- Evidence-based practice: the best outcomes for patients
- Based on the combination of three principles:
- Principle 1: patients’ values and expectations
- Principle 2: clinical expertise of the provider
- Principle 3: evidence from available academic sources
Research is one of the crucial elements of evidence-based practice. According to Grove, Burns, and Gray (2015), both the field expertise of the clinician and the preferences of the patient are subject to cognitive biases.
- Nursing issue: the challenges experienced by mothers
- The challenges occur during the breastfeeding process.
- Initiation and continuation of breastfeeding: low rates
- Insufficient breastfeeding: adverse impact on public health
- Challenges in education (Ericson et al., 2013)
The nursing issue selected for the project is the challenges experienced by mothers during the breastfeeding process. According to Renfrew, McCormick, Wade, Quinn, and Dowswell (2012), the rates of initiation and continuation of breastfeeding in many high-income countries are inadequately low.
- PICO: patient, intervention, comparison, outcome
- Patient: mothers suffering from postpartum depression
- Intervention: post-discharge breastfeeding support phone calls
- Comparison: no post-discharge support phone calls
- Outcome: the increase of breastfeeding success
PICO question: for the postpartum mother, would post-discharge breastfeeding support phone calls become an appropriate and appraised intervention that increases breastfeeding success if to compare with women’s attitude to the traditional model presupposes no post-discharge support phone calls?
Key Literature Support
- Correlation: Borra, Iacovou, and Sevilla (2015)
- Distressed status – breastfeeding patterns: weak correlation
- Carlsen et al. (2013): obese mothers’ breastfeeding
- Hatamleh (2012): low-income mothers’ breastfeeding
- Sharma and Sharma (2012): a theoretical exploration
Many scholarly sources focus on postpartum depression and breastfeeding patterns. Some authors investigate the correlations between these two issues. Women with high levels of depression are less likely to breastfeed their babies.
- The intervention: based on the triangulation method
- Triangulation: diversification of sources and methods
- Source triangulation: different social and racial backgrounds
- Method triangulation: using interviews and questionnaires
- Analyst triangulation: many people analyze data
A widespread method utilized by researchers is triangulation (Silverman, 2015). This method involves the diversification of the sources and methods used in data collection to provide a more detailed and potentially more accurate picture of the studied phenomenon
- Mitchell (2013): revolves around Lewin’s change theory.
- Lewin’s change model: unfreezing, changing, refreezing
- Unfreezing: determining what needs to be altered
- Changing: involving people in a new approach
- Refreezing: making the implemented changes permanent
Lewin’s theory is considered one of the most productive approaches to change implementation. The theory is suitable for the practical aspects of the research implementation as it breaks down the process into three major steps – unfreezing, moving, and refreezing.
Research Design and Sample
- Focus: on initiation and stimulation of breastfeeding
- The proposed research approach: of qualitative nature
- Intervention: delivered in the form of phone calls;
- Target population: new mothers discharged from hospitals
- Selected from one-two hospitals in a specific area
The intervention intended to stimulate breastfeeding intention in women will be delivered with the purpose of the provision of support to the latter so they could continue breastfeeding. The intervention is expected to last for six weeks.
- The data collection process: interviewing new mothers
- Distribution of questionnaires and phone interviews
- Data collection: processing and analyzing the data
- 1st time: to assign women to groups
- 2nd time: to measure the effectiveness of instructions
Thus, the research design identifies two data collection points – at the beginning and at the end of the research. The estimated length of time for data collection would be one week prior and one week after the proposed intervention, which would continue for a six-week period.
- Phenomenological analysis (Miles, Huberman, & Saldana, 2013)
- Read transcripts: to get a generalized feeling.
- Second-time reading: breaks transcripts into meaningful parts
- Integrate data groups based on content similarity
- Findings: subjugate to the free imaginative variation
Such data analysis outline is appropriate and traditional for the phenomenological types of qualitative research. The proposed data analysis should be efficient at processing the available data and will highlight the major and minor trends in attitudes of young mothers towards breastfeeding.
- Positive outcomes: phone calls might be appraised
- Phone calls: a positive impact on breastfeeding success
- Mothers and children: improved state of health
- Nurses: responsible for the education of mothers
- A monitoring tool: to eliminate misunderstandings
The main stakeholders of the process will benefit from the use of the new approach as it helps to improve the mother-health specialist relations, preconditions improved outcomes, and results in the decreased number of problems with breastfeeding.
- The results: phone calls support women’s health
- Intervention implementation: fundamental to the healthcare sector
- Barrier: the lack of information among nurses
- Additional resources: needed to introduce changes
- Human resources: resolved by engaging nurses into practice
The results mean that if a postpartum woman is supported by phone calls, her mood and state of health improves. It is achieved due to successful breastfeeding and the absence of postpartum depression.
- The suggested research issue remains rather significant.
- Breastfeeding should be considered the fundamental activity.
- The failure to breastfeed: a crucial problem
- The current project: the usefulness of phone calls
- A direct correlation between breastfeeding and satisfaction
In the course of the investigation, the direct correlation between breastfeeding success and the level of mothers’ satisfaction was proven. That is why their improved attitude to the suggested intervention evidences its efficiency and the positive impact on postpartum mothers’ overall state.
Borra, C., Iacovou, M., & Sevilla, A. (2015). New evidence on breastfeeding and postpartum depression: The importance of understanding women’s intentions. Maternal and Child Health Journal, 19(4), 897-907.
Carlsen, E. M., Kyhnaeb, A., Renault, K. M., Cortes, D., Michaelsen, K. F., & Pryds, O. (2013). Telephone-based support prolongs breastfeeding duration in obese women: A randomized trial. The American Journal of Clinical Nutrition, 98(5), 1226-1232.
Ericson, J., Eriksson, M., Hellström-Westas, L., Hagberg, L., Hoddinott, P., & Flacking, R. (2013). The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants: Study protocol for a randomized controlled trial. BMC Pediatrics, 13(1), 73-82.
Grove, S. K., Burns, N., & Gray, J. (2015).Understanding nursing research: Building an evidence-based practice (6th ed.). St Louis, MO: Elsevier Health Sciences.
Miles, M. B., Huberman, A. M., & Saldana, J. (2013).Qualitative data analysis (3rd ed.). New York, NY: Sage Publications.
Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32-37.
Renfrew, M. J., McCormick, F. M., Wade, A., Quinn, B., & Dowswell, T. (2012). Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Systematic Review, 5(5), 1-142.
Silverman, D. (2015). Interpreting qualitative data. New York, NY: Sage Publications.