Womens First and Later Pregnancies Critique - Research Paper Example

 Research Critique Measuring Factors Underlying Intendedness of Women’s First and Later Pregnancies. & Qualifications IleneS. Speizer- Consultant John S. Santelli-Chief Applied Sciences Branch at the Division of Reproductive Health, Centres for Disease Control and Prevention, Atlanta. Aimee Afable-Munsuz- Research associate, Centre on Social Disparities in Health, University of California, San Francisco Carl Kendall- Professor, Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans (Ilene et al. 200). Analysis Research Problem: The research problem eliciting this research bid was driven by the need to assess gaps in reproductive health services and family planning, which are not yet clearly understood. Unintended pregnancy levels are part of the core indicators of the gaps, and this indicator is important to policymakers and planners. These pregnancies determine the health outcomes of both mother and child, and as such are indicative of the gap in planning. Thus, the research seeks to assess levels of unintended pregnancies so as to understand the gap in planning (Ilene et al. 200). Review of the literature: The research reviews various relevant works on the same topic from the past. Most of the reviewed works presents past assessments on various variables related to the topic. The work reviews extensive resources that span a long period from the early 1990s to the mid 2000s. A majority of references were from the 90s with only a few being from recent times. Theoretical/Conceptual Framework: The research makes use of a descriptive conceptual framework, which outlines the relation of the variables under study. The theoretical framework states that pregnancy intendedness and women’s attitudes and motivations to get or avoid pregnancy are essential in conceptualizing the relation between the behavior of women and fertility. The framework also states that the measurement of these parameters is essential the estimation of gaps of unmet contraception needs. This framework, which is explicitly outlined is based on a substantive theory drawn from past related research bids. Research hypothesis: The researchers formulated a directional hypothesis for the research. The hypothesis is directional because from the conceptual framework it can be inferred that either a negative or positive relation will exist between intendedness and other variables in relation to the gap in family planning services access and health indicators (Ilene et al. 200). Research Design: The researchers adopted a correlational research design for this bid. This was due to the need to test for a statistical relation between intendedness of pregnancies and gaps in reproductive health services, which influence the risk of negative health outcomes for the child and mother (Ilene et al. 200). The lack of interventions and treatments in the research clearly rules out the application of experimental and quasi experimental designs (Burns & Grove, 2009). Research Population: The population featured in the research is an inner-city low-income population consisting of women from New Orleans. The population from which samples were drawn consisted of low income women from a black majority population in the inner-city of New Orleans. In addition to asking questions on demographic characteristics, pregnancy outcome and duration since pregnancy, the survey included 19 questions on pregnancy intendedness about the first pregnancy and 15 about the last or current pregnancy of higher order Variable How the variable was measured (instrument or tool) How was the Validity tested? Pregnancy Intendedness Intendedness was measured using 19 varying questions on the first pregnancy and 15 for the current or last pregnancy. This variable was measured using variables such as happiness, fear, confusion and partner’s acceptance of the pregnancy among others. Reliability coefficient calculation. Characteristics of clinic attendees These were measured using variables such as age, race, education, marital status and number of total pregnancies. Reliability coefficient calculation. Independent Variables: The independent variables include factors that affect intentionality such as happiness and partner’s acceptance, marital status, education and age (Ilene et al. 200). Dependent variables: The dependent variable in this research was intentionality, which was under the influence of multiple independent variables that either directly or indirectly influenced intentionality. It depicts the response to independent variables (Ilene et al. 200). Reliability: The researchers took steps to enhance reliability by enhancing internal consistency through attaining split-half reliability. This was achieved by splitting in half all test items intended to probe into the same area of knowledge-intentionality of pregnancies. The sampling of women from the prenatal clinic and family planning clinics created two different sets of study groups. The test questions were administered to each set of sampled members and computed results were correlated between the groups in the analytical process. Pilot Studies: There was no pilot study conducted and this can be deduced from the presentation of the research. Samples: The two samples used in the research were drawn from women visiting an inner-city public family planning clinic and a public prenatal clinic in the same area. The two samples were randomly selected with the acceptance of participation being the only differentiating factor between those that participated and the ones that did not participate. A total of 701 women from the from the family planning clinic participated, whereas 671 from the prenatal clinic took part (Ilene et al. 200). The sample sizes were large enough because virtually all women at one instance either had to attend a prenatal clinic or a family planning clinic. This implies that much of the relevant population sample was captured in the study and therefore, the results may be a true representative of the population. Data Collection: Data on the research was collected through personal interviews which featured trained interviewers who were tasked with the collection of data. The interviewees were randomly sampled from women that were on the waiting line before they got into the appointment room. Members that took part were informed before the interview and granted full discretionary power to participate in the interview. A total of 1372 women took part in the study. Limitations: Randomized data collection and split-half reliability enhancement are the two notably used controls in the research. The research faces a number of limitations that could be prompted by various threats to validity. For example, participants in these samples are from poor localities where financial issues may be significant life influences on most of the extraneous effects/history. These could in turn affect independent variables, and therefore, the overall research. Mortality or attrition and maturation had no effect on the limitations of the research because the study was an instantaneous process with no time for change. Similarly, the Hawthorne effect would have limited effect because the interviewees were not under a long period of observation within which they would alter their responses. Instrumentation is also not an issue in this research because there were no observed great variations in the measurements made. Selection would however pose a challenge to validity because there are different groups used for comparison under the same research. Data: The collected data can be grouped in ordinal, nominal, interval and ratio forms. The yes or no responses to questions on issues such as the desirability of pregnancy present nominal data. Most of the data from the 19 questions used to assess the first group required responses that fell within a scale of 1 to 5 and these questions produced Ordinal data. The collection of data on age for the participants produced ratio data, which is characterized by an absolute zero (Burns & Grove, 2009). All the presented tables helped in various ways in understanding the data. The first table helped in understanding how data was collected and the rest clearly laid out the data in an easily understandable manner, which presented the data in the respective samples. The data collected was presented in terms of means, standard deviations and percentages, which reflected the characteristics of the participants. The categorization and clear presentation of tabulated data made understanding of the data simpler. Statistical Analysis techniques: Results on various analyses were presented, but the researchers notably used t-tests in bi-variate analyzes and chi square tests in the analysis. The pre-set p-values differed according to clinics sampled and these were put at p≤0.01 and p≤0.001. The obtained results were statistically significant because the proportion of unintended pregnancies among the population studied was notably high. The overall level of unintended, first pregnancies was 62%. Additionally, 53% of the higher pregnancies were found to be unintended. This finding is also clinically significant because it implies that the group studied is clearly at a higher risk of first and higher order unintended pregnancies. Interpretation: The results are clearly presented and the writers of the research take the readership clearly through the research processes such as research conceptualization, data collection, analysis and presentation. The data is clearly presented in tabulated forms with clear explanations that make it easier to understand the results of the research and the implications of the findings. The clear presentation that elicits understanding makes results sensible and significant. In fact, I had initially expected that the intentionality of women from such a population with a low income and poor life should be having higher rates of unintended pregnancies. Communication of findings: The results drawn from the research show that there is a higher rate of unintended pregnancies among the low income populations. This also implies that the gap and disparity in reproductive health is greater. As such, the findings are relevant to practice because they prompt a search for a remedial step towards filling the gap. However, it has to be noted that the applicability of the research should be limited to the population in question because its reliability beyond the group may not be high enough. Research Ethics: The research adhered to the necessary ethical procedures by seeking approval of its procedures of the relevant authorities. The research consent procedures and protocol were submitted to the Institutional Review Boards (IRB) and approved. The approval was made by Charity Hospital, CDC and Tulane University Health Sciences Centre IRB boards. Strengths of Research: The research has the following strengths identified from the manner in which it was carried out: Thee kind of sampling adopted are random and contributes to the reduction of bias. The collection of data was professionally conducted through the use of trained interviewers and thus enhancing the probability of attaining proper data collection. The high number of questions used to capture various aspects of the desirability of pregnancies in the interview is a sure proof that all aspects on the variable are well taken care of. The selected sample size is quite significant and it offers a better representation of the population sampled. Weaknesses of Research: The selected prenatal clinic is close to the selected family planning clinic and they both serve the same population, this implies that the served population, which was the sample population, is homogenous and may have little validity. The sampled population is limited region-wise and therefore, the applicability of the research is limited to the population and area under study (low-income, inner-city women). There is an extensive list of questions assessing intentionality and all the measures were related to one latent factor. This is contrary to the qualitative findings and common sense, which suggests that desirability, is multidimensional. References Burns, N. & Grove, S.K. (2009), The Practice of Nursing Research: Analysis, Synthesis and Generation of Evidence (6th Ed.). St. Louis, MO: Saunders Elsevier. Ilene S. S. John S. S. Aimee A. & Carl, K. (2004), Measuring Factors Underlying Intendedness of Women’s First and Later Pregnancies; Perspectives on Sexual and Reproductive Health, 36(5): p. 198–205 Read More