Malignant wounds among patients can severely impact their personal Well-being and social life . To understand this relationship better, it is important to research the intersection between various physical, mental and social symptoms of malignant wounds. To understand the nature of impact, it is necessary to consider this topic from the point of view of patients, caregivers or nurses. However, study of past literature indicates that in most studies the perspective of health care practitioners was only considered. Thus, there is impending need to consider the former so that it addresses the overall medical needs of the patients with malignant wounds better.

In this research proposal, the background of the topic under consideration, its significance and review of available literature is undertaken to understand it in more depth. The intention is to outline a research path which along its way will define a methodology to address the core issue in an analytical, quantitative and logical manner.

TABLE OF CONTENTS

Problem Background

The physical symptoms of patients suffering from malignant wounds are given priority in medical treatment by the health practitioners. Some of these symptoms include malodor, exudates, pain and bleeding (Alexander 2009). The psycho-social symptoms among such patients that are not carefully analyzed are depression, social isolation, anorexia, impaired mobility, low confidence, worthlessness…etc. For instance, a patient suffering from cancer can be subjected to these psycho-social issues (Alexander 2009). In this line of research, these neglected psycho-social issues among patients with malignant wounds are brought to the fore in an effort to provide a complete medical strategy towards healing them.

The review of past literature on this subject indicates that the psycho-social issues of patients with malignant wounds, if considered were taken from health practitioners’ point of view and not from patients or nurses (Alexander 2009). Some of the research that was conducted on psycho-social issues highlighted the fact that they were difficult to manage and distressing (Alexander 2009). Since this perspective has not been given much emphasis in the past research studies, the proposed research will aim at fulfilling this impending need.

Literature Review.

Patients suffering from malignant wounds are affected adversely in all spheres, namely physical, psychological, social and spiritual (Alexander 2009). In most cases, it is possible to measure the physical suffering (Alexander 2009). However, the psycho-social suffering cannot be properly analyzed because of lack of formal guidance and information in this area (Alexander 2009). According to research conducted on 103 Canadian women, 80% reported that psycho-social issues were a major concern among women (Alexander 2009). Still, psycho-social concerns in patients are not viewed as a priority by medical practitioners. There is a communication barrier which needs to be surpassed between patient’s and medical practitioner’s over psycho-social problems. Further, it is important that any such communication is officially recorded, so that these psycho-social issues are given as much importance as the physical problems that result out of malignant wounds among patient’s (Alexander 2010). It is important to understand the mental impact that malignant wounds have on patients in their personal sphere and on their social well being (Piekkari 2004). As mentioned earlier, this is the missing link in providing holistic care to patients. Some of the common physical symptoms that patients with malignant wounds display are malodour, exudate, pain and bleeding. Some of the pyscho-social issues that result out of these physical symptoms are depression, embarassment, guilt, demoralization, insomnia, anorexia and social isolation. The inter-relationship between physical symptoms and psycho-social factors demand an in-depth study (Alexander 2009).

Research Questions

The major concern of this research proposal is to outline the psycho-social concerns of patients with malignant wounds. Further, the intention is to conduct a methodical study of these psycho-social concerns from the patient’s (or nursing) point of view (Alexander 2010). In short, following are some of the research questions pertaining to patient’s with malignant wounds:

What are their physical symptoms?

What are their psycho-social concerns?

What is the inter-relationship between physical and psycho-social factors? How can this inter-relationship be studied analytically, quantitatively and logically?

Why has this inter-relationship not been studied extensively in past research study in this area? What were the hurdles?

How can the psycho-social issues of patients be overcome? What are the challenges faced by the patients as well as nurses in overcoming them?

What are the challenges faced by the health professionals in addressing and overcoming these psycho-social issues among patients?

Research Objectives

The following are high level objectives of the intended research:

Outline and delve into inter-relationship between the physical and psycho-social aspects of patients with malignant wounds.

Develop a methodology to study the inter-relationship from a qualitative and quantitative point of view.

Based on research conducted, develop a strategy to quantize the sample points qualitatively to address the psycho-social issues of patients with malignant wounds.

Outline the challenges faced by the patients, nurses and health practitioners in addressing and consequently overcoming psycho-social issues?

Research Methodology

As mentioned earlier, there has been little research done on psycho-social issues of patients with malignant wounds. The proposed research will follow a three forked approach -exploratory, descriptive and triangulation (qualitative and quantitative). The exploratory dimension will focus on gathering extensive information on the subject of psycho-social issues which will help in addressing the research objectives better (Theory 2009). This mode of research will help in understanding hypothetical paradigms of intersection between physical symptoms and psycho-social patterns of patients with malignant wounds.

The descriptive mode of research will identify and acquire information on the characteristics of specific psycho-social issues (Theory 2009). Some of the questions that might be addressed here are:

· What percentages of patients with distinctive malignant wounds consider psycho-social issues important?

· What is the feedback of such patients on the mode of treatment given to them by health care professionals? For instance, some government bodies provide access to counseling services, spiritual care, healing therapies…etc as means of dealing with psycho-social issues among patients. It needs to be understood at a high level, if such services are beneficial to patients suffering from malignant wounds.

This kind of information can be condensed from past research conducted on this topic. This will comprise the secondary research results which can be quantitatively analyzed using statistical methods (Theory 2009).

6. Methods and Procedures

The data for primary research can be gathered using the survey structure of prior secondary research conducted in conjunction with active Triangulation approach (combination of qualitative and quantitative). The qualitative approach lays more importance on the type of patients (Maanen 1983) with varying nature of malignant wounds considered, than the number of such patients. This will determine the diversity in the sample space considered, which will ultimately pave way for a more realistic and fair response on this subject. The number of patient’s belonging to each sample point need to also be ascertained by a quantitative assessment. Once a survey is conducted on patient’s the results can be statistically correlated using quantitative methods. This research methodology is as much applicable to health practitioners and nurses, as it is to patients (Piekkari 2004).

The primary research results can then be compared with the secondary research results to ascertain consistency or exceptions in some of the research questions mentioned earlier (Secondary vs. Primary 2010). These are in line with the research objectives discussed in this proposal.

7. Setting and Participants

The research setting includes the type, nature and number of patients suffering from malignant wounds. Some of the relevant questions in this regard are as follows (Five Basic 2010):

What type of malignant wounds should be considered?

How many patients of each type with malignant wounds should be considered?

What type of major ailments/diseases must the patients considered for data selection pertain to?

How many patients with malignant wounds should be considered in total?

How many clinics/hospitals should be considered for data collection?

How many nurses and health practitioners should be considered for data collection?

What type of questions should form part of the survey? What should the emphasis be on?

Should there be formal interviews with patients (having malignant wounds)/nurses/ doctors? If yes, how many sample points of each should there be?

The intended research will take into account each of these aspects and quantize them based on time available for research (Five Basic 2010).

8. Rationale for Research

As mentioned earlier, there has been little research done about psycho-social issues in patients having malignant wounds. The research intended here takes into account this inconsistency and builds a methodology based on extrapolative and descriptive research (Theory 2009). This methodology is extended further to perform primary research using the triangulation approach, the results of which can try to diminish the existing void between of lack of research guidance available on this topic (Theory 2009).The data collection exercise can eventually answer some concrete research questions, which were otherwise ignored by prior research efforts. This research might assist in developing an overall holistic medical approach to address the problem of psycho-social issues of patients with malignant wounds and in turn mitigate their pain to a great extent. The sample points and results of this survey are subject to time availability and feasibility of conducting intended research (Theory 2009).

9. Timing Mileposts

Milestone

Description

Due date

Remarks

1

Step 1: Area of interest identified

1 November 2010

Physical, mental and social symptoms of malignant wounds

2

Step 2: Specific topic selected

1 November 2010

Psycho-social issues of patients with malignant wounds

3

Step 3: Topic refined to develop project proposal

8 November 2010

Define methodology to address the core issue in analytical, quantitative and logical to develop a research path, point of view from patients, care givers or nurses.

4

Step 4: Proposal start date

8 November 2010

Read articles online and through CQU library, books

5

Step 5: Proposal submission date

20 January 2011

6

Step 6: Research start date

8 November 2010

7

Step 7: Collection of data and information

8 November 2010

Physical symptoms: pain/bleeding

Psycho-social: depression/ mobility/social isolation

Literature: physical/ social/spiritual/ Communication/Challeng-es/ research objectives/ management of wounds

8

Step 8: Analysis and interpretation of collected data/information

10 November 2010

The relationship between physical symptoms and psycho-social factors/ assessment reports/medical management/ qualitative and quantitative approaches

9

Step 9: Writing up

15 November 2010

10

Step 10: Final draft prepared – submission of project to CLC

11

Final Deadline

31 January 2011