BACKGROUND
The article’s title, “Parental Smoking and Cessation,” refers to the smoking behaviours that mothers or fathers engage in during pregnancy and the resulting effects on the unborn child and the pregnancy (Harju et al., 2016). It has been determined that quitting smoking during pregnancy, or cessation, is an effective way to lower the likelihood that the fetus and children would experience asthma-related issues (Dolan et al., 2016). Out of a population of 28,000, it was discovered that 11.2% of teenagers used tobacco, 7.9% smoked tobacco, and 6.2% used smokeless tobacco, indicating the rate at which asthmatic disorders are increasing among young people (FACTSHEET 2018 MALDIVES, 2019). In addition, 25.35 percent of adults and 34.5% of youth were exposed to tobacco smoke even if they did not use it (FACTSHEET 2018 MALDIVES, 2019). The number of tobacco users in the Maldives is increasing, and although though people are aware of the negative effects and repercussions of smoking, only 39% of them quit. Of the 436,000 people living in the Maldives, 76100 are tobacco users (FACTSHEET 2018 MALDIVES, 2019). The sharp increase in smoking rates in the Maldives and the harm it is causing to children’s or nonsmokers’ health have made this a popular issue for research (Tettamanti et al., 2016). Evidently, the existing costs and procedures are insufficient, thus new policies must be created, particularly for expectant parents, to prevent the early onset of asthmatic disorders in their unborn child.
RESEARCH CRITIQUE
Comparing several literary works that offer various facets relating to the subject and drawing a general conclusion is the art of criticism. According to the writers Birks et al. (2017), critical analysis aids in identifying the drawbacks of a statement or theory that is being lauded by another. Numerous methods, like the Critical Appraisal Skills Programme (CASP) and the Joanna Briggs Institute’s JBI Critical Appraisal Checklist, can be used to critically evaluate literature (Gustavson et al., 2017). The various articles chosen for the research are properly compared and critiqued with the use of these tools, and decisions are then made appropriately based on the literature comparison. Since the checklist under the CASP framework varies depending on the kind of article chosen—for example, a different checklist is used for qualitative articles and a second one is used for systematic reviews, I have chosen it for the time being (Bailey et al., 2017). Since the currently chosen papers are qualitative studies with a retrospective focus, the CASP checklist will assist in providing pertinent and reliable criticism. Additionally, a major reason for using CASP as a critiquing instrument is the flexibility and convenience this checklist or appraisal tool offers.
AIM
The authors’ goal in this study is to determine how maternal and paternal smoking during pregnancy are combined, as well as how this affects the likelihood that the child would get asthma. According to Pugmire, Sweeting, and Moore (2017), the research paper’s title needs to be thorough and meet the purpose for why the study was conducted and the conclusions drawn. Now, the title “Parental smoking and cessation during pregnancy and the risk of childhood asthma” supports the goal of the study as well as the study’s methodology.
Layout
The researcher has employed a quantitative research design in which data pertaining to the study problem is gathered, examined, and quantitative conclusions are drawn (Vardavas et al., 2016). The chosen research strategy is a cohort study, which is a longitudinal investigation used to extract data related to a common base across time and then compare the results. Because the researchers are conducting a trend analysis of all pregnant women who smoked during their pregnancies and examining the effects of parental smoking behaviors on their offspring, this approach is ideal for the study. According to Knopik et al. (2016), cohort studies have the advantage of allowing for the calculation of cumulative indices and facilitating the comparison of various effects, repercussions, or measures of the same cause. However, the drawback is that it only aids in comprehending a single item, feature, or foundation and may not lead to the development of logical and well-supported conclusions.
Data Gathering Technique and Instrument
Primary data can be gathered using a variety of techniques, including surveys, questionnaires, case studies, and observation techniques. Each technique has advantages and disadvantages of its own (Biederman et al.). The current paper created a retrospective observational approach that allows for the study of historical records to find common patterns and determine growing trends throughout time (Lodge et al., 2018). According to Lodge et al. (2018), this is the most suitable method since it facilitates the analysis of data and patterns pertaining to pregnancies and children who have asthma. The primary advantage of the cohort study tool is that it facilitates the identification of trends that have been evolving over time, and it also simplifies and unifies the comparison of collected figures. However, the main drawback is that it is not a definitive tool for making predictions about the future or suggesting anything based on the collection of observational data (He et al., 2017). However, because the data gathered is not presumptive and legitimate inferences are made based on this realistic data, cohort research is a very useful and dependable method (Obel et al., 2016).
Sampling
Probabilistic and non-probabilistic methods of sampling are possible; in the former case, the respondents are chosen at random without any predetermined criteria or basis, while in the latter case, the selection is carried out only after the respondents have satisfied the predetermined criteria (Jones et al., 2011). At Kuopio University Hospital, a university-based obstetrics and gynaecology department in Finland, researchers currently employed the non-probabilistic method by choosing cases of women who gave birth between 1989 and 2006 and were discovered to be connected to the asthma reimbursement register (Jones et al., 2011). The study covered several variables, including age, parental asthma, smoking habits, delivery method, and more. Midwives and nurses also completed a questionnaire. Here, 75 questions about the expectant parents’ diet and health were included, along with information about any complacencies they may have had. Biases were significantly less likely because there were no selection criteria among the data of the pregnant women who had asthmatic tendencies (Obel et al., 2016). This is because all the girls were chosen at random, without regard to age, race, or any other consideration.
Ethics
The researchers complied with all the ethical research while conducting their study where they included informed written consent from the midwives that were selected for the interview. Also, no personal data pertaining to the cases that were selected for research was either used or disclosed by the researchers (Ruisch et.al., 2018). The researchers, Harju et.al., (2016), got the study approved by the Ethics Research Committee of Kuopio University Hospital and published the article only after getting their publishing approval.
Data Analysis
The quantitative tool was the data analysis approach employed in the study, and the data was measured using a variety of tests and methodologies. To make statistical inferences and determine trends pertaining to variableness, the researchers used the Chi-Square and Mann-Whitney tests to tabulate the parameters associated with asthmatics (Rice et al., 2018). To analyse the multivariate-adjusted data and draw conclusions on parental smoking and its effect on the likelihood that children may have asthmatic disorders, the researchers also used logistic regression analysis. The quantitative data so gathered was analysed using the Statistical Package for the Social Sciences 21.0 Software, and the relevant findings, which are described in detail in the findings section, were interpreted.
This tool assists in reaching pertinent findings that are grounded in numerical data rather than information, hence preventing any possibility of prejudice. Given that the data was gathered from the records of a single university, a hospital, the technique was suitable for the kind of research study being conducted since it improved the quality of the data that was gathered and allowed for more focused analysis and interpretation. Appropriate interpretations of the data were made possible by the statistical analysis tools that were employed.
Different interviewing techniques and questionnaire methods helped to fill in the data gaps, even though there were some aspects, like patient age and whether the pregnancy was intentional or forced about which specific information was unavailable. A deeper understanding would have been produced if these facts had also been provided. By giving more attention to or having a greater influence on the research of the kids who had asthmatic issues and thus had frequent follow-up tests in comparison to the kids who didn’t, the researcher attempted to reduce any potential bias in the study. Therefore, the researcher compared the various variables of children without follow-up individually to those of children with regular follow-ups to lessen the impact of such factors on the research (Dolan et al., 2016).
Main Findings
This report’s main conclusion was that: When comparing the effects of maternal and paternal smoking on the kids, it was determined that the paternal smoking effect was greater since mothers tended to abstain from smoking during pregnancy owing to social pressures and self-denial (Dong et al., 2018). Furthermore, it has been shown that prenatal exposure has a bigger effect than postnatal exposure. In comparison to non-smokers, the effect is 1.7 when moms smoke alone, 2.9 when fathers smoke alone, and 3.7 when both smoke because the mother and fetus are passively exposed, the effect of paternal smoking cessation was greater than that of maternal smoking cessation, which only reduced risk by 3.7 to 2.8 times. According to Harju et al. (2016), the risk was lowered by 0.4 times. Compared to fathers who did not smoke, fathers who stopped smoking during pregnancy had a lower risk.
Research Context
The impact of passive smoking in a family on the elevated risk of bronchiolitis, bronchitis, and other respiratory illnesses was the topic of the systematic review article chosen for comparison. In 2016, Harjuand et al. The two articles’ conclusions were comparable in that both maternal and paternal smokers should avoid exposing pregnant women to smoke. The publications did not agree on how to measure the implications, though; the first one focused on the effects of childhood asthma, while the second one examined the likelihood of bronchitis and other respiratory conditions in children. One could argue that several qualitative articles have incorporated thorough research into their studies or papers (Sciberras et al., 2017). In addition to evaluating the facts and human emotions associated with smoking parents, this study would have examined why pregnant and single mothers are more likely to smoke than pregnant women who smoke regularly (Biederman et al., 2017).
Such a qualitative insight would have strengthened the data that was already obtained, i.e., the finding that children whose fathers stopped smoking during pregnancy are more likely to develop asthma than children whose fathers did not smoke. Qualitative elements According to Huang et al. (2018), the use of RCTs, or randomized controlled trials, helps eliminate all biases by choosing research papers or evidence that the researcher has approved; in other words, the information gathered is filtered and unbiased. However, this is not the case for the cohort studies chosen in the first article. It is more nebulous and resembles a natural occurrence. Moreover, Thacher et al. (2016) argue that the evidence hierarchy represents the ranking of the evidence gathered for the study, determined by the research’s rigor and the biases present in the collected data. Given that the chosen article is founded on a systematic review and has also performed a meta-analysis, it occupies a leading position in the hierarchy. The main article chosen for this research contains quantitative data analysed through a Cohort Study, resulting in a lower ranking on the hierarchy of evidence.
SUMMARY OF KEY POINTS AND RECOMMENDATIONS
As previously mentioned, the primary article’s main conclusions were that kids born to parents who smoked frequently throughout pregnancy had a higher risk of suffering asthmatic disorders. Even though there was uncertainty about some of the research’s components, the cohort study approach, which was based on data gathered from a single institution, only assisted the researchers in carrying out their work efficiently (Sciberras et al., 2017). The results of the primary article, which concluded that parents should be discouraged from adopting or continuing smoking habits while the mother is pregnant in order to prevent the child from developing any respiratory diseases, were also supported by the second article’s findings, which were a systematic review.
Certain suggestions for physicians or nurses can be made based on the research (Dolan et al., 2016). The papers demonstrate the need to raise the level of awareness programs being implemented within the organization. As a result, the medical professionals who are employed, such as nurses, doctors, registered nurses, and others, can receive training to improve their knowledge, which they can then impart to others. There is now a smoking cessation clinic at the hospital, and one more that focuses on counselling and monitoring expectant mothers and fathers can be established (Biederman et al., 2017). The critique also assisted in identifying more environmental components that may have been employed in the research, as well as numerous additional human nature-related factors and characteristics that have not been addressed.
CONCLUSION
It is clear from the evidence presented in the two publications that both mothers and fathers should discourage smoking as soon as they become pregnant. According to the first study, children who have a father who smokes are more likely to acquire asthma, while the second study found that newborns who are exposed to both maternal and passive smoking are more likely to experience respiratory issues. The hierarchy of evidence was considered, and the critical analysis also revealed that the RCT is a more evidence-based approach than cohort studies.