Introduction
Perinatal depression is increasingly becoming a worldwide mental illness that affects expectant mothers. Although depression has always been categorized by world Health Organization (WHO) as a silent killer disease, perinatal depression continue to attract more attention due to its adverse effect on an entire family support system. It puts both the health of the mother, unborn baby, and the newly born at risk, and this risk is gradually transmitted to other family members who are taking care of them. More disheartening is the fact that this disease is more prevalence among the low-income mothers and those in the underserved remote areas. This research aims at investigating how culture plays crucial role in influencing perinatal depression preventive methods
Literature Review
Although perinatal depression disease has been for many years ignored evident from the countable number of researches conducted, it is slowly attracting attention from researchers from all walks of life. This is after WHO projected that in four years’ time, precisely in the year 2020, perinatal depression will assume the second place of disability-adjusted life years diseases. One of the latest research in this field was carried out by Goodman et al (2013) investigated “Pregnant African American Woman’s Attitude Towards Perinatal Depression Prevention” they found out that low income African American women were mostly affected as compared to white and Hispanic women.
In my view, I think the missing link between income and perinatal depression is the role played by predominant culture these women comes from. Based on Goodman e al. (2013) assessment on use of antidepressant medicines to remedy the situation, the response was one sided. White women and Hispanic women were more receptive to the use of these antidepressants while the African American women were too reluctant to adopt the preventive method.
Overreliance on quantitative method has informed my decision to follow a more descriptive approach that will give me an insightful information culpable of changing the whole approach toward perinatal depression prevention. My study will focus on qualitative research method and will become one of the unique studies ever done in this field. In terms of approach, investigation and analysis.
Methods
Design
In an effort to find out how culture influence the choice of prenatal depression prevention method, I will use qualitative research method to investigate some detailed fundamental issue which I believe will benefit many interest groups. For examples, the research will help other researchers, scholars, and medical practitioners in understanding the relationship between culture and medical related disease preventive methods such as the prenatal depression prevention at hand. I will employ the use of Case study as one of the favorite research design method to gain an in-depth information regarding the disease and how best it can be contained to avoid troubling the newly born.
My choice of case study as a research design is based on its ability to deliver detailed and insightful information from the respondents. Yin (2011) posits that any researcher who desires to carry out a more specified research problem study should use case study analysis as it avoids overlapping of research problems and does not possess general approach to a research problems unlike other designs. Therefore, the researcher will be able to come up with a more specific research findings.
In addition, little is known about how culture may influence an expectant woman’s choice of prenatal depression prevention method. Yin (2011) further emphasizes that in the event a researcher wishes to pursue a rare kind of research problem with scarce information, case study as a research design becomes indispensable as it is culpable of unearthing little known facts of the problem being pursued. The study will be non-experimental in nature and will focus on both observatory and behavioral techniques.
Finally, according to Creswell (2014), case study always stands out as the best research design when attention is directed to a specific group of people. In my case, I intend to centralize my research on the underserved women in the remote areas of my larger native community to assess the impact of culture on medical-oriented preventive methods to common worldwide diseases affecting pregnant women with key focus on prenatal depression prevention method.
(b) Participants
The research will adopt random sampling strategy to come up with ten women who will participate in the research in every community. Random sampling has been widely used in the past in major researches and has achieved success due to nondiscriminatory approach in getting the best sample size. In the current case, we do not want to rely on only affected people as the past researches such as that of Goodman et al (2013) which only focused on the victims being vising prenatal care clinics.
Getting those affected and likely to be affected will give an insightful information on whether the predominant culture is influencing or will influence or may influence their choice of prenatal depression prevention methods. Random sampling is likely to achieve past experience of those who may have passes the stage, who are currently experiencing prenatal depression and women who are closely approaching motherhood.
My research focuses to achieve the most out of my sample size. Having a sample size of ten women of varied age group or experience is likely to furnish my research findings with well-balanced responses and experience. Creswell (2014) highlights that a manageable sample size complements the quality of the findings when qualitative method to research has been used. He further argue that small sample size of between two to fifteen provides the right synergy needed among recipients. It enhances interactive participation and the participants will enjoy complementing one another responses to drive the point home.
(c) Procedure / Measures
The research data will draw mainly from the sample group discussions and interviews. The selected participants will first be subjective to a non-coercive interviews. The interviews will have five main questions the respondents will be required to answer to the best of their knowledge without guess work. The first question will be things they were taught by their mothers when they were teenagers that touched on motherhood. This question is tailored to capture some of the general parental teachings of young girls as they approach motherhood.
Further, based on the above question, I will ask the respondents if their mothers ever narrated to them what happens a few weeks to delivery and after delivery and what to do and not to do during that time. The second question will be to ask each respondent any medical related warnings they ever received especially for respondents who have delivered or pregnant. If yes did these warnings come from a medical practitioner or a village midwife or the elderly women in the society?
Next question will be to examine if there things they were taught or warned not to do as they grew up and for those who have gained contemporary conflicting knowledge on such issues how are they handling he two conflicting practices. Which practice among the two is superior? Following question will directly relate to their general understanding of prenatal depression? If yes what ae the visible symptoms they are aware of? What are the current preventive methods they know? If yes where did they get the motherhood education and if no would they wish to be educated on the same and will they embrace new advices on mother wood?
The last question will touch on their exposure to clinical medical treatment. In the past studies, women who were exposed to clinical treatment were much receptive to prenatal depression clinical preventive methods as opposed to those not used to such kind of medication. The question will seek to find out whether exposure to clinical medication can drive respondents to accept or adopt clinical prenatal depression preventive methods.
Upon completion of the five main questions, the respondents will be subjected to group discussions where they will freely interact with other participants to answer some general questions on prenatal depression and to share information they feel they might have left out during the interview process. In a qualitative research method, Creswell (2014) urges researchers to make good use of respondent body language, facial expression, and tonal variation as these three will form part of credibility and reliability test of the information provided.
Some medical background check can be carried out when the responded has clearly shown she has been under clinical medication. A visit to respondents nearest medical facility can further corroborate this information to put any element of doubt below the feet. In addition to doing a medical history follow up, having a normal chat with respondents parents can also act as a basis to validate the reliability and genuineness of the information provided. Further credibility checks can be done in case of dissatisfaction with the information gathered.
(d) Data Analysis Technique
The research findings will be compared against the projected responses then a more analytical approach will be taken to identify which part of respondent data be used in deducing a conclusive remarks. Although the five questions provided the respondents with unlimited freedom to answer the question in the best way possible, the research data analysis will also consider all noted respondent body language to further elaborate on the ides.
Finely analyzed information can now be visually be reported using pie charts and graphs to illustrate trends across various remote villages. Based on this graphical presentation, a more conclusive remarks can be drawn on the influence culture has on prenatal depression prevention. Further notes and reasoning as well as group discussion videos can be presented with the consent of the sample group to avoid any form of violating their privacy or subjecting them to public ridicule.
Yin (2011) in his response to qualitative data analysis argue that it is the sole duty of the researcher to determine what is material and immaterial for a particular analysis. The final research findings will be presented in form of power point presentation highlighting how various aspect of the research and data was carried out and what influenced the final decision.
(f) Ethical Issues
According to Hulley (2007), clinical or medical related researches always faces lack of truth from the respondent. He highlights that some respondents will answer the questions for the sake of it without understanding of what is required. From Hulley perspective, it is clear that this research is likely to encounter deception problem from some of the respondents. To overcome this, there will be a sensitization campaign on the need to tell the truth and implication of falsehood to the general public. This must be done at least one week prior to the action research to prepare the general public and to also be warmly accepted in the community. Warm reception always add value to the research in that the respondents will be more than willing to participate unlike the hostile community.
Conclusion
Prenatal depression continue to remain global mental disease affecting expectant women before delivery and after delivery. The severity of the condition regards the family chain problems it creates regarding need to be given quality prenatal care. Various studies have indicated low income mothers are likely to suffer more compared to their well off colleagues. However, low income has been discredited as a major contributor to this mental condition thus attracting more need to conduct a descriptive research as oppose to predictive research as the later misses out important aspects which can provide an insight to this problem. According to Galbally et al. (2014) responsive to prenatal depression prevention methods among women vary from on community to the next there by painting a loophole in cultural aspects of various women in these communities. But before concluding to any cultural relationship to choice of preventive methods, a quality research needs to be done to ascertain the claims.
References
Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches. Thousand Oaks, CA: SAGE Publications.
Galbally, M., Snellen, M., & Lewis, A. J. (2014). Psychopharmacology and pregnancy: Treatment efficacy, risks, and guidelines. New york city: Springer Heidelberg.
Goodman, S. H., Williams, K. G., & Dimidjian, S. (2013, January 19). Pregnant African American women's attitudes toward perinatal depression prevention. Retrieved April 14, 2016, from http://www.pubfacts.com/detail/23356356/Pregnant-African-American-womens-attitudes-toward-perinatal-depression-prevention
Hulley, S. B. (2007). Designing clinical research. Philadelphia, PA: Lippincott Williams & Wilkins.
Yin, R. K. (2011). Applications of case study research. Thousand Oaks, Calif.: Sage.
