Lung Cancer In Australia: An Evidence-based Practice Essay.

In Assessment 2, you chose a clinical problem/practice to research to find the best evidence underpinning that problem/practice with a nursing focus.  Your search located 3 pieces of evidence in relation to your chosen topic.  Continuing on from the work already achieved, Assessment 3 requires you to look at your particular problem/practice in terms of evidence based practice. 

Evidence based practice “…acknowledges that it involves the integration of the best research evidence with clinical expertise and the patient’s values and circumstances.  It also requires the health professional to consider characteristics of the practice context in which they work” (Hoffmann, Bennett & Del Mar, 2017, p. 3).

This will orientate the reader to the problem:

• The topic and its importance 
• Your interest in this topic 
• What you aimed to achieve 

• Critically analyse your best evidence articles based upon the strengths and limitations of the research methods, the relevance of the results identified above, and how they relate to the aims of your research. 

• Discuss how this evidence could be implemented into nursing practice using the principles of evidence based practice in relation to your chosen problem/practice, including any barriers to implementing best practice.
  • These principles include:
    • Patient values
    • Clinical expertise
    • Available research evidence
    • Context

Annotated Bibliography

Lung cancer is a common disease among Australian population. Most of the deaths caused by cancer in Australia are caused from Lung cancer. Approximately 1 in every 5 cancer deaths are caused by Lung cancer (Torre, Siegel & Jemal, 2016). Therefore, it is a serious concern of the country. I live in Australia and I have seen my 26 years old neighbour dying of lung cancer. She left a 3 years old son behind and her family is devastated. This way, lung cancer takes lives of a large number of people in Australia. Some of those families lose their sole bread earning member to this deadly disease. I want to gather effective knowledge regarding the same to spread awareness so that the number of deaths can be reduced to a greater extent.

1. DOI: https://doi.org/10.1016/j.jtho.2016.05.021

Cheng et al. (2016) are well published academics who have worked on different aspects of Lung cancer including its latest trends, disparities and characteristics of tumour. Their aim was to update the epidemiology of global lung cancer and also find out the changing patterns and disparities. The study reflects that as per the data acquired in 2012, Australia had very high HDI (Human Development Index) along with other countries such as Argentina, Canada, Germany, Hungary, Italy, Japan, Spain, Sweden, UK and USA. The study reveals that in 1980-2010, the prevalence of lung cancer has increased among Australian females and decreased among Australian males. The findings indicate cigarette smoking as the key reason behind such high prevalence of lung cancer in Australia. The Indigenous people of Australia are having a twofold higher risk of being affected by lung cancer as per the findings. The authors conclude that stronger tobacco control activities and campaigns can reduce the risk.

 2. DOI: https://doi.org/10.1016/j.lungcan.2017.02.025

Yu et al. (2017) are eminent academics who have focused on the long term trends of lung cancer among women of NSW (New South Wales), Australia in accordance to different socioeconomic groups. The study extracted research data from NSW Cancer Registry Database. The authors divided the study cohort among 5 quintiles in accordance to an index of education and occupation (IEO) based on area, and then the calculation of  annual age-standardised incidence rates was done by IEO quintile for the time span of 1985-2009. The results reflected that the number of women suffering from lung cancer have increased within the period. It was 19.8 per 100,000 in 1985, which became 25.7 per 100,000 in 2009. The affected women were aged between 25 years to 69 years. The study also revealed that the trend for women aged more than 70 years does not follow any clear pattern related to socioeconomic gradient. Authors concluded that stronger implementation of tobacco control initiatives are required.

Justifying the Evidence

 3. DOI: https://doi.org/10.1093/fampra/cmx057

Murray et al. (2017) are renowned researchers in this field of study. Here, the authors have established that primary intervention is highly required following the diagnosis. With the gap between diagnosis and treatment the risk factor also increases. This qualitative study that aims to evaluate the effectiveness of the CHEST Australia trial. The CHEST Australia trial intends to improve the knowledge of symptoms through prototypes of chest disease, develop personalised actions and promote self-efficiency etc. Smokers and ex smokers were invited to be part of this study and data was extracted through face-to-face interviews. This way the researchers were able to observe nonverbal cues and body language of the participator while they shared their experiences. Sampling was on the basis of age, location, gender and smoking status and the type was purposive sampling. 20 people participated in the survey. The result obtained reflected that the intervention provided effects which were theoretically underpinned.

Lung cancer is a much talked about issue globally. The studies reflect that Australia possess a high rank among the countries having most people being affected of lung cancer. In Australia, lung cancer is considered as one of the most severe diseases. A large number of Australians, adult males and females, are diagnosed with lung cancer every year (Banks et al. 2015). There are a number of reasons which causes lung cancer. But in Australia, smoking and consumption of tobacco is considered as one of the major causes of lung cancer (LILLARD, 2015). In Australia, the number of smokers increases rapidly. People suffering from lung cancer are mostly associated with smoking or tobacco. Possession of tobacco or cigarettes is very common among Australian men and women. The evidence provided by Cheng et al. (2016) reflects that the number of Australian women consuming tobacco have increased rapidly in past years. Despite of different anti-smoking laws presented by the Australian Government, the situation is not being improved. Moreover, teenage smoking has emerged as a new issue in Australia (World Health Organization. 2015). With women smoking cigarettes, the overall graph of women’s health of the country is going downwards (Liew, Zomer & Owen, 2017). This is adversely making a negative impact on the children’s health as well. Rising number of infant deaths has come across as an inevitable outcome of rapid smoking by childbearing mothers (Passmore, McGuire, Correll & Bentley, 2015). Thus, the health of both the child and the mother are at stake. As it is known that an Australian population comprises of Indigenous people, the smoking rates among them are comparatively higher (Smith, Chapman & Dunlop, 2015). Due to their socio-economical status, lack of employment opportunities, discrimination, the males and females of Aboriginal and Torres Strait Islander people are having relatively higher smoking rates. This is why the women of Indigenous communities tend to encounter lung cancer more than a non-Indigenous Australian (Gould, Bovill, Chiu, Bonevski & Oldmeadow, 2017). Yu et al. (2017) suggests that more women are becoming affected by lung cancer in Australia. Stress is another reason which causes smoking among Australian women. Women tend to encounter more social barriers and less employment and education opportunities than a man which gives rise to stress among them (Arjunan et al. 2016). This leads to smoking as the smokers have stated that smoking clams the mind and relaxes the brain. The smokers are not fully aware about the negative impacts of smoking. Therefore, the first two evidences conclude that tobacco control activities and campaigns should be implemented along with strict anti-smoking legislations. Again, Murray et al. (2017) have concluded in their study that CHEST Australia Trial is effective to encourage smokers for early consultation. Early identification of illness would reduce the chances of cancer deaths and fatalities related to the disease. The third evidence has successfully proven the effectiveness of CHEST Australia Trial in reducing the risk factor of lung cancer through early consultation.  The self help manual followed by self monitoring reminders of CHEST Australia Trial has positively impacted the lives of many smokers. As prevalence of lung cancer is making a negative impact on the overall health of the Australians, the country must adopt suitable ways to combat the problem. The women and children of Australia, especially those belonging from Indigenous population, are said to be most vulnerable. Proper healthcare facilities should be allotted to them and Government intervention is much needed in this context. Apart from that identification of the symptoms is mandatory to detect the disease at an early stage to avoid more complications. The evidences reveal that knowledge is of much importance to overcome the situation. With awareness programmes and tobacco control initiatives, the country would be able to reduce the number of cancer deaths and smokers at a greater extent.

Theoretical Framework

With effective nursing, the prevailing situation can be improved. Tobacco is injurious to health and most of the smokers are not fully aware of the consequences of smoking. The nurses must take a productive step by arranging education programmes for the smokers. The smokers should be identified and invited to the education programme (Li & Powdthavee, 2015). The nurses would allow them to know all the related aspects of smoking and tobacco consumption. Evidence based learning would be more appropriate in this scenario. Nurses can gather adequate evidence related to lung cancer cases in Australia and cancer deaths (Pierce, Dwyer, Hannan & Burke, 2017). This would strengthen their education programme and allow the smokers to gain deeper understanding regarding the factors of smoking. Nurses can use their knowledge to identify early symptoms of lung cancer and initiate treatment on the basis of that. Screening tools can also be used by nurses to trace affected people from potential smokers. Nurses are responsible for rendering healthcare services to the people affected from lung cancer. Being equipped with clinical knowledge about different illnesses, nurses are able to provide best healthcare services to the patients and accelerate the recovery process. Hence, it can be said that nurses have the power to educate and treat people and reduce the number of cancer deaths in the country. Although the researches are not able to analyse the healthcare policies of the country which is much relevant in this context. With proper healthcare policies at place, tobacco selling and consumption can be reduced, thereby, reducing the total number of smokers in the country (Yong, Borland, Cummings & Partos, 2018). However, the evidences successfully highlight and explore the situation related to prevalence of lung cancer in Australia. With more awareness programmes and preventive measures, the number of lung cancer affected people can be reduced to a greater extent.

References

Arjunan, P., Poder, N., Welsh, K., Bellear, L., Heathcote, J., Wright, D., ... & Wen, L. M. (2016). Smoking among Aboriginal adults in Sydney, Australia. Health Promotion Journal of Australia, 27(1), 66-69.

Banks, E., Joshy, G., Weber, M. F., Liu, B., Grenfell, R., Egger, S., ... & Beral, V. (2015). Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence. BMC medicine, 13(1), 38.

Cheng, T. Y. D., Cramb, S. M., Baade, P. D., Youlden, D. R., Nwogu, C., & Reid, M. E. (2016). The international epidemiology of lung cancer: latest trends, disparities, and tumor characteristics. Journal of Thoracic Oncology, 11(10), 1653-1671.

Gould, G. S., Bovill, M., Chiu, S., Bonevski, B., & Oldmeadow, C. (2017). Exploring an adapted Risk Behaviour Diagnosis Scale among Indigenous Australian women who had experiences of smoking during pregnancy: a cross-sectional survey in regional New South Wales, Australia. BMJ open, 7(5), e015054.

Li, J., & Powdthavee, N. (2015). Does more education lead to better health habits? Evidence from the school reforms in Australia. Social Science & Medicine, 127, 83-91.

Liew, D., Zomer, E., & Owen, A. (2017). P4419The mortality and productivity burden of smoking in Australia. European Heart Journal, 38(suppl_1).

LILLARD, D. R. (2015). Smoking in Australia. Life-Course Smoking Behavior: Patterns and National Context in Ten Countries, 15.

Murray, S. R., Kutzer, Y., Habgood, E., Murchie, P., Walter, F. M., Mazza, D., ... & Emery, J. D. (2017). Reducing barriers to consulting a General Practitioner in patients at increased risk of lung cancer: a qualitative evaluation of the CHEST Australia intervention. Family practice, 34(6), 740-746.

Passmore, E., McGuire, R., Correll, P., & Bentley, J. (2015). Demographic factors associated with smoking cessation during pregnancy in New South Wales, Australia, 2000–2011. BMC Public Health, 15(1), 398.

Pierce, J. P., Dwyer, T., Hannan, C. D., & Burke, N. (2017). Evaluation of the Sydney Quit For Life Anti-smoking Campaign: Part 2 Changes in Prevalence.

Smith, A. L., Chapman, S., & Dunlop, S. M. (2015). What do we know about unassisted smoking cessation in Australia? A systematic review, 2005–2012. Tobacco Control, 24(1), 18-27.

Torre, L. A., Siegel, R. L., & Jemal, A. (2016). Lung cancer statistics. In Lung cancer and personalized medicine (pp. 1-19). Springer, Cham.

World Health Organization. (2015). WHO global report on trends in prevalence of tobacco smoking 2015. World Health Organization.

Yong, H. H., Borland, R., Cummings, K. M., & Partos, T. (2018). Do predictors of smoking relapse change as a function of duration of abstinence? Findings from the United States, Canada, United Kingdom and Australia. Addiction.

Yu, X. Q., Luo, Q., Kahn, C., Grogan, P., O’Connell, D. L., & Jemal, A. (2017). Contrasting temporal trends in lung cancer incidence by socioeconomic status among women in New South Wales, Australia, 1985–2009. Lung Cancer, 108, 55-61.