Quantitative study
Campbell, D. A., Lake, M. F., Falk, M., & Backstrand, J. R. (2006). A randomized control trial of continuous support in labor by a lay doula. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35(4), 456-464.
Database from which the article was retrieved
Wiley Online Library
Study Design
The study utilized a randomized controlled design whereby the participants were randomized into either the control (no intervention) group or the experimental (doula group). As such, the design utilized was suitable and consistent with the study since it enabled the investigator to effectively compare the outcome measures of the two group and come up with significant inferences (Polit & Beck, 2013). Subsequently, this enabled the researcher to evaluate the effectiveness of this intervention in regard to the labor outcomes.
Aim/ Purpose of Study
The purpose of the study was to explore the labor outcomes of women who had a support person particularly a trained doula in addition to the standard care as compared to those who received only the usual or standard care (Campbell et al., 2006).
Dependent Variables
The study comprised various dependent variables that included; the pregnant mother’s mode of delivery, length of labor, Apgar scores and the timing as well as the type of anesthesia.
Independent variables
The key independent variable for the study was provision of labor support specifically by a trained lay doula who was a family member or friend.
Target Population
Basically, the target population for the study comprised of pregnant women from the low-income areas. Thus, this population was appropriate for the study since pregnant women from the low-income areas were usually associated with poor labor outcomes mainly due to lack of labor support since they do not afford the services rendered by a professional doula.
Study Population
The study population comprised nulliparous women with a singleton pregnancy. In addition, the population comprised of pregnant women drawn from various racial groups including; whites, Chinese, Filipino, Blacks and Hispanic and the mean age for women at delivery was twenty two years.
Inclusion/Exclusion Criteria
The inclusion criteria used in selection of participants included nulliparous women who had a singleton pregnancy. In addition, the participants were required to have a low-risk in regard to pregnancy or medical complications and had the capability of identifying a potential family member or friend who would act as a lay doula. Moreover, the participants were required to have no contraindications for labor. Thus, the inclusion criteria utilized was appropriate and enabled the researcher to select participants with the relevant characteristics.
Sample Size
The sample size comprised of six hundred pregnant women particularly nulliparous women with a singleton pregnancy. As such, the study utilized a convenient sample size that enabled the researcher to make significant comparisons between the two groups and come up with relevant findings.
Sampling Method
The participants were prospectively randomized into either the control or the experimental control. With regard to this, computerized randomization schemes were used whereby this helped to minimize incidences of biasness and enabled the researcher to come up with credible findings (Polit & Beck, 2013).
Methods
The outcome data was extracted from the hospital records following delivery of the pregnant mothers. Thus use of the hospital records helped the investigator to collect the accurate data pertaining to the outcome measures. With regard to intervention, the experimental group received additional support provided by a trained lay doula while the control group did not receive any form of additional support except the usual care.
Data Collection Instruments
Basically, the study utilized clinical records in collecting the relevant data pertaining to the outcome measures. Although, the investigator did not discuss the validity as well as the reliability of the instruments used, it is apparent that the instruments are reliable as well as valid since clinical records usually capture the collect data pertaining to each patient encounter.
Outcomes/Results
The study found out that the participants who received additional support provided by the lay doula had shorter labor periods, greater Apgar scores particularly at one and five minutes. Additionally, the intervention group had improved cervical dilation during epidural anesthesia. However, there was no significant difference observed in regard to the rate of caesarian delivery among the two groups (Campbell et al., 2006). Thus, use trained lay doulas either family members or friends is an effective strategy that can enhance the labor outcomes of pregnant mothers as well as their neonates. Therefore, healthcare professionals should promote the use of trained lay doulas during the labor process especially among low-income women who cannot afford professional support.
Strengths and Limitations
The main strength is that the study utilized a convenient sample population that enabled the investigator to come up with relevant and generalizable findings that can be used in developing suitable interventions. In addition, the sample population comprised pregnant women from diverse racial backgrounds whereby this helps in obtaining generalizable findings. More importantly, the study setting was a perinatal care hospital that usually served the low-income women who are associated with poor labor outcomes. Thus, study shall help in developing the relevant interventions to improve the labor outcomes especially among the low-income women. However, the key limitation for the study is that there was no blinding of caregivers as well as hospital staff whereby this may affect the credibility of the results obtained. More importantly, the key limitation is that the study had no restrictive policies in regard to visitation, thus participants in the control group could receive additional support especially from family members apart from the study participants thereby affecting reliability of the results.
Level of Evidence
The level of evidence provided by the study is considerably high since the study utilized an appropriate design and reliable instruments of data collection. As such, this emphasizes the need for healthcare professionals especially APNs to use the evidence to foster changes in clinical practice and polices so as to improve the labor outcomes of pregnant women (Campbell et al., 2006). In the light of this, healthcare professionals should advocate for the development of relevant policies to promote the use of lay doulas in providing additional support to pregnant women during labor. Moreover, healthcare professionals should educate pregnant women on the importance of additional support during the labor process, provide the relevant training to lay doulas and encourage use of trained lay doulas especially among low-income women so as to enhance their labor outcomes.
Qualitative study
Hinkley, T., Salmon, J., Okely, A. D., Crawford, D., & Hesketh, K. (2011). Influences on preschool children's physical activity: exploration through focus groups. Family & community health, 34(1), 39-50.
Database from which the article was retrieved
Lippincott Williams & Wilkins
Are the study findings valid/trustworthy/and credible? (Is this good solid research?)
How were the study participants chosen?
The study comprised a sample population of twenty three participants drawn from all the social-economic positions (i.e. middle, higher and lower social-economic positions). In regard to this, the participants were recruited via written invitations that were distributed through the childcare as well as preschool centers. Subsequently, participants who met the study’s eligibility criteria were randomly selected from the participating childcare as well as preschool centers and randomly grouped into each of the six focus groups. As such, the method used in selection of participants (i.e. random selection) was suitable for the study since it helped in minimizing the researcher’s biasness and enhanced the validity of the findings. In addition, the selection method enabled the investigator to explore the topic and come up with relevant findings since the sample population included participants from all the SEP (social-economic positions) (Hinkley et al., 2011).
How were accuracy of data and completeness of data assured?
The study utilized various techniques to ensure accuracy as well as completeness of the data collected. Firstly, verbatim transcriptions were made from the discussions obtained from each of the focus groups whereby this helped in correctly capturing the participants’ perceptions thereby enhancing accuracy of the data collected. Secondly, the obtained data was appropriately coded using thematic analysis whereby this helped in identifying the key themes associated with the phenomenon thereby ensuring completeness of data (Polit & Beck, 2013). Moreover, the transcripts were also coded by an independent researcher whereby this further enhanced data accuracy.
How plausible/believable are the results?
The study results are believable since they are consistent with the results obtained from similar studies carried out on the topic. In addition, the study’s framework was based on the SEM (Social Ecological Model) that is widely recognized especially in regard to understanding the influences pertaining to the behavior of young children.
Do the findings fit the data from which they were generated? (Y)
It is apparent that the findings are consistent with the collected data since the main themes depicted in the findings are consistent with the collected data relating to the various domains that influence the behavior of children based on the perceptions of parents. In the light of this, the findings include all the variables pertaining to the domains of social, individual as well as environmental factors that influence the behavior of children as indicated in the collected data.
What are the results of the study and are they important?
Does the research approach fit the design of the study? (Y)
The research approach is consistent with the study design since the appropriate approach (focus group) is utilized in the research process.
How does the researcher identify the study approach?
Are language and concepts consistent with the approach? (Y)
The concepts as well as the language used is consistent with the approach since the views of the participants were obtained using structured framework based on the study model and the variables used are in agreement with the approach.
Are data collection and analysis techniques appropriate? (Y)
The analysis as well as data collection techniques are suitable for the study since they enabled the investigator to come up with reliable, accurate as well as credible findings.
Is the significance/importance of the study explicit?
Does review of the literature support a need for the study? (Y )
The literature review clearly supports the need for this study based on the limited literature available in regard to the topic. More importantly, review of literature emphasizes the health benefits of engaging in physical activities among preschool children and indicates that their level of physical activity is suboptimal. Thus, this underscores the need for the study in order to identify the main influences pertaining to engagement in physical activities among the group based on the parents’ perspectives.
What is the study’s potential contribution? (Y)
The study sheds light on the parents’ perceptions in regard to various contributors to physical activities among their children. As such, this shall help healthcare professionals to clearly understand the topic and subsequently come up with suitable interventions to promote physical activities among this group and enhance their health outcomes.
Is the sampling strategy clear and guided by study needs?
Are courses and means of verifying data explicit? (N)
The means and courses for data verification are not explicitly indicated.
Are researcher roles and activities explained? (N)
Although the sampling strategy is well defined, the roles as well as activities carried out by the researcher are not clearly explained.
Is the phenomenon clearly defined? (Y)
The phenomenon of the study involved exploring the parents’ perceptions in regard to the influences pertaining to the engagement of their preschool children in physical activities.
Are the data collection procedures Clear? (Y )
The procedure of collecting data is well defined whereby the discussions of the focus groups were carried out using a semi-structured schedule comprising questions that were developed through the use of the SEM.
Are sources and means of verifying data explicit? ( Y)
The means and courses for data verification are explicit whereby the study utilized an independent researcher in verification of the transcribed verbatim.
Are researcher roles and activities explained? (Y)
The roles as well as activities carried out by the researcher are clearly explained. Particularly, the researcher facilitated discussions among the focus groups, recorded and managed the information obtained and subsequently analyzed this information
Are data analysis procedures described?
Does analysis guide direction of sampling and when it ends? (U)
Although, the collected data was analyzed using transcribed verbatim, it is unclear whether the analysis provides a guide to the sampling direction.
Are data management processes described? (Y)
The process of data managed in well described whereby the obtained data was properly coded using thematic analysis.
What are the reported results (description or interpretations)?
How are specific findings presented?
The findings are presented in a consistent and logical manner whereby the findings are mainly grouped into themes and where appropriate these themes are further categorized into subthemes.
Is presentation of the results logical, consistent and easy to follow? (Y)
The results are presented in a consistent as well as logical manner based on the themes as well as subthemes. In addition, well described tables were utilized in presentation of the results whereby this promotes easiness in regard to following these results.
Do quotes fit the findings they are intended to illustrate? (Y)
The quotes are consistent with the findings since they facilitate effective understanding of the topic and clearly highlight the parent’s perceptions pertaining the topic.
How are overall results presented?
Are meanings derived from the data described in context? (Y)
The meanings are in agreement with the data described in the content since they are drawn based on the collected data.
Are the results plausible and believable? (Y)
The results obtained are credible as well as believable since they are in agreement with existing literature and similar studies conducted on the topic.
Are conclusions consistent with reported study findings? (Y)
The conclusion is consistent with the study findings since it captures the key information pertaining to the identified themes.
Does the writing effectively promote understanding? (Y)
The writing is unambiguous and captures the relevant information whereby this promotes effective understanding of the topic.
3 implications for practice
The study provides valuable and significant information on the various aspects that influence as well as hinder the engagement of preschool children in physical activities based on the parents’ perception. As such, this shall help healthcare professionals to design and implement suitable interventions to promote the participation of these children in physical activities and subsequently improve their health outcomes (Hinkley et al., 2011). More importantly, the study offers valuable information on perceptions of parents drawn from diverse social-economic groups whereby shall assist the healthcare professionals to customize their interventions based on the needs and preferences of diverse groups. The findings of this study bear a lot of significance to nursing practice and places the healthcare provider at a vantage point in terms of understanding approaches for promoting physical exercise among preschoolers. Various demographic aspects such as economic status and ethnicity have a huge influence on physical exercise patterns among preschoolers, hence accentuating the need for fine-tuning physical activity programs to meet the specific needs of a given patient or patient population.
References
Campbell, D. A., Lake, M. F., Falk, M., & Backstrand, J. R. (2006). A randomized control trial of continuous support in labor by a lay doula. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35(4), 456-464.
Hinkley, T., Salmon, J., Okely, A. D., Crawford, D., & Hesketh, K. (2011). Influences on preschool children's physical activity: exploration through focus groups. Family & community health, 34(1), 39-50.
Polit, D. F., & Beck, C. T. (2013). Essentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams & Wilkins.
