Smoking Cessation During Pregnancy


For this assignment I will critique a research journal, a research critique is not just a summary of a study but the appraisal of the qualities and flaws of something. Brockopp (2003) says the research critique is the process of summarising the key aspects of a research report then determining the quality and merit of the study on the basis of predetermined criteria. The function of a critique is to identify areas of adequacy and inadequacy.To critique the journal I will use The Bennett Critiquing Framework (2001) which I will use to give structure to this piece of work. According to Innova (2004) to ensure that all aspects of a critique are covered, an evaluative framework should be in place. Critiquing a journal should entail adopting an objective and balanced approach. Lewis and Barnes (1997).

The title of the Journal I will critique is Smoking Cessation during Pregnancy: The influences of partners, family and friends on quitters and non-quitters. In my opinion the author has made this title complicated to the reader due to using the word cessation. The word cessation means the fact or process of ending or being brought to an end definition in the oxford dictionary. The British Journal of Psychiatry (2013) and Kasi (2009) states that a title should be brief and relevant but Parahoo (2006) believes that the title should immediately capture the reader's attention and should refer to the population from whom the data was collected. The author carried out the study to compare pregnant smokers' quitters and non quitter's accounts on how partners, family and friends influence their smoking cessation attempts. The study is a qualitative study www.csulb.edu/~msaintg/ppa696/696quali.htm. Qualitative research is aimed at gaining a deep understanding of a specific organization or event, rather than a surface description of a large sample of a population. It aims to provide an explicit rendering of the structure, order, and broad patterns found among a group of participants. It is also called ethnomethodology or field research. It generates data about human groups in social settings which was of secondary data according to Heaton (2004) secondary data analysis is known as a methodology for doing research using pre existing statistical data. The author should be commended for telling the reader that secondary data was used for this piece of research
The study was carried out to distinguish if the influences of people changed smoking habits for pregnant women.The journal was published on 15th March 2010 and carried out by P. Koshy,MBBS MPH, M.Mackenzie, BA(hons) MPH PHD, D. Tappin, MBBS MD MRCP, And L. Bauld, BA(hons)PHD. The journal does not give full details on what credentials the authors actually have to qualify them to carry out this research the author only gives abbreviations so this can be a criticism of the journal because according to Smith-Worthington and Jefferson (2011) an author's credentials are an important element in determining their value and gives authors with a strong and positive reputation, credibility to their writing. After having researched the qualification abbreviations then the authors can be commended for having the correct qualifications to conduct the study. This is supported by ESOMAR (2009) who states that 'it is difficult to defend and create confidence in the validity of ratings without personal credentials'.

The abstract of a journal is intended for the reader to be able to read it and know straight away whether the journal is relevant to their area of interest without having to read the whole journal. (Walters, 2009)states that interviews were undertaken as part of a smokechange program but no reference is made to what smokechange entailed although when I read the full journal an explanation of what this was, was sourced. Murray 2013 states the purpose of the abstract is to outline the whole paper however Christopher () contradicts this by saying an abstract does not convey all the details within an article nor does it provide information to judge the quality of the study. Driscrill (2013) describes a good abstract as including purpose, methods and scope with no results, conclusions and recommendations whereas, Parahoo (2006) states that an abstract should be a short summary of the chosen topic. The author has referenced that there is evidence that continued smoking whilst pregnant can result in riskier pregnancies but why has the author only referenced from one source when this topic is an issue that has been previously researched. When I researched this topic there are numerous sources that can support the statement referenced by the author. Rogers and Matsumara (2006) say babies born to smokers tend to be smaller which is also supported by the NHS who say stopping smoking whilst pregnant will be less likely to be born underweight.

It is apparent that the literature review is current and relevant because of the variety of references used from 1997- 2009 Dawidowicz(2010) says a literature review is to examine current literature to understand the state of the researched based knowledge topic. The authors can be criticised for not sourcing more references from differing authors in one particular area of research throughout the journal.In the review the author has referred to other studies but not specified what studies these were and from which journals.Sweetland( ) states that different types of referencing with great potential is the reference by citation,the reasons for this being further evidence of claims, for amplification of data, to give appropriare credit this is agreed with by Roberts and Priest(2010) who says the fundamental reason a citation appears is that the item cited is related to the document doing the citing.
There are several related citations which include; Angela Tod (2003 )Research in public health: Barriers to smoking cessation in pregnancy.
Thompson, Parahoo, Mc Curry, O' Doherty and Dorethy (2004) Womens perceptions of support from partners, family members and close friends for smoking cessation during pregnancy: combining quantitative and qualitative findings.
Everett, Murphy, Paijmans, Steyn, Matthew, Emmelin, Peterson(2011)Scolders,carers or friends: Midwifes contrasting styles of communication when discussing smoking cessation with pregnant women. After researching these several journals it was apparent that this author referred to several sources for referencing from text and also supported the need for further research through journal sourcing. The author failed to discuss any relevant government policies and procedures or Acts that have been put in place to support the cessation of smoking or to protect others that smoking can affect. In my research I found references supporting the government's duties that have been implemented. In the mid 1980s the increased efforts to warn women of the dangers of smoking whilst pregnant, were the federal cigarette labelling and advertising Act 1965 amended in 1984 required health warnings to be placed on cigarettes to be made explicit with direct references to the risks posed by smoking whilst pregnant, Crouse ( )
Linsley, Kane and Owen (2011) state the tobacco advertising and promotion Act (2003) came into force in the U.K. On March 2004 the smoking ban was put in place in Ireland to stop smoking in Bars and restaurants, in June 2004 Norway followed this ban and in October 2006 others countries including the U.K imposed this ban. In 2007 the ban was expanded to all public places including workplaces, healthcare and educational facilities.

The purpose of this research is to study if pregnant women's perceptions of social support for smoking cessation were indicative on their quitting of smoking during pregnancy. The aim was for midwifes to interview pregnant women using motivational interviewing techniques. In my opinion the aim of the interview could cause biases because would a person be truthful when being interviewed by an healthcare professional who is there to support the woman but also their for the wellbeing of the unborn child my opinion is backed up by Hamilton ( ) who says midwifes are there to provide individual care to the woman and their families, whilst encouraging them to participate in and determine how they want their pregnancy to progress.Motivational interviews according to Dart(2011)can be clinician and a method of promoting behaviour change through coaching using therapeutic communication but Rollock and Miller (2002) disagree with this and say motivational Interview is a directive, client centred counselling style for eliciting behaviour change by helping the person explore and resolve ambivalence. In my opinion these references are telling me that these styles of interviews are for the person being interviewed to consider the advantages and disadvantages of change.The study is qualitative but also used data from randomised controlled trails. Tilley (2005) says that the government and scientific communities agree that randomised controlled trails are the gold standard for assessing effectiveness. The authors should be commended on using a qualitative design within their research area because rather than being scientific it is based on the opinion of the person being interviewed. Ulin, Robinson and Tolley ( 2005) say qualitative methods are naturalistic in that they apply to real world situations as they unfold naturally.

The study was made up of 12 women who quit during pregnancy and 113 interviews with 94 non quitters also 478 recorded interviews were untranscribed. These figures do not tell the reader the actual number of pregnant women who participated in the motivational interviews or how many interviews each participant had although the journal did say between 0-5. From this I can notice a weakness because the authors used opportunity sampling which was quick and practical to use with what they had available to them at that time because these women signed up to these motivational interviews when they first signed into clinic. Mason (2002) says opportunity sampling is often viewed as the weakest form of a sample selection and being less demanding on researchers. The journal does not specify how the women were selected which can lead to biases because although we knew that all the interviewees were female and pregnant we do not know any others factors that could influence the outcome like where the women are in their pregnancy, their age, social background. Orleans and Slade(1993) say social, economic and environmental factors will influence the natural history or course of a smoking career agreed by Petraitis(1995) suggested that factors affecting tobacco use can be classified along two dimensions-type of influence and level of influence the three distinct types of influence underlie existing theories of tobacco use-social, cultural, and personal.

The study was undertaken in 3 steps the first was a potential rich sample which the author assumed was the most affected samples of the women that quit, this yielding a sample of 12 women.

The author is to be commended on consideration to ethics because although ethical approval for the SmokeChange study was received from the Yorkhill research ethics committee, ethical approval for the qualitative analysis was also sought as an amendment. Robertson and Dearling (2004) say that ethics are about the moral position adopted by the researcher and those funding the piece of research, each of these groups has a moral obligation to protect people from any mistreatment which could result from taking part in the research its self.

The author has used qualitative analysis and listened to the data via tape recordings and reading transcripts but no observations of the interviewees were undertaken by the author. Observations can offer verification of self report data and contribute to the reliability, validity, trustworthiness and rigor of a study, Gerrish and Lacey (2010).
Peraklya (1997) says the rationale for working with transcripts is that recordings and the transcripts can provide a highly detailed and accessible representation of social action. In my opinion this is interpreting information and maybe the researcher of would have been better conducting the interviews themselves to observe and truly relate with the interviewees. The data was arranged into charts using MS Excel software charting data enabled systematic comparisons. The computer software used to analyse data was ms excel the data was categorised which aided the process to identify links between themes.
Validity in qualitative research has been defined as the ability of the data collecting method to measure what it was suppose to measure. Cohen (2005) says within this research it was the perceptions, experience and feelings that validity embodies honesty, depth, richness and truth in collection and presentation of results. What participants report should be considered fact and remain undisputed and reported. Silverman (2001) therefore says in analysis of qualitative data, it is important to report the feelings and perceptions of the respondents. Qualitative data provides conceptual themes and sub themes via process of content analysis. Graneheim and Lundman (2004).
The results were presented in thematic categories which included: influences of partners, the role of close family and the support of friends which is a major process in qualitative data analysis which is the search for themes. Smith (1992) says thematic content analysis is the scoring of messages for content, style or both for the purpose of accessing characteristics or experiences of people, groups or historical periods, so the author should be commended for using thematic categories for this piece of research although the research can be criticised for using this style of analysis because Sappleton says that thematic analysis is the most frequently employed methodologies to study, so in my opinion the author has used a framework which fits the research and that is frequently used by other researchers.

Each result is outlined with headings which makes it easier for the reader to see the categories as single interpretations made by the interviewee. The main findings were more quitter woman than non quitter women talked about their partners offering encouragement regardless of being smokers themselves. A very similar pattern was reported in data both in quitters and non quitters which focused on female close family members such as mothers, sisters, mother in laws and sister in laws. Dunn (1998) suggest that close female friends and relatives may be an important source of influence during pregnancy for low income women and they were described as the most valued advice givers because they have firsthand experience with pregnancy www.http://her.oxfordjournals.org/content/18/3/352.full and in contrast health professionals were perceived as providing unrealistic textbook knowledge.

When reading the discussion it became apparent to me that the author had mixed findings from all support the pregnant women were given from partners, family and friends and when some of the motivational interviews took place some women had others present whilst these interviews were conducted.

The author uses other literature and resources of existing research although the author does not use several findings, only the findings from Wakschlag(2003).
Limitations were discussed the first being the distinction between quitter and non quitter because quitters were the ones who reported stopping smoking by the end of their pregnancy and this was verified by continine validation. Bramer (2003) says continine is a convenient bio maker because it is easily measured in body fluids including saliva, blood and urine and specific to body exposure. This is supported by Owing (2005) who says bio chemical validation of smoking status is now an essential requirement for establishing validity in smoking cessation programmes for pregnant women.

Conclusion

This piece of research was undertaken in 2010 and by this time the smoking ban was already in place in the U.K but the author does not mention this in the research or any legislation and if any research similar to this was undertaken before the smoking ban and if this altered any findings. In my opinion this leaves a window of opportunity for researcher to undertake further research whilst comparing their findings with the smoking ban and post smoking ban. This research had many bias and these included being unsure of the stage of pregnancy, when the women quit, social status, social background, women's age, women's personality, the amount the women smoked which to me caused the lack of validity and reliability. From not knowing all this information I felt that I could not relate to this journal as it was not specific to a certain group of pregnant woman although I can be criticised because some would say pregnant women are a group. This piece of work is not applicable within my working practice at present due to the age group of people in which I work with this Journal would be more applicable for somebody that was working with people under the age of 60. The study did not discuss any alternative strategies that could have assisted the woman to aid them with smoking cessation although studies show that the risks associated with using nicotine replacements are outweighed by the benefits of quitting smoking during pregnancy.
www.cdc.gov/tobacco/data-statistics/sgr/sgr-2000/00-pdfs/chapter 4.pdf.

The use of triangulation and mixed methods in research has been reported to increase the validity and reliability of research. Cohen (2005) and Creswell(2003).

References

Crouse, J, S (2010) Children at risk: The precarious state of children in America. New Jersey: Transaction publishers.
Dart, M. (2011) Motivational interviewing in Nursing Practice: Empowering the patient. London: Jones and Bartlett Publishers.
Dawidowicz, P. ( ) Literature reviews made easy: A quick guide to success
Graneheim and Lundman (2004)
Heaton, J. (2004) Reworking Qualitative Data. London: Sage
http://books.google.co.uk/books?
http://www.oxforddictionaries.com/definition/english/cessation?q=cessation
Innova, R. (2004) Evaluation Framework. Available at: http://rqhealth.ca/programs/drug_strategy/pdf_files/evaluation_framework.pdf
Kasi, P.M. (2009) Research: What, Why and How? USA: Author House
Linsley, P. Kane, R and Owen, S. (2011) Nursing for public health: Promotion, principles and practice. Oxford: Oxford University Press.
Mason, J.(2002) Sampling and selection in qualitative researching. London: Sage
Orleans, T and Slade, J. (1993) Nicotine Addiction: Principles and Management.
Parahoo, K. (2006) 2nd edn. Nursing Research ' Principles, Process and Issues. New York: Palgrave Macmillan.

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