Qualitative Research Critique

Qualitative Research Publication Critique

Qualitative research is subjective and pieces together a person’s experiences, interactions, beliefs, attitudes, and behavior to gain insight into the action and choices of human behavior, which contributes to the development of evidence-based interventions and guidelines (Grove, Gray, & Burns, 2015). In the article by Gaydos et al. (2015) regarding infant safe sleep recommendations, a qualitative study was conducted to gain knowledge of how providers counsel low-income, African American mothers on sudden infant death syndrome (SIDS) prevention and how well they understand and adhere to the safe sleep recommendations. The purpose of this paper is to discuss this qualitative research study that will:

describe the problem, purpose, and hypothesis; describe the methodology used; describe the data collection, analysis, and reporting procedures; analyze the strengths and weaknesses; analyze the significance of the research problem with the ethical implications to the patient care setting; and justify the study as an appropriate source of information for patient care decision making.
Problem, Purpose, and Hypothesis of the Research
In order to begin a qualitative research study, the researcher begins with a topic of interest that must be specific, measurable, achievable, and completed in the allotted time frame (Quick & Hall, 2015).

Since the American Academy of Pediatrics (AAP) in 1992 recommended the supine sleep position, on a firm mattress, and no bed sharing, there has been a decrease in SIDS by more than 50% of all populations in the United States (U.S.); however, in the African-American population, rates for SIDS are twice as high as Caucasian infants (Gaydos et al., 2015). Research demonstrates that African-American mothers are more likely to place infants in the prone position to sleep and bed share despite awareness and understanding of safe infant sleep recommendations (Gaydos et al., 2015). Thus, Gaydos et al. (2015) discovered that little research exists on provider reactions to the non-compliance of African-American parents on safe sleep recommendations; therefore, this study is to compare the decision-making choices of low-income, African-American women in infant sleep positions and the counseling practices used by providers to reduce the rates of SIDS in this

population.
Methodology
This research study does not identify a particular methodology except as being qualitative; however, based on this study design to “understand” how low-income, African-American mothers understand safe sleep recommendations, their choices of infant sleep positions, and how physicians act upon the choices to better understand methods to reduce SIDS (Gaydos et al., 2015), would make this an exploratory-descriptive qualitative research study.

Grove et al. (2015) describes an exploratory-descriptive approach as one that is done for a specific purpose in which the information gathered is needed to develop an intervention for a specific group of people. This type of study is developed to offer insight into clinical issues that will produce practical solutions (Grove et al., 2015). Thus, the focus of this study is the why of infant sleep choices of low-income, African-American mothers to better understand how to offer interventions to decrease rates of SIDS in this

population.
Data Collection, Data Analysis, and Reporting Procedures
Gaydos et al. (2015) used data collection from focus groups of African-American new mothers and interviews with medical providers for this study. Ideally, focus groups are comprised of five to eight participants which consist of unstructured interviews and allows the subject participants and the facilitator to interact freely to collect group-centered data in a nonjudgmental way (Grove et al., 2015). Interviews are used to gain authentic insight from participant responses to questionnaires or surveys for data analysis (Grove et al., 2015).
Data Collection
Gaydos et al. (2015) recruited research participants by placing fliers in waiting rooms at clinical settings which included non-profit clinics and public health departments in Atlanta and Albany, Georgia with eligibility requirements to include English speaking, African-American women over the age of 18, first time mothers, and infant less than six months of age. Sixty women divided into eight focus groups participated (Gaydos et al., 2015). All focus groups were given informed consent, conducted by two facilitators, audio recorded, professionally transcribed, and lasted 90 minutes (Gaydos et al., 2015).
Twenty providers participated in the study comprised of a diverse sampling who were selected based on those who see new mothers, location, gender, and years of practice (Gaydos, et al., 2015). Interviews were conducted by researchers that lasted 45-60 minutes, audio recorded, and professionally transcribed (Gaydos et al., 2015).
Data Analysis
To obtain data analysis, Gaydos et al. (2015) used a team of five researchers to summarize the interview findings, observations, and coding of data into major themes, which were then presented to an expert panel of academic researchers, providers, and government stakeholders for validation and feedback.
Reporting Procedures
An important part of the research study is the written narrative in thematic order to engage the reader (Quick & Hall, 2015). Gaydos et al. (2015) provide tables in the study report of the sleep safety questions used in data collection, participant demographics, and selected quotations by theme along with detailed sections on data analysis, results, discussion of results and recommendations.
Strengths and Weaknesses
Themes related to safe sleep practices were discussed which included understanding and compliance of the AAP recommendations, compliance and non-compliance reasons, and parental decisions based on culture and family roles (Gaydos et al., 2015). Gaydos et al. (2015) found that all but three of the African-American women disclosed bed sharing with their infants and that majority were aware of and understood the safe sleep recommendations of placing infants supine to sleep; however, they did not understand the rationale. Providers concurred mothers understood the AAP sleep recommendations; however, cultural factors influenced non-compliance along with perceived safety by mother and infant sleep quality (Gaydos et al., 2015).
Weaknesses of this study is that it is the first to explore both maternal and provider beliefs of safe sleep practices, maternal responses in focus groups may not be completely factual which could pose an increased SIDS risk, and the study is limited to safe sleep practices versus bed sharing reasons for promoting breastfeeding and bonding. Weaknesses could be minimized by using this study to incorporate a future quantitative study, ask more probing questions on a survey versus a focus interview to establish participant knowledge on AAP recommendations, and further studies to measure provider counseling strategies.
Significance of the Research Problem
An estimated 2,300 infants will die of SIDS each year in the U.S. with peak ages between two to four months (Arnold, 2015). Even for African-American mothers who begin putting their infants in the supine position for sleeping, approximately 25% of the infants will begin sleeping in the prone position by two to four months of age, which is a high-risk period for SIDS (Gaydos et al., 2015). Gaydos et al. (2015) recommends detailed education to this population to address factors that increase and decrease SIDS risk, and develop revised guidelines to allow providers greater flexibility in their counseling strategies for more effective promoting of the AAP recommendations. These revised guidelines will need to incorporate rationale for the safe sleep recommendations as currently the focus is on how to create the safe sleep environment but not the why of the recommendation.
Ethical Implications
Federal regulations and codes are in place to ensure the protection of research participants. Research involving patients must first be approved by the healthcare institution and given informed consent that is voluntary, without coercion, and the decision to opt out may occur at any time (Quick & Hall, 2015). The study by Gaydos et al. (2015) was approved by a university institutional review board with ethical standards upheld and informed consent documented for all participants prior to participation.
Justification of the Study
Although the AAP expanded the recommendations for SIDS prevention in 2000 to include avoidance of smoke exposure, sleeping on a firm surface, breastfeeding promotion, and pacifier use, there is no provider guidance in adapting the recommendations for their patients (Gaydos et al., 2015). Furthermore, despite African-American mothers acknowledging awareness of safe sleep recommendations to place infants supine for sleep, several reasons surface for placing infants prone: perceived comfort, concerns of infant aspiration if vomits in supine position, and cultural influence (Gaydos et al., 2015). This study by Gaydos et al. (2015) is justified by increasing awareness that more efficient counseling is needed to provide rationale for prevention of SIDS and to address familial and cultural preferences.
Conclusion
Qualitative research has a holistic, humanistic approach and is used to understand human emotions, feelings, perceptions, and behavior. Nurses use qualitative research to understand the how and why of human experiences. Although qualitative research delivers non-numerical data, this type of study greatly contributes to health research and evidence-based guidelines and interventions.