Radical Surgery Essay

Catheterization options following radical surgery for cervical cancer.
Naik (2006)

Karen Roberts, Raj

Background
• The purpose of the study was to investigate the options for women who were diagnosed with early signs of cervical cancer following a radical hysterectomy. • Options included using a intermittent self catheter (ISC) and a suprapubic catheter (SPC)

About the researchers
Both authors are from Gateshead Health NHS Trust

• Karen Roberts: Nurse Consultant
The main focus of Karen’s research has been in the areas of cancer survivorship, examining the effect of cancer treatment on sexual functioning.
(http://www.northumbria.ac.uk/sd/academic/sches/research/ches/disability_LTC/staffprofiles/karen_roberts/)

• Raj Naik:
Consultant Gynaecological Oncologist.
Research interests are optimising surgical treatment of cervical cancer and ultra radical surgery in ovarian cancer.
http://www.excellence-in-oncology.org/node/534

Literature review
• • • • Madersbacher and Weissteiner 1977 McConville 2002 Edwards et al 2004 Pilloni et al 2005

Study Aim
To explore whether the proven benefits of ISC in non cancer can be confirmed in the postoperative bladder care of women with a mid line laparotomy wound following a radical hysterectomy.

Study design
Quantitative: ‘Quantitative research is a broad, umbrella term for research that uses methods that collect evidence that can be transformed into numerical data and are based on a positivist position.’ (Procter et al 2010)

Experimental design

http://www.nationaltechcenter.org/index.php/products/at-researchmatters/experimental-study-design/

Study sample
The study population is made up of • 40 women (median age of 45) • All had the same operation radical hysterectomy following early signs of cervical
cancer.

Convenient sample:
• Convenience sampling is a non-probability sampling technique where subjects are selected because of their convenient accessibility and proximity to the researcher.
(http://www.experiment-resources.com/conveniencesampling.html#ixzz1dzW8yp2G)

Convenient sample can not be generalised as that of the population

Data collection
• Questionnaire • Observations • Microbiology testing

Advantages
• Questionnaires are familiar to most people • Questionnaires are very cost effective when compared to face-to-face interviews. • Questionnaires are easy to analyse. Data entry for nearly all surveys can be easily done with many computer software packages. • Questionnaires are less intrusive than telephone or face-toface surveys.

Limitations
• low response rates. • Returned it is natural to assume that the respondent is the same person you sent the questionnaire too. • Finally, questionnaires are simply not suited for some people.

Validity: refers to the concept of whether the data collect is a ‘true’ picture of what is being studied (Walsh and Wigens 2003). Reliability: Relates to the method that is being used to collect data and refers to the accuracy and consitancy of the measurmentsgenerated by this method (Rees 2003).

Ethical considerations
• Informed consent was obtained before the study • Ethical approval was obtained from Gateshead Research Ethics Committee • No mention of confidentiality/ anonymity

Ethic committee
Ethics committee work to national guidelines and look at the research submitted in terms of the welfare and dignity of participants and validity of the research study.
(Walsh & Wigens 2003)

Data Analysis
• Descriptive approach • Analysed using SPSS version 11 • Pearson Chi square test -A chi-square test can be used to test if the standard deviation of a population is equal to a specified value.
(http://itl.nist.gov/div898/handbook/eda/section3/eda358.htm)

• Fishers exact test • P value

Study Results
• 19 women out of 40 stated their preference before the operation. There was statistical difference P=0.267 • The first 5 days showed more women in the ISC group developed infections than the SPC group. P=0.004 • By day 21: 8 of the 17 women reported having problems with their SPC site of which 4 had positive wound swabs

Discussion
• The aim of the research was answered • Limitations to the study were acknowledged (poor response rate of the questionnaire by week 12) • The clinical implications discussed

Conclusion and recommendations
• Strict adherence to protocol (questionnaires) • The results of this study supports previous studies (although the study doesn’t compare the finding of using the ISC from previous studies) • Reliability ?

My recommendations

• How reliable was the study? • The sample size?
Reference
• • • • • • • Bennett. G (2001) Critique Guidelines, University of Glamorgan, unpublished C.Rees,2003. Introduction to research Midwifes.2nd edition. London.BFM http://itl.nist.gov/div898/handbook/eda/section3/eda358.htm(accessed 21/11/2011) http://www.excellence-in-oncology.org/node/534(accessed 11/17/2011) http://www.experiment-resources.com/convenience-sampling.html#ixzz1dzW8yp2G (accessed 17/11/2011) http://www.nationaltechcenter.org/index.php/products/at-research-matters/experimentalstudy-design/(accessed 20/11/2011) http://www.northumbria.ac.uk/sd/academic/sches/research/ches/disability_LTC/staffprofiles /karen_roberts/ (accessed 17/11/2011) Procter et al [2010]S. Procter, T. Allan & A. Lacey – The Research Process In Nursing, Sixth Edition, 2010 Roberts,K. Naik,R. Catherterization Options following Radical Surgery for Cervical Cancer.British Journal of Nursing , 2006vol15, no19 Walsh and Wigens (2003). Introduction to Research. L.ondon Norman Thornes

•
• •