Kathleen A Sternas
Seton Hall University, USA
Title: Appraisal, coping, resources and health of women with breast cancer: strategies for building evidence-based research into nursing education
Biography
Biography: Kathleen A Sternas
Abstract
Problem: National and international studies report stress, poor quality of life, increased emotional distress among women with breast cancer. Factors which impact health after breast cancer include appraisal, coping and resources. Nurse educators teach students how to improve clinical outcomes. Research utilization by nursing students can increase evidence-based practice and improve outcomes.
Purpose: The purpose of this study is to investigate about appraisal, coping, resources and health of ethnic women with breast cancer; describe strategies to build evidence-based research on breast cancer into education of nursing students.
Methodology: In this study Lazarus and Folkman’s stress-appraisal-coping framework was used. Women aged 29 to 80 (n=47) having mastectomy or lumpectomy surgery of African-American, Caucasian or Hispanic ethnicity were referred by surgeons and nurse interviewed before surgery.
Instruments: Appraisal of Breast Cancer Scale/Ways of Coping Revised/Resources Assessment/Physical Health Rating/Profile of Mood States.
Findings: Women appraised breast cancer as challenging with harmful losses. Challenges: Maintain self-esteem/feel good emotionally/stay active. Losses: independence/finances/social life. African-Americans had more beneficial-positive appraisals than Caucasians (t=2.80, p=0.008).
Ways of Coping Used: Ways used include concentrated on what to do; work/activity; prayed; accepted sympathy; talked; changed/grew. African-Americans used more distancing than Caucasians. Hispanic women waited/slept/used alcohol. Helpful resources: social supports/ACS/ religion/ cultural practices/ grieving/ finances/good relationships. African-Americans had less tension-anxiety/confusion, more vigor, less mood disturbance (t=-3.22, p=.002) than Caucasians. Hispanics reported uncertainty/fatigue. There were no physical health differences. Educational strategies: integrating teaching and research; incorporating evidence-based breast cancer research readings in courses; students as research assistants; attendance at research conferences; researcher role education; providing support/time/resources for research.
Conclusions: Women hold positive and negative meanings about breast cancer, use variety of coping strategies/resources to reduce stress. African-Americans use more beneficial-positive appraisals/distancing/had better emotional health.
Implications: educate women on positive appraisals, helpful coping strategies/resources since these factors can affect health. Research contributes to new knowledge on breast cancer. Use of evidence-based research when teaching, stimulates students’ interest in utilizing/conducting research.