Kelli Whitted completed her BSN from Georgia College and State University in 1994, her MSN in the FNP program at Troy University in 2001, and her DNP from Troy University in 2011. She serves as an Assistant Professor in the Graduate School of Nursing at Troy University and teaches in both the FNP and the DNP programs.
Breast cancer is a possibly fatal disease that affects one in eight women. This type of cancer is the most frequently identified form of cancer, and it is the second leading cause of cancer related death among women. Some patients who are at a high risk of developing breast cancer will elect to have a mastectomy as a prophylactic measure. Prophylactic mastectomy can be performed to lessen the risk of breast cancer in women with high risk factors. A study has established that a mastectomy was an effective means of preventing breast cancer. The study reported a significant decline in the occurrence of breast cancer and of death from breast cancer after a prophylactic mastectomy even among women classified at very high risk for developing the disease. Findings of the study concluded that prophylactic mastectomy was correlated with at least a ninety percent decrease in both the occurrence of breast cancer and the risk of death from breast cancer. Another study concluded that a bilateral prophylactic mastectomy reduced the risk of breast cancer developing in women with BRCA1 or BRCA2 gene mutations by ninety percent. More emphasis is being placed on the prevention of breast cancer now rather than solely upon treatment measures. The practice of prophylactic mastectomy is increasing. The frequency of this preventative treatment of breast cancer doubled from 1998 to 2003. The literature validates a high rate of patient satisfaction and also long-term oncologic protection with a prophylactic mastectomy. Some significant psychological benefits from a prophylactic mastectomy are a decrease in chronic anxiety and worry, anguish associated with false positive mammography results, and dependency on physician screening and self-breast examinations. For women who have a validated fear of developing breast cancer, the psychological benefits of the preventative surgery can outweigh the undesirable risks. Women who have a higher risk of developing breast cancer can make educated choices when it comes to determining whether or not to choose a prophylactic mastectomy.
Katie E Kok is currently a graduate nursing student at Millikin University School of Nursing in Decatur, Illinois and will graduate in December 2014. She has a Bachelor of Arts degree in history from Wheaton College in Wheaton, Illinois. While studying at Millikin University she became particularly interested in patient education and health literacy and the challenges patients face with adhering to treatment recommendations.
Anticoagulation therapy is a prevalent and effective treatment for the prevention of stroke and other complications resulting from many cardiac conditions. Unfortunately, management of anticoagulation therapy is difficult, and mismanagement can have severe, adverse effects. In addition, inadequate health literacy is a prevalent issue and a barrier to patient education in the United States. The purpose of this research study was to examine health literacy and patient knowledge as they relate to anticoagulation therapy in a cardiac population. This pilot study used a prospective, descriptive design to assess the knowledge of anticoagulation therapy of participants (n=35) and their health literacy using a questionnaire that included the Brief Health Literacy Screening Tool. Results of the study demonstrated that 35% of the patients had inadequate or marginal health literacy despite the fact that 60% of the participants had education past high school/GED; next, the overall knowledge of patients was low (63%) even though 88.6% of the patients reported receiving instruction regarding anticoagulation therapy from their healthcare provider; and although patients reported learning from printed materials, the low health literacy and low reported knowledge indicate these methods were ineffective for patient education. The results of this study demonstrate that among patients with a cardiac condition on anticoagulation therapy, patient education has the potential to improve knowledge, but only if the education is targeted to the learning styles and educational needs of patients throughout therapy.