Routine Screening in Gynecological Cancer Setting

Routine Screening in Gynecological Cancer Setting

Article Critique

O’Connor, M., Tanner, P., Miller, L., Watts, K., & Musiello, T. (2017). Detecting distress: Introducing routine screening in a gynecological cancer setting. Clinical Journal of Oncology Nursing. 21(1), 79-85.


Cancer diagnosis, disease symptoms, and side effects of cancer treatment cause a multifactorial unpleasant emotional experience that affects cancer patients psychologically, emotionally or spiritually causing patient distress; this interferes with the patient’s capability to effectively cope with the disease, cancer physical symptoms, and the treatment. The purpose of this paper, therefore, is to perform a critique of the selected article by O’Connor et al (2017). According to the article, cancer causes various challenges attributable to patient distress. Therefore, it is important to recognize distress in cancer patients in order to implement the appropriate interventions to address the distress and ensure improved patient outcomes. Therefore, the article sought to establish the incidence of distress among gynecologic cancer patients, identify problems experienced by cancer patients, and investigate the perception of nurses regarding distress screening for this population (O’Connor et al, 2017).  Routine Screening in Gynecological Cancer Setting


Research Question

The research question in the article was whether screening of gynecologic cancer patients is effective in identifying distress and thus improving patient health outcomes and their quality of life. Screening tools such as Distress Thermometer (DT) have been shown to be effective in identifying distress in cancer patients by examining emotional problems such as anger, bitterness, anxiety, depression, as well as physical and social needs that are unmet and the desire for such patients to get professional help. When the distress is identified, such patients can receive the appropriate interventions or get a referral for appropriate treatment. The research question in the article was driven by the high rate of distress among patients with cancer; the distress adversely affects their quality of life and health outcomes and therefore it is important to detect the distress and treat the distress appropriately (O’Connor et al, 2017).

Research Design of the Study

The study adopted a mixed-method research design where both qualitative and quantitative research methods were used. The qualitative technique was used to collect qualitative data using interviews with the healthcare providers while the quantitative technique was used to collect data from patients regarding distress levels (O’Connor et al, 2017). Use of both quantitative and qualitative research techniques allowed researchers to gain scope and depth of understanding and validation on the research perspectives. In addition, the use of both research techniques enabled triangulation. Triangulation enables researchers to identify research aspects more precisely because the study is approached from various vantage points using different research techniques. In addition, this research design helped in providing rich datasets and increasing reliability and credibility of the study findings increasing the likelihood of generalizing the study results (O’Connor et al, 2017). However, the adopted research design has some weaknesses such as requiring more analysis and interpretation. Another weakness is that the data has to be converted in some way in order to ensure effective integration of the two types of data during analysis, a process that can be complex. Lastly, there might be inequality between different techniques and this may lead to unequal evidence in the research; this can significantly hinder findings’ interpretation.

Study Sample

For the patient sample, 62 patients having gynecologic cancer were recruited in the study. The inclusion criteria included women who were aged 18 years and above; had a gynecologic cancer diagnosis, and had the ability to understand and complete the PL and DL (O’Connor et al, 2017). Women aged 18 years and below were excluded from the study. The healthcare providers sample included 6 oncology healthcare providers, specifically 3 nurses, 2 social workers, and 1 physiotherapist (O’Connor et al, 2017). The sample size is very small for mixed mixed-method research design and especially for the patient sample. This is because, for the patient sample, the data was collected using a quantitative technique. Normally, a quantitative technique requires a large sample size. Generally, the sample size is supposed to be adequate in order to decrease uncertainty to a satisfactory level for all variables of interest. Larger sample sizes tend to have more information and hence the research uncertainty decreases. In addition, the sample should be adequate in order to be representative of the populations because failure to have a representative means the sample is taken from a subset of the population distribution.    Routine Screening in Gynecological Cancer Setting

The patient sample included patients who had a diagnosis of gynecologic cancer while the sample for the healthcare providers consisted of nurses, social workers as well as a physiotherapist. Basically, the sample was relevant to the study and in comparison to the aim of the study (O’Connor et al, 2017). This is because the study aimed to investigate the incidence of distress in patients with gynecologic cancer and at the same time identify the perception of nurses regarding patient distress in cancer patients. However, for healthcare providers, sample numbers were not adequate. This is because only 6 healthcare providers were interviewed yet the hospital has a larger number of healthcare providers and also diverse healthcare providers (O’Connor et al, 2017). For example, the sample did not include physicians who key people involved in the management and treatment of patients with cancer.

Data Collection Methods

Distress Thermometer (DT) tool was used to collect data about distress in the patient sample while the problem list (PL) was used to collect data about the specific problems the patients were experiencing. The data from patients was mainly collected by research officers who explained to the patients regarding the study and patients were given the DT and PL to complete on their own. Oncology nurses and social worker also played a role in the data that was collected using the DT and PL (O’Connor et al, 2017). For instance, the oncology nurse was fundamental in evaluating the DTs and PLs and in determining patients who needed interventions to address their distress.

On the other hand, the data from healthcare providers was collected by the research officer and a trained interviewer. Interviewing is the tool that was used to collect data from healthcare providers. Interviewing enabled the healthcare providers to give their perceptions regarding the study topic and the interviews were recorded digitally (O’Connor et al, 2017). Consent was sought from all the study participants before they participated in the study. Before patients participated in the study, the research officer met every patient and sought informed consent from them. Only patients who consented to the study participated in the study. For the healthcare providers, the research officer also sought informed consent from them and they were only interviewed after consenting to take part in the study (O’Connor et al, 2017). However, the article does not indicate whether permission was sought from the relevant ethics organization before the study was started. Routine Screening in Gynecological Cancer Setting


Limitations of the Study

The key limitation of the study was that it was not possible to track referrals for the patients because contacting them was problematic. Secondly, researchers were not able to approach all patients who were attending the hospital due to the busy hospital setting while at times the research officer was not available to obtain informed consent from patients (O’Connor et al, 2017). In future studies, these limitations can be overcome by ensuring that contacts from the research subjects are taken with their permission; this will facilitate future contacts with the research subjects for follow-up. The second limitation could be overcome by ensuring that adequate time is scheduled for the research project in order to ensure that there is time to approach all patients targeted in the study. The last limitation can be overcome by having enough research officers to attend to the research subjects. It is important to list limitations in order to implement appropriate strategies to overcome the limitations in future studies.

Findings Reported in the Study

According to the study findings, the majority of the patients had a score of 4 or above on the DT indicating a need for follow-up or referral to have the distress managed and further assessed. The other percentage of patients was either highly distressed or was experiencing low distress (O’Connor et al, 2017). The main problems that were listed by patients included worrying, sleep disturbances, fatigue, anxiety and being fearful (O’Connor et al, 2017). The findings answered the research question because the research sought to find out the distress levels for patients with gynecologic cancer and the type of problems they experience. These findings are reliable because previous studies show that patients with cancer often experience distress exhibited by anxiety, worry, sleep problems, depression, among others. This indicates the credibility of the study findings. Routine Screening in Gynecological Cancer Setting

Article Summary

The article aimed to investigate the occurrence of distress for patients diagnosed with genealogy cancer, identify the problems they experience and investigate the perception of healthcare providers regarding screening of distress among cancer patients. The study adopted both qualitative and quantitative techniques as the research design. The findings indicated that the majority of patients were moderately distressed indicating the need for follow-up or referral while other patients were either highly distressed or lowly distressed (O’Connor et al, 2017). This indicates that patients with genealogic cancer were experiencing some form of distress. The main distress problems these patients were experiencing included anxiety; worrying; fear; sleep disturbances, and fatigue (O’Connor et al, 2017). These findings indicate that a practice change is warranted where standard screening for distress in all patients with cancer should be implemented in all healthcare institutions. This is because the provided evidence is strong enough to suggest a need to perform distress screening for all patients with cancer.  This is because, in this study, all patients were experiencing some form of distress. Patient distress in patients with cancer is common and it hinders with their ability to handle the disease, symptoms as well as the adverse effects of cancer treatment; this indicates the significance of distress screening in all cancer patients.


O’Connor, M., Tanner, P., Miller, L., Watts, K., & Musiello, T. (2017). Detecting distress: Introducing routine screening in a gynecological cancer setting. Clinical Journal of Oncology Nursing. 21(1), 79-85.


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Routine Screening in Gynecological Cancer Setting

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