have been among
the population of 40 patients in UK hospitals. In the second quantitative article, a sample of
1000 people have been done especially the people suffering from prostate cancer. Similar in
the findings of other studies people have been taken for the study who are patients suffering
from various forms of cancer. However the studies of the fifth article and further articles
onwards, the studies have been conducted form the responses of the nurses in the hospital
settings. Moreover, the responses of the non-participants have also been taken. The seventh
article explores the concept of nursing care from the perspective of the nurses through
randomized control surveys. Furthermore different studies like qualitative ones have been
done also with 72-90 nurses in the following studies through the assessment of manually
prepared questionnaires. Thus it can be seen that 6 articles that is from the fifth to the 10 th
articles, qualitative studies alongside randomized controls have been done among the nurses
and their experience and over views have been noted. However in the first few articles,
patients suffering from cancer has been interviewed and their responses have been recorded
(Hui et al. 2015). Most of the articles considered for comparison have been based on the
results of primary data. Most of them have been semi-quantitative analysis through manual
interview and questionnaires. Thus the choice of the sample has been considered. There are
various advantages due to which researchers which allows them. Moreover semi structured

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interviews helps in providing comparative as well as reliable data and further helps in two
way communication. According to the findings of (Siegal, scientist and Joemal 2015) the
sample size should be adequate for prevention of the errors. Moreover the consideration of
sample size should be done in a way that the scattering of the data is done properly for
accurate measurement for statistical analysis (Silverman 2018).
Ethical issues
Ethics and ethical principles are important components of a statistical study. There is
involvement of the unique as well as legal and various political considerations for conducting
research studies. Ethics based on research studies are analysis of various ethical issues which
are usually raised and often involved among the people who have been in the study (Conelly
2014). In the first article the author has clearly mentioned the voluntary participation of the
subjects during the study. Letter have been mailed to the participants in the study and details
of the research to be conducted before their participation. Many people have been unwilling
and thus have been not concluded which claims that the study has been voluntary. In the
second study also voluntary participation has been done and research studies has been
conducted with the prior information to the subjects. Various studies has been systemic
researches where an amalgamation of research papers and various inclusion and exclusion
criteria has been considered thus not requiring any ethical consideration. In most for the
papers the proper consent of the patients have been taken and their personal information has
not been disclosed thud maintaining patient confidentiality.
Findings/Results
Systematic reviews includes various systematic literature methods which have been
based on secondary data (Boell and Kecmanocvich 2015). It includes critical appraisal of the
research studies and would ultimately lead to the synthesis of finding through with qualitative
or quantitative results of the design of a systemic review which is aimed at provision of a

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complete as well as exhaustive summary of current evidence which is usually relevant to
research question (Gough, Oliver and Thomas 2017). From the results of the first article it
can be understood that various aspects affecting the opinion of the patients whose family
members have been deceased include information as well as communication, involvement in
decision making, symptom control as well. All the articles have been in alignment with the
research statement and findings of the author where maximum percentage of people have not
received supportive care including sexual, health psychological needs (Kelly, Hawick and
Greenhalgh 2015). Over all from the studies of the authors it can be understood that the
common theme of emergence of the psychosocial care have been included through diseases
related events along with family support. Moreover the basic theme of provision of
psychological care to the families. Thus the theme of provision of care and support to the
families has been elucidated clearly through the findings of the authors (Temel et al. 2017).
For the fourth article, it can be seen that there is the emergence of various theme which have
been mentioned clearly. From the various focus interviews the theme of the nurse’s
perception of palliative care along with multiple role of the nurses in palliative care have
been explored. Moreover the misconceptions of palliative care along with various challenges
in the provision of palliative care can be seen (Zimmerman et al. 2015). From the qualitative
studies various research concepts have emerged from the studies of the researchers which
involves patient care giver characteristics, along with influence of the effects of various
interventions (Hui et al. 2014). Thus from the systemic review of the following articles
various themes have emergence in accordance of the research question and has been in
alignment for the kind of care given to the patients suffering from cancer.
Key advantages of the papers
The theoretical framework which has been considered for the following studies
include critical appraisal skills tool where the findings are evaluated on truth as well as false

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of the findings. Moreover the conduction of RC are randomized controlled trails are
important as poorly reported trails RCT have been not been useful and have led to
compromise of the research integrity especially during false credibility of the results (Burls
2014). Critical appraisal is a process which is inclusive of careful and systemic examination
of research evidence which would be useful in the judgment of the trustworthiness of the
results (Wood and Haber 2015). Moreover the CASP tool have been used as is mainly helps
in guiding the skills of the healthcare professionals regarding the determination of the
evidence during cases when the results are either true or false (Mclean et al. 2015). Moreover
the relevance of the information to the patents is important for the patients and their
subsequent assessments. Thus in the systemic review the studies have been based on the
following tool which have focused clearly of the research question of the provision of care to
the patients especially suffering from cancer.
Discussion
Discussion is an important part of critical appraisal which gives the researchers idea
about the research theme and topic being undertaken and justifies the research methodologies
along with the results and findings (Merrian and Griener 2019). Research themes are very
important as they define various recurring data various topics as well as subjects which
usually appear in statistical works. There are various research themes usually helps in
revealing the actual emerging concept from the discussion of the studies and would be useful
in simultaneous formation of analysis as well as insights (Burns, Bush and Sinha 2019). From
the critical analysis of the ten articles related to cancer, hospice in-patient care has been
highlighted where it has been proved to give better management of cancer pain as compared
to hospital care as it improves the communication of care provider with patients and their
relatives (1). (10) In his study found that nurses take idea about the patient while
communicating with patients rather than using quality of life assessment (Boddy 2016).

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Therefore, there is great need to train nurse to develop holistic relationship with the patient to
give palliative care. This finding is in disagreement with finding of (1). Related to the
nursing care, it was known that men suffering from prostate cancer needs psychological,
health system and related information which is part of treatment factors and supportive care
(2). Such psychological intervention is met by the supportive nurse and said informal care
giver are infective in assessing the patients. The finding hold great disagreement with (7)
whose finding recognized the importance of informal caregiver in providing psychological
intervention. This will help in maintaining the mental health of the patients. Psychological
care in the important part of cancer management which require emotional and family support
(4). The palliative care given helps to improve the health of cancer patient. The result is in
disagreement with result of Anney (2014) where the author found that establishment of
palliative care is most challenging because of factors like deficient in trained nurse and nature
of the patient and family. The finding was quite in relationship with the (3) where the author
have recognized various barrier to delivery of psychosocial care by the nurse. Patients are not
receiving information and effective communication about the psychosocial care related to
treatment plan. Thus, there is the need to improve the communication skills of the nurses. In
order to challenge such issue (8) Found that with effective counselling of the nurse regarding
the care of cancer patient after therapy has resulted in improved emotional, pain, social
contact and depression levels.
From the finding of the (6) district nurse has the role in giving dying news as they are
the one who are with the patient in the last days of the life. For this they need crucial tailored
training as part of their work. (9) Founded the desire to die is seen in the patient who is
receiving palliative care for treatment of cancer. Author found that it is not necessarily the
sign of mental health problem as they may suffer from the distress which can be due to

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physical health or social consequences. Therefore, nurse need to encourage the patient to
tackle their depression and anxiety which aroused because of painful cancer treatment.
The strengths and weaknesses of a systemic analysis are a pivotal part of the
comparison. The weaknesses of the article are inclusive of major downfall or shortcomings of
the research study involving the research design, the methodologies and the comparisons of
the results and findings. Since a critical analysis is inclusive of the main findings of the paper
written n lucid way, the understanding of the reader or the researcher is one of the biggest
strengths of the paper. Research methodologies are important as they are used for data
collection as well as information for the process of decision making. Research methodologies
are inclusive of surveys, research interviews for semi quantitative methods along with the
justifications of research techniques. On examining the research article, the major strength
found in the papers that the finding in each of the paper is generalized and selection process
is designed well. It was easy to analyse the data as it was consistent, detailed and reliable.
Some of the paper were having quantitative data, authors have given detailed information
about the topic in order to explain the complex finding. The method of collection of data used
is cost effective. Though there are some of the strength of the paper, major limitation has
been noted in some of the articles. There was having some difficulty in understanding the
context of the occurrence. Some of the data was difficult to analyse and get confirm result.
The research methodology used is time consuming and depend on the role of the researcher
to draw result on their finding. In few paper the sample size taken was less in number which
has made the result uncertain.
My experience in finding the article was quite stressful as I was limited in time.
However limited time has been compensated with the available resource that I was hiving.
This has ease my finding of the result from the research articles. I was able to well manage
my access to the literature by analysis it critically. I used keyword and search term to get

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faster result. I have also take the article of limited time period. This effort of mine has helped
me to find good quality of research article. Thus from the following paragraphs it can be
understood that there are various limitation of the study which should be avoided for effective
interpretation of the results.
Conclusion
From the findings of the authors of the studies involving qualitative along with
quantitative studies, the main research theme has been explored. The systemic analysis of the
articles which has been considered have been taken on the basis of the provision of care and
support given to the patients suffering from cancer. There has been various inclusion and
exclusion criteria for the development of the concept. The topic of the nurse in provision of
supportive as physiological care has been considered. In the first few papers, the concept of
care and support has been achieved form the perspective of the patients suffering from
cancer. The next of the articles have been aimed at exploring the concept of care holistic
approach and support from the perspective of thee nurses. Nurses have been found for writing
recommendations inclusive of information which should be confidential. Thus various verbal
as face to face conservations have been useful in increasing the communication abilities of
the patients. Most of the articles have been undertaken in UK in a generalized hospital
setting. Moreover the sample population has been variable, ranging from the patients
suffering from cancer to the nurses who have been at the oncology ward and responsible for
the effective care and treatment given to the patients. Most of the findings of the authors have
detected a significant gap in the idea of provision of care along with the duties of the care
giver. There has been a distinct gap in communication which has affected the nurse patient
relationship. Apart from a holistic care approach, along with an effective care plan and
effective communication skills, nurses should have the basic knowledge of providing support
and care to the patients along with their effective treatment.

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