Judith Fry McComish

Avoiding Common Pitfalls in Qualitative Data Collection and Transcription

The subjective nature of qualitative research necessitates scrupulous scientific methods to ensure valid results. Although qualitative methods such as grounded theory, phenomenology, and ethnography yield rich data, consumers of research need to be able to trust the findings reported in such studies. Researchers are responsible for establishing the trust worthiness of qualitative research through a variety of ways. Specific challenges faced in the field can seriously threaten the dependability of the data. However, by minimizing potential errors that can occur when doing fieldwork, researchers can increase the trustworthiness of the study. The purpose of this article is to present three of the pitfalls that can occur in qualitative research during data collection and transcription: equipment failure, environmental hazards, and transcription errors. Specific strategies to minimize the risk for avoidable errors will be discussed.

Family-Focused Substance Abuse Treatment: A Program Evaluation

Abstract Until recently, few programs were available for children whose mothers are in recovery. A refinement of the gender-specific model of substance abuse treatment, the “family-focused” approach, has placed increased emphasis on the needs of children and other family members. However, because these programs are relatively new, little is known about the effectiveness of this type of treatment for either the mother or her children. This article presents findings from a three-year evaluation of a family-focused residential treatment program for women and their children. Longitudinal assessment of the mothers indicated that their psychosocial status and parenting attitudes improved over time. Additionally, the mothers remained in treatment longer. At intake, as a group, the children who were birth to three years of age did not exhibit developmental delay. However, developmental concerns were identified for some children in the areas of motor and/or language development. The results reported here provide beginning evidence that family-focused treatment improves retention, psychosocial functioning, and parenting attitudes of pregnant and parenting women. It also provides a mechanism for early identification and intervention for children.

Predictors of prenatal substance use and birth weight during outpatient treatment

This paper presents evaluation results of a CSAP-funded case management project associated with an outpatient substance abuse treatment (SAT) program for women and their children. Key findings are: (a) case management and threat of child protective services encourage retention in SAT during pregnancy, (b) retention in SAT has a positive effect on reducing illicit substance use, (c) receiving methadone during pregnancy has a negative effect on reducing illicit substance use, and (d) reduction in illicit substance use has a positive effect on birth weight. These findings indicate retention in SAT and decreased illicit drug use are associated with improved infant birth weight, which is associated with other improvements, such as decreased infant mortality and morbidity. The finding of a relationship between methadone maintenance treatment (MMT) and illicit drug use creates a dilemma for practice: to what extent should the dose of methadone be decreased during pregnancy, given the fact that women may then increase illicit use of drugs.

Domains of Postpartum Doula Care and Maternal Responsiveness and Competence

OBJECTIVE To describe the domains of postpartum doula care and illustrate how doulas facilitate development of maternal responsiveness and competence. DESIGN Qualitative study using ethnographic method of participant observation. SETTING Homes of mothers who received postpartum doula care. PARTICIPANTS Thirteen women and their infants; 4 postpartum doulas. RESULTS Eleven domains emerged: emotional support, physical comfort, self-care, infant care, information, advocacy, referral, partner/father support, support mother/father with infant, support mother/father with sibling care, and household organization. Emotional support was used consistently and in combination with the other domains. Activities in all of the domains were used to facilitate the development of maternal responsiveness and maternal competence with 3 issues: resolution of infant feeding, integrating the infant into the family, and supporting developmental care and attachment. CONCLUSIONS Data suggest that by using 11 domains of care, postpartum doulas facilitate maternal responsiveness and competence. Development of a long-term relationship, mother-centered care, and education and support related to infant feeding, integrating the infant into family, and developmental care and attachment may contribute to these outcomes.

Development of a doula intervention for postpartum depressive symptoms: participants' recommendations.

PROBLEM About 10-15% of women experience postpartum depression (PPD). Doulas provide support and education about PPD. METHODS This qualitative study used focus groups with mothers, doulas, and doula trainers to develop educational materials for doulas to help mothers identify symptoms of depression and seek treatment. FINDINGS All participants preferred materials that use simple language and avoid psychiatric jargon. Three themes emerged: someone to talk to, flexibility, and interactivity. Materials developed include tri-fold brochure and content for an application for smartphones and digital tablets. CONCLUSIONS Doulas can use these interactive materials to provide supportive, relationship-based care that complements nursing care.

Evaluation of a Grief Group for Women in Residential Substance Abuse Treatment

Most women in substance abuse treatment have experienced significant losses. This preliminary study examined the effectiveness of a therapy group addressing grief and loss among women enrolled in a gender-specific residential substance abuse treatment program. The intervention group consisted of 24 grief group participants and the comparison group consisted of 31 nonparticipants. Qualitative analysis revealed a pattern: participants identified traumatic loss, moved to emotional loss and abandonment by their own mothers, then focused on their own children. Data obtained at induction and at exit or follow-up were used for quantitative analysis. Length of stay, self-esteem, depression, mood, and parenting attitudes were assessed using standardized instruments. Women who participated in the grief group remained in treatment longer. While both groups were depressed and had low self-esteem at induction, the self-esteem of nonparticipants was significantly lower than that of participants. Both groups improved over time on mood, depression, and parenting. At exit or follow-up, participants had higher self-esteem. Based on these findings, we hypothesized that higher self-esteem at induction made it possible for women to participate in and benefit from the grief group, thus contributing to length of stay. To test this hypothesis we conducted regression analyses which found that, individually, group status (participation) and self-esteem explained 11% of the variance in length of stay. However, since the number of women with available data varied for group status and self-esteem, group status was a significant predictor of length of stay and self-esteem showed only a trend toward significance. These findings support our hypothesis. The womens pattern of disclosure and the hypotheses drawn from the results of this preliminary analysis will be examined further in an evaluation of a series of groups focused on loss and grief.

Early intervention and perinatal depression: is there a need for provider training?

An estimated 5–25% of women suffer from perinatal depression (PD). If left untreated, PD can have negative consequences for maternal and child mental health. During pregnancy and the postpartum period, women are in contact with a variety of professionals and paraprofessionals such as public health nurses, early childhood providers and home visitors, which provides an excellent opportunity for identification, referral or treatment of PD. Using the pre‐test data from a training series about PD, this article describes participants’ self‐reported knowledge about risk factors for the onset, medication, effects, screening and treatment of PD. Relationships between level of self‐reported knowledge, occupation and education, and the implications for practice are also described. Findings from this study suggest that there is a need for training in PD, especially for paraprofessional home visitors and early childhood providers.

ORAL METRONIDAZOLE VS. METROGEL VAGINAL FOR TREATING BACTERIAL VAGINOSIS :COST-EFFECTIVENESS EVALUATION

OBJECTIVE To compare the cost-effectiveness of metronidazole versus Metrogel Vaginal in the treatment of bacterial vaginosis. STUDY DESIGN Sixty consecutive patients with a clinical diagnosis of bacterial vaginosis were randomly assigned prospectively into either the metronidazole, 500 mg (twice daily for seven days by mouth) or Metrogel Vaginal (one applicator twice daily for five days) treatment group. The study patients were aged 18-30 years, without other medical problems. The patients proceeded with outpatient therapy and returned 7-10 days after the completion of treatment for reevaluation. During the study, patients refrained from sexual relations, avoided alcohol and drugs, and avoided all medication. The physician evaluated the patients for bacterial vaginosis through standard wet preparation, whiff test and pH testing prior to and after treatment. The patients were randomized by a nurse and were blinded for study purposes to the evaluating physician. RESULTS Successful treatment outcomes for bacterial vaginosis occurred in 27 and 28 patients for Metrogel Vaginal and metronidazole, respectively, out of the original 30 patients in each study group. All patients introduced into the study completed the study without difficulty. No significant complications were found in either treatment group. Three patients treated with metronidazole experienced nausea during the treatment interval. The entire cost of treatment was

Education and Endorsement in Infant Mental Health

19.71 and

Postpartum doulas: Motivations and perceptions of practice

1.51 for Metrogel Vaginal and metronidazole, respectively. CONCLUSION The most cost-effective treatment for bacterial vaginosis was generic metronidazole. While the use of the more expensive Metrogel Vaginal may be reasonable for patients experiencing side effects of oral metronidazole, most patients should be treated with the less expensive generic metronidazole.