Critically Appraising Qualitative Evidence for Clinical Decision Making Chapter 6

Any academic source is fine.
Jerald is a newborn baby born to a crack-cocaine-addicted mom, Geraldine. She loves her child, but knows that she cannot take care of him at this time and asks her social worker to place him in the foster care system. As Geraldine’s nurse and Jerald’s nurse talk, they both wonder what is foster care like for these kinds of infants. Jerald’s nurse remarks, “Well, it isn’t like he is going to be a piece of cake to care for … I wonder if families even know what they are getting themselves into when they agree to care for babies like Jerald.” To help them better understand Jerald’s future, they ask this clinical question: How do families willing to care for babies (P) exposed to prenatal substance abuse (I) perceive the care they provide (O)?

Upon searching the literature to answer this question, the following study was found, among others: Marcellus, L. (2008). (Ad)ministering love: Providing family foster care to infants with prenatal substance exposure. Qualitative Health Research, 18, 1220–1230. The nurses begin to consider the aspects of studies that they realize are important for all studies: design, sample, methods, and analysis. They note in the abstract that this study was a constructivist grounded theory study design. The nurses are not quite familiar with this study methodology, so they look in the Powers’ chapter of the Melnyk and Fineout-Overholt EBP book and find that constructivist grounded theory was defined by a scientist named Charmaz in 2006 as follows: “A number of the disputes among grounded theorists and critiques by other colleagues result from where various authors stand between interpretive and positivist traditions … Constructivist grounded theory is part of the interpretive tradition … Constructivists study how—and sometimes why—participants construct meanings and actions in specific situations … to show the complexities of particular worlds, views, and actions” (pp. 129, 130, 132).

Pondering the how and why of family foster care, the nurses find the research question: What is the process of becoming and providing family foster care giving in the context of caring for infants with prenatal drug and alcohol exposure? The study sample was foster families (N = 11) in five different communities; all but one with at least one foster child in the home; and 10 of whom had their own children participating in the study, with ages ranging from 5 to 31. The study authors began their study methods by conducting open-ended, semistructured, family interviews lasting between 1 and 2 hours. Interviews were recorded, transcribed, and mailed back to family participants for editing and elaboration on further thoughts they may have had while reading the transcript. Researcher observations and reactions were recorded after each interview. Additional data collection strategies included follow-up telephone calls and e-mails, attendance at foster parent events and child welfare conferences, examination of relevant government documents related to child-in-care policies and guidelines, and review of professional and lay literature and media. Three social workers, all with at least 10 years of experience supporting foster families, were also interviewed. Data analysis involved grounded theory techniques of constant comparison, increasingly abstract consideration of the data, and identification of a basic social process.

The nurses now turn to rapid critical appraisal of this study to determine its worth to their current practice and how they care for this mom and baby. There are three questions that they know need to be asked: (1) Are the results valid? (2) What are the results? and (3) Are the results applicable to my patients?

Remember to cite your sources when providing evidence from the article and include a reference page.

Are the results valid/trustworthy and credible?
-Provide a sample selection:
-Accuracy and Completeness:
-Plausibility/Believability:
What were the results of the study?
-Approach/Purpose/Phenomenon:
-Reported Results:
Will the results help me in caring for my patients?
-Relevance:
-Application: