¶ … Sensitive Issues in Nursing -- Loss of Pregnancy Nursing

At least 2.5 single spaced pages. Do not double space. Put answers in boxes. Each answer at least one solid paragraph, make boxes longer if necessary.

Format for Research Article Critique Name:

Directions: The purpose of this assignment is to review a research article and determine how it impacts nursing practice. Use this form to analyze the relevance of the research to nursing practice. APA format for the research critiques are required only for the citation for the article. The answers to the questions do not have to be written in APA format, but do need to be in complete sentences.

Caelli, PhD, K., Downie, PhD, J., & Letendre, A. (2002). Parent's experiences of midwife-managed care following the loss of a baby in a previous pregnancy. Journal of Advanced Nursing, 39(2), 127 -- 136.

Read the article. Write a one paragraph summary describing the purpose of the study:

Based on reported statistics and inferred statistics or projections that have not been reported, it is a fairly common occurrence for women and couples to experience the death of a baby while in utero, or shortly after birth. One reason why the authors conducted this study was to bring awareness to this occurrence; women and couples are suffering from loss because of the death of their babies. Furthermore, the authors conducted this research study to offer support for this traumatic experience for expecting parents. The authors comment that childbearing women and couples have a moderate statistical likelihood of experiencing a death of a baby preceding the successful birth of a subsequent child. There is a distinct possibility of physical and psychological risk factors for parents that have suffered the trauma of a death of a baby from a previous pregnancy as they experience a current or subsequent pregnancy. The study aims to acknowledge these parents, their traumas, and gain insight into the experiences of loss and/or grief associated with neonatal deaths. The study additionally aims to understand or assess the efficacy of the Special Delivery service programme, which is a midwife managed form of intervention that has been recently added or included along with the normative health treatment and routines for expecting parents.

Describe the study design. Why did the researcher choose this design? Would a different design been more effective? Why or why not?:

The researchers declare very early on in the study, as well as specifically in the Methodology section that they have chosen a phenomenological research design. Their reasoning for this kind of design is quite specific. While this is a medical or scientific occurrence, the affects and effects are experiential and emotional. As the focus of the study is upon qualitative experience, a phenomenological approach is a sound choice. Phenomenology is a field with philosophy that has been translated to other fields for use such as psychology, medicine, computer science, and media theory. Phenomenology in its most basic form is the study of experience, as it occurs from the first person perspective. There is usually some kind of intention of direction associated with the experience, such as the experience of pregnancy has an intention of raising a child or expanding one's family, among other numerous intentions that are possible. It is uncertain as to whether another form of research design would be better for this experiment; an experimental form of research methodology may haven proven just as fruitful or productive, but not necessarily better. This study's focus is of the quality or character of parents who have suffered a neonatal loss. Phenomenology exclusively values and upholds the truth, validity, and intensity of first person experience; therefore, this approach is a valid and logical selection. The study also focuses upon the parents' experience with the SPS and the experience with the subsequent pregnancy. Experience is fundamental to the study, to the data analysis, and to the conclusions rendered by the researchers. Thus a research study that values the primacy of experience should use a research methodology that supports and complements the objectives of the researchers, as phenomenology does.

Describe the strengths of this research study:

There are a number of strengths to this study, first of which is the topic of the experiment. This is a fairly common experience for childbearing parents that is somewhat taboo or unspoken. People do not have engage in conversations or studies of this nature regarding...

This is the kind of trauma that most people want to forget or move on from as soon as possible. Yet, the trauma exists and occurs with relative statistical stability across several continents, as mentioned in the study. Therefore the choice of topic is a perceived strength. Another strength is the choice of methodology. In previous decades, researchers may have and actually did argue against the validity of phenomenology, arguing along the lines that experience is not objective and objectivity is one of the highest priorities in scientific research. In the 21st century, where there are fields such as experience design, interface design, and interaction design, experience is key to the success of many products and services. In the 21st century, the age of the peer review, experience is crucial and one of the greatest assets to a study, for nursing, marketing, or otherwise. The study is very aware of the ethical implications of undergoing such a study. This is very important. This is a sensitive issue and in the process of gathering data, participants could quite likely become upset again as they revisit and recount painful memories. The mental and emotional health of the participants seemed to be a great priority, which is an additional strength of the study.
Describe the weaknesses of this research study:

The study could have been more directed. What is meant by that is that, the study did not seem to have a greater or meta- intention for nursing, or health. Yes, there is awareness of neonatal deaths. Yes, the SPS demonstrates itself as valuable and useful for childbearing parents and medical facilities, but this reader was left thinking, now what? Or, so what? How is this studying contributing to neonatal death besides stating that it exists and the SPS is a resource? There is value to this study; I just think they could have considered a greater purpose or utility to childbearing parents and neonatal deaths. The researchers saw patterns in the countries and continents in which neonatal deaths occur with relative stable frequency. They could have applied their research and findings to a greater phenomenological inquiry regarding what overlapping factors of those cultures and societies contribute to or set the stage for neonatal deaths. In any case, this reader was left thinking there was an aspect of the study that was missing or missed.

What conclusions did the researcher(s) reach as a result of the study? Do you agree? Why or why not?:

The conclusions of the researchers were that the SPS is successful in supporting traumatized parents, and that the inclusion of such services can be critical to the physical and psychological health of the parents regarding their perspectives on parents as they go through another pregnancy. They concluded that having a health care professional that specifically deals with pregnancy and babies, such as a midwife, served as a great support for parents, especially a midwife's ability to listen and care about their experience without some ulterior motive. I agree with the results. As I stated earlier, this is not the kind of experience people want to talk about or want to hear about, but talking about trauma is one of the most effective ways to move through the trauma and heal from it successfully. I think if parents with these kind of experiences do not talk it out or talk it out with people who do not care or have adequate time to listen (as opposed to listening to diagnose) that they will have less likelihood to attempt to have children again. I also think that without a SPS kind of service, the children from subsequent pregnancies might suffer traumas as a result of the traumas that their parents have not completely worked through. I think a service like the SPS saves families and saves lives.

Is this study relevant for your practice? Why or why not?:

This study is relevant to my practice because nurses have to deal with all kinds of patients. In order to be an effective nurse, we need to know how past traumas physically or otherwise, may play a role in a current medical condition. It may not be 100% relevant as my concentration is not in this field, but it is relevant insofar as it is an example of a study that provides an "out of the box" type of service that is clearly effective and useful. Whatever the concentration for a nurse may be, it is relevant to see what other nurses are focused on because one never knows from where inspiration comes.

What changes in practice would you recommend based on the results of this study?:

I am not precisely sure as to what changes I…