Introduction
The primary emphasis of this paper is to critique the research article titled “Traditional practices for maternal and newborn care among Turkish postpartum women” in an attempt to explore traditional practices of women as it relates to postpartum care. The purpose of this article is to describe healthcare-related problems in a third-world environment. The data quality seems to be guided by principles of quantitative research as the researcher explores the causes of maternal and infant mortality in the postpartum period which is predominantly driven by traditional beliefs. The researchers employed a descriptive study using questionnaires to collect data from a convenient sample of women.
When I first saw the topic, it sparked my interest because I have firsthand experience as a parent. I know that the postpartum period is a critical period for the survival of both mother and infant. Another reason for choosing this topic for critique is that as a student nurse and as a father I feel the need to increase my level of knowledge.
I know that when I become a nurse, it is likely that I will encounter patients from different cultural backgrounds that will employ traditional practices that can negatively affect the health of the mother and infant in the postpartum period. As an evidence-based nurse, I would be better able to identify barriers to quality care and educate patients on the adverse effects that some traditional practices exert during the postpartum period.
The article did not utilize the stated research question. However, one did not seem to be necessary because the author of the research skillfully inferred in the abstract and the introductory phase of the study. As it pertains to the hypothesis, one was stated in the initial phase of the increase of infants and maternal mortality rate in developing compared to developed countries.
The authors of the research used real figures from the World Health Organization that represented a specific population. In fact, to be more specific the author efficiently utilized a statistical hypothesis which from my perspective, brought a certain level of validity to the research article. The research employed a descriptive study designed to explore the effects of traditional practices in relation to infant and maternal mortality within the postpartum period. The method employed in obtaining the research sample is defined.
However, what I found peculiar was the fact that people who had medical complications and were unmarried were conveniently excluded from the sample skewing it towards people who were married and had no medical complications. This could, in fact, affect the accuracy of the outcome of the research because this approach would represent a deviation from a sample that is an accurate representation of the entire population. Excluding those with medical complications or unmarried women represents data that was not collected from individuals that may have provided valuable information.
The researcher also alluded to this fact and stated that one limitation of the study is that it represents the women who participated in the study; therefore, the current study findings would not be generalizable to other populations.
The sample was described as consisting of women who were of childbearing age from early teens to early adulthood. The authors describe their sampling technique. The research population was taken from the obstetric clinic in the Turkish region’s largest government hospital. Eight hundred and seventy-two women were asked to participate of which 18 refused to participate.
Eventually, the researchers excluded 67 women from the research due to missing information related to traditional practices. The research was descriptive, and conveniently designed to determine the effects of women who utilize conventional practices during the postpartum period as it relates to the health of mothers and infants.
Synopsis (4, 5, 6, 7)
The inclusion criteria for the research study were reasonable. The researchers specified the criteria that the potential subjects must have. These inclusion characteristics included age, sex, marital status, postpartum stage, and women with postpartum traditional beliefs and practices regarding infant and maternal care. Subjects who had medical complications and those who had missing data were excluded from the research study.
The criteria for inclusion were strongly justified because it aligned with the aim of the study as well as the research being convenient. Other variables that I would have included is unmarried women and postpartum women who had medical complications.
The researchers utilized a questionnaire form to collect data for the study. The questionnaire included questions about the inclusion characteristics listed above. The research method that was employed was that of a descriptive study.
The main findings related to traditional postpartum practices for maternal care found that a little less than half of the participants put Qur’an, a packing needle under their pillow and almost half stated that they had a person stay with them in order to prevent evil spirits from causing mental health problems.
Another quarter of the participants poured cold water on their stomachs in an attempt to prevent postpartum bleeding, while almost 70 percent of the women ate sweet foods to enrich breast milk.
On the other end of the spectrum, the main findings related to traditional postpartum practices for newborn care found that less than half of the participants poured lead in a cup over the head of the infant to ward off evil spirits. Another twenty-nine percent gave the infant a mixture to the mouth to prevent thrust, and almost fifty percent covered the newborn’s face with a piece of yellow cloth to prevent jaundice.
Credibility (1, 2, 3)
The research study was published in Elsevier Applied Nursing Research journal. It is reported to be presented originally, reviewed by peers, and clear for direct application of nursing expertise.
The study design employed was linear and appropriate to the research question.
In using a descriptive design, the researchers were able to describe the characteristics of the population and the phenomenon being studied as it relates to the traditional practices of women in relation to maternal and newborn care in the postpartum period.
The design addressed the inferred question put forward by the researcher, accomplishing the aim of leading to an outcome within the confines appropriate to the population being studied. The data analysis conducted effectively answered the inferred research question by assessing the associations between multiple dependent variables and independent variables of interest.
The data obtained and the analysis made enabled comparisons between the responses from the subjects on the knowledge of traditional practices and along with other variables enabling the research to answer the researcher’s question inferred.
Credibility (4, 5, 6 & 7)
The study used various instruments of measurement. Using a sample recruited from the region’s largest government hospital where most births are reported to occur. The response rate for this sample was 60% which cannot be considered a very credible source or accurate data.
For further research and accuracy, the study includes data collection through a questionnaire. Questionnaires are often a valid tool for the measurement and collection of data. The questionnaire used for this study included questions related to the participant’s age, occupation, education level, marital status, and postpartum traditional beliefs and practices regarding maternal and infant care. This seems to be a reasonable way to measure participants’ experiences and practices which are highly subjective and variable due to individuality and personalized answers. But, the data will give a closer insight into the research.
The data was then entered into SPSS version 11.5 (Chicago, IL) for analysis, which is a widely used software program for statistical analysis and data management. The study used the chi-square test to assess the relationship between dependent and independent variables. This method is also a credible and reasonable way to analyze data. Therefore, the study is considered correct to an extent.
Variables that aren’t studied but affect the result variables of a study are called extraneous variables. Even though these variables are sometimes known and unknown other times, they are always present in a study. Extraneous variables are a threat to the reliability and validity of the research. If these variables are not controlled or accounted for can be a flaw in the accuracy of the data (Brown 2002).
In this research project, the extraneous variables have been accounted for to a great extent. These include the age of the participants, the age of the participants when they got married (an earlier martial age shows traditional traits), and the education level of these women, which is also a factor affecting the likeliness of women following traditional practices. Other extraneous variables that were considered during the research included the number of pregnancies the participant had, whether they lived with their partners or not, and how often they practiced traditional activities.
Additionally, some extraneous variables that I believe affected the results but were not accounted for include the number of responses and the area where they were collected. A group of people selected from the same hospital might have similar mindsets or belong to a certain class. Low-income and rural women are more likely to follow traditional practices. The honesty of the participants also affects the questionnaire. How could their responses be influenced? Were they questioned in front of their family members who might’ve been strict about traditional practices? Were the participants afraid to be judged? These extraneous variables were not accounted for in the study and had a potential influence on the results and its credibility.
Bias refers to the tendency that results in prejudiced research of a topic or study. Bias research occurs when intentionally or intentionally a researcher prefers one outcome of the study over another. Bias is introduced to sampling and testing when the researcher encourages a certain result. This can affect the judgment of the research study and also affect the accuracy of the sampling and testing (Pannucci & Wilkins, 2010).
In Simge Zeyneloglu’s research on “Traditional practices for maternal and newborn care among Turkish postpartum women” bias is a variable affecting the reliability of the study. It seems that the researcher preferred the result to be that illiterate women were following traditional practices so he/she could recommend better education in conclusion. The sample taken from one hospital where there might’ve been similar mindset people is a sign of bias. Secondly, the questionnaire tried on a group of people selected from the same clinic, as well as including questions related to similar traditional practices might have influenced the outcome of the responses.
The research is a descriptive study that has the aim of examining the traditional practices of women in relation to maternal and newborn care in the postpartum period. A descriptive study is a more observational study of topics or problems already existing in the community (“Descriptive Studies,” n.d.).
The study focuses on identifying one of the many causes of postpartum deaths and infant deaths, i.e., the traditional practices and lack of education of Turkish women. However, I believe that it was essential to consider the health facilities for the general public. Low-income groups might not be able to afford expensive private hospitals that use advanced technology to save the lives of mothers and their children. Delivery in pregnancies is mostly unexpected and sudden. The availability of nearby good clinics and hospitals is a necessity. I would have steered the research towards the healthcare facilities provided to different groups of people in different areas and how they can be improved.
The details provided in the study about factors affecting the use of traditional postpartum practices are very unclear as the information is stuffed in one paragraph without any proper order. The information could have been provided in the following way:
“Women whose educational status is lower than others are more likely to believe and use traditional postpartum practices” and continuing a similar pattern of explanation of the data would make the message clear.
The findings of Simge Zeyneloğlu are very similar to the research of other interested parties. In a study by Sultan Ayaz (Ayaz & Efe, 2008) the results concluded that about 45% of the 121 educated women followed traditional postpartum practices. Most of these traditional practices are harmful to both the mother and the infant. The study also considered women’s age, education level, marital age, and birthplace.
Another descriptive study also supports the claims of Simge in her research. The study was conducted on 273 women belonging to different groups of ages, educational status, and employment and family backgrounds. The conclusion stated that postpartum care of women and their newborn babies was critical in Turkish culture and many followed these practices. Some of which also had harmful effects (Geçkil, Şahin, & Ege, 2009).
Considering the support of other research findings, I find these conclusions credible to the extent that traditional postpartum practices are common among illiterate Turkish women; however, education is not the key factor affecting their choices since many literate women followed similar practices. It is important to consider factors such as income levels, and geographical and healthcare facilities provided to the Turkish people.
Clinical Significance
The study doesn’t discuss risk ratios or odds ratios, but it highlights the primary reason behind the high rate of postpartum deaths of women and newborn babies. The clinical significance of this study is its proof and demand for improvements required in certain areas of gynecological care. It is crucial to gain a comprehension of the cultural and religious beliefs of women from all backgrounds to cater to their needs and not conflict with the patient’s interests. Nurses should be able to discuss these findings with their patients and their family members to show the significance of modern healthcare facilities and the negative side of traditional practices.
Increasing communication about such topics and the beliefs of women will increase opportunities for better healthcare services provided to them without hurting their status on such matters. The spreading of awareness regarding the harmful side effects will help patients understand the situation and restrain from such traditional activities.
As an aspiring nurse, it is important for me to understand the cultural beliefs all patients that I will interact with during my practice. To respect and care for their needs, I will have to gain a better understanding of their traditional practices.
Trust is the key factor affecting the relationship between nurse and patient. With such research studies and findings, I will be able to provide evidence to my patients related to their traditional practices without hurting their faith and social status. I will be able to encourage my patients to use modern healthcare services and improve the chances of their children’s survival, as well as, avoid the possibilities of fatal infections after postpartum.
With the help of my knowledge, experience, and such studies I will be able to implement these findings in my nursing practice and serve to my full potential.
References
Ayaz, S., & Efe, S. Y. (2008). Potentially harmful traditional practices during pregnancy and postpartum. The European Journal of Contraception & Reproductive Health Care, 13(3), 282–288. https://doi.org/10.1080/13625180802049427
Brown ([email protected]), J. D. (n.d.). Questions and answers about language testing statistics: Extraneous variables and the washback effect. Retrieved February 13, 2018, from http://hosted.jalt.org/test/bro_14.htm
Descriptive Studies. (n.d.). Retrieved February 13, 2018, from http://www.drcath.net/toolkit/descriptive-studies
Geçkil, E., Şahin, T., & Ege, E. (2009). Traditional postpartum practices of women and infants and the factors influencing such practices in South Eastern Turkey. Midwifery, 25(1), 62–71. https://doi.org/10.1016/j.midw.2006.12.007
Pannucci, C. J., & Wilkins, E. G. (2010). Identifying and Avoiding Bias in Research. Plastic and Reconstructive Surgery, 126(2), 619–625. https://doi.org/10.1097/PRS.0b013e3181de24bc
