Research Article Critique assignment

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Critique Assignment #1

Lauren Barrett

NUR 3223

Palm Beach Atlantic University

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Critique Assignment #1

The relationship between gestational age and the severity of neonatal abstinence syndrome.

This paper will be a critique of the quantitative research study done in the relationship

between gestational age and the severity of neonatal abstinence syndrome. The purpose of the

article, population of interest, study of variables, time perspective, inclusion and exclusion of

criteria, and the overall study design will be discussed. Limitations of this study will also be

explained in this paper.

Article Purpose Statement

The purpose of the article I am critiquing is to find out if there is a difference in the length of

pharmacotherapy and hospital stay in infants exposed to opioids before birth (Gibson, Stark,

Kumar, & Bailit, 2017). The article looks at the relationship of the severity of neonatal

abstinence syndrome and the gestational age at delivery (Gibson et al, 2017).

Population of Interest

Population of interest is defined as a complete set of individuals or objects the researcher

uses that have similar characteristics of interest (Nieswiadomy, 2018). In the article the

population of interest were all of the deliveries of infants born to opioid addicted mothers

(Gibson et al, 2017). There were 403 eligible participants in the research study (Gibson et al,

2017). Of those 403 participants 102 late pre-term born at the gestational age of 34–36 weeks

(Gibson et al, 2017). 158 of the participants were considered early term born at the gestational

age of 37–38 weeks (Gibson et al, 2017). 122 of the participants were considered full term born

at the gestational age of 39–40 weeks (Gibson et al, 2017). Lastly 21l of the participants were

considered late term born at or after 41weeks gestational age (Gibson et al, 2017).

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A target population is defined as a group of people or objects the researcher wishes to

base his/her findings on (Nieswiadomy, 2018). The target population in the research article was

all deliveries effected by opioid exposure between the times of January, 2000 to October, 2014

(Gibson et al, 2017). The researcher grouped the infants based of their gestational age at birth,

and compared the age groups for the need of treatment for neonatal abstinence syndrome

(Gibson et al, 2017).

Study Variables

An independent variable is defined as the “cause,” or the variable that influences the dependent

variable (Nieswiadomy, 2018). This independent variable is what the researcher manipulates. In

the research study the independent variable is the gestational age of the infants (Gibson et al,

2017). A dependent variable is defined as the “effect,” or the response that is influenced by the

independent variable (Nieswiadomy, 2018). The dependent variable in the research study is the

length of the hospital stay of the babies effected by neonatal abstinence syndrome (Gibson et al,

2017).

Correlational Variables

Correlational variables are the target population and the other variables the researcher measures

in the study (Nieswiadomy, 2018). In the research study I am critiquing the correlational

variables are the pharmacotherapy used to treat the infants (Gibson et al, 2017).

Time Perspective

A retrospective study is a study where the dependent variable in the present and the researcher

tries to determine the independent variable (Nieswiadomy, 2018). Conversely, prospective

studies are those in which the independent variable is defined and the researcher follows the

subjects to determine the “effect” or dependent variable (Nieswiadomy, 2018). The research

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study I am critiquing is a retrospective study in which the researcher knows the dependent

variable (gestational age of the infants) and is looking to find the independent variable (length of

stay for infants with neonatal abstinence syndrome) (Gibson et al, 2017).

Inclusion and Exclusion Criteria

The study included woman between the ages of 18 and 50 years old whom had a history of

opioid use during pregnancy (Gibson et al, 2017). In the study there were six sets of twins

included as well as other infants who were admitted to the neonatal intensive care unit with

severe neonatal abstinence syndrome (Gibson et al, 2017). Infants were excluded from the study

who were younger than 34 weeks gestational age, for abnormalities found prior to birth, and for

patients who were missing information (Gibson et al, 2017).

Study Design

Setting

The research study took place in Cleveland, Ohio at the MetroHealth Medical Center (Gibson et

al, 2017). This hospital was chosen because it has a level III Neonatal Intensive Care Unit that

deals with a high number of opioid dependent pregnancies (Gibson et al, 2017).

Methodology

The article was a quantitative study that used an explanatory technique to examine the

relationship between the length of pharmacotherapy and hospital stay among opioid exposed

infants (Gibson et al, 2017). Explanatory studies are concerned with cause and effect relationship

(Nieswiadomy, 2018). In explanatory study the researcher is able to manipulate the variables

(Nieswiadomy, 2018). This is seen in the study I am critiquing by the manipulation of the

gestational age at birth of the babies, and the length of pharmacotherapies they receive. The

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study is also an experimental research study. Experimental research is concerned with cause and

effect relationships where one object or event makes some other object or event happen

(Nieswiadomy, 2018). Experimental research is highly respected in the scientific world, involves

the manipulation or control of independent variables, and measurement of a dependent variable

(Nieswiadomy, 2018).

Measures and Tools

Quantitative research studies are concerned with the collection of observable data

(Nieswiadomy, 2018). It is also used in scientific research to combine statistical, and

mathematical techniques to obtain data for the researcher to study (Nieswiadomy, 2018). In the

articles study the researcher collected the data by way of reviewing patient medical records

(Gibson et al, 2017). The researcher used a research assistant who was trained to collect prenatal

history, social and drug use history, delivery details, neonatal outcomes, and use of medications

on the infants to relieve symptoms of neonatal abstinence syndrome (Gibson et al, 2017). The

data collected was then entered into an electronic database to be compiled (Gibson et al, 2017).

To obtain the medical records the researcher had to obtain informed consent from a local review

board and from patients before starting the research process (Gibson et al, 2017).

Conclusion

The relationship between gestational age and the severity of neonatal abstinence

syndrome was a study that was done with the end goal of finding out if there is a difference in the

length of pharmacotherapy and hospital stay in infants exposed to opioids before birth. The end

result of the study showed that there was not a correlation between gestational age and the need

for pharmacotherapy in infants with neonatal abstinence syndrome (Gibson et al, 2017). They

did find however that a shorter duration of pharmacotherapy was needed for infants in the late

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pre term period (34–36 weeks gestational age) at birth with neonatal abstinence syndrome

(Gibson et al, 2017).

The research study did have some limitations one of which was that the data was

obtained via chart review (Gibson et al, 2017). During the chart review process there could have

been bias in measuring the true frequency of the data due to this collection method. Also because

the collection of data through review of the chart relies on accurate data being entered into the

chart in the first place, there is a possibility the information collected is inaccurate or skewed.

Another limitation of the research study was the time period in which the data was collected

(Gibson et al, 2017). The data was collected between a 14 year period which could have seen a

change in drug use patterns among pregnant woman. The population being taken from a single

hospital site is also a limitation (Gibson et al, 2017). This limits the data because there is a

possibility the data from this single site does not accurately reflect the whole population, and

potentially can lead to a limit in the generalizability of the study. The last limitation of the study

was the fact that the limited size of the data collected did not allow for accurate categorical

analysis by individual week, instead gestational cohorts were used (Gibson et al, 2017).

Overall, this study was important to review because it gives insight into an increasing

problem of neonatal abstinence syndrome. With the rapid growing opioid epidemic in recent

years the number of cases of neonatal abstinence syndrome is growing. It is important to gather

as much information as we can to insure accurate teaching to women of child baring age who are

considering doing drugs, or who are currently taking drugs that could lead to this potentially

deadly problem.

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References:

Gibson, K. S., Stark, S., Kumar, D., & Bailit, J. L. (2017). The relationship between gestational age and the severity of neonatal abstinence syndrome. Addiction, 112(4), 711-716. Retrieved February 7, 2019, from https://onlinelibrary- wiley.com.proxy.pba.edu/doi/full/10.1111/add.13703. Nieswiadomy, R. M., & Bailey, C. (2018). Foundations of nursing research (6th ed.). NY, NY: Pearson.