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  • [Solved] Report Help

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    See Attachments – ## ReportInstructions.docx – BURGLARYASSIGNMENTPACKET-1-11.pdf **## ReportInstructions.docx** In this supplemental report, your job as the acting supervisor of the Criminal Investigation Division (CID) is to address policy problems from an investigative standpoint (i.e., are the of…

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    See Attachments

    – ## ReportInstructions.docx

    – BURGLARYASSIGNMENTPACKET-1-11.pdf

    **## ReportInstructions.docx**

    In this supplemental report, your job as the acting supervisor of the Criminal Investigation Division (CID) is to address policy problems from an investigative standpoint (i.e., are the officers at your police department responding to crime scenes effectively).  Policy problem areas to focus on include, but are not limited to, the following considerations: spelling/grammatical errors, the officer not listing the correct charges, an incomplete or incorrect list of stolen or damaged items, or not verifying serial numbers in the NCIC database. These are just some policy areas that could be noted while you read this report. Please note that spelling and grammatical errors were deliberately inserted into this burglary report to see if the students can recognize them.

    **Create a Word document that will address the administrative policy elements (or pitfalls) you observed while reading the patrol I/O report.**

    Please upload a Microsoft Word Document to answer the questions below:

    1. Is the narrative structured correctly? If so, then outline how the narrative is structured. If the narrative is not structured, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    2. Is it factual, accurate, objective, complete, concise, clear, and free of grammatical/spelling errors?  If the narrative is factual, accurate, and objective, outline how it meets these qualifications. If not, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    3. Is it audience-focused? If the narrative is audience-focused, then outline how it is audience-focused. If the narrative is not audience-focused, provide policy guidance and implementation procedures based on currently accepted empirical practices.

    4. Are the criminal statutes appropriate? In other words, should additional charges be added to the case?  If not, what charges are applicable, and provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    5. Was the crime scene processed thoroughly? If not, what steps would an investigator have to follow up on? If not, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    1. 4th amendment considerations: Never assume a victim of a burglary automatically gives a patrol officer who responds to a burglary complaint full access to search the complainant's home.

    2. Evidence Oversight Policy Issues, such as not comprehensively documenting the scene (i.e., photography), not collecting or addressing sources of inculpatory and exculpatory evidence items, not adhering to crime scene perimeter check policies (i.e., sometimes referred to as "neighborhood canvas" —-verification of other homes, etc.).

    6. Was the accuracy of the NCIC information verified by the patrol officer through official receipts provided by the victim? If not, what steps could the investigator take to verify the victim's information (i.e., serial number of stolen items)? If not, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    1. Think about this: What "proof" (other than the complainant's word of mouth) would a criminal investigator be able to use in court that the reported serial number on the weapon was, in fact, the serial number?

    2. In other words, serial numbers given to a responding officer MUST BE INDEPENDENTLY verified before being entered into the NCIC database. Moreover, what checks and balances exist, in terms of policy, to ensure that the dispatcher entered the correct serial number into NCIC (think about the times that you have mistyped a number—if a dispatcher types in the wrong serial number into NCIC, major issues follow).

    **BURGLARYASSIGNMENTPACKET-1-11.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/burglaryassignmentpacket-1-11-pdf)

    **BURGLARYASSIGNMENTPACKET-1-11.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/burglaryassignmentpacket-1-11-pdf)

    **## ReportInstructions.docx**

    In this supplemental report, your job as the acting supervisor of the Criminal Investigation Division (CID) is to address policy problems from an investigative standpoint (i.e., are the officers at your police department responding to crime scenes effectively).  Policy problem areas to focus on include, but are not limited to, the following considerations: spelling/grammatical errors, the officer not listing the correct charges, an incomplete or incorrect list of stolen or damaged items, or not verifying serial numbers in the NCIC database. These are just some policy areas that could be noted while you read this report. Please note that spelling and grammatical errors were deliberately inserted into this burglary report to see if the students can recognize them.

    **Create a Word document that will address the administrative policy elements (or pitfalls) you observed while reading the patrol I/O report.**

    Please upload a Microsoft Word Document to answer the questions below:

    1. Is the narrative structured correctly? If so, then outline how the narrative is structured. If the narrative is not structured, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    2. Is it factual, accurate, objective, complete, concise, clear, and free of grammatical/spelling errors?  If the narrative is factual, accurate, and objective, outline how it meets these qualifications. If not, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    3. Is it audience-focused? If the narrative is audience-focused, then outline how it is audience-focused. If the narrative is not audience-focused, provide policy guidance and implementation procedures based on currently accepted empirical practices.

    4. Are the criminal statutes appropriate? In other words, should additional charges be added to the case?  If not, what charges are applicable, and provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    5. Was the crime scene processed thoroughly? If not, what steps would an investigator have to follow up on? If not, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    1. 4th amendment considerations: Never assume a victim of a burglary automatically gives a patrol officer who responds to a burglary complaint full access to search the complainant's home.

    2. Evidence Oversight Policy Issues, such as not comprehensively documenting the scene (i.e., photography), not collecting or addressing sources of inculpatory and exculpatory evidence items, not adhering to crime scene perimeter check policies (i.e., sometimes referred to as "neighborhood canvas" —-verification of other homes, etc.).

    6. Was the accuracy of the NCIC information verified by the patrol officer through official receipts provided by the victim? If not, what steps could the investigator take to verify the victim's information (i.e., serial number of stolen items)? If not, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    1. Think about this: What "proof" (other than the complainant's word of mouth) would a criminal investigator be able to use in court that the reported serial number on the weapon was, in fact, the serial number?

    2. In other words, serial numbers given to a responding officer MUST BE INDEPENDENTLY verified before being entered into the NCIC database. Moreover, what checks and balances exist, in terms of policy, to ensure that the dispatcher entered the correct serial number into NCIC (think about the times that you have mistyped a number—if a dispatcher types in the wrong serial number into NCIC, major issues follow).

    **BURGLARYASSIGNMENTPACKET-1-11.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/burglaryassignmentpacket-1-11-pdf)

    **## ReportInstructions.docx**

    In this supplemental report, your job as the acting supervisor of the Criminal Investigation Division (CID) is to address policy problems from an investigative standpoint (i.e., are the officers at your police department responding to crime scenes effectively).  Policy problem areas to focus on include, but are not limited to, the following considerations: spelling/grammatical errors, the officer not listing the correct charges, an incomplete or incorrect list of stolen or damaged items, or not verifying serial numbers in the NCIC database. These are just some policy areas that could be noted while you read this report. Please note that spelling and grammatical errors were deliberately inserted into this burglary report to see if the students can recognize them.

    **Create a Word document that will address the administrative policy elements (or pitfalls) you observed while reading the patrol I/O report.**

    Please upload a Microsoft Word Document to answer the questions below:

    1. Is the narrative structured correctly? If so, then outline how the narrative is structured. If the narrative is not structured, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    2. Is it factual, accurate, objective, complete, concise, clear, and free of grammatical/spelling errors?  If the narrative is factual, accurate, and objective, outline how it meets these qualifications. If not, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    3. Is it audience-focused? If the narrative is audience-focused, then outline how it is audience-focused. If the narrative is not audience-focused, provide policy guidance and implementation procedures based on currently accepted empirical practices.

    4. Are the criminal statutes appropriate? In other words, should additional charges be added to the case?  If not, what charges are applicable, and provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    5. Was the crime scene processed thoroughly? If not, what steps would an investigator have to follow up on? If not, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    1. 4th amendment considerations: Never assume a victim of a burglary automatically gives a patrol officer who responds to a burglary complaint full access to search the complainant's home.

    2. Evidence Oversight Policy Issues, such as not comprehensively documenting the scene (i.e., photography), not collecting or addressing sources of inculpatory and exculpatory evidence items, not adhering to crime scene perimeter check policies (i.e., sometimes referred to as "neighborhood canvas" —-verification of other homes, etc.).

    6. Was the accuracy of the NCIC information verified by the patrol officer through official receipts provided by the victim? If not, what steps could the investigator take to verify the victim's information (i.e., serial number of stolen items)? If not, provide policy guidance and implementation procedures that are based on currently accepted empirical practices.

    1. Think about this: What "proof" (other than the complainant's word of mouth) would a criminal investigator be able to use in court that the reported serial number on the weapon was, in fact, the serial number?

    2. In other words, serial numbers given to a responding officer MUST BE INDEPENDENTLY verified before being entered into the NCIC database. Moreover, what checks and balances exist, in terms of policy, to ensure that the dispatcher entered the correct serial number into NCIC (think about the times that you have mistyped a number—if a dispatcher types in the wrong serial number into NCIC, major issues follow).

    **BURGLARYASSIGNMENTPACKET-1-11.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/burglaryassignmentpacket-1-11-pdf)

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  • [Solved] catherine owens

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  • [Solved] 611m5r

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  • [Solved] Journal

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    If you are not currently on an athletic team or coaching, use your most recent team/athletic experience when you answer questions that relate to your current experience. You need to include both the questions and your answers when you submit the assignment; do not leave the questions out. The comple…

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    If you are not currently on an athletic team or coaching, use your most recent team/athletic experience when you answer questions that relate to your current experience.
    You need to include both the questions and your answers when you submit the assignment; do not leave the
    questions out. The completed assignment for the module should be 1 – 2 pages.
    answer the following questions:
    1. Have you and/or your teammates focused too much on outcome goals during your career?
    2. How do you determine your performance goals?
    3. During a contest, did you stay focused on process goals? If not, how could you have improved that focus?
    4. Read Exodus 34:5–7, how does “sin” or “dysfunctional behavior” get passed down from generation to
    generation?
    5. How do you measure your masculinity/femininity as an athlete?

  • [Solved] Journal

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    Select 2 of the following questions to answer. Pick one question from each group of questions. Critical thinking must be demonstrated in each answered question. Group A 1. Pick any topic covered this term. Create a complex question regarding that topic and respond accordingly. Use this as an opport…

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    Select 2 of the following questions to answer. Pick one question from each group of questions.
    Critical thinking must be demonstrated in each answered question.
    Group A
    1. Pick any topic covered this term. Create a complex question regarding that topic and
    respond accordingly. Use this as an opportunity to discuss a topic of your choice and one
    that you have not written about in prior journals.
    2. Should your tax dollars be used to build sport arenas? Should we provide tax incentives
    for sport organizations but not for the other private business?
    3. In what ways has sport mirrored moral and societal issues in society?
    4. What affect would be promoting gender fairness and equality in sport have upon our
    societal views toward women?
    5. Should sport impose a minimum eligibility requirement based on age (e.g., in women’s
    tennis, 14 yr. old’s can compete against 30 yr. old’s.)?
    6. Are the NCAA rules of eligibility and opportunity to play racially discriminatory?
    7. Should coaches be fired for running up the score? What do cases suggest about good
    sporting behavior.
    8. Why is using a team name such as the fighting Sioux or the Redskins a problem?
    Group B
    1. We have discussed the role of government in passing laws that may affect sports in a
    variety of ways. How would you decide between passing a federal or state law to address
    a particular situation? What is the role of government at each level? Why is it critical for
    government to address certain issues that affect sports rather than simply allow sport
    organizations to formulate and enforce their own rules?
    2. In the well-documented case of Colin Kaepernick, after he kneeled in protest of the
    treatment of blacks by law enforcement he was never able to regain a position in the NFL
    despite clearly having the ability and skills. Do you believe that he should have been
    protected by law for demonstrating his personal beliefs in the workplace? Why or why
    not?
    3. What are the key factors to eliminating the destructiveness of hazing in sports and similar
    group activities?
    4. In light of the Supreme Court decision to allow states to formulate their own policies on
    sports wagering, what role should sport organizations take to protect their athletes from
    the risks of increased sports gambling?
    5. As society changes and attitudes toward women and their rights evolve, how can we
    influence men to adopt attitudes and behavior that is respectful of girls and women
    especially regarding sexual battery and rape?
    6. Which of the apparent social trends in the United States do you think will have the most
    impact on sport and why? Discuss at least three trends.
    7. What evidence of environmental sustainability is there at your university for recreational,
    intramural, and intercollegiate sports?
    Based upon the assigned readings and presentations, you will answer all questions using current
    APA formatting (Times New Roman, 12-point font, and double spaced). All answers must be
    compiled in a Word document and submitted on the course online platform. Citations from the
    assigned reading are required in answering the questions. Each answer must be comprehensive,
    with sport related current examples. Each question must be answered with 200-300 words.
    Critical thinking must be demonstrated in each answered question. Include a proper APA title
    and reference page for each journal.
    At least one (1) peer-reviewed reference is required per question (including at least 1 non-
    textbook reference per Journal Assignment). Remember to use in-text citations with page
    numbers from the required readings and include at least one (1) scripture to support your
    statements for each question.
    It is important that you spend adequate time on the assignments as you progress through the
    course. Write your thoughts out effectively as you complete the reading assignments for each
    Module: Week. Do not answer ‘yes’ or ‘no’ to any of the questions

  • [Solved] Disorder

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  • [Solved] PP2

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    | | |
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  • [Solved] discussion

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  • [Solved] disc 6 509

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    \ disc6509.png](https://www.sweetstudy.com/files/disc6509-png "disc6509.png") \ rubricfordisc509.png](https://www.sweetstudy.com/files/rubricfordisc509-png-10409803 "rubricfordisc509.png")

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    \
    disc6509.png](https://www.sweetstudy.com/files/disc6509-png "disc6509.png")
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  • [Solved] ROUGH DRAFT NURS682L-B

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    – ## instructionsforroughdraftNURS682LB.docx – ## ImprovingCareforRecurrentBreastCancerPatients.docx – ## IntegratingTheoreticalFrameworksinBreastCancerCare.docx – ## ProblemIdentificationandDescriptionUsingPICOTFormat2.docx – EnhancingCareCoordinationandQualityofLifeforWomenwithRecurrentBreastCance…

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    – ## instructionsforroughdraftNURS682LB.docx

    – ## ImprovingCareforRecurrentBreastCancerPatients.docx

    – ## IntegratingTheoreticalFrameworksinBreastCancerCare.docx

    – ## ProblemIdentificationandDescriptionUsingPICOTFormat2.docx

    – EnhancingCareCoordinationandQualityofLifeforWomenwithRecurrentBreastCancer.docx
    – Recommendationsandconclusionswk3.docx
    – IntegratingPsychosocialSupportingRecurrentBreastCancerCare.docx

    **## instructionsforroughdraftNURS682LB.docx**

    This week, you will bring together all of the assignments you have completed thus far, and compose the rough draft of your change project paper. At this point, you will have submitted each section and received feedback. An attempt to incorporate all previous assignment feedback should be evident.
    Your rough draft contains all of the expected components of the final draft and is presented in APA format including a cover page, references, and appendices when warranted. Your rough draft is your opportunity to polish previously submitted assignments and combine the sections in a comprehensive paper that show your change project is ready to be implemented.

    You will take this time to identify and address any weaknesses or gaps in your change project. Your rough draft should only require minor revisions before the final paper.

    Your paper should be between 20 and 30 pages in length, not including the cover page, references, and any appendices. It must follow current APA manual style and format. Each section of the paper should be clearly identified using proper headings

    **## ImprovingCareforRecurrentBreastCancerPatients.docx**

    2

    **Improving Care for Recurrent Breast Cancer Patients: A Microsystem Approach**

    Name

    Instructor

    School

    Date

    **Improving Care for Recurrent Breast Cancer Patients: A Microsystem Approach**

    Among the provisions in the readings this week, the chapter in the Clinical Microsystems Greenbook that corresponds the most to my project topic of recurrent breast cancer is the chapter on improving care to the patients with chronic illness. Recurrent breast cancer is a complex and chronic ailment that requires regular and all-encompassing care management. The chapter provides the framework on how to enhance the care of patients at the microsystem level: in interdependent teams of small size (healthcare professionals) where the provision of care is personalized. It is notable that this concept especially applies to recurrent breast cancer, whereby patients may have long-term follow-up, need management of various symptoms, and may need adjustment of the treatment plans.

    The microsystem approach focuses more on the patient engagement that is important in the repeated breast cancer management. Patients have to deal with constant treatment and emotional issues, and therefore, it is essential to think about how they see the situation and include their own preferences in the course of treatment. As one example, through regular reassessment of physical and emotional needs and engaging patients with the decision-making process, clinicians will be able to create more efficient plans of care that would be based on the unique needs of a particular patient (Fathiya et al., 2023).

    More than that, the focus on the usage of data on monitoring the process and the improvement of processes constantly is noted in the chapter, and it can be directly applied to my project. In case of recurrent cases of breast cancer, information regarding the effectiveness of treatments, recurrence, and, in general, the quality of life may be gathered and frequently analyzed to adjust clinical methods and guarantee the best roles. With the help of this microsystem concept, healthcare teams will greatly transform their collaboration to meet the many needs of recurrent breast cancer patients in terms of structure and functioning as well as to finally improve patient outcomes.

    This reading has applied strong footing in implementing change in my project because it puts importance on individualized care, collaboration between teams, and application of data-driven changes, which all play an important role in enhancing care and treatment of breast cancer episodes.

    **References**

    Fathiya, L. Y., Siswanto, A., Diah, P., & Chlara, Y. P. (2023). Empowerment-Based Palliative Care to Improve Psychological Well Being and Quality of Life in Women with Breast Cancer.
    _International Journal of Scientific Multidisciplinary Research (IJSMR)_,
    _1_(8), 1085-1102.
    [http://repository.um-surabaya.ac.id/id/eprint/8341](http://repository.um-surabaya.ac.id/id/eprint/8341)

    **## IntegratingTheoreticalFrameworksinBreastCancerCare.docx**

    2

    **Integrating Theoretical Frameworks in Breast Cancer Care**

    Name

    Instructor

    School

    Date

    **Integrating Theoretical Frameworks in Breast Cancer Care**

    The variables that I will use as far as my change project is concerned include the Health Belief Model (HBM) and Bio-Psychosocial Model. The two frameworks will inform the implementation of the project because it will target both psychosocial support to women along with the recurrent breast cancer and clinical treatment.

    In order to initiate the implementation of this change project, certain steps have to be undertaken:

    **1.Assess Patient Perceptions:** With the aid of the Health Belief Model, evaluate the perceptions of women and the likelihood of their recurrence as well as the value of treatment. Eliminate the obstacles that hinder the responses to both psychosocial and clinical care (Mehrabizadeh et al., 2024). As an example, not every woman will embrace the practice of psychosocial care, as it does not seem to bring benefits. With specific education, one can change this attitude and promote the involvement of both sides of care.

    **2.Provide Holistic Care**: The Bio-Psychosocial Model combines clinical care along with emotional and social support. Coming up with a care plan to consider the physical, psychological, and social components of care (Kahan et al., 2022) is necessary. As an example, the patients who reported the anxiety regarding recurrence ought to be given some emotional support, in addition to healthcare provisions, to better their overall experience and increase adherence.

    **3.Evaluate Barriers and Facilitators**: Determine aspects that can hinder patient interaction, including financial or social support, etc. To improve patient outcomes, these factors should be dealt with. A synergistic cooperation with social workers or counselors could assist in lessening these barriers so as to provide better integration of care.

    **4.Monitor and Adjust the Model**: Keep track of the results of the initiative and make adjustments in the interventions. It will involve following the qualitative changes in life quality and coordination of care with references to the patients and healthcare providers.

    Adhering to these steps, the project will design a complete, patient-based care model covering both emotional and physical demands of women having recurrent breast cancer, thus enhancing their quality of life and outcome of their treatment.

    **References**

    Mehrabizadeh, M., Zaremohzzabieh, Z., Zarean, M., Ahrari, S., & Ahmadi, A. R. (2024). Narratives of resilience: Understanding Iranian breast cancer survivors through health belief model and stress-coping theory for enhanced interventions.
    _BMC Women's Health_,
    _24_(1), 552.
    [https://link.springer.com/article/10.1186/s12905-024-03383-7](https://link.springer.com/article/10.1186/s12905-024-03383-7)

    Kahan, Z., Szanto, I., Dudas, R., Kapitany, Z., Molnar, M., Koncz, Z., & Mailath, M. (2022). Breast cancer survivorship programme: follow-up, rehabilitation, psychosocial oncology care. 1st Central-Eastern European professional consensus statement on breast cancer.
    _Pathology and Oncology Research_,
    _28_, 1610391.
    [https://pmc.ncbi.nlm.nih.gov/articles/PMC9200958/](https://pmc.ncbi.nlm.nih.gov/articles/PMC9200958/)

    **## ProblemIdentificationandDescriptionUsingPICOTFormat2.docx**

    2

    **Improving Recurrent Breast Cancer Care: Problem Identification Using the PICOT Framework**

    Name: Milena B Lopez Hernandez

    Instructor: Professor Guelsy Diaz

    School: West Coast University

    Date: 7/13/2025

    **Improving Recurrent Breast Cancer Care: Problem Identification Using the PICOT Framework**

    **i. Clinical Setting and Problem Description**

    The clinical practice that will be used in this identification of a PICOT problem is an oncology clinic involved in the treatment of recurrent breast cancer. The clinic offers follow-up services to the patients diagnosed with breast cancer, those who have recurred cancer even after undergoing anticancer treatment. The given field is an important sphere of oncology, and controlling recurring breast cancer has several challenges including complicated treatment plans, the psychological distress on individuals, and monitoring them on a regular basis to check the occurrence of a recurring condition.

    The clinic covers a big metropolitan area with massive population that includes people with specific needs of treating cancer. The patients are mainly adults over the age of 40 but a significant proportion is of those who have already had before the breast cancer treatment but are currently experiencing the reoccurrence. It is also observed that the clinic has a high concentration of people who are found at the lower end of the socioeconomic ladder, or have having difficulties in accessing care; thereby aggravating their health issues. Also, underserved minority groups are highly represented and this leads to the fact that such people experience cultural and linguistic barriers related to access to care.

    It is possible to single out a number of recurrent issues in the clinic, such as the absence of individual care plans offered to the patients, coordination among various healthcare services, as well as the overall inability to manage the emotional and psychological aspects of patients with recurring breast cancer. The emotional load of recurrence is very problematic to many patients, and the mental health needs of many patients are simply provided with no attention but rather concentrated on the clinical treatment. The other significant concern is the problem of the constant monitoring of recurrent breast cancer treatment that can be addressed only with constant surveillance and advanced diagnostic equipment.

    **ii. Problem Statement and Target Population**

    The identified problem is insufficient care and treatment of recurrent breast cancer in the clinic. These comprise lapses in clinical as well as emotional support to the patients, which means poor outcomes in both survival rates and quality of life. A total number of adult women diagnosed with recurrent breast cancer and their families, which are frequently involved in the process of care, should become the target population of this problem.

    The scale of this issue is not narrow enough so that it can be approached only through a single perspective; this is clinical, psychological, and socio-cultural. Clinically, the issue is the difficulty in coping with a long-term disease, the need to pay constant attention to it, treating side effects, and developing an individual treatment strategy. The psychological aspect consists of the emotional burden on patients who could be affected by anxiety, depression, and hopelessness concerning their cancer returning. Lastly, at a social level, the issue consists of socio-economic position, care accessibility issues, and cultural challenges among heterogeneous populations as well.

    The problem of recurring breast cancer cannot be ignored, since it is relevant enough to be explored and carefully planned in terms of interventions. Due to the challenges of managing cancer recurrence effectively, its issue has numerous aspects that have to be handled comprehensively and multidisciplinary. By creating an evidence-based project, it will be possible to work on these dimensions and develop a more effective care model that does not only look at clinical treatment of a patient but also his/her emotional well-being and provide care to more people, especially underserved populations.

    **iii. Significance of the Evidence-Based Project**

    Recurrent breast cancer is one of the biggest issues in the field of oncology. The recurrent cancer is one of the areas where the know-how is lacking due to the changes in the treatment protocols. This renders it an extremely important subject of evidence-based practice (EBP) and intervention. These gaps will be important in the improvement of clinical outcomes and the quality of life of the patients with recurrent breast cancer through this project.

    Among the key clinical gaps revealed based on the observations, the lack of coordination among various healthcare providers can be pointed out. Although the oncologists are concerned with medical management, patients usually lack adequate services regarding the provision of emotional counseling, symptom management, and primary care/specialist integration services. Most patients in the clinic have complained of a lack of consistency in follow-up visits as well as psychological support to enable them to bear the psychological stress associated with recurrent cancer. This failure to coordinate care is why it usually creates an uncoordinated treatment plan that makes the patient feel not supported, medically and psychologically.

    This evidence-based project is also important due to such studies as the importance of psychosocial support in cancer care in the research. Research has indicated that the survivors of breast cancer, especially those who have a recurring cancer, are at risk of depression, anxiety, and distress. A research study performed in one of the cities revealed that 4 out of 10 breast cancer victims show a high degree of psychological distress, and victims with the recurrence of cancer report more anxiety (Sohrabei et al., 2024). Neglecting these psychological needs will result in poorer clinical consequences, and the patient might fail to comply with the treatment regimen because of mental issues.

    In addition, breast cancer is also characterized by intermittent and costly pre- and post-treatment regimes, which have to be carefully monitored and modified. Due to the availability of resources or a lack of coordination among the healthcare providers, the implementation of innovative diagnostic technologies and bespoke treatment programs might be obstructed (Hu, 2022). This points to the robustness of the system of care toward more holistic provision of support, which combines clinical and emotional assistance as a way to meet multidimensional needs of patients.

    The studies on the management of recurrent breast cancer have been numerous, but that does not say that they are perfect, as there are still loopholes in projecting the most comprehensive study on breast cancer management. Evidence-based models have proven that multidisciplinary teams are capable of increasing patient outcomes by applying both the physical and the emotional requirements of patients (Franzoi et al., 2025). Nevertheless, they are not always implemented consistently into various clinical environments, therefore failing to provide an opportunity to achieve better patient satisfaction and clinical outcomes.

    The nursing profession will be added to this evidence-based project by improving the quality of care for patients with recurrent breast cancer, filling in the care gaps, facilitating coordination with other healthcare providers, and adding psychosocial support for the patients in the care plan. This way, it will conform to the objectives of the nursing profession, such as holistic care practice, patient-centered practice, and better patient outcomes.

    **References**

    Hu, K. (2022).
    _Psychological distress and breast cancer: a bidirectional link_. Karolinska Institutet (Sweden).
    [https://search.proquest.com/openview/de7854730fe5d3da28536a211c7197ae/1?pq-origsite=gscholar&cbl=2026366&diss=y](https://search.proquest.com/openview/de7854730fe5d3da28536a211c7197ae/1?pq-origsite=gscholar&cbl=2026366&diss=y)

    Sohrabei, S., Moghaddasi, H., Hosseini, A., & Ehsanzadeh, S. J. (2024). Investigating the effects of artificial intelligence on the personalization of breast cancer management: a systematic study.
    _BMC cancer_,
    _24_(1), 852.
    [https://link.springer.com/article/10.1186/s12885-024-12575-1](https://link.springer.com/article/10.1186/s12885-024-12575-1)

    Franzoi, M. A., Janni, W., Erdmann-Sager, J., Kline-Quiroz, C., Schäffler, H., Pfister, K., … & Luis, I. V. (2025). Long-Term Follow-Up Care After Treatment for Primary Breast Cancer: Strategies and Considerations.
    _American Society of Clinical Oncology Educational Book_,
    _45_(3), e473472.
    [https://ascopubs.org/doi/abs/10.1200/EDBK-25-473472](https://ascopubs.org/doi/abs/10.1200/EDBK-25-473472)

    **EnhancingCareCoordinationandQualityofLifeforWomenwithRecurrentBreastCancer.docx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/enhancingcarecoordinationandqualityoflifeforwomenwithrecurrentbreastcancer-docx-10409553)

    **Recommendationsandconclusionswk3.docx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/recommendationsandconclusionswk3-docx)

    **IntegratingPsychosocialSupportingRecurrentBreastCancerCare.docx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/integratingpsychosocialsupportingrecurrentbreastcancercare-docx-10409555)

    **IntegratingPsychosocialSupportingRecurrentBreastCancerCare.docx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/integratingpsychosocialsupportingrecurrentbreastcancercare-docx-10409555)

    **## instructionsforroughdraftNURS682LB.docx**

    This week, you will bring together all of the assignments you have completed thus far, and compose the rough draft of your change project paper. At this point, you will have submitted each section and received feedback. An attempt to incorporate all previous assignment feedback should be evident.
    Your rough draft contains all of the expected components of the final draft and is presented in APA format including a cover page, references, and appendices when warranted. Your rough draft is your opportunity to polish previously submitted assignments and combine the sections in a comprehensive paper that show your change project is ready to be implemented.

    You will take this time to identify and address any weaknesses or gaps in your change project. Your rough draft should only require minor revisions before the final paper.

    Your paper should be between 20 and 30 pages in length, not including the cover page, references, and any appendices. It must follow current APA manual style and format. Each section of the paper should be clearly identified using proper headings

    **## ImprovingCareforRecurrentBreastCancerPatients.docx**

    2

    **Improving Care for Recurrent Breast Cancer Patients: A Microsystem Approach**

    Name

    Instructor

    School

    Date

    **Improving Care for Recurrent Breast Cancer Patients: A Microsystem Approach**

    Among the provisions in the readings this week, the chapter in the Clinical Microsystems Greenbook that corresponds the most to my project topic of recurrent breast cancer is the chapter on improving care to the patients with chronic illness. Recurrent breast cancer is a complex and chronic ailment that requires regular and all-encompassing care management. The chapter provides the framework on how to enhance the care of patients at the microsystem level: in interdependent teams of small size (healthcare professionals) where the provision of care is personalized. It is notable that this concept especially applies to recurrent breast cancer, whereby patients may have long-term follow-up, need management of various symptoms, and may need adjustment of the treatment plans.

    The microsystem approach focuses more on the patient engagement that is important in the repeated breast cancer management. Patients have to deal with constant treatment and emotional issues, and therefore, it is essential to think about how they see the situation and include their own preferences in the course of treatment. As one example, through regular reassessment of physical and emotional needs and engaging patients with the decision-making process, clinicians will be able to create more efficient plans of care that would be based on the unique needs of a particular patient (Fathiya et al., 2023).

    More than that, the focus on the usage of data on monitoring the process and the improvement of processes constantly is noted in the chapter, and it can be directly applied to my project. In case of recurrent cases of breast cancer, information regarding the effectiveness of treatments, recurrence, and, in general, the quality of life may be gathered and frequently analyzed to adjust clinical methods and guarantee the best roles. With the help of this microsystem concept, healthcare teams will greatly transform their collaboration to meet the many needs of recurrent breast cancer patients in terms of structure and functioning as well as to finally improve patient outcomes.

    This reading has applied strong footing in implementing change in my project because it puts importance on individualized care, collaboration between teams, and application of data-driven changes, which all play an important role in enhancing care and treatment of breast cancer episodes.

    **References**

    Fathiya, L. Y., Siswanto, A., Diah, P., & Chlara, Y. P. (2023). Empowerment-Based Palliative Care to Improve Psychological Well Being and Quality of Life in Women with Breast Cancer.
    _International Journal of Scientific Multidisciplinary Research (IJSMR)_,
    _1_(8), 1085-1102.
    [http://repository.um-surabaya.ac.id/id/eprint/8341](http://repository.um-surabaya.ac.id/id/eprint/8341)

    **## IntegratingTheoreticalFrameworksinBreastCancerCare.docx**

    2

    **Integrating Theoretical Frameworks in Breast Cancer Care**

    Name

    Instructor

    School

    Date

    **Integrating Theoretical Frameworks in Breast Cancer Care**

    The variables that I will use as far as my change project is concerned include the Health Belief Model (HBM) and Bio-Psychosocial Model. The two frameworks will inform the implementation of the project because it will target both psychosocial support to women along with the recurrent breast cancer and clinical treatment.

    In order to initiate the implementation of this change project, certain steps have to be undertaken:

    **1.Assess Patient Perceptions:** With the aid of the Health Belief Model, evaluate the perceptions of women and the likelihood of their recurrence as well as the value of treatment. Eliminate the obstacles that hinder the responses to both psychosocial and clinical care (Mehrabizadeh et al., 2024). As an example, not every woman will embrace the practice of psychosocial care, as it does not seem to bring benefits. With specific education, one can change this attitude and promote the involvement of both sides of care.

    **2.Provide Holistic Care**: The Bio-Psychosocial Model combines clinical care along with emotional and social support. Coming up with a care plan to consider the physical, psychological, and social components of care (Kahan et al., 2022) is necessary. As an example, the patients who reported the anxiety regarding recurrence ought to be given some emotional support, in addition to healthcare provisions, to better their overall experience and increase adherence.

    **3.Evaluate Barriers and Facilitators**: Determine aspects that can hinder patient interaction, including financial or social support, etc. To improve patient outcomes, these factors should be dealt with. A synergistic cooperation with social workers or counselors could assist in lessening these barriers so as to provide better integration of care.

    **4.Monitor and Adjust the Model**: Keep track of the results of the initiative and make adjustments in the interventions. It will involve following the qualitative changes in life quality and coordination of care with references to the patients and healthcare providers.

    Adhering to these steps, the project will design a complete, patient-based care model covering both emotional and physical demands of women having recurrent breast cancer, thus enhancing their quality of life and outcome of their treatment.

    **References**

    Mehrabizadeh, M., Zaremohzzabieh, Z., Zarean, M., Ahrari, S., & Ahmadi, A. R. (2024). Narratives of resilience: Understanding Iranian breast cancer survivors through health belief model and stress-coping theory for enhanced interventions.
    _BMC Women's Health_,
    _24_(1), 552.
    [https://link.springer.com/article/10.1186/s12905-024-03383-7](https://link.springer.com/article/10.1186/s12905-024-03383-7)

    Kahan, Z., Szanto, I., Dudas, R., Kapitany, Z., Molnar, M., Koncz, Z., & Mailath, M. (2022). Breast cancer survivorship programme: follow-up, rehabilitation, psychosocial oncology care. 1st Central-Eastern European professional consensus statement on breast cancer.
    _Pathology and Oncology Research_,
    _28_, 1610391.
    [https://pmc.ncbi.nlm.nih.gov/articles/PMC9200958/](https://pmc.ncbi.nlm.nih.gov/articles/PMC9200958/)

    **## ProblemIdentificationandDescriptionUsingPICOTFormat2.docx**

    2

    **Improving Recurrent Breast Cancer Care: Problem Identification Using the PICOT Framework**

    Name: Milena B Lopez Hernandez

    Instructor: Professor Guelsy Diaz

    School: West Coast University

    Date: 7/13/2025

    **Improving Recurrent Breast Cancer Care: Problem Identification Using the PICOT Framework**

    **i. Clinical Setting and Problem Description**

    The clinical practice that will be used in this identification of a PICOT problem is an oncology clinic involved in the treatment of recurrent breast cancer. The clinic offers follow-up services to the patients diagnosed with breast cancer, those who have recurred cancer even after undergoing anticancer treatment. The given field is an important sphere of oncology, and controlling recurring breast cancer has several challenges including complicated treatment plans, the psychological distress on individuals, and monitoring them on a regular basis to check the occurrence of a recurring condition.

    The clinic covers a big metropolitan area with massive population that includes people with specific needs of treating cancer. The patients are mainly adults over the age of 40 but a significant proportion is of those who have already had before the breast cancer treatment but are currently experiencing the reoccurrence. It is also observed that the clinic has a high concentration of people who are found at the lower end of the socioeconomic ladder, or have having difficulties in accessing care; thereby aggravating their health issues. Also, underserved minority groups are highly represented and this leads to the fact that such people experience cultural and linguistic barriers related to access to care.

    It is possible to single out a number of recurrent issues in the clinic, such as the absence of individual care plans offered to the patients, coordination among various healthcare services, as well as the overall inability to manage the emotional and psychological aspects of patients with recurring breast cancer. The emotional load of recurrence is very problematic to many patients, and the mental health needs of many patients are simply provided with no attention but rather concentrated on the clinical treatment. The other significant concern is the problem of the constant monitoring of recurrent breast cancer treatment that can be addressed only with constant surveillance and advanced diagnostic equipment.

    **ii. Problem Statement and Target Population**

    The identified problem is insufficient care and treatment of recurrent breast cancer in the clinic. These comprise lapses in clinical as well as emotional support to the patients, which means poor outcomes in both survival rates and quality of life. A total number of adult women diagnosed with recurrent breast cancer and their families, which are frequently involved in the process of care, should become the target population of this problem.

    The scale of this issue is not narrow enough so that it can be approached only through a single perspective; this is clinical, psychological, and socio-cultural. Clinically, the issue is the difficulty in coping with a long-term disease, the need to pay constant attention to it, treating side effects, and developing an individual treatment strategy. The psychological aspect consists of the emotional burden on patients who could be affected by anxiety, depression, and hopelessness concerning their cancer returning. Lastly, at a social level, the issue consists of socio-economic position, care accessibility issues, and cultural challenges among heterogeneous populations as well.

    The problem of recurring breast cancer cannot be ignored, since it is relevant enough to be explored and carefully planned in terms of interventions. Due to the challenges of managing cancer recurrence effectively, its issue has numerous aspects that have to be handled comprehensively and multidisciplinary. By creating an evidence-based project, it will be possible to work on these dimensions and develop a more effective care model that does not only look at clinical treatment of a patient but also his/her emotional well-being and provide care to more people, especially underserved populations.

    **iii. Significance of the Evidence-Based Project**

    Recurrent breast cancer is one of the biggest issues in the field of oncology. The recurrent cancer is one of the areas where the know-how is lacking due to the changes in the treatment protocols. This renders it an extremely important subject of evidence-based practice (EBP) and intervention. These gaps will be important in the improvement of clinical outcomes and the quality of life of the patients with recurrent breast cancer through this project.

    Among the key clinical gaps revealed based on the observations, the lack of coordination among various healthcare providers can be pointed out. Although the oncologists are concerned with medical management, patients usually lack adequate services regarding the provision of emotional counseling, symptom management, and primary care/specialist integration services. Most patients in the clinic have complained of a lack of consistency in follow-up visits as well as psychological support to enable them to bear the psychological stress associated with recurrent cancer. This failure to coordinate care is why it usually creates an uncoordinated treatment plan that makes the patient feel not supported, medically and psychologically.

    This evidence-based project is also important due to such studies as the importance of psychosocial support in cancer care in the research. Research has indicated that the survivors of breast cancer, especially those who have a recurring cancer, are at risk of depression, anxiety, and distress. A research study performed in one of the cities revealed that 4 out of 10 breast cancer victims show a high degree of psychological distress, and victims with the recurrence of cancer report more anxiety (Sohrabei et al., 2024). Neglecting these psychological needs will result in poorer clinical consequences, and the patient might fail to comply with the treatment regimen because of mental issues.

    In addition, breast cancer is also characterized by intermittent and costly pre- and post-treatment regimes, which have to be carefully monitored and modified. Due to the availability of resources or a lack of coordination among the healthcare providers, the implementation of innovative diagnostic technologies and bespoke treatment programs might be obstructed (Hu, 2022). This points to the robustness of the system of care toward more holistic provision of support, which combines clinical and emotional assistance as a way to meet multidimensional needs of patients.

    The studies on the management of recurrent breast cancer have been numerous, but that does not say that they are perfect, as there are still loopholes in projecting the most comprehensive study on breast cancer management. Evidence-based models have proven that multidisciplinary teams are capable of increasing patient outcomes by applying both the physical and the emotional requirements of patients (Franzoi et al., 2025). Nevertheless, they are not always implemented consistently into various clinical environments, therefore failing to provide an opportunity to achieve better patient satisfaction and clinical outcomes.

    The nursing profession will be added to this evidence-based project by improving the quality of care for patients with recurrent breast cancer, filling in the care gaps, facilitating coordination with other healthcare providers, and adding psychosocial support for the patients in the care plan. This way, it will conform to the objectives of the nursing profession, such as holistic care practice, patient-centered practice, and better patient outcomes.

    **References**

    Hu, K. (2022).
    _Psychological distress and breast cancer: a bidirectional link_. Karolinska Institutet (Sweden).
    [https://search.proquest.com/openview/de7854730fe5d3da28536a211c7197ae/1?pq-origsite=gscholar&cbl=2026366&diss=y](https://search.proquest.com/openview/de7854730fe5d3da28536a211c7197ae/1?pq-origsite=gscholar&cbl=2026366&diss=y)

    Sohrabei, S., Moghaddasi, H., Hosseini, A., & Ehsanzadeh, S. J. (2024). Investigating the effects of artificial intelligence on the personalization of breast cancer management: a systematic study.
    _BMC cancer_,
    _24_(1), 852.
    [https://link.springer.com/article/10.1186/s12885-024-12575-1](https://link.springer.com/article/10.1186/s12885-024-12575-1)

    Franzoi, M. A., Janni, W., Erdmann-Sager, J., Kline-Quiroz, C., Schäffler, H., Pfister, K., … & Luis, I. V. (2025). Long-Term Follow-Up Care After Treatment for Primary Breast Cancer: Strategies and Considerations.
    _American Society of Clinical Oncology Educational Book_,
    _45_(3), e473472.
    [https://ascopubs.org/doi/abs/10.1200/EDBK-25-473472](https://ascopubs.org/doi/abs/10.1200/EDBK-25-473472)

    **EnhancingCareCoordinationandQualityofLifeforWomenwithRecurrentBreastCancer.docx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/enhancingcarecoordinationandqualityoflifeforwomenwithrecurrentbreastcancer-docx-10409553)

    **Recommendationsandconclusionswk3.docx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/recommendationsandconclusionswk3-docx)

    **IntegratingPsychosocialSupportingRecurrentBreastCancerCare.docx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/integratingpsychosocialsupportingrecurrentbreastcancercare-docx-10409555)

    **## instructionsforroughdraftNURS682LB.docx**

    This week, you will bring together all of the assignments you have completed thus far, and compose the rough draft of your change project paper. At this point, you will have submitted each section and received feedback. An attempt to incorporate all previous assignment feedback should be evident.
    Your rough draft contains all of the expected components of the final draft and is presented in APA format including a cover page, references, and appendices when warranted. Your rough draft is your opportunity to polish previously submitted assignments and combine the sections in a comprehensive paper that show your change project is ready to be implemented.

    You will take this time to identify and address any weaknesses or gaps in your change project. Your rough draft should only require minor revisions before the final paper.

    Your paper should be between 20 and 30 pages in length, not including the cover page, references, and any appendices. It must follow current APA manual style and format. Each section of the paper should be clearly identified using proper headings

    **## ImprovingCareforRecurrentBreastCancerPatients.docx**

    2

    **Improving Care for Recurrent Breast Cancer Patients: A Microsystem Approach**

    Name

    Instructor

    School

    Date

    **Improving Care for Recurrent Breast Cancer Patients: A Microsystem Approach**

    Among the provisions in the readings this week, the chapter in the Clinical Microsystems Greenbook that corresponds the most to my project topic of recurrent breast cancer is the chapter on improving care to the patients with chronic illness. Recurrent breast cancer is a complex and chronic ailment that requires regular and all-encompassing care management. The chapter provides the framework on how to enhance the care of patients at the microsystem level: in interdependent teams of small size (healthcare professionals) where the provision of care is personalized. It is notable that this concept especially applies to recurrent breast cancer, whereby patients may have long-term follow-up, need management of various symptoms, and may need adjustment of the treatment plans.

    The microsystem approach focuses more on the patient engagement that is important in the repeated breast cancer management. Patients have to deal with constant treatment and emotional issues, and therefore, it is essential to think about how they see the situation and include their own preferences in the course of treatment. As one example, through regular reassessment of physical and emotional needs and engaging patients with the decision-making process, clinicians will be able to create more efficient plans of care that would be based on the unique needs of a particular patient (Fathiya et al., 2023).

    More than that, the focus on the usage of data on monitoring the process and the improvement of processes constantly is noted in the chapter, and it can be directly applied to my project. In case of recurrent cases of breast cancer, information regarding the effectiveness of treatments, recurrence, and, in general, the quality of life may be gathered and frequently analyzed to adjust clinical methods and guarantee the best roles. With the help of this microsystem concept, healthcare teams will greatly transform their collaboration to meet the many needs of recurrent breast cancer patients in terms of structure and functioning as well as to finally improve patient outcomes.

    This reading has applied strong footing in implementing change in my project because it puts importance on individualized care, collaboration between teams, and application of data-driven changes, which all play an important role in enhancing care and treatment of breast cancer episodes.

    **References**

    Fathiya, L. Y., Siswanto, A., Diah, P., & Chlara, Y. P. (2023). Empowerment-Based Palliative Care to Improve Psychological Well Being and Quality of Life in Women with Breast Cancer.
    _International Journal of Scientific Multidisciplinary Research (IJSMR)_,
    _1_(8), 1085-1102.
    [http://repository.um-surabaya.ac.id/id/eprint/8341](http://repository.um-surabaya.ac.id/id/eprint/8341)

    **## IntegratingTheoreticalFrameworksinBreastCancerCare.docx**

    2

    **Integrating Theoretical Frameworks in Breast Cancer Care**

    Name

    Instructor

    School

    Date

    **Integrating Theoretical Frameworks in Breast Cancer Care**

    The variables that I will use as far as my change project is concerned include the Health Belief Model (HBM) and Bio-Psychosocial Model. The two frameworks will inform the implementation of the project because it will target both psychosocial support to women along with the recurrent breast cancer and clinical treatment.

    In order to initiate the implementation of this change project, certain steps have to be undertaken:

    **1.Assess Patient Perceptions:** With the aid of the Health Belief Model, evaluate the perceptions of women and the likelihood of their recurrence as well as the value of treatment. Eliminate the obstacles that hinder the responses to both psychosocial and clinical care (Mehrabizadeh et al., 2024). As an example, not every woman will embrace the practice of psychosocial care, as it does not seem to bring benefits. With specific education, one can change this attitude and promote the involvement of both sides of care.

    **2.Provide Holistic Care**: The Bio-Psychosocial Model combines clinical care along with emotional and social support. Coming up with a care plan to consider the physical, psychological, and social components of care (Kahan et al., 2022) is necessary. As an example, the patients who reported the anxiety regarding recurrence ought to be given some emotional support, in addition to healthcare provisions, to better their overall experience and increase adherence.

    **3.Evaluate Barriers and Facilitators**: Determine aspects that can hinder patient interaction, including financial or social support, etc. To improve patient outcomes, these factors should be dealt with. A synergistic cooperation with social workers or counselors could assist in lessening these barriers so as to provide better integration of care.

    **4.Monitor and Adjust the Model**: Keep track of the results of the initiative and make adjustments in the interventions. It will involve following the qualitative changes in life quality and coordination of care with references to the patients and healthcare providers.

    Adhering to these steps, the project will design a complete, patient-based care model covering both emotional and physical demands of women having recurrent breast cancer, thus enhancing their quality of life and outcome of their treatment.

    **References**

    Mehrabizadeh, M., Zaremohzzabieh, Z., Zarean, M., Ahrari, S., & Ahmadi, A. R. (2024). Narratives of resilience: Understanding Iranian breast cancer survivors through health belief model and stress-coping theory for enhanced interventions.
    _BMC Women's Health_,
    _24_(1), 552.
    [https://link.springer.com/article/10.1186/s12905-024-03383-7](https://link.springer.com/article/10.1186/s12905-024-03383-7)

    Kahan, Z., Szanto, I., Dudas, R., Kapitany, Z., Molnar, M., Koncz, Z., & Mailath, M. (2022). Breast cancer survivorship programme: follow-up, rehabilitation, psychosocial oncology care. 1st Central-Eastern European professional consensus statement on breast cancer.
    _Pathology and Oncology Research_,
    _28_, 1610391.
    [https://pmc.ncbi.nlm.nih.gov/articles/PMC9200958/](https://pmc.ncbi.nlm.nih.gov/articles/PMC9200958/)

    **## ProblemIdentificationandDescriptionUsingPICOTFormat2.docx**

    2

    **Improving Recurrent Breast Cancer Care: Problem Identification Using the PICOT Framework**

    Name: Milena B Lopez Hernandez

    Instructor: Professor Guelsy Diaz

    School: West Coast University

    Date: 7/13/2025

    **Improving Recurrent Breast Cancer Care: Problem Identification Using the PICOT Framework**

    **i. Clinical Setting and Problem Description**

    The clinical practice that will be used in this identification of a PICOT problem is an oncology clinic involved in the treatment of recurrent breast cancer. The clinic offers follow-up services to the patients diagnosed with breast cancer, those who have recurred cancer even after undergoing anticancer treatment. The given field is an important sphere of oncology, and controlling recurring breast cancer has several challenges including complicated treatment plans, the psychological distress on individuals, and monitoring them on a regular basis to check the occurrence of a recurring condition.

    The clinic covers a big metropolitan area with massive population that includes people with specific needs of treating cancer. The patients are mainly adults over the age of 40 but a significant proportion is of those who have already had before the breast cancer treatment but are currently experiencing the reoccurrence. It is also observed that the clinic has a high concentration of people who are found at the lower end of the socioeconomic ladder, or have having difficulties in accessing care; thereby aggravating their health issues. Also, underserved minority groups are highly represented and this leads to the fact that such people experience cultural and linguistic barriers related to access to care.

    It is possible to single out a number of recurrent issues in the clinic, such as the absence of individual care plans offered to the patients, coordination among various healthcare services, as well as the overall inability to manage the emotional and psychological aspects of patients with recurring breast cancer. The emotional load of recurrence is very problematic to many patients, and the mental health needs of many patients are simply provided with no attention but rather concentrated on the clinical treatment. The other significant concern is the problem of the constant monitoring of recurrent breast cancer treatment that can be addressed only with constant surveillance and advanced diagnostic equipment.

    **ii. Problem Statement and Target Population**

    The identified problem is insufficient care and treatment of recurrent breast cancer in the clinic. These comprise lapses in clinical as well as emotional support to the patients, which means poor outcomes in both survival rates and quality of life. A total number of adult women diagnosed with recurrent breast cancer and their families, which are frequently involved in the process of care, should become the target population of this problem.

    The scale of this issue is not narrow enough so that it can be approached only through a single perspective; this is clinical, psychological, and socio-cultural. Clinically, the issue is the difficulty in coping with a long-term disease, the need to pay constant attention to it, treating side effects, and developing an individual treatment strategy. The psychological aspect consists of the emotional burden on patients who could be affected by anxiety, depression, and hopelessness concerning their cancer returning. Lastly, at a social level, the issue consists of socio-economic position, care accessibility issues, and cultural challenges among heterogeneous populations as well.

    The problem of recurring breast cancer cannot be ignored, since it is relevant enough to be explored and carefully planned in terms of interventions. Due to the challenges of managing cancer recurrence effectively, its issue has numerous aspects that have to be handled comprehensively and multidisciplinary. By creating an evidence-based project, it will be possible to work on these dimensions and develop a more effective care model that does not only look at clinical treatment of a patient but also his/her emotional well-being and provide care to more people, especially underserved populations.

    **iii. Significance of the Evidence-Based Project**

    Recurrent breast cancer is one of the biggest issues in the field of oncology. The recurrent cancer is one of the areas where the know-how is lacking due to the changes in the treatment protocols. This renders it an extremely important subject of evidence-based practice (EBP) and intervention. These gaps will be important in the improvement of clinical outcomes and the quality of life of the patients with recurrent breast cancer through this project.

    Among the key clinical gaps revealed based on the observations, the lack of coordination among various healthcare providers can be pointed out. Although the oncologists are concerned with medical management, patients usually lack adequate services regarding the provision of emotional counseling, symptom management, and primary care/specialist integration services. Most patients in the clinic have complained of a lack of consistency in follow-up visits as well as psychological support to enable them to bear the psychological stress associated with recurrent cancer. This failure to coordinate care is why it usually creates an uncoordinated treatment plan that makes the patient feel not supported, medically and psychologically.

    This evidence-based project is also important due to such studies as the importance of psychosocial support in cancer care in the research. Research has indicated that the survivors of breast cancer, especially those who have a recurring cancer, are at risk of depression, anxiety, and distress. A research study performed in one of the cities revealed that 4 out of 10 breast cancer victims show a high degree of psychological distress, and victims with the recurrence of cancer report more anxiety (Sohrabei et al., 2024). Neglecting these psychological needs will result in poorer clinical consequences, and the patient might fail to comply with the treatment regimen because of mental issues.

    In addition, breast cancer is also characterized by intermittent and costly pre- and post-treatment regimes, which have to be carefully monitored and modified. Due to the availability of resources or a lack of coordination among the healthcare providers, the implementation of innovative diagnostic technologies and bespoke treatment programs might be obstructed (Hu, 2022). This points to the robustness of the system of care toward more holistic provision of support, which combines clinical and emotional assistance as a way to meet multidimensional needs of patients.

    The studies on the management of recurrent breast cancer have been numerous, but that does not say that they are perfect, as there are still loopholes in projecting the most comprehensive study on breast cancer management. Evidence-based models have proven that multidisciplinary teams are capable of increasing patient outcomes by applying both the physical and the emotional requirements of patients (Franzoi et al., 2025). Nevertheless, they are not always implemented consistently into various clinical environments, therefore failing to provide an opportunity to achieve better patient satisfaction and clinical outcomes.

    The nursing profession will be added to this evidence-based project by improving the quality of care for patients with recurrent breast cancer, filling in the care gaps, facilitating coordination with other healthcare providers, and adding psychosocial support for the patients in the care plan. This way, it will conform to the objectives of the nursing profession, such as holistic care practice, patient-centered practice, and better patient outcomes.

    **References**

    Hu, K. (2022).
    _Psychological distress and breast cancer: a bidirectional link_. Karolinska Institutet (Sweden).
    [https://search.proquest.com/openview/de7854730fe5d3da28536a211c7197ae/1?pq-origsite=gscholar&cbl=2026366&diss=y](https://search.proquest.com/openview/de7854730fe5d3da28536a211c7197ae/1?pq-origsite=gscholar&cbl=2026366&diss=y)

    Sohrabei, S., Moghaddasi, H., Hosseini, A., & Ehsanzadeh, S. J. (2024). Investigating the effects of artificial intelligence on the personalization of breast cancer management: a systematic study.
    _BMC cancer_,
    _24_(1), 852.
    [https://link.springer.com/article/10.1186/s12885-024-12575-1](https://link.springer.com/article/10.1186/s12885-024-12575-1)

    Franzoi, M. A., Janni, W., Erdmann-Sager, J., Kline-Quiroz, C., Schäffler, H., Pfister, K., … & Luis, I. V. (2025). Long-Term Follow-Up Care After Treatment for Primary Breast Cancer: Strategies and Considerations.
    _American Society of Clinical Oncology Educational Book_,
    _45_(3), e473472.
    [https://ascopubs.org/doi/abs/10.1200/EDBK-25-473472](https://ascopubs.org/doi/abs/10.1200/EDBK-25-473472)

    **EnhancingCareCoordinationandQualityofLifeforWomenwithRecurrentBreastCancer.docx**

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    **Recommendationsandconclusionswk3.docx**

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    **IntegratingPsychosocialSupportingRecurrentBreastCancerCare.docx**

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