Article Critique: Experiences of women with a body mass index of 30 or more. Lavender et al 2015
The social problem which this research by Lavender and Smith (2015) seeks to address is maternal obesity. Accordingly, the authors analyze this issue after establishing that there is little information regarding the pregnancy experiences of obese women. In addressing the issue, the authors seek to answer the following question: what are the experiences which obese pregnant women go through when they try to assess maternal services and when attending lifestyle programs? In linking the social issue with the research question, the authors have analyzed the experiences of participants who are mostly obese pregnant women who are believed to provide a true reflection on what the study focuses on. In particular, the researchers employed semi-structured interviews and focus groups with post-natal obese women to obtain firsthand information concerning this issue.
In this article, Lavender and Smith have also utilized an extensive literature and note that there has been a consistent increase of maternal obese in England over the past two decades from 5.6 to 15.6% of pregnant women (Centre for Maternal And Child Enquiries). This necessitates that the problem be identified and dealt with accordingly. Currently, there is lack of global agreement in regard to guidance on weight management in the course of pregnancy. Further, the authors go on to identify a lack of suitable interventions either in existence or proposed by relevant bodies concerning weight management in the course of pregnancy or after the pregnancy. This therefore, provides a basis on the necessity of conducting this study for the purpose of establishing the experiences of pregnant women body mass index [BMI]≥30 kg/m 2) in England. This will also provide a basis upon which interventions and prevention mechanisms will be drawn.
The researchers have employed constructivist research paradigm in addressing the issue under question. In answering the research question, the authors rely on the subjective experiences of post-natal women with an antena-tal BMI ≥30 kg/m. Kenny (2010) postulates that in constructive research, the experienced reality or the mental world is “brought forward” or constructed actively, while the observer plays a critical role in theory. In this case, the researchers can be regarded as observers who bring out the mental world or experiences of the participants. The experiences of these participants are captured through structured interviews and focus groups. These instruments and approach ensures that each participant provides satisfactory view about herself as possible. This also implies that the authors rely mainly on the information provided by the participants in making their conclusions and analysis regarding the problem under discussion.
When reporting results of the study, the authors rely on the participant’s description of their pregnancy experiences. What is more, the authors also acknowledge the women’s understanding and feelings and go on to make recommendations based on these feelings and understanding. In particular, the authors confirm that the obese women are aware of their status and that they are ready to change if given proper guidance by relevant parties. Contrary to positivist research, there is no concept which the authors measure in this research, hence confirming that the authors relied mainly on a constructivism research system. What is more, it is also evident that the authors held women’s belief highly in making assumptions on making a difference on their lives, improving their healthy alongside the health of their family.
In conducting the study, the researchers dealt with two key ethical issues. First, they had to seek the consent of the participants before commencing the study. The second ethical issue was the necessity to seek approval from the various institutions that were involved in the research including the University, and local health departments. Prior to commencement of the research, the author sought and successfully obtained approval from University, local NHS Research and Development Departments, and local NHS Research Ethics Committee. It could have been ethically wrong if the authors proceeded with the research without first of all obtaining permission from these relevant bodies. However, despite the participants being aware on their involvement in the study, the researchers did not inform whether these women ever signed consent forms to approve of their participation. This consent conforms should also have included the aspect of audio recording and transcription of the participants responses.
The principle of informed consent does not require signing of a particular form as proof of willingness to participate (Babbie, 2010). However, it is necessary that participants be given full information regarding benefits and risks of their involvement (Madathil et al, 2011). It appears that Lavender and Smith did not bother to provide this information to participants such as the case of maintaining the anonymity of the researchers and failure to inform them on audio recording, where or how the information will be used. According to the University of North Carolina, (2016) participants must be made me to know that they do not have to volunteer and that they are free to withdraw from the study at any time they so desire.
In regard to methodology, the study was qualitative in nature with interviewing and focus groups as the main means of collecting data and information. Participants included 68 women who were at least <30-week gestation, with a body mass of a BMI≥30 kg/m2 and who were at that time undergoing a ten week lifestyle programme. The sample population was 227 women. Nine interviews and 10 focus groups were conducted with 34 women, 8 interviews and 4 focus groups were undertaken with sixteen women on the first site while 1 interview and 7 focus groups were undertaken with eighteen women on the second site. The length of the interview and focus groups ranged from 14.17 to 80.45 min. The focus group participation were two to five women.
Apparently, the research procedure was appropriate and scholarly. The samples were also relevant considering that they were carefully selected according to the problem at hand. In other words, all the participants were those who had directly experienced the problem under discussion. What is more, the sample used (68) could also be considered as sufficient in generating the required information. Bryman (2001) points out that qualitative research does not necessarily need high number of cases in the sample design, rather, such a study mostly relies on small number of cases as long as those included adhere to the demographic characteristics that the study seeks.
Findings in this study were that majority of women felt disappointed with their pregnancies. These disappointments were derived from lack of concern by health professionals dealing with them and their issues, failure to be given guidance and information regarding their conditions. Further, the researchers noted that despite majority of these women being ready to make lifestyle changes in order to improve their healthy, the health professionals did not seem to bother encouraging them with this endeavor. However, there were behavioral change among obese women who were attending lifestyle programs. Additionally, the motivations to participate in these programs were derived from the women’s belief of small changes making a difference and the desire to improve their health. Following these findings, the authors conclude that pregnant women who are obese are aware of their situation and expect to be given information and guidance on how they can changes to their lifestyle. They also concur that health practitioners are not concerned or are not aware of women’s readiness for change and do not therefore design effective communication mechanisms during the women’s pregnancy. Among the recommendations of the authors is inclusion of professional training for pregnant women with aBMI ≥30 kg/m or above and improving the manner in which health professionals approach obese pregnant women. Apparently, have adequately answered the research question which is to analyze the experiences of obese pregnant women in their course of their pregnancies as well as while participating in lifestyle changes. These experiences have been established and presented in this research. Further, the researchers have also come up with recommendations aimed at dealing or leveraging these experiences for the benefit these women and healthcare fraternity.