NR439 Evidence-Based Practice


Look at the evidence that can support professional nursing practice.

To interpret published research results, use research principles

For credibility and laboratory significance, evaluate published nursing research that is evidence-based.

Recognize and accept the role of research findings in evidence-based clinical practice.

Answer to Question: NR439 Evidence-Based Practice


This article reviews socio demographic factors related to pregnancy.

They include factors such psychosocial factors related stress and depression which affect the mothers during the pregnancy period.

As a measure of postpartum depression, the article will discuss medical, psychological, birth outcomes, and pregnancy related factors.

These factors will then be evaluated and will be used to inform the management of depression among pregnant mothers.

A prospective cohort study was conducted among pregnant women. The results were used to inform medical practice.

Research Problem in the Article

The most common problem for pregnant women is postpartum depression.

The article states that between 7% to 3% of women will experience these episodes.

The effects of postpartum depressive symptoms can have a negative impact on the future.

As risk factors, the socio-demographic and social factors associated with postpartum depression were identified.

Research has also shown that post partum depressive symptoms can be caused by hormonal, psychological, and/or genetic factors outside the mothers’ control. (Gavin et. al., 2005).

Post partum Depression has been linked to women in lower socioeconomic positions. This information informs about women’s access to economic empowerment that can play a crucial role in reducing the risk of suffering from postpartum depression.

Adopted Research Design

The article used prospective cohort design to follow women who were between 4-6 weeks pregnant. After that, the mothers completed questionnaires regarding their health.

Two men were required to complete at least one survey. Follow-up was for six weeks. The patients who were included in the article were women attending an obstetrical clinic.

These parameters were used to exclude participants.

This design can be used in research to compare the characteristics of individuals and follow them up over time. (Bhandari Joenson and Stuttgart, 2009).

It is crucial to consider the potential for selection bias in prospective cohort studies and other factors that may affect the validity or reliability of the results.

These study designs have several advantages. They allow for the identification of related factors and assessment of study exposure outcomes.

Unfortunately, this study design can result in subjects disappearing and can also lead to bias.

A Sample Size for the Study

Prenatal care was the only type of prenatal care that was included in the study.

All women who had completed at least one survey within the second and third trimesters of obstetrical care were eligible to participate in the study.

The study included patience and required them to complete both the 4 and 8-month questionnaires. However, it did not include those under 15 or unable.

The total number of women chosen was 1,423

The study included comparisons of this group to the control group.

The initial study recruited 3,039 female participants. Following screening and inclusion criteria, however, the study recruited 1, 423 additional women.

Although the participants in this study were sufficient, they could have a negative impact on the research findings.

The larger sample size is intended to compensate for the loss of follow up.

The study hypothesis will not be assessed with a small sample size (Jones Craley & Harrison, 2003). However, large samples can make the study difficult and require justification for the sample size calculation (Livingstone & Cassidy (2005)).

For this article, the sample size calculation is more effective at achieving higher statistical power.

Data Collection Methods

Surveys were used to collect data among women in the article.

Surveys were conducted among women as part of the recruitment criteria.

In order to evaluate the severity of depression during pregnancy and the subsequent postpartum period, a questionnaire was administered to patients.

For the assessment of depressive symptoms after giving birth, the health questionnaire was used.

To assess anti depressant use, we used self-reported questionnaires.

The smoking free family’s prenatal screening instrument was used to determine if there had been any.

To further strengthen, computerised medical data were used to get vital characteristics of the women such as birth date, fatality, and offspring birth weight.

University of Washington Human Subjects Institutional Board approved the ethical protocols.

Data collection among participants was assisted by clinical staff.

Limitations to the Study

It was not possible to conduct structured psychiatric interviews due to the geographical location of participants. This prevented them from diagnosing depression and assessing past episodes. However, they were able assess BMI and Body Mass Index.

The validated patient questionnaire was used to address this limitation.

The ability to identify research limitations is crucial in giving greater validity to the results of the study. It also helps to assess the effectiveness and efficiency of the research process.

An effective tool must be used to capture the history of the patients so that this study limitation can be overcome.

Study Results

The study evaluated the women during the postpartum phase using a 4-8 month assessment for socio demographic factors.

The prospective study was able to compare the two groups of women, particularly those who suffered from significant postpartum depressive symptoms.

P values of P 0.04 were found for women who had the highest likelihood of being employed. P values of pregnant-associated depressive conditions were P 0.0001.

Psychosocial stress made people more likely to smoke at p0.0001; they were also more likely take antidepressants drugs.

Thanks to the efficient data collection tolls, the study results are credible.

It increases the reliability of study findings due to the large sample size. Thus, the findings support the study’s problem statement.


The article review focuses on major themes within the paper. Particular attention is paid to sub headings such as research issue, sample size determination, data collection methods, and limitations.

The study article examined the effects of sociodemographic health behaviours on women in the postpartum period. Particular attention was paid to birth outcomes and risk factors for postpartum illness.

Findings from the study showed that women who experienced unemployment were often affected by depression symptoms and psychological stresses. It also led to increased likelihood of engaging in alcohol- and smoking-related behaviours and later developing medical illnesses like diabetes and neurology diseases.

The study will provide information to the health care providers about the need to treat post partum depression.

As such, post partum illness was more likely to develop in those who were younger than the average age and had antenatal depression symptoms.

This will make it crucial to assess the socio demographic factors that influence post partum depression among women.

Refer to

Bhandari A, Joensson. Stuttgart; Thieme Medical Publishers.

Prospective Cohort Study.Clinical Research for Surgeons

Gavin NI. Gaynes BN. Lohr KN. Meltzer Brody S. Gartlehner G. Swainson T (2005) Perinatal depression: A systematic review. Obstet Gynecol 106(5):1071-1083

Hallowell, N., Crawford G. Lucassen A. Parker M. Snowdon, C (2010) An investigation on patients’ motivations for participating in genetics research.

J Med Ethics 36.37-45.Jones, S., Carley, S., & Harrison, M. (2003).

An introduction to power, sample size estimation and power. Emergency medicine journal: EMJ, 20(5), 453.Livingston, E. H., & Cassidy, L. (2005).

An overview of how to estimate the required subjects and statistical power for a study that uses the t test: A surgeon’s primer.

Journal of Surgical Research 126(2): 149–159.