#51108-Week 8: Signature Assignment – Evidence-Based Project Proposal MSN563
Breast cancer is the most common cancer diagnosed in women in the United States. Breast cancer can occur in both men and women, but it’s mostly common in women. According to the Mayo Clinic (2021), due to significant funding and research, it has brought about early detection of diagnosis and treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths associated with this disease is steadily declining, mainly due to factors such as earlier detection, a new personalized approach to treatment, and a better understanding of the disease. Substantial support for breast cancer awareness and research funding has helped create advances in the diagnosis and treatment of breast cancer (Mayo Clinic, 2021). Although the popularity of breast cancer awareness has gained momentum, breast cancer is the second leading cause of death from cancer in American women. (National Cancer Institute [NIH], 2021). Being well educated or having adequate information regarding the importance of being screened is still a priority to keep the disease in a declining state. We need to continue to increase awareness; we need to include awareness in education at multiple levels of learning for the community.
The goal of breast cancer screening is to detect breast cancer at an early stage before a person discovers a lump. Breast cancer is cancer that forms, multiples, and occurs in the cells of the breasts. These changes are detectable via screening, but to screen, we must also assess, and self-assessment is essential for early detection even when we are having our annual physical check-ups. We must be diligent and knowledgeable to consider one’s self. According to Pearlman et al. (2017), “Breast cancer risk assessment is very important for identifying women who may benefit from more intensive breast cancer surveillance; however, there is no standardized approach to office-based breast cancer risk assessment in the United States.” In which Pearlman et al. (2017) explained; This can lead to missed opportunities to identify those women at high risk of breast cancer and may result in applying average- risk screening recommendations to high-risk women. The article further discusses that; “risk assessment and identification of women at high risk allow for referral to health care providers with expertise in cancer genetics counseling and testing for breast cancer-related germline mutations (e.g., BRCA), patient counseling about risk-reduction options.” (Pearlman et al., 2017). In developing an educational-based approach, we can increase awareness of the importance of screening for breast cancer. We have the opportunity to build a standard risk assessment that can benefit the community we serve for early detection and potentially come closer to understanding how to control this disease than letting it control the lives of those affected.
The research project is to increase awareness of the benefits of breast cancer screening by developing an education-based approach that will provide appropriate information to understand the benefits and risks. Breast cancer screening aims to help find breast cancer early so that it is earlier to detect and treat.
Breast cancer screening, according to the CDC (2021), “means checking a woman’s breasts for cancer before there are signs or symptoms of the disease. All women need to be informed by their health care provider about the best screening options for them.”
“Most breast cancers are found in women who are 50 years old or older, but breast cancer also affects younger women. While breast cancer diagnosis and treatment are difficult for women of any age, young survivors may find it overwhelming. CDC is working to increase awareness of breast cancer and improve the health and quality of life of young breast cancer survivors and young women who are at higher risk of getting breast cancer.” (CDC, 2021)
This research project aims to understand the hindrances to be appropriately screened for breast cancer or identify the reasons why most women wait until late or only when symptoms occur to get screened or tested. The hypothesized problem, according to Augusta Health (2017), “is lack of information or misinformation, such as only older women need mammograms, they might find something, so instead, they avoid it or mostly are simply afraid of the exam hurting.”
The impact of increasing awareness of breast cancer screening is for every generation to feel comfortable opening up about the possibility and to raise awareness to remove the stigma attached to breast cancer. To advocate for ourselves by raising their question of when it is appropriate to get tested in their lifetime. This research project is beneficial and increases our understanding of ourselves and our bodies and proactively guides us to act for ourselves. We will see the betterment of our mental health when we control our health rather than letting any illness or disease take over. By providing an education-based approach to increase awareness of the importance of breast cancer screening, we are targeting different generational needs by identifying the most basic information across the board. They can understand the information and be able to make conscious decisions for the betterment of their health.
P- In patients informed of the benefits of screening I – how does early breast cancer screening
C – compared with those without appropriate information O – affect their choices for screening and testing
T – within two years of this proposed project of education-based approach
Breast cancer is the most common cancer diagnosed in women in the United States. Breast cancer can occur in both men and women, but it’s mostly common in women. According to Pearlman et
- (2017), “Breast cancer risk assessment is very important for identifying women who may benefit from more intensive breast cancer surveillance; however, there is no standardized approach to office-based breast cancer risk assessment in the United States. This can lead to missed opportunities to identify women at high risk of breast cancer and may result in applying average-risk screening recommendations to high-risk women”.
The literature review includes key terms or mostly known as a keyword, according to Davis (2021), “a significant word from a title or document used especially as an index to content.” Keywords should contain words and phrases that suggest what the topic is about. As for my research questions, these terms are essential to understand during the study appropriately.
Breast Cancer – as defined by the American Cancer Society (2019), Breast cancer is a type of cancer that starts in the breast. Cancer begins when cells begin to grow out of control.
Cancer Screening – according to the CDC (2021), it “means checking your body for cancer before you have symptoms.”
Educational approach – is a method to provide knowledge and information and develop the necessary skills and understanding for patients to make an informed choice about their health behavior at the appropriate timeframe in their life.
Awareness – defined by Merriam-Webster as “knowledge and understanding that something is happening or exists.”
High-risk – used as a medical term, refers to a group that is particularly subject or exposed to danger or has a more increased chance of being affected by either internal or external factors.
DeLano et al. (2016), In their article, discussed the lack of an appropriate screening program for women in an inpatient setting was identified by a nurse navigator. That detecting and preventing early is essential in decreasing a woman’s mortality from breast cancer. “The objectives of the project were to develop a simple assessment tool that screened 100% of patients upon admission to the inpatient setting to identify women over the age of 40 years who had not had a mammogram within the past 12 months.” (DeLano et al., 2016). Because of their project, DeLano et al. (2016) found out, “The problem being addressed is that women all too often forgo or avoid their yearly mammograms for personal reasons. The American College of Radiology estimates that 40% of women over the age of 40 years are avoiding their yearly mammogram.” This article provides the vital need for a proper educational approach to encourage women not to forgo their screening.
In this article, Guilford et al. (2017), “The purpose of this study was to examine breast cancer knowledge, beliefs, and screening behaviors among college women utilizing the health belief model… Health behavior theories are often used to understand health behaviors and help professionals assist people in making desired changes.” This article provides evidence to develop an appropriate educational approach to support the clinical question.
Lofters et al. (2017) discuss adherence to cancer screenings and follow-ups. “We used pre-and post-session questionnaires to assess changes in participant awareness of cancer susceptibility and screening guidelines and changes in screening self-efficacy.”
Huhmann (2020) provided a study for the immigrant women’s population about their perceptions towards screening. “Somali women were least likely to understand the purpose of a mammogram, and those who correctly understood breast cancer screening had gained this knowledge since immigrating to the United States. Misconceptions regarding risk factors also led to an incorrect understanding of breast and cervical cancers which may cause Somali women to believe they are less susceptible to cancer because of its cultural classification as a western disease.” This article provides evidence of the need to increase awareness with a goal of inclusivity and understanding for other ethnic groups within the community.
Nasiriani et al. (2017), the benefit of this article to the research question is the essential need to consider the need for cancer screening based on family history. And that other alternatives for effective educational approaches to encourage screening via telephone counseling.
These research studies are examples of evidence that can support the research question: “Developing an Education-based Approach to Increase Awareness on Breast Cancer Screening.”
As for critically appraising the literature, we can identify strengths and weaknesses in the literature to support the research question appropriately. We continue to use critical appraisal tools such as CINAHL, PubMed, Medline, etc., to identify the appropriate literature. Strengths help reduce the burden and allow you to focus on articles relevant to the research question, and that can reliably support or refute its claims with high-quality evidence or identify high-level research pertinent to your practice. Weaknesses can be overwhelming volumes of results which can vary in quality. For this research question, the strengths from appraising the literature increase the validity and purpose of the study, the clinical applicability, and usefulness. The identified weakness from the supporting evidence was the lack of studies or information about screening for younger women who can be considered high-risk because most studies only target women 40 or older regarding the importance of screening. I believe this can cause a knowledge gap that can be regarded as a weakness within the supporting pieces of literature that I may use for my research questions because I want to educate women of different age groups, ethnicity, and populations to achieve increased awareness of the importance of early screenings for breast cancer.
For this project proposal, EBP standards are essential to guide it to success. According to AIR (2021), “Evidence-based interventions are practices or programs that have peer-reviewed, documented empirical evidence of effectiveness. Evidence-based interventions use a continuum of integrated policies, strategies, activities, and services whose effectiveness has been proven or informed by research and evaluation.” The following are Evidence-Based Interventions for Breast Cancer Screening that are essential; to name a few, the first is Client reminders; this can be in the form of a written or telephone communication to inform the patient that their screening is upcoming, due, or late. This intervention considers the patient’s schedule and availability to ensure they remain in an appropriate timeframe for screeing. And any concerns or questions are answered appropriately during this time. Providing this service to patients has increased their compliance rate of getting screened promptly. Secondly, One-on- one education this intervention has proven tremendous compliance for breast cancer screening because the provider can address individual concerns or questions, listen in depth to the patients’ information, and assess accordingly to their personal preferences. This has always been proven, just as Jean Watson’s Theory on Human Caring theoretical framework has taught us, that caring for more than just the physical aspect provides a positive outcome for a patient’s well-being by ideally including her Caritas in our care plan. And lastly, Reducing Structural Barriers this intervention again considers understanding the barriers that cause the patient’s noncompliance, that by knowing the barriers, we can re-adjust and restructure our approach, just as using an appropriate interpreter for those with language barriers or provide daycare for single mothers during their appointments, in order to convey that it is important to always focus on one’s health in order to be healthy to care for our own family or children. These evidence-based interventions are essential because they are adjustable to the patient in need of care, such as breast cancer screening; they can consider any differences in culture, ethnicity, status, or background. Which will increase compliance when one knows they are being cared for in that personable manner.
This project proposal has identified the impact it can bring to every generation to learn to raise awareness within their generation aside from differences such as culture, race, or age and bring down the stigma they have learned from others. Women will learn to advocate for themselves and the direction of their care. The project will contribute to nursing research by gathering data on the level of compliance, level of understanding, and barriers affecting women’s awareness of the importance of breast cancer screening. This project will be able to provide and develop an education-based approach to increase the awareness of the importance of breast cancer screening and guide them to appropriate information, resources, and confidence of asking so that they can understand the information and be able to make conscious decisions for the betterment of their health.
Mayo Clinic. (2021). Breast cancer. Mayoclinic.org. Retrieved on July 18, 2021, from https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470
National Cancer Institute at the National Institutes of Health [NIH]. (2021). Breast cancer screening.
Cancer.gov. Retrieved on July 17, 2021, from https://www.cancer.gov/types/breast/patient/breast-screening-pdq
Pearlman, M., Jeudy, M., & Chelmow, D. (2017 July). Breast Cancer Risk Assessment and Screening in Average-Risk Women. The American College of Obstetricians and Gynecologists. Retrieved on July 17, 2021, from https://www.acog.org/clinical/clinical-guidance/practice-
Centers for Disease Control and Prevention [CDC]. (2021). Breast Cancer: What is breast cancer screening?. CDC.gov. Retrieved on July 30, 2021, from https://www.cdc.gov/cancer/breast/basic_info/screening.htm
Augusta Health. (2017 October 17). 6 Surprising reasons why women don’t get mammograms.
Augustahealth.com. Retrieved on July 31, 2021, from https://www.augustahealth.com/health-focused/6-surprising-reasons-why-women-dont-get-mammograms
Davis, B. (2021 June 2). What is the definition of key terms in research?. MVOrganizing.org. Retrieved on August 14, 2021, from https://www.mvorganizing.org/what-is-definition-of-key-terms-in-research-3/
American Cancer Society. (2019 September). What is Breast Cancer?. Cancer.org. Retrieved on August 14, 2021, from https://www.cancer.org/cancer/breast-cancer/about/what-is-breast-cancer.html
Centers for Disease Control and Prevention [CDC]. (2021). Screening test. CDC.gov. Retrieved from https://www.cdc.gov/cancer/dcpc/prevention/screening.htm#:~:text=Screening%20means%20checking%20your%20body,who%20are%20at%20high%20risk.
Pearlman, M., Jeudy, M., & Chelmow, D. (2017 July). Breast Cancer Risk Assessment and Screening in Average-Risk Women. The American College of Obstetricians and Gynecologists. Retrieved on August 14, 2021, from https://www.acog.org/clinical/clinical-guidance/practice-
Merriam-Webster. (n.d.). Awareness. In Merriam-Webster.com dictionary. Retrieved August 14, 2021, from https://www.merriam-webster.com/dictionary/awareness
DeLano, N., Lane, S., & DeMayo, M. (2016). Implementing a Breast Screening Assessment Tool in the Inpatient Setting…Academy of Oncology Nurse & Patient Navigators. Journal of Oncology Navigation & Survivorship, 7(9), 48–49.
Guilford, K., McKinley, E., & Turner, L. (2017). Breast Cancer Knowledge, Beliefs, and Screening Behaviors of College Women: Application of the Health Belief Model. American Journal of Health Education, 48(4), 256–263. https://doi.org/10.1080/19325037.2017.1316694
Lofters, Aisha, Ankur Jain, Winnie Siu, Meghan Kyte, Nakia Lee-Foon, Fran Scott, and Onye Nnorom. (2017). “Ko-Pamoja: The Feasibility of a Lay Health Educator-Led Breast and Cervical Screening
Program for Black Women in Ontario, Canada (Short Report).” Cancer Causes & Control 28(11): 1207–18. doi:10.1007/s10552-017-0920-0.
Huhmann, K. (2020). Barriers and Facilitators to Breast and Cervical Cancer Screening in Somali Immigrant Women: An Integrative Review. Oncology Nursing Forum, 47(2), 177–186. https://doi.org/10.1188/20.ONF.177-186
Nasiriani, K., Motevasselian, M., Farnia, F., Shiryazdi, S. M., & Khodayarian, M. (2017). The Effect of Telephone Counseling and Education on Breast Cancer Screening in Family Caregivers of Breast Cancer Patients. International Journal of Community Based Nursing & Midwifery, 5(4), 306–316.
American Institutes for Research [AIR]. (2021). Evidence-Based Interventions: The National Center for Healthy Safe Children. Retrieved on August 23, 2021, from https://healthysafechildren.org/topics/evidence-based-interventions
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The purpose of the signature assignment is for students to apply the research and EBP concepts they have learned in this course and develop a framework for the initial steps of the student’s capstone project. The assignment allows the student to initiate the steps for planning, researching and developing an evidence-based practice intervention project proposal.
On or before Day 7, of week eight each student will submit his or her final proposal paper to the week eight assignment link in D2L. This formal paper will include and expand upon work completed thus far in prior assignments.
Essential Components of the Final Project Proposal will include:
1. Introduction– Provide an introduction to your topic or project. The introduction gives the reader an accurate, concrete understanding what the project will cover and what can be gained from implementation of this project.
2. Overview of the Problem – Discuss the problem, why the problem is worth exploring and the potential contribution of the proposed project to the discipline of nursing.
3. Project Purpose Statement – Provide a declarative sentence or two which summarizes the specific topic and goals of the project.
4. Background and Significance – State the importance of the problem and emphasize what is innovative about your proposed project. Discuss the potential impact of your project on your anticipated results to the betterment of health and/or health outcomes.
5. PICOt formatted Clinical Project Question(s)– Provide the Population, Intervention, Comparison, Expected Outcomes and Timeframe for the proposed project.
6. Literature Review – Provide the key terms used to guide a search for evidence and discuss at least five (5) summaries of relevant, credible, recent, evidence-based research studies to support the project proposal.
7. Critical Appraisal of Literature – Discuss the strengths and weaknesses of the evidence, what is known from the evidence and what gaps in evidence were found from the appraisal of evidence-based research studies.
8. Develop an EBP Standard – Describe two to three interventions (or a bundle of care) from the evidence and discuss how individual patient preferences or the preferences of others will be considered.
9. Implications – Summarize the potential contributions of the proposed project for nursing research, education and practice.
• Length: A minimum of 8 pages and a maximum of 10 pages (excluding the title and reference pages)
• Format: Formal scholarly paper in APA 7th ed format
• Reference Citations: A minimum of five, recent (past five years), peer-reviewed scholarly references cited in APA 7th ed format.
• File name: Save the file with Student First Name_Last Name_SigAssignment
See USU NUR Research Paper Rubric for additional details and point weighting.
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