NURS 3600 Nursing Research
Literature Review Matrix
Name: _Lindsey Butler________
AUTHOR,
TITLE,
JOURNAL
YEAR
METHOD &
DESIGN
STUDY
PURPOSE
A. M. Kabel &
L.P. Johnson
Cancer Patients
and the Changing
Nature of
Holistic Health
Health, Culture,
& Society
2014
Descriptive
survey
To examine
familiarity with
and frequency
of CAM use
among female
cancer patients
at a Midwestern
oncology clinic.
To gain insight
into the
motivations for
use.
Sheila Garland,
David Valentine,
Krupali Desai,
Susuan Li, Corey
Langer, Tracey
2013
CrossSectional
Survey
To find the
associations
between the use
of CAM and the
ability to find
VARIABLES
(Omit if a qualitative study)
Dependent
Independent
response
manipulation
Meditation,
Number of
supplements,
times CAM
prayer,
therapy was
chiropractic,
used
massage, yoga,
Reason CAM
aroma therapy,
therapy was
organic diet, and used
reflexology.
chamomile tea,
aloe Vera,
Echinacea,
elderberry, green
tea, rosemary, St.
John’s Wart,
garlic, ginger,
milk thistle,
lavender,
evening primrose
oil.
SUBJECTS
Benefit from
CAM use with a
diagnosis of
cancer
No benefit
Age
Gender
Race/ethnicity
Educational
level
RESULTS
COMMENTS*
About half of the
participants denied
CAM use when first
asked, but after being
asked multiple times.
Several admitted to
CAM therapy use. The
majority of
participants did not
discuss the use of these
therapies with their
physicians and
physicians did not
typically ask patients
about CAM. It is a
field less understood
and patients need
proper education
before hand in order to
know what are CAM
therapies and the
benefits versus the
costs.
Even though the
information is well
presented they
acknowledged the
need for more research
Number
Characteristics
Sample Method
25
Female cancer
patients. 18 to 91
years, newly
diagnosed or
relapsed recruited at
a women’s cancer
clinic in the
Midwest. No
language barrier or
inability to read.
Recruitment took
place over
approximately three
weeks and participants
were recruited in the
waiting area of the
clinic Individuals
were surveyed in a
private room.
The prevalence of CAM
use among the patient
population and
confirmed patient
reluctance to admit
using CAM therapies.
48% of the participants
answered “no” when
asked if they used
CAM, but upon further
questioning, described
using one or more of
these therapies.
316
Participants were at
least 18 years of
age, with a primary
diagnosis of cancer
and a Karnofsky
Outpatient oncology
clinics (Breast, Lung,
Gastrointestinal) at the
Abramson
Cancer Center of the
61.3% reported CAM
use following diagnosis.
Factors associated with
CAM use were female
gender, college, or
Evans, & Jun
Mao
Complementary
and Alternative
Medicine Use
and Benefit
Finding Among
Cancer Patients
The Journal of
Alternative and
Complementary
Medicine
Robyn Andersen,
Erin Sweet,
Kimberly A.
Lowe, Leanna J.
Standish, Charles
W. Drescher, &
Barbara A. Goff
2013
Crosssectional
survey
benefit in the
cancer
experience.
shown from
CAM use with a
diagnosis of
cancer
Employment
Cancer type
Cancer stage
Surgery
Radiation
Chemotherapy
Time since
diagnosis
To determine
the extent to
which patients
with ovarian
cancer were
using CAM
supplements
Poor
conventional
interaction
between chemo
and CAM
therapy
No interaction
Antioxidants,
Supplements,
and Herbs,
Patients Who
Took
Substance
During
219
patients
score of 60 or
greater. The
approval
of their oncologists
and the ability to
understand and
provide informed
consent in English
University of
Pennsylvania
Trained research
assistants screened
medical records and
approached
potential participants
in the waiting area of
the
Oncology clinics.
Medicine–oriented
gynecologic
oncology practices.
Speak English
fluently, older than
age 21 years. Each
eligible woman was
Of the 447 women in
practice records, 388
had current
Contact information
and were approached
to participate. Six
had recently died,
higher, education;
breast cancer diagnosis;
and being 12 to 36
months post-diagnosis.
The greatest unique
variance to benefit
finding (23%), followed
by time from diagnosis
(18%), and age (14%).
CAM use uniquely
accounted for 13% of
the variance in benefit
finding. Individuals
using energy healing
and healing arts
reported significantly
more benefit than
nonusers. Special diet,
herbal remedies,
vitamin use, and
massage saw a smaller
increase in benefit
finding, while
acupuncture,
chiropractic,
homeopathy, relaxation,
yoga, and tai chi were
not significantly
associated with benefit
finding.
200 women reported
having chemotherapy to
treat their ovarian
cancer. 40% reported
using 1 or more CAM
supplements that could
be cause for concern
to evaluate the causal
relationship between
CAM use, benefit
finding, and better
psychosocial wellbeing. I agree I would
need more research for
my question to be
answered accurately.
Many herbs and
supplements are
available without
prescription and may
be used by women
with ovarian cancer
without discussion
Dangerous
Combinations:
Ingestible CAM
Supplement Use
During
Chemotherapy in
Patients with
Ovarian Cancer
The Journal of
Alternative and
Complementary
Medicine
J.D. Schultz, M.
Stegmuller, A.
Faber, C. Thorn,
K. Hormann, R.
Nowack, A.
Sauter
Complementary
and Alternative
Medications
Consumed by
Patients with
Head and Neck
Carcinoma: A
Pilot Study in
Germany,
Nutrition and
Cancer
2012
a crosssectional,
descriptive
study
at times when
they might be
potentially
dangerous when
taken with
conventional
treatments.
Also to
determine how
frequently
patients
discussed their
supplement use
with physicians,
both allopathic
physicians and
CAM-providing
naturopathic
physicians.
To document
the frequency
and pattern of
CAM and
health food
consumption in
patients with
head and neck
cancer, by using
a self-reported
questionnaire.
This study
also
investigates this
population’s
attitudes and
basic
knowledge with
between CAM
and Chemo
therapy
Chemotherapy,
Women Who
Discussed
CAM Use
With Their
Conventional
Provider,
Women Who
Discussed
CAM Use
With Their
CAM Provider,
Comorbidity
Mineral
supplements
Vitamins
Phytotherapy
Herbal teas
Juices
others
Head & neck
tumor patients
Control group
Gender
Age
219
approached by mail
through her
oncologist and
asked to participate
in the study
leaving 382 potential
participants not
known to be
ineligible; 219 of
these (56.4% of those
approached)
demonstrated
eligibility and
returned the
questionnaire.
when taken with 1 or
more of the
Chemotherapy
medications they were
receiving. Many
patients took multiple
supplements of
potential concern.
Of these women, 42%
consulted with a
conventional provider
and 24% consulted with
a CAM provider about
the contraindicated
supplements they used.
with any medical
provider. CAM
therapy does not seem
well discussed or
monitored in the
physician-client
treatment plan
The overall mean
age of patients was
(range = 22 to 72)
in the control group
(range = 18 to 88)
in the group of
patients with a
malignancy of the
head and neck.
Manifest tumor
disease within the
head and neck
region, first
diagnosis, currently
under therapy,
independent of the
treatment modality
or patients in follow
otorhinolaryngology
and head and neck
surgery, University
Hospital, Mannheim,
Germany and was
evaluated. 107 (65
males; 42 females,
patients with a
malignant tumor of
the head and neck.
A significantly higher
prevalence of CAM
consumption between
tumor patients and the
control group was
detected. Concerning
the frequency of CAM
usage, a significant
increased consumption
of CAM among tumor
patients (42.8% vs.
62.6%) especially for
herbal teas,
phytotherapy,
supplement products,
and “other”
supplements comparing
the controls.
Only 6.25% of the
controls and 19.6% of
tumor patients know
about
pharmacodynamic or
pharmacokinetic
interactions and
possible side effects.
Furthermore, only
1.7% of the controls
and 6.5% of the tumor
patients informed their
attending physician
about the CAM usage.
Patients are not very
aware of the possible
interactions of
different treatments
respect to the
safety of CAM
Alesandre Chan,
Tay Hui Lin,
Vivianne Shih,
Tan Huey Ching,
Joen Chiang,
Clinical
Outcomes for
Cancer Patients
Using
Complementary
and Alternative
Medicine,
Alternative
Therapies
2012
Single center,
retrospective
cohort study.
The patients
had
participated
previously in
a
crosssectional
prevalence
survey about
the types of
oral CAM
The current
study evaluates
the effects of
CAM use in
cancer
patients;
up appointments.
CAM users
Non CAM users
Immunity related
General health
related
Female
Age
Chinese
Malay
Indian
Others
Cancer type
Chemo
treatment
Type of CAM
used
357
National Cancer
Centre Singapore
The study excluded
patients if their
medical records
were incomplete
and/or if the
patients had not
received any
cytotoxic or
targeted therapies at
the time of the
survey.
recruited between
October 2007 and
March 2008 at the
National Cancer
Centre Singapore
Furthermore a
significant influence of
female gender and an
increased CAM usage
was detected. Only
6.25% of the controls
and 19.6% of tumor
patients know about
possible side effects but
only 1.7% of the
controls and 6.5% of
the tumor patients
informed their
physician about the
CAM usage. The
frequency of CAM in
head and neck tumor
patients seems to be
relevant in the
supervision of
anticancer therapies.
As a whole, CAM use
provided an absolute
reduction of infection
episodes by 11.9% and
of antibiotic use by
10.3%. A reduction of
documented infection
17.9% and a 13%
decrease in
hospitalizations due to
infections among
metastatic cancer
patients who used
CAM. CAM usage was
not associated with
significant changes of
This study successfully
evaluated whether use
of CAM reduced acute
complications of
chemotherapy. Results
of this cohort study
suggest that cancer
patients who
consumed CAM
experienced a
significant decrease in
infection occurrence
(11.9% reduction) and
an overall decrease in
antibiotics use (10.3%
reduction). More
hepatic and renal
function.
Anna Finnane,
Yuan Liu, Diana
Battistutta,
Monika Janda,
and Sandra C.
Hayes,
Lymphedema
after Breast or
Gynecological
Cancer: Use and
Effectiveness of
Mainstream and
Complementary
Therapies,
The Journal of
Alternative and
Complementary
Medicine
2011
crosssectional
study
To describe the
use and
perceived
effectiveness of
mainstream and
CAM therapies
in the treatment
of lymphedema
following breast
or
gynecological
cancer.
Compression
garment
Laser therapy
Limb exercises
Massage
Acupuncture
Aromatherapy
Bowen therapy
Chi machine
Chiropractic
Circulation
booster
Homeopathy
Kinesiotape
Meditation
Naturopathy
Osteropathy
Reflexology
Reiki
Spritual healing
T’ai Chi
Pilates
Age
Location
Marital status
Employment
status
Yearly income
Private Health
insurance
Cancer type
Number of
cancers
Cancer
treatment
95
A self-administered
questionnaire was
sent to 247
potentially eligible
women.
Of those returned
(50%), 23 were
ineligible and 6
were excluded due
to level of missing
data.
convenience sample
In the previous 12
months, the majority of
women (90%) had used
mainstream treatments,
with massage being the
most commonly used
(86%). One (1) in 2
women had used CAM,
and 98% of those using
CAM were also using
mainstream treatments.
Over 27 types of CAM
were reported, with use
of a chi machine,
vitamin E supplements,
yoga, and meditation
being the most
commonly reported
forms. The perceived
effectiveness ratings (1–
7 with 7 = completely
effective) were
importantly, the
authors did not
observe any significant
toxic effects on
hematological, liver,
and renal function
among CAM users.
Due to this study CAM
can be beneficial.
CAM therapies should
still be monitored and
discussed with the
physician as part of the
care plan for safety
reasons.
Almost all women
reported the use of
CAM & mainstream
therapies during the
same period; it seems
more likely that CAM
therapies were
considered
complementary rather
than alternative. It
seems plausible that
while the forms of
CAM treatment
reported were
perceived to be
effective, multiple
barriers prevented
them from becoming
alternative forms of
treatment rather more
complementary.
John jGillett,
Clare Lentile,
Joanne Hiscock,
Ashley Plank,
and Jarad Martin,
Complementary
and Alternative
Medicine use in
Radiotherapy:
What are Patients
Using?,
The Journal of
Alternative and
Complementary
Medicine
2012
validated
questionnaire
To determine
the prevalence
of CAM usage
by outpatients
attending the
Radiation
Oncology
Queensland and
assess the
disclosure of
patients CAM
use to
oncologists and
general
practitioners
Yoga
CAM user
Non CAM user
Age
Gender
Ethnicity
Location
Employment
Cancer type
101
outpatients
attending
the Radiation
Oncology
Queensland,
Toowoomba for
Radiotherapy clinic
between April and
July 2009
questionnaire was
given to consenting
outpatients in this
ethics-approved study
considered high.
38% of the total patient
group used CAM, with
vitamins (53%),
antioxidants (29%),
spiritual/meditation
practices (29%), and
herbs (18%) being the
most commonly used.
The intention of CAM
use was to improve
quality of life in 69% of
patients and for either
hope of cure or to assist
other forms of treatment
in 26%. 58% were
using CAM prior to
their diagnosis of
cancer, with 40%
starting at diagnosis or
during conventional
treatment. Patients
spent up to $300/ month
on CAM use. Patients
using CAM were
significantly more
likely to also receive
chemotherapy versus
non-CAM users (45%
versus 24%).
Significantly fewer
CAM users expected
cure from conventional
therapy, compared to
non-CAM users (50%
versus 75%). More
CAM users expected
Likert scale of 1-5,
with 1 being "not at all
helpful" and 5 being
"extremely helpful,"
the CAM users'
median rating of
helpfulness was 3.
Twenty-two percent
(22%) rated
CAM use as "not
helpfiil" (rating 1 or
2); however, 36%
rated CAM usage as
"very" or "extremely
helpful" (rating 4 or 5)
for treating of their
cancers. Ninety-two
percent (92%) of
CAM users responded
that CAM usage was
"safe." No patients
attributed any sideeffects from their
CAM therapies. From
the patient perspective
it was supported that
CAM was more
helpful than not.
conventional therapy to
prolong life (58%
versus 32%). Only 40%
discussed CAM use
with their oncologists.
Now that you have summarized the articles you obtained, please answer the following questions:
1. Does the evidence answer your clinical question?
Actually as I began the matrix, I realized the articles I had searched were not specific enough or the type of article I was looking for. I had to find almost all new articles to better fit my question. Even with the new
articles, the above research is a step to answering my clinical question, but I did not receive enough supporting evidence to comfortably answer the question. The research supported that CAM therapy is being used
by a great percentage of the population being diagnosed with cancer; however, the most of the articles suggested that further research needed to be studied about CAM therapies. The article above also have some
conflicting information some say it is effective, others say it is dangerous, and some even discovered that patients are not even sure what it is.
2.
If the evidence answered your clinical question, what is the answer?
3. If the evidence did not answer your clinical question, what are your next steps?
I think the next step is to revise my clinical question. I think that CAM therapy is a newer concept that is being looked at in the United States and a more revised specific question needs to be asked. I also realized
through this experiment how specific and detailed the question should be. However, there is a pro and con to being specific. In the specification the topic is narrowed and the critiquer knows exactly what to look for
and there are fewer distractions. The con side is that it is very time consuming and can be challenging to find specifics to meet the parameters. There is more than one option for progression though. I could continue
to research literature and find more research that might answer the question. Also, I could try to find a research team studying CAM and participate in the research process and get information that way.
Lit Review Matrix
Lit Review Matrix
Criteria
Ratings
Number of articles
References 6-8 research
articles
20 pts
Instructor Comments
Study method, design, and
purpose
Instructor Comments
Correctly identifies each
study design/method;
includes each study's
purpose
Pts
References 4-5 research References less than 4
articles
research articles
12 pts
9 pts
Incorrectly identifies
study method/design or
does not identify study
purpose
20 / 20 pts
25 / 25 pts
Lit Review Matrix
Criteria
Variables
Instructor Comments
Sample and sample method
Instructor Comments
Study results
Ratings
25 pts
12 pts
Correctly identifies
dependent & independent
variables if quantitative
research
25 pts
Does not identify
variables if quantitative
research or incorrectly
identifies dependent vs.
independent variables
12 pts
Describes number &
characteristics of sample;
includes sample method
for each study
25 pts
Includes most
components of sample
description & sample
method for most studies
15 pts
Concisely summarizes
each study's results
25 pts
Does not summarize
each study's results &/or
includes study
implications/conclusions
instead of results
12 pts
Includes comments for all
articles
25 pts
Includes comments for
most articles
15 pts
Does not include
comments or comments
included for few articles
9 pts
25 / 25 pts
Accurately, clearly, and
thoroughly describes if
evidence answered
Conclusion regarding
the evidence is unclear;
if evidence did not
No conclusion included
regarding the evidence in
answering clinical
25 / 25 pts
Instructor Comments
Comments
Instructor Comments
Concluding questions
Instructor Comments
Pts
18 / 25 pts
Does not include
sample description
&/or sample method
9 pts
25 / 25 pts
25 / 25 pts
Lit Review Matrix
Criteria
Ratings
clinical question; if
evidence did not, provides
next steps reflective of
course content
25 pts
Total Points: 163/170
Pts
answer clinical question, question or conclusion is
includes next steps but
incorrect
reader forced to make
9 pts
inferences to see
connection with course
content
12 pts