ARTICLE CRITIQUE
QuantitativeResearch Article Critique
Unit
This paper is a critique of the article “Healthy late preterminfants and supplementary artificial milk feeds: Effects on breastfeeding and associated clinical parameters” by Mattsson, Funkuist,Wickstrom, Nyqvist and others published in the midwifery journal. Keydefining aspects of quantitative studies are examined in depth.
Purpose
The paper clearly identifies the purpose in the abstract andintroduction as comparing the effect supplementary milk onbreastfeeding behavior and certain clinical indicators againstexclusive breastfeeding among healthy late preterm infants. Placingthe purpose on the abstract and towards the end of the introductionmakes it clearly visible though there is excess wording in thestatement that can be confusing. Nonetheless, the topic is veryimportant to nursing in the modern world as more supplementaryartificial milk continues to flood the market and many motherscontinue to opt out of breastfeeding for health and lifestylereasons.
Reviewof literature
The introduction section provides the review of literaturesuccinctly. Using previous studies from reliable peer-reviewedjournals and other sources of authority such as the World HealthOrganization (WHO), the researchers have presented a solid basis forthe study first by identifying the health risks facing late preterminfants (LPIs), the related issues affecting LPIs and breast feedingand the existing knowledge gap. The researchers used a balancedcombination of recent studies and classic sources relevant to thetopic. The sources thus provide critical and relevant information onexisting knowledge in the issue of breastfeeding LPIs that give asolid basis for the study.
Theoretical/conceptualframework
The article does not provide a theoretical or framework that wouldhave identified the goals of the study and the type of resultsexpected given the rationale of the study and how it would havefitted within a given theory or concept. For instance, a groundedtheory framework would seek to proof a certain theory. However, lackof theoretical/conceptual framework does not have far-reachingimplications on the article.
Hypothesis/researchquestions
The article has no hypotheses or research questions. Hypotheses arecommon in most quantitative studies. Hypotheses or research questionswould guide the study in terms of the relationship betweenindependent and dependent variables or provide basic questions toguide the study.
Researchmethods
Given that the study was based on Sweden, the researchers soughtethical evaluation of the study from the Regional Ethical ReviewBoard in Uppsala, Sweden. Participants were also informed about thestudy and the objectives of the study. The participants were alsorequired to give written consent to participate in the study on avoluntary basis. Given that the study was administered in hospitalsettings, privacy was not guaranteed as some data was collected frompatients’ medical records but the researchers do not address anyprivacy concerns in the study, which is a key issue in modernstudies.
Researchdesign
The article does not provide hypotheses or research questions thus itis impossible to assess how well the research design was suited tothe study. However, it is clear that the authors employed aquantitative and comparative design to collect data from medicalrecords and from diaries that the participants filled out. These twoways of collecting data enrich the data collected and potentially thefindings. The data collection points were sufficient with mothersfilling out diaries provided to them throughout their hospital staywith one researcher providing assistance where necessary. Thus theresearcher also strengthened the internal construct of the study. Keyfactors that were ignored that might have affected breastfeedingpractices and were ignored socioeconomic background, level ofeducation and ethnicity.
Populationand sample
The article identifies population to be studied very clearly inseveral occasions in the papers and the parameters used. An initialsample of 206 participants was targeted with only 86 agreeing toparticipate in the study and only 77 actually participating. Theresearchers do not explicitly indicate the chosen sampling method butit appears they applied the purposive sampling method (homogenous)that suited this type of study. However, there was power analysisused to estimate the required sample as the study was restricted bythe period of study and the fact that it involved one healthcarefacility.
Datacollection and measurement
The author provides conceptual definitions of the key terms used andhow they applied to the data collected. However, there is no clearindication on the operationalization of key variables such as theimpact of nipple shield on breastfeeding patterns. Furthermore, thereis no clear indication of the main instrument used in the study inthis case the diary filled out by mothers. Again, there is noindication of prior training or knowledge of the researchers whoassisted the participants in filling out diaries and handling queriesfrom participants or even provided medical record data.
Dataanalysis
Descriptive statistics were applied in characterizing theparticipants. Social Sciences (SPSS) version 20.0 (SPSS Inc.,Chicago, IL) was applied for the statistical analyses as well as χ2-tests and independent t-tests to examine variance between groups.Three groups were compared namely: artificial milk supplementation,exclusive breastfeeding and combined sample. Descriptive statisticsprovided is thorough as it provides percentages, median, average etc.
Presentation
The findings of the study are well presented using several tables andall the core variables addressed discussed. The authors have alsoexplained the meaning of key statistical tests and what they mean tothe study. The results could also be applied in a meta-analysis oreven repeated elsewhere. However, the implications of the findingsare absent and the study might not be sufficient to guideevidence-based practice.
Implicationsand recommendations
The study acknowledges the existence of some variables that mighthave been ignored by the current study but does not suggest howfuture research might benefit from the experiences of the researchersin addressing the same subject or other areas related to the currentsubject. The article also lacks to give recommendations to nurses andeven to breastfeeding mothers of LPIs which is characteristic of moststudies.
Limitations
In terms of limitation, the authors noted that the data onbreastfeeding frequency was only based on mothers self-reports.Awareness of the study might have also affected subject behaviorthough the authors do not identify this limitation in the paper.Another key limitation was the short hospital stay for the motherinfant which did not provide ample time for mothers to establishstable breast-feeding behavior. Other limitations identified includethe absence of certain variables that may influence breast-feedingbehavior such as use of a pacifier.
Conclusion
The article covers an important subject in nursing and generalhealthcare. Generally, it meets the basic requirements of a reliableand credible research study but there are some missing aspects, whichare rather academic. As such, the credibility of the article isacceptable though the study faced too may limitations and poorassessment of data that affects the reliability of the findings.
References
Mattsson, E.Funkquist, E., Wickstrom, M., Nyqvist, K., & Volgsten, H. (2015).Healthy late
preterm infants and supplementary artificial milk feeds: Effects onbreast feeding and associated clinical parameters. Midwifery3 426–431.