Qualitative Critiquing
Overall critique
This paper is a critique of an article written by Philips & Cohen (2011) under the title “The Meaning of Breast Cancer Risk for African American Women”. The purpose of this study was to describe the experience of African American for being at high risk for breast cancer. This article can be regarded a high-quality qualitative research article for a number of reasons. In general, the article researches on a topic that been modestly studied, it targets to explore meaning together with subjective experience of the participants. In addition, it is exploratory in natures and employs hermeneutic phenomenological approach to guide in-depth interviews and analysis. Finally, the research makes interpretations of its findings by use of subjective and reflexive approach.
Purpose of the research
The purpose of this research was to describe the meaning and experience of being at high risk for breast cancer (personal history, family history, and genetic mutation) for African American women under the age of 40. The research question is well crafted to understand the lived experience of African American women with breast cancer. In this regard, the article is thorough in meeting the purpose of the research (Philips & Cohen, 2011). In the introduction, the authors start by clearly establishing the critical nature of breast cancer as the number one killer disease among women between ages 20 and 59 years in high-income countries.
The authors do well to note that there has been limited research relating to breast cancer risk perceptions along with related behaviors among young African American women who have the highest risk. The research clearly notes that there have been no studies exploring the meaning of the disease for African American women under the age of 40 years. In addition, the authors appreciate that there have been little researches employing qualitative approach to examine the real meaning of being high risk.
In terms of the need for a qualitative approach, the article succinctly points out to the need for further longitudinal research that trails high-risk African American women over years to fully correlate their long-term experience of living with the risk of breast cancer. In addition, it is noted that there is need for research that examines the resource and emotional needs of younger women, their families together with their significant others. The article also scores points on suggesting detailed investigations of the effect of genetic testing in young women, where the results would help in designing customized interventions among high-risk populations.
Significance of the research
The study has significant clinical relevance in the sense that breast cancer has increasingly become prevalent in young women, especially African American women aged 40 and under (Philips & Cohen, 2011). A clear understanding of the experience and meaning of being high risk of breast cancer among young African American women is thus significant to encourage healthy lifestyles, early screenings and detection, instantaneous follow-up for suspicious findings, as well as adherence to recommended breast cancer surveillance for this population.
Research subjects/population
The sample of the research included twenty high-risk African American women aged between 23 and 40 years with an established family history, personal history or genetic mutation of breast cancer. The bulk of the population was drawn from a major academic medical center that specialized in management of high-risk populations. Other participants were recruited from community-based centers so as to boast the diversity of experiences described. Qualitatively, it can be argued that the small sample of twenty participants enabled the research team to easily gain better comprehension of the population’s lived experience (Philips & Cohen, 2011). However, the hermeneutic phenomenological method has weakness in terms of bias in selection of sample given that the participants were handpicked, which compromises their representational element of the experience of the larger African American population.
Research methods
The research team used hermeneutic phenomenological, descriptive, together with interpretive research methods. The choice of these research methods was appropriate considering the research aimed to determine how the participants interpret their lives and draw meaning of their experience with breast cancer. The qualitative research methods were particularly effective in gathering the culturally specific information about the opinions, values, behaviors and social context of the given population regarding to breast cancer. Interpretive approach, in particular, was best placed to comprehend the phenomena through the meaning that the population assigns to them. It was also appropriate given that there were no predefined dependent and independent variables as focus is on complexity of human sense making as situation progresses. Similarly, use of the phenomenology enabled the researches to focus the lived experienced of the participants and find a true picture of their individual point of view relating to their vulnerability and impact of breast cancer to their lives (Philips & Cohen, 2011).
Findings of the study
The research found that twelve out of the 20 participants had a known personal history of breast cancer whilst the remaining eight admitted family history of the disease. The women with known history were diagnosed at between ages 20 and 37. Thirteen of them were unmarried; all had a high school education while nine were holders of college degrees (Philips & Cohen, 2011). Five of them were on Medicaid program; 14 on private insurance while one woman had a state-issued women’s health card qualifying for women’s health services only. Eight women reported having a first-degree relative with breast cancer whilst two participants reported having three or more first-degree relatives with the disease.
According to the authors, all participants described dealing with breast cancer as a life-changing experience. Living with breast cancer was also said to have both positive and negative impact of the women’s relationships with significant others, families, and children. Participants also shared their healthcare experience in terms of high cost of surveillance/treatment and positive/negative relationship with healthcare providers. The women also showed great commitment to improve awareness about the prevalence of breast cancer in younger women. Majority of the women cited a higher power as their great source of strength in their dealing with breast cancer. The results largely compliment the research question by describing the lived experiences of African American women at high-risk of breast cancer.
Authors’ Interpretation of Results
The authors held that the results of their study highlighted the significance of education and sensitization of healthcare providers relating to incidence of breast cancer among younger women along with their unique needs. They stressed the need for more breast health programs addressing unique support and resource needs of young African American women. As such, contemporary programs ought to evaluate the meaning of breast cancer risk when formulating breast health programs for such high-risk populations (Philips & Cohen, 2011).
Strengths and limitations
The main strength of the study is in the small manageable size of the sample together with the appropriate research techniques used especially that it was cross-sectional. The major weakness of the study is that the participants were interviewed varyingly on their breast cancer risk and experience. It would have been better to apply a longitudinal approach using detailed interviews so as to clearly depict how the women’s’ experience, breast cancer risk perception along with related behaviors change over time (American Cancer Society, 2011). Furthermore, the study is limited to African American women meaning that the experience of other cultures is unknown and thus cannot be compared.
Implications for the students’ personal nursing practice
The study enriches the learner’s individual nursing practice by providing detailed insight into the experience and meaning of high-risk of African American for being at high risk for breast cancer. The student is able to understand the gap in the research areas and understand the point of view of the populations as relates to the disease.
References:
American Cancer Society. (2011). Breast Cancer Facts & Figures 2011-2012. Retrieved from: http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-030975.pdf
Philips, J., & Cohen, M. (2011). The Meaning of Breast Cancer Risk for African American Women. Retrieved from: http://www.researchgate.net/publication/51612673_The_meaning_of_breast_cancer_risk_for_African_American_women
