Role in a Strength-Based Approach to Breast Screening in Australia

Posted on: 17th May 2023

Question

Context: This essay addresses a health problem as a societal issue. It requires integration of the role of an Australian nurse with the building of healthy communities in order to highlight the reality that nursing practice environments reach beyond hospital settings and into the wider community.

Topic: Cancer Screening (specifically Breast Cancer)

Community within Australia: Women 30-40 years old with a paternal relative who has Breast Cancer.

The writer can change the age group of the community; however, it cannot fall into the 50-70 year old age range. This is because screening in Australia is readily available to women over the age of 40-50 years old.

Essay Content:

Part A

Identify a community in Australia, including the key characteristics of your chosen community. Provide a rationale for why you have selected this community in relation to your chosen topic.

- Rationale as to why the community has been chosen and why the topic has been chosen together with the community.

- Comprehensively discuss the key characteristics of the community

- You will not be able to exhaustively write about the community within the discussion however the fundamental elements of the community should be noted and highlighted with credible evidence.

- Describe why these elements are important to note

- Rationale should be clear and supported by credible evidence

Part B - using critical thinking, reasoning, and evidence

Describe how nurses can work in partnership with the community, using a strength-based approach, to address Cancer Screening, specifically Breast Cancer screening in Australia.

- Demonstrate how the nurse works WITH the community NOT FOR the community.

- Comprehensively discuss the nurses’ role, community partnerships and strength-based approach with a wide range of relevant and credible sources

- The nurses’ role needs to be adequately discussed rather than merely mentioned

- Demonstrate an understanding of how to utilise a strength-based approach within the community

Ideas need to flow from one paragraph to the next, comprising of an introduction or an introductory paragraph, body of essay and a conclusion. Introductory paragraph should introduce all the key points that you are going to discuss throughout the body of the essay and sequence it in the manner that it will be discussed.

Avoid standalone sentences within the essay, a paragraph should comprise of at least four sentences to allow for a key idea to be discussed adequately. To allow for a flow of ideas include linking sentences at the beginning and/or at the end of paragraphs.

The number of body paragraphs in the essay should directly relate to how many key ideas are going to be discussed.

Introduction is going to take about 10% of the word count, about 200 words, and the conclusion makes up about 5% so it should be about 100 words.

1700 words to work with, on average a paragraph is usually about 200 to 250 words.

Part A comprises of 20% of the essay body, and Part B comprises of 50% of the essay body.

Conclusion should succinctly summarise all the key points that have been discussed throughout the essay. Use a wide range of sources, for example a mix of journal articles, government sites and books and E books demonstrating the essay has reviewed different types of literature to inform what has been discussed.

Sources should be credible; the authors qualification is important to note and avoid using sources such as Wikipedia. Is the source relevant or not, think about the topic that is being written about, for example if you're writing about how the nurse may assist with vaccination hesitancy, then sources shouldn't be utilised that refer to the role of the physio in vaccination hesitancy in the hospital setting.

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Solution

Role in a Strength-Based Approach to Breast Screening in Australia

Part A

Each territory and state in Australia offers free breast cancer screening services, which form part of the national breast cancer screening program. Women falling within the ages of 40 to 49 years are eligible for breast cancer screening after every two years without being sent an invitation. Nevertheless, those between 30 and 40 years have to get a referral from their doctors to access breast cancer screening at any public or private screening facility. Breast cancer screening is also not recommended for women under 40 years in Australia. The main reason for choosing this topic is that the chance for a woman to develop cancer up to the age of 85 is an eighth (Cancer Council, n.d). Besides, breast cancer is regarded as a common disease in Australia. Approximately 17,000 women have been diagnosed with breast cancer in Australia annually (Cancer Council, n.d). Early detection of breast cancer reduces the number of deaths. Nurses have proven to improve breast cancer screening among women between 40 and 49. Therefore, this study identifies and describes the population of women between 40 and 49 and how nurses can partner with the community using the strength-based nursing approach to address cancer screening in Australia.

Cancer has become a common disease in Australia, affecting women up to 85 years old. Although the disease can occur at any age, it commonly affects women aged 60 years and above. Most importantly, approximately one-quarter of those women diagnosed with breast cancer in Australia are under the age of 50 years (Better Health, 2021). Women between the ages of 40 and 49 years are not sent an invitation, although they are eligible for breast cancer screening. In Australia, each state and territory operate its breast cancer screening programs. The programs form part of the national screening program. The programs also target some Trans and other gender-diverse women within eligible age groups. The breast cancer screening program is not recommended for women under 40 (Australian Government, 2004). Therefore, the focus of this study emphasizes the need to enhance breast cancer screening among women between 40 and 49 years. By chance, women aged between 40 and 49 years may have had a relative who had breast cancer. Nonetheless, the Cancer Council (n.d) maintains that less than 5% of breast cancer cases are associated with family history. Therefore, it is crucial for women between the ages of 40 and 49 to speak to an expert if they have doubts about the risk factors.

The average age of women diagnosed with breast cancer in Australia is 60 years. Although the risk of cancer increases with age, approximately 25% of the diagnosed breast cancer cases are women below 50 years (Melbourne Breast Cancer Surgery, 2008). Similarly, although 75% of breast cancer cases in Australia are reported among women aged 50 years, younger women are at risk of developing the disease, with 7.5% of new cases reported by women 40 years and below (Kemp et al., 2013). Furthermore, about 700 women aged 40 years and below are diagnosed with breast cancer annually (Kemp et al., 2013). Therefore, there is a need to enhance breast cancer screening among women aged between 40 and 49 as this reduces the cases of death. However, the overall survival rate of women under 50 years has increased due to early detection through breast cancer screening. According to Dasgupta et al. (2017), recent statistics suggest that more than 90% of women diagnosed with breast cancer will be alive in the next five years. Therefore, the indicator is crucial in reiterating the need for early detection of the disease, which is known to reduce the causes of death. Noteworthy, the rate of survival has been established to be lower among women aged between 40 and 49 years at 89.7% (Dasgupta et al., 2017). As such, there is a great need to encourage younger women to attend early breast cancer screening.

Breast cancer is the most common cancer-related death in Australia among women. Therefore, it is important to identify the diseases' dynamics, especially concerning different age groups. The idea is to encourage younger women to attend early detection screenings. According to the Australian Government (2004), all women of all ages must understand that detecting and treating breast cancer early is important. Seeing breast cancer when it is still small and confined to the breast allows effective treatment of the disease for affected women. Several benefits for early detection of breast cancer have been identified, including increased survival rates, improved quality of life, and advanced options for treatment. According to Mitchell et al. (2006), an increase in age has been mentioned as one of the disease's risk factors, with 75% of the identified cases being women above 50 years. However, tumors have been established to be larger and extremely aggressive in younger women, likely reducing the chances of survival compared to older women. Therefore, the choice of women between 40 and 49 years is appropriate due to the risk factors and the opportunity to detect the disease early hence increasing chances for survival. The idea to target younger women is also informed by the need to create awareness of breast cancer among Australian women. In Australia today, more than half of the diagnosed cases of breast cancer are done after investigating the changes noted in the breast by the doctor or the patient (Roder et al., 2012). Therefore, this suggests the need for awareness about early screening among women aged 40 to 49.

Part B

Early breast cancer screening in combination with treatment and follow-up reduces the number of deaths resulting from the disease. According to Drake et al. (2015), studies show that most women begin regular breast cancer screening later than the recommended date. The studies also show that many women do not have their breast cancer screening at the recommended intervals and lack appropriate and timely follow-ups (Hahn et al., 2007). The condition is even worse for women residing in areas with limited access to medical facilities. Breast cancer screening has been developed as a solution to delivering breast cancer care. The studies that have been advanced have revealed the importance of early screening as a solution to breast cancer care which has helped enhance its adoption. Several programs have been developed in Australia to aid breast cancer screening by eliminating barriers created by income, access to facilities and care, and insurance status. Thus, healthcare workers have collaborated with other partners to navigate care among women aged 40 to 49 and provide breast cancer screening services (Kim & Jang, 2008). The use of patients' navigators has proven important as it includes issues of primary care preventions, screening, and follow-ups. 

Attempts to promote breast cancer screening among younger women in Australia have been met with numerous challenges. However, as Ellen Tichich (2021) states, the efforts by nurses to partner with other stakeholders in health have proven adept in finding ways for success, especially where there is the greatest need. As aforementioned, lives can be saved through early detection and diagnosis of breast cancer. One of the challenges nurses face in the quest to get younger women screened for breast cancer is the lack of resources, including oncology specialists and screening centers. According to Cederbaum and Klusaritz (2009), nurses are best positioned to provide the important linkages between patients, resources, and programs. To achieve this, nurses employ the use a strength-based nursing approach. The strength-based nursing approach refers to the type of care guided by eight core values of nursing action, which promote self-efficacy, empowerment, and hope (Gottlieb, 2014). The nurse's main focus is on inner and outer strengths through this approach. In other words, nurses emphasize what patients and their families perform to help them deal with the problems best and minimize the deficits. According to Swartz (2017), strength-based nursing reaffirms the goals of nursing, such as health promotion, facilitating healing, and eliminating suffering through creating environments that bolsters innate healing mechanisms and patients' health capacities. By achieving this, strength-based nursing provides care, a language communicating the contribution to families and patients about health and healing, and empowers the patients and families to take charge of their health and healing process.

Strength-based nursing creates a new balance in the realm of deficit-based care. Therefore, it focuses on identifying the deficits and problems in a holistic and broader context that reveals inner and outer strengths. Most nurses apply several aspects of strength-based nursing without labeling them as such. However, labeling is crucial due to its potential to take the awareness of the approach to a higher level. Although there are variations in the perceptions of the role of nurses in the medical treatment process, it has been established that a strength-based nursing approach is important in treating chronic diseases such as breast cancer (Gottlieb et al., 2005). In a meta-analysis consisting of 29 quality studies, 27 reviews, and nine evaluations conducted by Byrne et al. (2015), it was established that interventions involving specialty trained nurses would supplement and not replace the efforts of physicians. Furthermore, it was established that nurses are important in ensuring proactive as opposed to reactive assessment and monitoring services to patients suffering from chronic diseases. Most importantly, the study stated that nurses provide better and less costly outcomes through the strength-based nursing model than physician-led interventions (Knibbs et al., 2012). One of the ways that nurses achieve this is through a partnership with the communities, families, and patients, ensuring that patients take control over their health.

Breast cancer is continuously becoming a major non-communicable disease in Australia with the ill-prepared and inadequate nursing workforce. However, as Challinor et al. (2016) stated, a team approach can ensure successful care for breast cancer patients. More importantly, trained oncology nurses play the most critical role in the functioning of such teams. Goals such as reducing incidences of cancer, providing better palliative care, and chances of survival cannot be achieved without the input from nurses. Oncology nurses work with communities and at the bedside to deliver the necessary health education to the communities, families, and patients (Wang-Gillam et al., 2019). Other important roles nurses play include implementing early detection programs through screening, identifying complications, administering treatments, collaborating and leading clinical research, and administering palliative care. Oncology nurses who are well trained have proven effectiveness and efficiency in breast cancer screening programs in high-income countries (Galassi & Challinor, 2015). The most important aspect of the contribution of nurses in enhancing breast cancer screening efforts is to offer appropriate patient education and contribute to attempts to reduce cancer in Australia.

Breast cancer screening is often designed to conduct systematic explorations or tests to identify the disease during its onset. The programs are designed to improve prognosis by enhancing diagnosis at the earliest time possible. Screening for breast cancer is advisable within the context of programs due to improved quality, access to services, and information. Lynge et al. (2012) state that a well-designed breast cancer screening program takes a multidisciplinary approach. Nurses play a pivotal role in the early detection and prevention of breast cancer among younger women in Australia. According to Llucia Benito et al. (2014), the most important role nurses play in cancer control in Australia is education and awareness about cancer screening programs for young women. The cancer screening nurses are involved in specific roles that enhance the efficiency and effectiveness of their roles. In a study by Glasper (2012), the researcher found that nurses play the roles such as follow-ups, ensuring the continuity of the process, coordinating treatment, and disseminating up-to-date and patient pertinent information to ensure patients' choice and knowledge. Besides, nurses also work to ensure coordination in all levels of care, ensure continuous training, lead in research and publications, and collaborate in investigations based on early detections of breast cancer cases. 

In conclusion, the study aimed to describe the community of women aged between 40 and 49 years in Australia regarding breast cancer screening programs. The study also aimed at providing the role of nurses in enhancing screening among women below 50 years through strength-based nursing approaches. Women between 40 and 49 years are at a higher risk of death due to cancer. Therefore, it is crucial to emphasize the need to access screening services for this community. Several states and territories, including the national Government, provide a range of screening programs for women in Australia. Women need to use such programs to reduce the impacts of breast cancer. Nurses play a vital role in health outcomes through a strength-based approach. The approach entails partnering with the community, families, and patients to enable them to take charge of their health.

References

Australian Government. (2004). Early Detection of Breast Cancer. Australian Government.

Better Health. (2021). Breast Screening. Department of Health, State Government of Victoria, Australia. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/breast-screening#who-is-eligible-for-breast-screening

Cancer Council. (n.d). Early Detection of Breast Cancer. Cancer Council. https://www.cancer.org.au/cancer-information/causes-and-prevention/early-detection-and-screening/early-detection-of-breast-cancer

Cederbaum, J., & Klusaritz, H. A. (2009). Clinical instruction: Using the strengths-based approach with nursing students. Journal of Nursing Education, 48(8), 423-424.

Challinor, J. M., Galassi, A. L., Al-Ruzzieh, M. A., Bigirimana, J. B., Buswell, L., So, W. K., ... & Williams, M. (2016). Nursing’s potential to address the growing cancer burden in low-and middle-income countries. Journal of global oncology, 2(3), 154.

Dasgupta, P., Baade, P. D., Youlden, D. R., Garvey, G., Aitken, J. F., Wallington, I. & Youl, P. H. (2017). Variations in outcomes for Indigenous women with breast cancer in Australia: A systematic review. European Journal of Cancer Care, 26(6), e12662.

Drake, B. F., Tannan, S., Anwuri, V. V., Jackson, S., Sanford, M., Tappenden, J., ... & Colditz, G. A. (2015). A community-based partnership to successfully implement and maintain a breast health navigation program. Journal of community health, 40(6), 1216-1223.

Ellen Tichich, M. F. A. (2021). Collaboration, Determination Improves Cancer Screenings in Rural Areas. Oncology Nursing News. https://www.oncnursingnews.com/view/collaboration-determination-improves-cancer-screenings-in-rural-areas.

Galassi, A., & Challinor, J. (2015). Strengthening the oncology nurse workforce in low-income and middle-income countries. The Lancet Oncology, 16(8), 887-888.

Glasper, A. (2012). Can nurses help to promote earlier diagnosis of bowel cancer?. British Journal of Nursing, 21(1), 50-51.

Gottlieb, L. N. (2014). CE: strengths-based nursing. AJN The American Journal of Nursing, 114(8), 24-32.

Gottlieb, L. N., Feeley, N., & Dalton, C. (2005). The Collaborative Partnership Approach to Care-A Delicate Balance: Revised Reprint. Elsevier Health Sciences.

Hahn, K. M., Bondy, M. L., Selvan, M., Lund, M. J., Liff, J. M., Flagg, E. W. & Coates, R. J. (2007). Factors associated with advanced disease stage at diagnosis in a population-based study of patients with newly diagnosed breast cancer. American journal of epidemiology, 166(9), 1035-1044.

Kemp, A., Preen, D. B., Saunders, C., Holman, C. D. A. J., Bulsara, M., Rogers, K., & Roughead, E. E. (2013). Ascertaining invasive breast cancer cases; the validity of administrative and self-reported data sources in Australia. BMC medical research methodology, 13(1), 1-8.

Kim, J. Y., & Jang, S. N. (2008). Socioeconomic disparities in breast cancer screening among S women: trends from 2000 to 2005. Journal of preventive medicine and public health, 41(3), 186-194.

Knibbs, K., Underwood, J., MacDonald, M., Schoenfeld, B., Lavoie-Tremblay, M., Crea-Arsenio, M., & Ehrlich, A. (2012). Appreciative inquiry: a strength-based research approach to building Canadian public health nursing capacity. Journal of Research in Nursing, 17(5), 484-494.

Llucia Benito, R. N., Gemma Binefa, M. D., Teresa Lluch, R. N., Carmen Vidal, M. D., & Milà, N. (2014). Defining the role of the nurse in population-based cancer screening programs: a literature review. Clinical journal of oncology nursing, 18(4), E77.

Melbourne Breast Cancer Surgery. (2008). Statistics. https://www.melbournebreastcancersurgery.com.au/statistics.html

Mitchell, K. J., Fritschi, L., Reid, A., McEvoy, S. P., Ingram, D. M., Jamrozik, K. & Byrne, M. J. (2006). Rural–urban differences in the presentation, management and survival of breast cancer in Western Australia. The Breast, 15(6), 769-776.

Roder, D., Silva, P. D., Zorbas, H., Kollias, J., Malycha, P., Pyke, C., & Webster, F. (2012). Survival from synchronous bilateral breast cancer: the experience of surgeons participating in the breast audit of the Society of Breast Surgeons of Australia and New Zealand. Asian Pacific Journal of Cancer Prevention, 13(4), 1413-1418.

Swartz, M. K. (2017). A strength-based approach to care. Journal of Pediatric Health Care, 31(1), 1.

Wang-Gillam, A., Hubner, R. A., Siveke, J. T., Von Hoff, D. D., Belanger, B., de Jong, F. A., ... & Chen, L. T. (2019). NAPOLI-1 phase 3 study of liposomal irinotecan in metastatic pancreatic cancer: Final overall survival analysis and characteristics of long-term survivors. European Journal of Cancer, 108, 78-87.

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