Research Critiques and PICOT Statement Final Draft

Research Critique Guidelines – Part I

Qualitative Studies

Background of Study

The initial breastfeeding rate for the healthy people 2020 goal is 81.9% (Pitts, Faucher & Spencer, 2015). Pennsylvania recorded a 70.2% breastfeeding initiation rate in 2013. These figures show that breastfeeding is a global public health concern. Looking at the “ten steps to successful breastfeeding,” step three is “Inform all pregnant women about the benefits and management of breastfeeding.” The question posed: how does a mother’s decision to initiate breastfeeding impacted by the knowledge of breastfeeding during prenatal education vs. education on admission or none? Breastfeeding is the most natural method for mothers to feed infants and is highly recommended by Pediatricians, Nurse Midwives, and Lactation Nurses, yet breastfeeding rates remain extremely low. It also provides several other benefits for infants, such as the transfer of antibodies from mother to infant as a source of immunity against several illnesses. As a result, by breastfeeding, infant’s hospital re-ad-mission rates can decrease. There are some challenges and contextual factors that face low- and middle-income families, especially when receiving breastfeeding education interventions. These challenges, as discussed by Pitts, Faucher & Spencer (2015) and Schreck et al. (2017) in their studies, perhaps might hinder the duration supposed to be taken by breastfeeding mothers. Findings show that families who have their income are more likely to stop breastfeeding than those without. According to Schreck et al. (2017), an infant should start breastfeeding in the first hour after birth, and through the first six months of life because breast milk is believed to have essential nutrients and vitamins for healthy child development and growth. Therefore, this paper seeks to answer the PICO question: “How does prenatal education impact a mother’s decision to initiate breastfeeding?”

How do these two articles support the nurse practice issue you chose?

Pitts, Faucher & Spencer (2015) say that a child should be breastfed throughout the six months of life because breastfeeding is healthy for both the child and the mother. However, how is this supposed to be beneficial for both the mother and child without first knowing to breastfeed? Thus, these two qualitative articles try to educate women who are preparing to give birth and those already with infants to have the best knowledge about breastfeeding.

Looking at the Pitts, Faucher & Spencer (2015) qualitative study, it can be deduced that women’s breastfeeding initiation, duration, and exclusivity increases upon receiving prenatal breastfeeding education. Authors state that women are provided with evidence-based breastfeeding information and guidance about prenatal breastfeeding based on technology-based education programs, recurrent, face-to-face teaching. This article sensitizes nurses' role in embracing the culture of educating breastfeeding mothers and those expecting their newborns about its importance. The report shows that some women don’t understand the importance of breastfeeding, bringing relevance to my PICOT question that intends to find out the impact of prenatal education on a mother’s decision about breastfeeding.

Conversely, research by Schreck et al. (2017) revealed that to improve the breastfeeding duration and exclusivity, a breastfeeding mother needs both prenatal education and ongoing post-discharge support. The article’s results showed increased breastfeeding initiation, exclusivity, and duration for healthcare facilities that increase maternal breastfeeding self-efficacy through teaching and support in post-discharge. Increasing the rate of breastfeeding initiation and duration required a consistent evaluation of maternal confidence in breastfeeding and appropriate interventions. It is evidenced that; breastfeeding mothers’ long-term positive health outcome is influenced by breastfeeding duration and exclusivity. This source is crucial to me as it helps me answer my PICOT question, whereby I want to find out how the breastfeeding initiation rate increases through prenatal breastfeeding education. However, as compared to both articles, my study used a different research intervention. Along this line, Schreck et al. study did not have a control group.

Method of Study:

Pitts, Faucher & Spencer (2015) used a quasi-experimental qualitative approach to assess breastfeeding mothers who were receiving education from certified nurse-midwives. By using computer tablets, each woman was given a breastfeeding module which was distributed at the 32-, 34-, and 36- week of every prenatal visit. At the end of every module, women answered questionnaires, acting as a measure for content learning and level of participation. Also, at the 6th week of every postpartum visit, each woman completed a survey to assess the summative perceptions. On the contrarily, Schreck et al. (2017) used chart review and telephone survey to assess a total of 650 women using a semi-structured study after delivery to determine their breastfeeding initiation, duration, and exclusivity. Healthcare-based prenatal and postpartum education had an impact on the rate of breastfeeding among women. The breastfeeding education equips mothers with information for a successful long duration of breastfeeding. The benefit of using qualitative studies in my chosen articles is that qualitative data analysis organizes the data by theme. This is done through reading and re-reading the transcripts to find common topics. However, qualitative studies are faced with a significant limitation of quality, heavily dependent on the researcher's skills, and more easily influenced by the researcher's personal biases and quirks.

Results of Study

The findings of the study performed by Pitts, Faucher & Spencer (2015) indicate that breastfeeding mothers learning through the tablet methodology successfully acquired informed information about the importance of breastfeeding. Further, the results confirm that working women can now breastfeed their infants after receiving prenatal breastfeeding education. Another factor found to be vital in increasing breastfeeding duration is timing. It means breastfeeding initiation and continuation increased through proper prenatal breastfeeding education.

The findings of the exploration conducted propose that pre-birth education can significantly affect the choice to breastfeed, just like the actual duration of breastfeeding. Moms who knew about specific suggestions to breastfeed were more likely to start breastfeeding. If healthcare facilities can provide early breastfeeding education to women in the pre-birth period, we may see a considerable rise in the number of women who choose to breastfeed versus formula feed. Breastfeeding provides significant health benefits to both the babies and their moms. Low-salary women and their kids accordingly fail to get the vital benefits breastfeeding provides. Breastfeeding, especially exclusive breastfeeding, is a significant method to guarantee the well-being and prosperity of these babies and their moms.

The implication in nursing practice calls for establishing a standardized prenatal breastfeeding education program for women who lack the knowledge and importance of breastfeeding. The findings of these articles help nurses identify women who require additional support and identify women with high levels of self-viability who may not require further intervention.

Ethical Considerations

Firstly, both researchers received ethical approval to conduct their research from the Research Ethics Committee. The participants were provided with written information and consented to participate in the research study. Secondary sources were sufficiently cited by both analysts, which demonstrated they are recognizing and offering credit to different scholars. Authors likewise supported their data employing a lot of writing. This implies the two researchers have played within the standards featured by the Research Ethics Committee.

References

Pitts, A., Faucher, M. A., & Spencer, R. (2015). Incorporating breastfeeding education into prenatal care. Breastfeeding Medicine, 10(2), 118-123. From: 

https://pubmed.ncbi.nlm.nih.gov/25565242/

Schreck, P. K., Solem, K., Wright, T., Schulte, C., Ronnisch, K. J., & Szpunar, S. (2017). Both prenatal and postnatal interventions are needed to improve breastfeeding outcomes in a low-income population. Breastfeeding Medicine, 12(3), 142-148. From: 

https://www.liebertpub.com/doi/10.1089/bfm.2016.0131

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