Question 1.
Explain why a booster tetanus injection was given to Vivienne.
Accurately and clearly explains two reasons why a booster was given and correctly linking
it to information in the case study.
Question 2.
Describe the physiological basis of any 3 of her wound observations. Relate your response
to the case study.
Correctly identifies and explains three wound observations with accurate and highly
outstanding scientific detail, clearly linking each wound observation to the case study.
Question 3.
Explain how Vivienne’s fever developed and state 2 benefits of fever .
Provides an accurate and outstanding scientifically relevant explanation for the
development of fever.
Correctly identifies 2 benefits of fever that are scientifically relevant.
INTRODUCTION TO HEALTH BREAK DOWN
SECTION TWO
Question 4.
Name two most likely sources of the contamination of the wound by S. aureus and explain
how the organism was transmitted to the wound from each source.
Correctly identifies two sources of contamination relevant to the case study.
Clearly outlines and fully describes the chain of infection from each of the two sources with
an outstanding level of detail.
Question 5.
Explain why Augmentin is one of the appropriate drugs given to Vivienne
Provides a completely thorough, accurate and relevant scientific explanation for why
Augmentin a suitable drug for the treatment of Vivienne’s wound infection.
Response extends to also include a very clear and specific explanation highlighting the role
of the major ingredients in Augmentin
Question 6.
Discuss the mode of action of Augmentin and name 2 common adverse reactions of the
drug.
CASE STUDY 2
Provides a completely thorough and accurate scientific description of the mode of action of
Augmentin and its impact on the survival and activity of the bacteria.
Correctly identifies two common adverse reactions to the drug.
Question 7.
If Vivienne’s blood sample was taken for a differential blood count when she returned to
the medical centre, name 2 leukocytes that will be elevated and explain why. (3)
Case Study
1. Overview of the research design(Total: 5 marks)
1.1 What was the aim of the research?
The aim of the research was to determine what effects music therapy had, on anxiety of female
patients with breast cancer after radical mastectomy in the context of China.
1.2 What research design did the researchers use? Was it appropriate? Why /why not?
The researchers employed a randomized and controlled clinical trial, with a between-group
comparison of the participants. The control group received only routine care while the
intervention group received music therapy together with routine nursing care (Li et al., 2012).
This research design was appropriate because it provides a lucid understanding of whether music
therapy has an overall impact/effect on the anxiety of breast cancer patients or not.
- Sampling (Total: 10 marks)
2.1 Who were the study participants and what sampling technique was employed in this
study?
The participants were 120 female patients who had breast cancer. The sampling technique
involved selecting patients with breast cancer and had been admitted to a general hospital in
Xian, China (Li et al., 2012).
2.2 What are the inclusion and exclusion criteria of the sample? Why is it important to have
these criteria identified before recruitment?
The inclusion criteria: female of between 25 and 65 years who had a pathological diagnosis of
breast cancer and requires radical mastectomy including extensive radical mastectomy (ERM)
and modified radical mastectomy. Exclusion criteria: if allergic to sound, or did not prefer
listening to music, or had the voice sensitivity of epilepsy (Li et al., 2012). It is essential to have
these criteria identified before recruitment in order to include only those participants who will be
comfortable with the research and would not feel bothered by music.
2.3 How were the participants allocated into groups? Was this appropriate? Why/why not?
CASE STUDY 3
The 120 participants were allocated to the groups randomly. A randomization procedure was
carried out with 120 numbers generated by a computer program, and the patients were allocated
to two separate groups randomly: a control group and an experimental group, each with 60
participants (Li et al., 2012). This was appropriate because it helps to effectively detect or tell the
difference that music therapy has on the two groups of female breast cancer patients.
2.4 Describe the treatment the intervention and control group received during the study?
The experimental group received music therapy plus routine nursing care. They selected their
music of preference, controlled the volume, and listened to the music using headphones
connected to the MP3 player. This music therapy was twice every day, and 30 minutes per
session. The control group received only routine nursing care including chemotherapy nursing
care and the perioperative nursing care of breast cancer (Li et al., 2012).
- Data collection (10 marks)
3.1 What are the independent and dependent variables in this study? Why?
The independent variable is the amount of time or duration that the participants in the
experimental group are allowed to listen to music, during the music therapy. This duration is
controlled by the experimenting scientists and is only twice per day and 30 minutes per session.
The dependent variable is the variable that is being affected by the independent variable (Burns
et al, 2010), and in this case, it is the anxiety of breast cancer patients following radical
mastectomy.
3.2 What instrument/s was/were used to collect the data?
Instruments used in the data collection included the Chinese version of State Anxiety Inventory
(SAI), and a standardized demographical data questionnaire (Li et al., 2012).
3.3 How was the data collected?
The SAI was used in evaluating anxiety in the patients. The patients completed the pretest of SAI
prior to radical mastectomy. The three post-test SAI were carried out on the day before their
discharge from the health facility. A standardized demographical data questionnaire included 15
items such as residence, level of education, monthly income, occupation, marital status, age and
of initial suffering from breast cancer. The patients were asked all the items that were in the
questionnaire, and data collectors documented all their answers.
3.4 Define the concept of reliability and discuss how reliability has/has not demonstrated in
this study?
Reliability refers to the degree to which the results of the study are consistent over time, and
accurately represent the entire population being studied, and whether the results could be
replicated under a comparable methodology (Korhan, Khorshid & Uyar, 2011). Reliability has
been demonstrated in this study in the sense that the results are a representation of the entire
population that was studied. In addition, the results can be accurately reproduced repeatedly
under similar methodology.
CASE STUDY 4
3.5 Define the concept of validity and discuss how validity has/has not demonstrated in this
study?
Validity in research determines the truthfulness of research results or whether the study actually
measures that which it intended to measure. It is also the degree to which an instrument truly
measures that which it purports to measure (Burns et al., 2010). In this case, the study is valid in
that it truly measures the effects of music therapy on anxiety of breast cancer patients following
radical mastectomy, since this is what it intended to measure/study in the first place.
- Results (10 marks)
4.1. What differences in outcomes were identified between the intervention and control
groups?
After music therapy, the anxiety scores of patients in the experimental group were considerably
lower compared to that of the control group.
4.2. Were the results significant and why?
The result is significant because it demonstrates that music therapy has the ability to improve
anxiety.
4.3. Can the study results be generalized to other settings?
Yes, the results can be generalized to other settings. The study included participants of between
the ages of 25 to 65 years, the young adult and the old – and this is the age group in which breast
cancer is most prevalent. Therefore, the results can be generalized to other settings such as on
older breast cancer patients, who are of more than 65 years old. - Ethical consideration and applications of the study (Total: 10 marks)
5.1 What ethical considerations were applied or not applied to this study and how are they
relevant?
With regard to ethical considerations, the research was assessed, and then approved by the
relevant Human Research Ethics Committee. Every participant was informed about the study
prior to taking part, and they gave written informed consent prior to the voluntary participation
(Li et al., 2012).
5.2 Based on the study design and result, identify whether or not the study can be used to
inform clinical practice. Justify your answer with current literature. Ensure to synthesise your
response and not merely restate your previous answers.
This study can be effectively used to inform clinical practice. Music therapy involves using
recorded or live music and this helps to promote relaxation and provide distraction from side
effects and symptoms such as nausea and pain. In addition, music therapy helps to increase
CASE STUDY 5
feelings of psychological and physical well-being, and in so doing, reduces anxiety (Lin et al.
2011).
Reference
Burns, D. S., Sledge, R. B., Fuller, L. A., Daggy, J. K., Monahan, P. O. (2010). Cancer patients’
interest and preferences for music therapy. Journal of Music Therapy, 42, 185-199.
CASE STUDY 6
Korhan, E.A., Khorshid, L., & Uyar, M. (2011).The effect of music therapy on physiological
signs of anxiety in cancer patients. Journal of Clinical Nursing, 20, 7-8.
Li, X.M., Zhou, K.N., Yan. H., Wang. D.L. & Zhang, Y.P. (2012). Effects of Music Therapy on
Anxiety of Patients with Breast Cancer after Radical Mastectomy: A Randomized
Clinical Trial. Journal of Advanced Medicine.
Lin, M.F., Hsieh, Y.J., Hsu, Y.Y., Fetzer, S., & Hsu, M.C. (2011). A randomised controlled trial
of the effect of music therapy and verbal relaxation on chemotherapy-induced anxiety.
Journal of Clinical Nursing, 20, 988-999.