Critiquing a Research Article: Quantitative Study
A critique is a careful appraisal of a study strength and weakness (Polit and Beck, 2012, p.125). The Article “Improving maternal health and safety through adherence to postpartum hemorrhage protocol in Latin America” published in International Journal of Gynecology and Obstetrics in 2014 by Olmedo, Miranda, Cordon, Pettker, and Funai.
Problem of study is clearly defined by the researchers as “Since the … year” (Olmedo et al., 2014, p. 1). According to Burns and Groves (2011), “The research problem is an area of concern where there is a gap in the knowledge base needed for nursing practice.” (p.146). The problem is also researchable because researchers have collected the data through observations and interviews and analyze it very well. Along with it, it fulfills the gap and is feasible. “The significance of the research problem indicates the importance of the problem to nursing and health care and to the health of individual” (Burns & Grove, 2011, p.146). Moreover, this problem is significant to nursing as many problems arises in women due to postpartum hemorrhage like shock, blood loss and can lead to death even. In addition it is applicable in the fields of Maternal and Child health and Community and Public Health Nursing with support to the literature and statistics mentioned by authors in introduction part. Additionally, background information is well explained in the article and is correctly written in introduction part and flow of content is maintained. Researchers has also given prevalence of national and international level like “worldwide… year” and “importantly… by 2015” (Olmedo et al., 2014, p. 1). According to Burns & Grove, 2011 state that “background for a research problem briefly identified what we know about the problem area” (p.146). However the authors have not mentioned any of the similar studies conducted in past in which the knowledge of acute management of third stage of labor and maternal health are compared.
The primary purpose of the literature review is to define, develop the research question & identify the gaps in the literature and suggestion on filling those gaps. (Burns & Grove, 2007). The literature review part of this article is present in introductory part but no separate heading of literature is present. Moreover, as the article was published in 2014, but the studies used in are from 2003-2012, ideally it should be within 05 years of study. According to Burns & Grove (2007), “the majority of studies should demonstrate an appropriate depth and breadth of reading around the topic and should include recent origin and ideally less than five years old”. Moreover the sources that are used by authors in this article are clearly and completely cited at the back of article with proper the use of comma, full stop, hyphen where needed. In addition, citations that are present at the back are not written in alphabetical order. Other than this, authors have paraphrased in text citations so that it does not question article’s authenticity if the quotes and content are fabricated. The relationship between problem and previous studies is mentioned clearly and is relevant. Moreover results of observations and interviews are also compared locally, nationally and regionally to get vast and true results. Besides this, range of views and varying opinions are not mentioned in the article as no other authors’ views are cited. Additionally, researchers have mentioned a brief summary of the literature at the end but without specific heading of conclusion and gave an implication in a nutshell “the large…impact” (Olmedo et al., 2014, p. 3).
Authors have clearly and briefly mentioned his purpose of study “the aim of …Peru” (Olmedo et al., 2014, p. 1). Moreover they have also discussed with whom he want to gather data and where by mentioning that “determining whether…Peru” (Olmedo et al., 2014, p. 1). Furthermore at another place authors have mentioned that with whom he is interested to collect data and what are his target places “the sites…level” and “the primary… institutions” (Olmedo et al., 2014, p. 2). According to (Polit & Beck, 2008), in quantitative study, a statement of purpose identifies the study variables, their interrelationships, and the nature of the population of interest. Besides, relationship between two variables are clearly discussed in the article, which are providers with more training and greater clinical experience as independent variable whereas, increase level of protocol adherence is dependent variable. A hypothesis is a formal statement of the expected relationship between two or more variables in a specified population (Burn & Grove, 2011). The hypothesis stated in the article as “we hypothesized…adherence” (Olmedo et al., 2014, p. 1). In addition the authors have also discussed the conceptual definition of postpartum hemorrhage but has not mentioned operational definitions “worldwide…1000ml” (Olmedo et al., 2014, p. 1). According to Burn & Grove (2011) conceptual variable has only theoretical meaning and operationalize variable can be measured statistically.
In the article, the researcher used appropriate study design (QUERY??????)
Researchers have explicitly described the target population in the article who were the health care professionals “the primary…midwifery” (Olmedo et al., 2014, p. 2). The target population is entire population in which researchers are interested and want to generalize findings (Polit and Beck, 2011). They selected convenience sampling which is a non-probability sampling type for their study in which they included n=24 at national level n=30 at regional and n=24 at local level. Additionally authors have mentioned “all participants…interviews” (Olmedo et al., 2014, p. 2), which illustrates that convenience sampling is used. (THIS PARAGRAPH IS INCOMPLETE AND QUERY ABOUT SAMPLING METHOD)
Researchers have used research tool that was adopted from previous studies and the Latin American Perinatal Information System but no specific name of tool is mentioned. Moreover, it is mentioned that 52 interviews were conducted representing all three levels of care i-e national, regional and local level but they didn’t mention that what type of questions they asked, open ended or close ended and how they asked these questions either verbally or in written form. But it is discussed that author (Olmedo. B) has used Spanish language to conduct interviews. Again it is questionable that the language which was used for interviews was understandable for all participants or not because it is not clearly mentioned here in the article. Moreover authors did not share reasons, content, strength and weakness of questions. Additionally, they did not mention tool validity but for reliability, researchers have mentioned that tool was taken from previous study but if we see reference of given study so two of them are not available and only one reference is opening which is of WHO 2009 but again no specific questions were not present in that reference as well. So again its reliability is questioned. According to Burns & Groves (2011), reliability tells the accuracy of the measurement method and validity tells that how well the instrument measure the abstract concept, which is supposed to be measure.
The data collection procedure was appropriate to the study as researchers conducted interviews and observations but it is not mentioned that if they have filled any questionnaire or not. According to Burn and Groves (2011) data collection is the accurate, organized gathering of information relevant to the research purpose or question of the study (p 52). It is explicitly mentioned in the article that when and where the study was conducted “between March…June 30, 2011” (Olmedo et al., 2014, p. 2). After this they have also shown interpretation of results which depicts that some of the steps of data collection were followed. Moreover they have not mentioned about any language barrier participant, training of interview conductors, the reliability of data collectors which shows that all the steps of systemic data collection were not followed. Moreover, they have followed the ethical principle of autonomy by taking consent but it was not mentioned either it was verbal or written consent which question the authenticity of study. The study can be replicable in similar settings, however the process of data collection should be considered for its exact replication. According to Burns & Groves (2011) replication studies are those studies “that are repeated to determine whether similar findings will be obtained” (p 546). Lastly, limitations and significant assumptions are not mentioned in the article which should be there so that readers can know what hurdles they have faced during research and what things they need to make sure for other researches. Limitations are the hindrance of the study which decrease the credibility and generalizability of findings (Burns & Grove, 2011). But in my view reliability of instrument tool was the limitation of study.
The choice of statistical procedure is appropriate as researcher used both type of statistics like descriptive and inferential. The quantitative data is analyzed by statistics, which includes any calculation like computing average, frequency or doing any calculation which is appropriate for the study (Polit & Beck, 2010). Researchers have used mean and standard deviations in order to get an idea of what total population may be like and how widely the scores are dispersed. Moreover they have used ANOVA to see difference between results of different groups; in addition results are compared with chi-square test to compare categorical responses of independent variables. Furthermore, they have shared probability p<0.05 which is significant. Lastly, they have used Vassar Stats (statistical website) for data analysis which is a good part of study. Correspondingly, a result table is also presented to display all comparable results. In my view researchers should have also use graphs as well for clearer and better understanding.
Generalizability is unwarranted in this article as it was mentioned above that researchers have used convenient method which cause biasness and biasness in a study distorts the findings of the results. According to Burns and Grove (2007) “Generalizability is the criterion used in a quantitative study to assess the, extend to which the findings can be applied to other groups and setting and other targeted population”. Moreover, results of all 03 levels were varied and were highly different from each other which also affect generalizability. Additionally, interpretation is the process, in which researcher compare and contrast the study findings in the light of previous studies and his own findings to make a final conclusion (Burns & Groves, 2011). Likewise in the given study the interpretation of the given data is appropriately mentioned in the discussion. Additionally, there is no separate heading of conclusion but it is given with discussion part which is based on data collected. Conclusion is a synthesis of the study findings (Burns & Groves, 2011). Conclusion in the study is given in a clear and precise way which makes it easy for readers to grasp the concepts as it is mentioned that “the present…LMICs” (Olmedo et al., 2014, p. 3). Finally recommendations is a part which helps researchers for future studies so, in our article recommendation portion is not mentioned separately but few are given in discussion part. Authors recommended that cultural beliefs should be cared to improve adherence to care and protocols and large prospective trial quality control protocol should be given which should focuses on cultural safety at institutional level.
My own recommendations to article:
In my view, separate heading of each part (summary, conclusion, recommendation, and limitation) should be given so that it would be easier for reader to understand. Secondly, tools that are used by researchers should have reliability to make study authentic and lastly, generalizability should be given by researchers from the sample and sampling technique.