Article
The Effect of Mindfulness-Based Music Therapy
on Attention and Mood in Women Receiving Adjuvant
Chemotherapy for Breast Cancer: A Pilot Study
Teresa Lesiuk, PhD, MT-BC
C
ancer treatments, such as chemotherapy
and radiation therapy, are thought to
damage normal cognitive functioning of
women with breast cancer (Reuter-Lorenz
& Cimprich, 2013; Von Ah & Tallman,
2014). Mindfulness, a type of contemplative practice,
improves cognitive functions, including attention and
working memory, in adults (Jha, Krompinger, & Baime,
2007; Jha, Stanley, & Baime, 2010; Tang et al., 2007). Music stimuli are an ideal source of focus for mindfulness
practice (Graham, 2010). No study, to date, has used
mindfulness-based music therapy (MBMT) to address
the attention deficits and symptom distress reported by
women who receive chemotherapy treatments. This pilot
study explores the efficacy of MBMT to reduce attention
problems and mood distress experienced by women
receiving adjuvant chemotherapy for breast cancer.
Neurocognitive deficits in women with breast cancer
have been associated with a phenomenon referred to as
“chemobrain” (Hurria, Somlo, & Ahles, 2007; ReuterLorenz & Cimprich, 2013). Chemotherapy treatments
are reported to negatively affect domains of attention,
working memory, and several psychomotor abilities
(Correa & Ahles, 2008; Hurria et al., 2007; McDonald &
Saykin, 2011). A meta-analysis that evaluated the effects
of chemotherapy on women with breast cancer revealed
significantly lower cognitive ability for executive function, information processing speed, verbal memory, and
visual memory as compared to normative data (ReuterLorenz & Cimprich, 2013). Deficits in cognitive function
were also found in women who had received adjuvant
chemotherapy for breast cancer six months postchemotherapy (Jim et al., 2012). In addition, brain-imaging techniques revealed a reduction of brain gray matter density
in patients who received chemotherapy for breast cancer
(McDonald & Saykin, 2011). The reduced density was
observed bilaterally in the frontal and temporal brain
regions one month after chemotherapy treatments relative to baseline density. The changes in gray matter were
not found in patients with breast cancer who were not
276
Purpose/Objectives: To explore the efficacy of mindfulnessbased music therapy (MBMT) to improve attention and
decrease mood distress experienced by women with breast
cancer receiving adjuvant chemotherapy.
Design: Quantitative, descriptive, longitudinal approach.
Setting: A comprehensive cancer hospital and a university
in southern Florida.
Sample: 15 women with a diagnosis of breast cancer,
stages I–III, receiving adjuvant chemotherapy.
Methods: Participants individually received MBMT for
one hour per week for four weeks. The sessions consisted
of varied music activities accompanied by mindfulness
attitudes, or mental strategies that enhance moment-tomoment awareness, and weekly homework. Demographic
information was collected at baseline.
Main Research Variables: Attention was measured using
Conners’ Continuous Performance Test II. Mood was measured using the Profile of Mood States–Brief Form. Narrative comments collected from the homework assignments
served to reinforce quantitative data.
Findings: Repeated measures analysis of variance showed
that attention improved significantly over time. Although all
mood states significantly improved from the beginning to
the end of each MBMT session, the mood state of fatigue
decreased significantly more than the other mood states.
Conclusions: MBMT enhances attention and mood, particularly the mood state of fatigue, in women with breast
cancer receiving adjuvant chemotherapy.
Implications for Nursing: A preferred music listening and
mindfulness exercise may be offered to women with breast
cancer who experience attention problems and mood distress.
Key Words: mindfulness-based music therapy; breast cancer; attention; mood
ONF, 42(3), 276–282. doi: 10.1188/15.ONF.276-282
treated with chemotherapy or who were healthy controls. One year later, patients showed partial recovery
of gray matter (McDonald & Saykin, 2011).
Women with breast cancer receiving adjuvant
chemotherapy report frequently having problems with
focus, attention, and short-term memory; one typical
Vol. 42, No. 3, May 2015 • Oncology Nursing Forum
complaint is that they often forget where they put their
car keys. Improvement in attention ability is much desired by these patients and their physicians (A. Montero,
personal communication, July 13, 2012). Treatment can
interfere with the activities of daily living; poor information processing, attention, and working memory
also are negatively associated with treatment (Brezden,
Phillips, Abdolell, Bunston, & Tannock, 2000; Jansen,
Miaskowski, Dodd, Dowling, & Kramer, 2005; Von Ah
& Tallman, 2014). In addition, negative mood states
(e.g., anxiety, fatigue, depression) are often observed
in women with breast cancer (Berger & Higginbotham,
2000). Fatigue is a common complaint and is rated as
the longest lasting and most disruptive symptom that
results from adjuvant chemotherapy treatment (Berger
& Higginbotham, 2000; Carlson et al., 2004, 2013). These
areas of concern for patients and healthcare providers
require intervention, and one noninvasive approach
may be offered by mindfulness: MBMT.
Mindfulness
Mindfulness is a contemplative practice of being fully
aware of what is occurring in the present moment (Bishop et al., 2004; Brotto, 2013). It involves paying attention
to an item, event, or moment without overanalyzing,
evaluating, or judging. The practice of mindfulness can
help a person not to worry about the past or the future,
as well as to move out of automatic pilot responses
(Brown & Ryan, 2003; Kabat-Zinn, 1990; Williams, Teasdale, Segal, & Kabat-Zinn, 2007). Sometimes referred to
as the third wave of psychology, mindfulness is useful
as an approach for increasing awareness and responding skillfully to mental processes that contribute to
emotional distress and maladaptive behavior (Bishop
et al., 2004). Mindfulness involves being aware of and
attentive to the form of thoughts rather than the content
of thoughts. Whereas cognitive behavior therapy emphasizes addressing the content of distressing thoughts
and reframing them, mindfulness entails being aware
of having those types of thoughts, feelings, and body
sensations. This sort of functioning is referred to as prereflexive because it acts on, not within, thought, feeling,
and other forms of consciousness (Brown & Ryan, 2003).
Cognitive mechanisms have been reported as significantly improving with the practice of mindfulness
(Zeidan, Johnson, Diamond, David, & Goolkasian, 2010),
even when practiced in the short term (Tang et al., 2007).
Benefits of mindfulness practice include increased focus
and self-regulation (Baer, 2003), as well as increased attention and working memory (Chiesa, Calati, & Serretti,
2011; Jha et al., 2007, 2010). Significant improvements
in mood and sleep (Carlson & Garland, 2005; Carlson
et al., 2013) and increased well-being (Brown & Ryan,
2003) were reported by women with breast cancer who
Oncology Nursing Forum • Vol. 42, No. 3, May 2015
participated in a mindfulness-based stress reduction
(MBSR) program. In a randomized, wait-list controlled
study, the mood and symptoms of stress of outpatients
with cancer significantly improved after partaking in
weekly 1.5-hour MBSR sessions for seven weeks (Speca,
Carlson, Goddey, & Angen, 2000). The MBSR program
consisted of three components: teaching materials
pertaining to relaxation and meditation, experiential
practice of meditation in group and home settings, and
group work focused on problem solving. The patients
had varied cancer diagnoses, stages of illness, and ages;
breast cancer constituted the largest subgroup. A significantly reduced mood disturbance was found for the
Profile of Mood States–Brief Form (POMS-BF) subscales
of anxiety, depression, anger, and confusion (McNair &
Heuchert, 2006). A significant increase in vigor was also
reported, whereas fatigue was not found to be significantly improved (Speca et al., 2000).
Graham (2010) found that music stimuli may serve
as an ideal source of focus for mindfulness. Although
mindfulness-based art therapy was found to significantly reduce symptom distress in women with cancer
(Monti et al., 2006), its efficacy to improve attention
was not investigated. The practice of mindfulness and
music therapy was presented to conference attendees
at the 14th World Congress of Music Therapy (Lesiuk,
2014). However, to the author’s knowledge, no known
studies of MBMT examine the effects of cognition in any
patient population. This article examines the effect of an
MBMT program on attention and mood states in women
receiving adjuvant chemotherapy for breast cancer. The
findings reported in the current article may contribute
to nursing and mindfulness-based practices, as well as
to music therapy literature and clinical practice.
Methods
Study Design and Procedure
This study aimed to determine (a) the effect of MBMT
on participant attention, as measured by the Conners’
Continuous Performance Test II (CPT-II), version 5,
prior to and following the four-week MBMT program
(Conners, 2004) and (b) the immediate effect of MBMT
on participant mood, as measured by POMS-BF. A descriptive, longitudinal design was used. Demographic
information was collected at baseline. Attention was
measured by eight subscales and at two time points
(once at baseline [Time 1] and again at the completion
of the study [Time 2]). Mood was measured using the
POMS-BF at the beginning (pre) and end (post) of each
weekly one-hour session. Each MBMT weekly session
differed by theme.
The study received participants research approval
from the Sylvester Comprehensive Cancer Center, part
of the University of Miami Health System, and the
277
Table 1. Mindfulness-Based Music Therapy
Weekly Sessions
Session
Music Therapy Activity
Mindfulness Attitude
1
Focused music listening
and writing
Nonjudging
2
Novel instruments and
familiar songs
Beginner’s mind
3
Rhythm imitation, simple instrument playing
Suspending judgment
4
Music-assisted relaxation
Acceptance and letting go
University of Miami, both in Florida. An MBMT
program was developed by the author to potentially
enhance the attention and mood states of women who
received adjuvant chemotherapy for breast cancer.
Participants in the MBMT program received individualized one-hour MBMT sessions once a week for four
weeks in a comfortable room within the Frost School
of Music at the University of Miami. Participants were
also assigned 15–20 minutes of daily homework consisting of music listening exercises and written reflections that matched the weekly theme and mindfulness
attitude, respectively. Each week, participants were provided with a different music CD created by the author.
The POMS-BF, measuring mood state, was administered immediately prior to and following each session.
The CPT-II, measuring attention, was administered
immediately prior to the first session and following the
end of the fourth session. All participants completed
the four MBMT sessions. Table 1 shows the various music therapy activities by week and the accompanying
four mindfulness attitudes, which are mental strategies
that allow individuals to enhance their practice of being
in the moment. Each session began with an opening
exercise using sound and then music as the anchor for
attention. The opening exercise, which lasted about five
to seven minutes, was developed to introduce focus on
sound and music rather than on breath, which is the
traditional focus (Graham, 2010). Discussions followed
regarding whether participants’ minds wandered or
remained on the sound, as well as whether they could
simply observe their thoughts, feelings, and body sensations without reacting to them. The full disclosure
of the program requires a lengthy description beyond
the purpose of the findings reported here. Therefore,
MBMT program development, a detailed description of
the program, and narrative comments from homework
are provided for readers elsewhere (Lesiuk, 2014).
Participants
Fifteen women with a diagnosis of breast cancer were
recruited from the Sylvester Comprehensive Cancer
278
Center. The women traveled to the clinic for their appointments and chemotherapy treatments. All participants spoke English fluently. Criteria for inclusion in
the study were a diagnosis of breast cancer (stages I–III)
and current adjuvant chemotherapy treatment. Exclusion criteria included any prior cognitive impairment
(e.g., head injury, history of psychosis). Women who
met the study criteria were identified by the clinic nurse
and were provided with information about the MBMT
study from the researcher. Session meeting times that
were agreeable to each participant were scheduled.
Measures
Conners’ Continuous Performance Test II: The
CPT-II is a 14-minute-long computerized assessment of
attention, impulsivity, and vigilance. The CPT-II may
be used as a screening tool to monitor the effectiveness
of treatment and medication or for research purposes.
The CPT-II profiles produced help to identify potential
problems of executive function in clinical populations.
During administration of the CPT-II, participants press
a computer keyboard spacebar as quickly and accurately
as possible for every screen display of a letter of the
alphabet, except for the letter “X.” Following administration of the CPT-II, a score report in which participant
raw scores are converted to t scores is generated. These
scores may be compared to those of individuals in the
normative group of the same gender and age range.
For the purpose of this study, CPT-II scores specifically related to the measure of attention were analyzed.
For example, a t score of omissions indicates failing to
respond to the target alphabet letters, and a t score of
commission errors indicates responses incorrectly given
Table 2. Demographic Characteristics (N = 15)
Characteristic
Education
High school
Bachelor’s degree
Master’s degree
Other
Ethnicity
Caucasian
Hispanic
African American
Asian
Stage of breast cancer
I
II
III
Treatmenta
Adjuvant chemotherapy
Surgery
Hormone therapy
Radiation therapy
a
n
4
5
3
3
6
6
2
1
2
6
7
15
11
4
4
More than one treatment could be reported.
Vol. 42, No. 3, May 2015 • Oncology Nursing Forum
Variable
Attention
Error (attention)
Time
Error (time)
Time × attention
Error (time × attention)
SS
df
MS
F
928.43
18,226.24
1,267.07
2,651.53
421.7
5,899.67
7
98
1
14
7
98
132.63
185.98
1,267
189.4
60.24
60.2
0.71
–
6.69*
–
1
–
* p < 0.05
MS—mean square; SS—sum of squares
to the nontarget letter, “X.” Several response times are
calculated in milliseconds for the remaining measures
(i.e., hit reaction time, hit reaction time standard error,
variability, detectability, reaction interstimulus interval
change, and standard error by interstimulus interval).
All of these scores constitute a measure of attention for
each participant. Detailed explanations of the response
times are provided by Conners (2004). CPT-II measures,
when combined into indices for neurologic assessment,
have a reliability coefficient of 0.92 (Conners, 2004).
Profile of Mood States–Brief Form: POMS-BF consists of 30 items regarding how an individual feels at
the time of testing. This mood scale is efficient at differentiating the effects of experimental manipulations
of mood in patients with cancer (Andersen et al., 2007).
The brief version was developed in 1989 for the purpose of providing a shorter and less time-consuming
form to patients in medical settings. For each of the six
POMS-BF subscales (i.e., anger-hostility, confusionbewilderment, depression-dejection, fatigue-inertia,
tension-anxiety, and vigor-activity), patients respond
to items on a five-point Likert-type scale by circling
numbers from 0 (not at all) to 4 (extremely). For
example, items within the tension-anxiety subscale
include “tense, shaky,” whereas items within the vigoractivity subscale include “lively, vigorous.” All internal
consistencies of the factors are high, with 0.9 or above
(McNair & Heuchert, 2006). Relatively lower stability
coefficients are expected for the POMS-BF scale; individuals’ state moods fluctuate because of situational
factors in the time they are captured.
Data Analysis
Data were analyzed using SPSS®, version 22, and all
statistical assumptions were met. A repeated measures
analysis of variance (ANOVA) was used for analysis of
the effect of MBMT on participant attention over time. A
repeated measures ANOVA was used for analysis of the
effect of MBMT on participant mood from each of the
four weekly pre- and postsessions. All 15 participants
completed the four sessions. Participants were not required to log homework time. However, participants
Oncology Nursing Forum • Vol. 42, No. 3, May 2015
were asked at the end of the study how much time,
on average, they had spent on homework per week;
time spent ranged from 30 minutes to seven hours.
Missing items found infrequently on the POMS-BF
scales were averaged with similar subscale item responses prior to data entry.
Results
Participants
The mean age of the 15 participants was 52.6 years
(SD = 11.3, range = 27–70 years). All participants were
receiving adjuvant chemotherapy while enrolled in the
MBMT study. Most participants received chemotherapy
every three weeks for six cycles. Participants had, on
average, 1.9 years (SD = 3.25, range = 0–10 years) of
music training. Two of the women were involved in active music making (e.g., singing in a choir), and five had
some previous experience with meditation (see Table 2).
Attention
A repeated measures ANOVA revealed that the twoway interaction of time with attention is not significant
(see Table 3). However, the main effect of time is statistically significant (F [1, 14] = 6.69, p = 0.022). The attention
t score at Time 1 is 51.54 (SE = 1.76) and 46.94 (SE = 0.87)
55
52.5
t Score
Table 3. Repeated Measures Analysis of Variance
of Attention and Time
50
47.5
45
42.5
2
1
Time
Commissions
Detectability
Hit reaction time
Hit reaction time standard error
Omissions
Reaction interstimulus interval change
Standard error by interstimulus change
Variability
Figure 1. Conners’ Continuous Performance Test II
of Attention Mean Scores at Baseline (Time 1)
and Following All Sessions (Time 2)
279
ed that fatigue decreased significantly more than the
other negative mood states. The mean of the fatigueinertia subscale pretest was 6.13, and the post-test mean
was 1.43, with the largest subscale difference score being
4.7 (p < 0.001).
A follow-up analysis using Bonferroni correction to
control for overall alpha level shows significant mean
differences between pretest and post-test for each
POMS-BF subscale (see Table 4). These improvements
in mood state indicate a relevant change in symptom
distress of the women.
10
t Score
8
6
4
2
0
Pretest
Post-Test
Time
Anger-hostility
Confusion-bewilderment
Depression-dejection
Fatigue-inertia
Tension-anxiety
Vigor-activity
Figure 2. Profile of Mood States–Brief Form
Mean Scores Before and After All Sessions
at Time 2. The significantly lower score at Time 2 indicates an improvement in attention over time. Figure 1
illustrates the attention measure over time.
Mood Distress
Discussion
This pilot study found that the MBMT program
significantly improved attention over time. This significant improvement in attention over time reinforces
the findings posited by Chiesa et al. (2011) and Jha
et al. (2007) that mindfulness-based interventions significantly improve attention. In addition, music stimuli
appear to be an excellent way to capture attention for
passive listening (Huron, 1992) and active music making
(Gardiner, 2005).
The results of this pilot study also determined that
MBMT significantly reduced negative mood states in
women with breast cancer who were receiving adjuvant chemotherapy. Specifically, the MBMT intervention significantly reduced states of tension, depression,
anger, fatigue, and confusion in women with breast
cancer, and it significantly improved their levels of
vigor and activity. Statements made by the women
during the MBMT corroborate the quantitative findings regarding mood states. For example, some women
reported feeling more relaxed and less stressed, as well
as being able to sleep better. The problem of fatigue
frequently reported by women receiving adjuvant
chemotherapy treatment for breast cancer (Berger &
Higginbotham, 2000) showed the greatest decrease
A repeated measures ANOVA revealed that the
change in mood from the beginning to the end of
each session did not vary by the type or the theme of
the session for each subscale. However, the change in
mood from the beginning to the end of each session
differed by subscale across all sessions (F [5, 65] = 20.83,
p < 0.001). Although a statistically significant reduction in mood disturbance
from the beginning to the
end of the MBMT ses- Table 4. Profile of Mood States–Brief Form Subscale Means and Mean
sions was observed, the Differences From Pre- to Postsession
magnitude of the change
Pre
Post
was not the same across
—
—
—
Subscale
X
SD
X diff
SE
X
SD
all mood states.
Figure 2 illustrates Anger-hostility
2.8
2.53
2.75
0.65**
0.05
0.14
the overall mean of the Confusion-bewilderment
4.28
3.13
2.35
0.73*
1.93
0.78
POMS-BF subscales at Depression-dejection
2.28
2.09
1.87
0.47**
0.42
1.35
6.13
3.49
4.7
0.65**
1.43
1.6
the beginning (pre) and Fatigue-inertia
Tension-anxiety
3.75
2.68
3.35
0.59**
0.4
0.69
end (post) of the MBMT
Vigor-activity
6.26
3.09
–3.23
0.71**
9.5
4.79
sessions. All mood states
of the participants im- * p < 0.01; ** p < 0.001
—
proved from the start to SE—standard error; X diff—mean difference
the end of all four MBMT Note. The difference scores are calculated by subtracting the total postsession mood scores from the total
sessions. Post-hoc pair- presession mood scores. Positive change scores indicate improvement in the negative moods, whereas
the negative change score indicates an improvement in the positive mood.
wise comparisons reveal
280
Vol. 42, No. 3, May 2015 • Oncology Nursing Forum
Knowledge Translation
Mindfulness-based music therapy (MBMT) improves attention and mood in women with breast cancer receiving
adjuvant chemotherapy.
Fatigue is significantly relieved by MBMT in these patients.
MBMT can be used by nurses for their patients.
following the MBMT sessions. The significant reduction
in negative mood states, particularly fatigue, and the
marked improvement in vigor confirms the benefits for
mood alteration from a MBMT intervention. Speca et al.
(2000) did not find improvements in fatigue in the use
of an MBSR program for patients with cancer; however,
fatigue was reduced significantly with MBMT. Perhaps
the MBMT program, with its combined emphasis on
enhancing attention and reducing mood distress, is
particularly effective for fatigue reduction.
Although the development, detailed description,
and participant narrative comments of the MBMT
program are provided for readers elsewhere (Lesiuk,
2014), the following participant comment, taken from
a participant’s homework journal regarding acceptance
and letting go, corroborates the finding that negative
moods can be altered through MBMT.
This week, the music was extremely relaxing and
beautiful. . . . My mood, thoughts, and feelings
changed. I was apprehensive, nervous, etc. Now, I
feel acceptance, relaxed, ready for the approaching
surgery—totally with a positive attitude!
The current study is limited by a small sample size
and the absence of a wait-list control condition. In
addition, although chemotherapy treatments were
concurrent with the MBMT sessions, they varied in
duration prior to the MBMT sessions. For example,
some women had completed only one-third or one-half
of their treatments when they began the study, whereas
others were closer to completing the prescribed cycles
of chemotherapy. Future research investigations should
account for the length of time and number of cycles of
chemotherapy received prior to and during MBMT.
Attention and mood responses may be variable based
on the length of time on chemotherapy and the number
of chemotherapy cycles women had been receiving.
Recommendations for a more comprehensive research
study beyond this pilot study include use of a larger
number of participants and a wait-list control condition.
MBMT could also be offered in a small-group format as
opposed to only individual sessions. The social connection available in a group setting may further enhance the
benefits of MBMT for the women. Measuring the effect
of MBMT on fatigue during stages of chemotherapy
Oncology Nursing Forum • Vol. 42, No. 3, May 2015
treatment (Berger & Higginbotham, 2000) would elucidate the strength of the MBMT to reduce fatigue.
Women with stage IV breast cancer were excluded
from participation in the current study, but a study of
the effect of MBMT on symptom distress and quality
of life for women with stage IV breast cancer is also
recommended. Measures of perceived home and worklife stress also could be included to account for MBMT
effectiveness when these factors are controlled for.
Implications for Nursing
Nurses who observe symptom distress and attention
problems in women receiving adjuvant chemotherapy
for breast cancer may help by facilitating a simple
mindfulness-based music technique for their patients.
For example, patients can be instructed to bring in their
preferred music selections and focus on a particular attribute in the music (e.g., melody, specific instrument).
In beginning mindfulness practice, the patient’s attention may naturally drift to thoughts, feelings, or body
sensations. However, the patient should be instructed to
gently guide her mind back to the particular attribute in
the music. The patient should also be told to be aware of
any thoughts and to watch them as a bystander would.
This mindfulness exercise that involves being with the
music in the moment can be practiced at any time.
Guided instructions for using preferred music listening to practice mindfulness are provided by Graham
(2010) and Goldberg (2014). The music listening and
mindfulness practice may not only be employed by patients, but also by nurses who desire to practice mindfulness. A music therapist may provide guidance to nursing staff regarding how to facilitate mindfulness-based
music listening with their patients. Nursing administrators interested in providing MBMT for their patients
should contact the American Music Therapy Association
(www.musictherapy.org) or the author of the current article for assistance with locating music therapy services.
Conclusion
The unique contribution of music to mindfulness
practice in the form of MBMT significantly improved
attention and mood states for women receiving adjuvant chemotherapy for breast cancer. The symptom
of fatigue, a common complaint of the women, was
particularly alleviated by the MBMT treatment. This
music-based intervention, although in need of further
investigation with a larger sample, is promising for the
relief of symptom distress and to allay the attention
problems associated with chemobrain.
The author gratefully acknowledges Joyce Chavarria, DNP, RN,
OCN®, and Olga V. Moreira, MSN, ARNP, for their assistance with
patient referrals and program support.
281
Teresa Lesiuk, PhD, MT-BC, is the director of and an associate professor in the music therapy program in the Frost
School of Music at the University of Miami in Coral Gables,
FL. This study was funded, in part, by the Provost’s Research
Award from the University of Miami. Lesiuk can be reached at
tlesiuk@miami.edu, with copy to editor at ONFEditor@ons
.org. (Submitted July 2014. Accepted for publication December 12, 2014.)
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Vol. 42, No. 3, May 2015 • Oncology Nursing Forum
Copyright of Oncology Nursing Forum is the property of Oncology Nursing Society and its
content may not be copied or emailed to multiple sites or posted to a listserv without the
copyright holder's express written permission. However, users may print, download, or email
articles for individual use.
1. Week 6: Web Link Assignment #2
Students are to search the Internet for scholarly articles on the events and causes that led to
World War I. These can be primary or secondary sources but should come from academic
sources. Recommended topics include: essays and articles on the rise of nationalism and
imperialism in Germany and the other major powers involved in World War I; the rise of
militarism in the decade before World War I; Irish- and German-American reaction to World
War I; etc. These entries will provide a valuable resource for your second historical
essay. Unacceptable internet resources include but are not limited to: Wikipedia, online
general reference encyclopedias such as Encyclopedia Britannica, online dictionaries, and
general informational search sites such as infosearch.com, infoplease.com, about.com,
answers.com, etc.
See the Web Link Assignment Grading Guidelines (Links to an external site.)Links to an external
site. for more information. (I attached this).
Submit this assignment as a Word document.
2. Research Article Critique Guidelines
Purpose
The purpose of this assignment completed as an APA Paper is for the student to learn to
examine, analyze, critique, and summarize an original research article.
Course Outcomes
Through this assignment, the student will demonstrate the ability to meet the following course
outcomes:
CO1: Examine the sources of evidence that contribute to professional nursing practice. (PO7)
CO2: Apply research principles to the interpretation of the content of published research
studies. (POs 4 and 8)
CO4: Evaluate published nursing research for credibility and lab significance related to
evidence-based practice. (POs 4 and 8)
CO5: Recognize the role of research findings in evidence-based practice. (POs 7 and 8)
Points
The assignment is worth a total of 175 points.
Rubric
Click to view and download the NR439 Research Article Critique Paper Rubric (Links to an
external site.)Links to an external site..
Due Date
You are to submit your paper by Sunday 11:59 p.m. MT at the end of Week 6.
Requirements
Through this assignment, the student will:
1. Critique the required article found below and in your own words, describe the research
question, sample, design of study, data collection method, findings, and limitations of each.
(CO 1, CO2,)
2. Summarize the research article and evaluate the significance to nursing. Do not just quote the
author's words. Paraphrase the information. (CO 4, CO5).
You are required to use the article below or you will earn a "0" for the assignment. In
addition, assignments that do not follow the current guidelines and use the required article
will be evaluated for evidence of an academic integrity violation.
After the due date, there will be no opportunity for revision or resubmission of assignments
that have been uploaded to the submission area. It is your responsibility to submit the correct
assignment to the correct submission area.
Guidelines to Writing the Paper
1. This assignment is completed as an APA paper. APA resources can be found on the Course
Resources Module.
2. Download the required article for analysis:
Lesiuk, T. (2015). The effect of mindfulness-based music therapy on attention and mood in women
receiving adjuvant chemotherapy for breast cancer: A pilot study. Oncology Nursing Forum,
42(3), 276-282.
https://chamberlainuniversity.idm.oclc.org/login?url=http://search.ebscohost.com/login.asp
x?direct=true&db=edswsc&AN=000354233000010&site=eds-live&scope=site (Links to an
external site.)Links to an external site. (I attached this)
3. Introduction (one paragraph): The introduction should be interesting and capture the reader's
attention.
a. Provide a brief description of the research article to be discussed.
b. Discuss the purpose of your paper. The purpose statement of the paper should relate to the
research article reviewed and the implications that it has to evidence based nursing practice.
c. You will need to summarize and analyze the information from the article in your own words
4. Describe the research question for this study in a paragraph.
a.
b.
c.
d.
Describe the research in greater detail.
Include your observations about this question.
Discuss events or trends that could have affected this question.
You will need to summarize and analyze the information from the article in your own words
5. Describe the research design of this study, and in your own words discuss the design.
a. Discuss the research design of the study.
b. Discuss the strengths and weaknesses of the type of design and hypothesize why the author
utilized the design as opposed to others.
c. You will need to summarize the information from the article in your own words
6. Describe the sample.
a. Briefly describe the sample size used for this study
b. Make a judgment as to whether the sample size was adequate and defend your answer.
c. Describe the number or participants and determine if the number of participants was
adequate compared to the research question and the intent of the study.
d. Are these numbers adequate? Discuss gaps in that you identified.
e. You will need to summarize and analyze the information from the article in your own words
7. Describe the data collection method(s)'
a.
b.
c.
d.
Who collected the data?
What tools were used?
What were the ethical considerations addressed and discuss gaps you identified.
You will need to summarize and analyze the information from the article in your own words
8. Describe the limitations of the study.
a.
b.
c.
d.
Identify the limitations within the study
Describe how the limitations could be overcome in subsequent studies
Comment on why limitations are important to list and discuss within a study
You will need to summarize and analyze the information from the article in your own words
9. Describe the findings reported in the study.
a. Describe the findings reported in the study
b. Discuss whether the findings of the study answered the research question posed within the
study
c. Discuss the credibility of the findings
d. If the findings do not support the research question posed within the study, what do you
believe is the reason?
e. You will need to summarize and analyze the information from the article in your own words
10. Summary
a. Summarize important points from the body of your paper including the key components of
the paper.
b. Include a statement about the research question and the findings.
c. Discuss the probability of implementation into practice. Based on these findings, is the
evidence that you found on your topic strong enough to suggest a change in practice, or an
idea for practice?
d. End with a concluding statement.
11. Citations and References must be included to support the information within each topic area.
Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations
are to be noted for all information contained in your paper that is not your original idea or
thought. Ask yourself, "How do I know this?" and then cite the source.
12. Reference Page: The Reference Page should start on a new page (insert a page break). All
references should be cited within the body of the paper as (Author, year) and the full
reference should be included in APA format on the reference page. A url link alone is not an
adequate reference. See the APA Guidelines in Course Resources for examples of properly
formatted references.
13. Submit the completed paper by 11:59 p.m. MT on Sunday at the end of Week 6.
**Academic Integrity Reminder**
Chamberlain College of Nursing values honesty and integrity. All students should be aware of
the Academic Integrity policy and follow it in all discussions and assignments.
By submitting this assignment, I pledge on my honor that all content contained is my own
original work except as quoted and cited appropriately. I have not received any unauthorized
assistance on this assignment.
Please see the grading criteria and rubrics on this page.
Week 2: Web Link Assignment #1
Search the library for scholarly articles on the debate surrounding the composition and
ratification of the Constitution. These can be primary or secondary sources but should come
from academic sources. Recommended topics include: state constitutions drafted after the
American Revolution; correspondence from significant colonial figures (e.g., John Dickinson,
James Madison, Alexander Hamilton, and others); the Virginia and/or New Jersey Plan; the
Federalist Papers, and so on. These entries will provide a valuable resource for your first
historical essay. Unacceptable internet resources include but are not limited to: Wikipedia,
online general reference encyclopedias such as Encyclopedia Britannica, online dictionaries,
and general informational search sites such as coursehero.com, infosearch.com,
infoplease.com, about.com, answers.com, etc.
See the Web Link Assignment Grading Guidelines (Links to an external site.)Links to an external
site. for more information.
Submit this assignment as a Word document.
WEB LINK ASSIGNMENT GRADING GUIDELINES
General Instructions
Write a 4-6 sentence description of a single URL on the specified topic. Submit the assignment
as a Word document.
Your Web Link Assignments should include an introduction to the site and a description,
and/or evaluation, of it. Be specific. The key is that someone should be able to read your entry
and know whether this site is one that might be relevant to their research. See the example below
for a good description.
Example
Pennsylvania State Constitution of 1776. (2008)
http://avalon.law.yale.edu/18th_century/pa08.asp
The Pennsylvania Constitution of 1776 (ratified September 28, 1776) has been described
as the most democratic in America and was drafted by Robert Whitehill, Timothy
Matlack, Dr. Thomas Young, George Bryan, James Cannon, and Benjamin Franklin. The
Constitution provides for a unicameral legislature, a Supreme Executive Council, a
President elected by an Assembly and Council together, and a Council of Censors. The
constitution was later copied by revolutionaries of Vermont as a basis for their
constitution. This site is useful as it gives us an insight into the debate over constitutional
government that would culminate in 1787.
Grading Criteria
•
•
•
•
•
•
The entry is from an academic or literary source.
You have included a helpful description of at least 4-6 sentences that tells the readers
what we’ll find on the site.
Your description is grammatically and mechanically correct.
The URL is correct.
The URL is NOT from Wikipedia or other wiki or social media sites
Other unacceptable sites include online general reference encyclopedias such as
Encyclopedia Britannica, online dictionaries, and general informational search sites such
as infosearch.com, infoplease.com, about.com, answers.com, etc.
Revised 6-27-17
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