Critical Thinking

1.1 their life in a normal way possible.

1.1  BACKGROUND OF STUDY

Cancer which is a
well-known silently fearsome type of disease has been one of the main causes of
the death of the human beings throughout the global range. Long ago, before the
advancement of the technology as well as the available modernized treatments, the
people had been suffered with cancer without even knowing the existence of this
type of disease which nowadays, as eloquently stated by MedicalNewsToday, it
has been varies over 100 different type of cancer (2016). The second highest
common type of deadly disease is cancer in United States of America and can be
in a portion of 1 from every 4 deaths (MedicalNewsToday, 2016; cited from
American Cancer Society). As stated by the National Cancer Institute, breast
cancer has been the most common leading type of cancer, while it has been
expectedly in 2017 to be more than 255,000 new reported occurrences in United
States (2017). Besides that, it has also been stated that lung cancer and
prostate cancer are the next highest occurrences type of cancer whilst as for the
colorectal cancer which has been combined as one due to the often referral of
the name, there are approximately about 95,520 and 39,310 respectively referred
to new expected colon and rectal cancer which give a sum of 135,430 in total of
new expected cases of colorectal cancer (National Cancer Institute, 2017). Due
to the suffering of disease, people tend to be mostly experienced with the
difficulty to live their life in a normal way possible. There is so far, no
technology that is able to nourish the psychological being of the human as they
are trying to endure and fight the disease they suffered with during their
entire life. As recently indicated by Grimmett, Haviland, Winter, Calman, Din,
Richardson, Smith and Foster, there is indeed the cancer aftercare self-management
that has been highlighted and mushrooming but there is very few management on
disease-related problems which depends on the confidence of the patient to
fight with cancer symptoms or as known as the patient’s self-efficacy and the
changes of this throughout the time (2017). Thus, the importance of the
self-efficacy is quite important to be explored as to identify the pattern of
it as well as its association with other factors.

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In regard of colorectal
cancer, it has been the second highest occurrence after breast cancer which
rated as most common cancer among men patients and third most common cancer
among the women patients in Malaysia. Besides colorectal cancer which can be
classified as one of the gastrointestinal cancer, there are other cancer that
related to human digestive systems such as started from esophagus, stomach,
liver, gallbladder, pancreas, large and small intestine, rectum as well as
anus. In this globalization era, there are many patients that have been exposed
with so many information about their health status especially their disease as
it could be reached only with one click with the utilization of gadget. Despite
knowing the fact of their disease, humans have not too aware of their own
self-efficacy and how it related with anxiety and depression level as they
suffered with certain disease like cancer. As for anxiety, it can be referred
as being fear or having worriment over time which getting worse throughout the
period and affects the life of a person while the feeling of discouragement,
being sad, empty hope, unmotivated and lack of interest in life which they
influence the activity daily living as a normal person for about two weeks and
more can be regarded as depression. Thus, do the patients really know on how
great they are in handling themselves and how to improve themselves in term of
being confidence that is self-efficacy while caring of themselves? And how
their self-efficacy status and pattern affect their psychological
characteristic such as anxiety and depression level in adapting with their
cancer? Self-efficacy happened to be associated with the other factors besides
the psychological factors that are physical and social factors. As studies by
Kohno, Maruyama, Matsuoka, Matsushita T., Koeda and Matsushima E.,
self-efficacy and psychological factors such as anxiety and depression are
strongly related to each other whilst the variety of treatments at certain
stages in term of psychological interventions performance are greatly necessary
among the patients of gastrointestinal cancer patients (2010). Laconically,
this study will explore the association between self-efficacy with anxiety and
depression among gastrointestinal cancer patients.

 

1.2  PROBLEM STATEMENT

Having to adapt with the
fact of being a cancer survivor, life is not as easy as a plain sailing.
Therefore, the inner quality that motivates a person in enduring such hardship
is absolutely important as that is how their self-efficacy can improve their
psychological factors. In fact, the outstanding psychological adjustments are presented
when the gastrointestinal cancer patients have high level of self-efficacy (Kohno
et al., 2010). Besides that, there is a significant association between lower
self-efficacy which resulted in higher deprivation, domestic status, increased
co-morbidities, worse level of fatigue and pain, decreasing positivity and more
negativity (Grimmett et al., 2017). In general, cancer patients despite
understanding their health status and condition, do they know the level of
their self-efficacy, how this quality may affect their psychological factors
such as anxiety and depression and do they even know how to overcome this
problem in order to be better in caring for themselves and improve their
psychological adjustments? Expectantly and in a great desire of achieving the
objectives, this study may expose about the status of self-efficacy and its
relations with the anxiety and depression level dedicatedly among
gastrointestinal cancer survivors.

1.3  SIGNIFICANCE OF STUDY

In conducting this study,
the researcher is having the desire to discover the status of self-efficacy and
its association with level of anxiety and depression among gastrointestinal
cancer survivors in Hospital Tengku Ampuan Afzan (HTAA) which is located at
Kuantan. In Malaysia, this kind of study has not been widely highlighted despite
of the advancement of the technology and the upgraded treatment of cancer. As
such, the number of the gastrointestinal cancer patients have been growing as
the second most leading of cancer-caused death which indicates that the primary
intervention of health care in promoting the healthy lifestyle as well as the
early screening in order to detect this cancer has been successfully achieved
with the upgraded way of treating cancer. However, how great the self-efficacy
of the survivors is being questioned as well as its role as the influencer of
their other health aspects like psychological status.

Thus, desirably this
study may contribute such a great result in assisting the health care personnel
especially nurses whose knows as one of the closest staffs that help the
patients during hospitalization. The nurses may give a great help in
influencing the patients related to their self-efficacy status, as well as
attending to their anxiety and depression in order to enhance their life to be
better in surviving their cancer life by being a good assistance to patients
when they are in a great need of support system after and ongoingly being
treated as cancer patients.

 

1.4  RESEARCH QUESTIONS

1.      What
is the status of self-efficacy of gastrointestinal cancer patients?

2.      How
is the self-efficacy associated with the level of anxiety and depression of
gastrointestinal cancer patients?

1.5  RESEARCH OBJECTIVES

1.5.1       
GENERAL
OBJECTIVES

To
determine the status of self-efficacy among gastrointestinal cancer patients.

1.5.2       
SPECIFIC
OBJECTIVES

·        
To explore the level of anxiety among
gastrointestinal cancer patients.

·        
To investigate the depression level of
gastrointestinal cancer patients.

·        
To evaluate the association between
self-efficacy with anxiety and depression among gastrointestinal cancer
patients.

 

1.6  HYPOTHESIS

1.6.1       
NULL
HYPOTHESIS

·        
There is no association between
self-efficacy with anxiety and depression among gastrointestinal cancer
patients.

1.6.2       
ALTERNATIVE
HYPOTHESIS

·        
There is association between self-efficacy
with anxiety and depression among gastrointestinal cancer patients.

 

1.7  OPERATIONAL DEFINITION

·        
Cancer: Abnormal growth of cell which may
spread and invade other bodily parts which is known as malignant tumor.

·        
Gastrointestinal: including to both the
stomach and intestines.

·        
Self-efficacy: the power and confidence to
achieve wanted result or effect.

·        
Anxiety: feeling of fear of being nervous
about what might happen in future

·        
Depression: serious condition as the
person feels terribly sad, unwanted and hopeless which influence the normal way
of living.

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