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DPIPEF04 Cancer Epidemiology Question: Write about breast cancer (The Effects of Psychoeducation and Telephone Counseling on the Adjustment of Women with Early-Stage Breast Cancer). Answer: According to the global cancer statistics, the cancer that is most frequently diagnosed among women is breast cancer. In the developing countries, its prevalence is higher in comparison to the less developed countries. Adjuvant therapies have been used to addresses breast cancer, however the patients often experience manifestations that are sue to the primary disease of the treatment of the disease (Matthews, Grunfeld & Turner, 2017). Simultaneously they face several symptoms which are psychological in addition to the physical symptoms. This paper aims to implement such evidence based practise models into clinical interventions or practices, thereby conduction of translational research. Randomized clinical trials were conducted in order to examine the factors of emotional, physical and social adjustments. This was particularly in the women who received psychoeducation in the form of video and counselling through telephone. Interventions in terms of psychosocial support can be implemented to provide assistance along with encouragement to the individuals who are facing physical or emotional disabilities as a result of breast cancer (Agboola et al., 2015). The quality of life is an important aspect that needs to be considered before implementation of the evidence practices in the form of interventions of clinical practise. Provision of telehealth has emerged as a popular model of supportive care delivery for the patients suffering from cancer. Telehealth is involved in provision of opportunities to the patients in terms of long-term monitoring along with health education and coaching (Jones et al., 2013).  The intervention also provides modification of behaviour along with sharing of health information with the carers who are involved in caregiving. Several studies were conducted in conjunction to the telephone based interventions which showed that these interventions involved professional interventionist comprising of the nurses, the psychologists and the counsellors (Matsuda et al., 2014). Some of these telephonic interventions also involved use of an automated voice response that was used along with the personnel providing life support.   The implementation of the theoretical framework of Stress and Coping Model and the Crisis Intervention Model helped in the transition of the evidence based model into practise. According to the given model, cancer is viewed as combination of loss, threat and challenge (Sherman et al., 2012). In view of this implementation model, the main focus is on the prevention of crisis by increasing the amount of physical adjustment and emotional adjustment along with role performance. In addition to this, there is perceived social support and the overall health status. The telephone counselling intervention is involved in addressed the particular needs of patients who are experiencing breast cancer. This is done through the assessment of the phase-specific perceptions and emotions of the patients. Secondly by clarifying the questions related to the medical treatments, procedures, and its various side effects. Thirdly by exploring the efficacy of the social supports. Lastly it is done by assessing the effectiveness of the mechanisms used for coping (Mustafa et al., 2013). Studies showed that implementation of this evidence based practise into use in the clinical filed showed that the efficacy of pain education can be increased in using telemonitoring. A randomised controlled trial showed that the nurse specialists provided the patients with video-assisted educational material in both arms which was only pain education and pain education along with telemonitoring. There was a daily telemonitoring carried out for the first week in the experimental arm. This showed that there was a significant amount of improvement in the pain as well as in the depression outcomes as compared to the borderline data. Another case of implementation of the intervention model into practise was seen from the study of Pérez et al., (2014), where a sample population of cancer patients were randomised into three arms, which consisted of the two intervention arms and a single passive referral arm. In the case of the active referral arms, the professionals referred the individuals to a Cancer Helpline actively. In the case of the Active Referral-4, it was seen that the patients were receiving calls through the helpline within one week of diagnosis and additionally at 6 weeks, a period of 3 months and also 6 months post diagnosis. While in the case of the Active Referral-1 arm, the patients were receiving call only once within 1 week of diagnosis. However in the control arm that is the passive referral, the patients were being referred to contact the Helpline by taking their own initiative. These telephone helplines were being developed by various cancer organizations which are customised to provide information to the needs of the cancer patients along with provision of support, and referral to supportive service. Another study showed that in a trial conducted, a sample population of cancer patients were randomly assigned to an intervention group out of which some were to receive intervention care while others would receive normal care. Patients who were in the intervention group received telecare management that was centralised. The care was received by a nurse-physician specialist team along with an automated home-based symptom monitoring through the interactive voice recording or online (Jassim et al., 2015). The study reported that the intervention helped in improved outcomes of pain and depression in cancer patients who were to receive the intervention care.  According to another study, reports suggested that the integration of evidenced-based psychosocial interventions in clinical cancer care is of significant importance. A meta-analysis highlighted that cognitive behavioural therapy was seen to be quite consistent with the most effective psychosocial intervention that promotes improvements in anxiety, depression and the quality of life (Jones et al., 2013). However from the above studies it was perceived that the individuals who received telephone counselling showed lower levels of emotional adjustment along with discussion on personal level. It was related to their cancer experience, in addition to provision of an outlet for their concerns. This might not allow the opportunity to move health-related concerns to the background. References Agboola, S. O., Ju, W., Elfiky, A., Kvedar, J. C., & Jethwani, K. (2015). The effect of technology-based interventions on pain, depression, and quality of life in patients with cancer: a systematic review of randomized controlled trials. Journal of medical Internet research, 17(3). Jassim, G. A., Whitford, D. L., Hickey, A., & Carter, B. (2015). Psychological interventions for women with non-metastatic breast cancer. Jones, J. M., Cheng, T., Jackman, M., Walton, T., Haines, S., Rodin, G., & Catton, P. (2013). Getting back on track: evaluation of a brief group psychoeducation intervention for women completing primary treatment for breast cancer. Psycho?oncology, 22(1), 117-124. Matsuda, A., Yamaoka, K., Tango, T., Matsuda, T., & Nishimoto, H. (2014). Effectiveness of psychoeducational support on quality of life in early-stage breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Quality of Life Research, 23(1), 21-30. Matthews, H., Grunfeld, E. A., & Turner, A. (2017). The efficacy of interventions to improve psychosocial outcomes following surgical treatment for breast cancer: a systematic review and meta?analysis. Psycho?oncology, 26(5), 593-607. Mustafa, M., Carson?Stevens, A., Gillespie, D., & Edwards, A. G. (2013). Psychological interventions for women with metastatic breast cancer. The Cochrane Library. Pérez, M., Sefko, J. A., Ksiazek, D., Golla, B., Casey, C., Margenthaler, J. A., … & Jeffe, D. B. (2014). A novel intervention using interactive technology and personal narratives to reduce cancer disparities: African American breast cancer survivor stories. Journal of Cancer Survivorship, 8(1), 21-30. Sherman, D. W., Haber, J., Hoskins, C. N., Budin, W. C., Maislin, G., Shukla, S., … & Rosedale, M. (2012). The effects of psychoeducation and telephone counseling on the adjustment of women with early-stage breast cancer. Applied Nursing Research, 25(1), 3-16.

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