Question
Please read and answer the following questions. 1. How was the sample selected ? We’re demographics collected ?
2. Is the sample representative of the target population? If not how was the sample “improved “ to make the results more reliable and valid?
3. What is the design of the study?
4. How were the human subjects protected ?
5. Were instruments used reliable and valid ? Did they measure the phenomenon under the study( how do you know that ?)
Methods Study design and participants Pregnant women enrolled in this study were identified among all women aged 14-40 years presenting to the emer- gency department (ED) at the Hospital of the University of Pennsylvania between January 1999 and August 2001 and residing in selected ZIP codes in Philadelphia. The ED was selected to recruit pregnant women into this study because many urban pregnant women utilize the ED for primary care and we may not have identified this group of pregnant wo- men through a traditional prenatal care clinic until much later in their pregnancy. It should be noted that the majority of enrolled women were seeking care in the ED for nonurgent, nonpregnancy-related reasons (over 85%) and 70% had not yet received a prenatal care visit during the pregnancy. Thus this population represents a group of urban, low-income pregnant women who have been identified, by others, as a high risk group for UP 1.9,10
NELSON AND LEPORE men do not.1Each woman meeting the eligibility criteria was ing individual engths and re versity. Factors hysterectomy. or a normal menstrual cycle in the past 28 days vels of social cts of risk fac assessment was interested in the examination of the role of heperiencing violence, stress, and depressive symptoms among women pregmamcy per hospital protocol Women self-reporting ur rent pregnancy greater than 22 weeks of gestation, a history of were excluded from the pregnancy screening process, since this We suspect early in pregnancy. Women who had delivered or reported a ation between therapeutic or spontaneous abortion in the previous 14 days g to abort the were also not screened for pregnancy. Urine pregnancy tests uffer and may were conducted on all other women regardless of the reason for Women with the ED visit. Following a positive urine pegnancy test, we will be able to further excluded non-English-speaking women; women diag- will have the nosed with an ectopic, molar, or twin pregnancy, or women who presented to the ED with an acute mental illness ( 325). Since the majority of patients seen in the ED were speaking, less than 5% of the women were excluded as non- English speaking. Among the remaining eligible pregnant women, 96% agred to participate in the study (ns 1494). independently ter healthy de- ymptoms and resiliency and d experiencing At enrollment, while in the ED and after pregnancy con- because these firmation, each woman completed an extensive, 40-minute in- plessness about person interview administered by a nurse interviewer. Data Women with were collected on social and demographic factors, curment eive the pros living arrangements, self-reported current receipt of public d their coping assistance (yves/no), prior and current substance abuse, social support, current levels of psychosocial stress and depressive ocial and psy symptoms, and current and past exposure to interpersonal erate the rela violence Tolerance, Worry, Eye-opener, Amnesia, Cutdown as sadness or (TWEAK), a five-item, validated scale commonly used among population of young women, was used to assess problem drinking. n- two low resil- tention of the pregnancy was captured in the baseline inter- s and current view. All women provided written informed consent, and the e relationship protocol and consent forms were approved by the University the pregnancy. of Pennsylvania institutional review board. factor, social g to abort the derstanding of Study measures ess or wanting Pregnancy intention. Pregnancy intention was the main estigation will outcome in this assessment. The intention of the pregnancy s to abort the was captured by questions concerning feeling happy or sad at the time the pregnancy was finst confirmed, and current plans terminate the pregnancy. A woman was identified as having UP (yes/no) if she felt sad (compared with happy) when she first learned of the pregnancy or she planned to/ considered terminating the pregnancy. Although the litera- ture frequently uses a more precise construct of pregnancy le factors that ere identified intendedness, which includes both an assessment of mistimed g to the emer and unwanted pregnancies, previous research suggests that University of happiness versus sadness about being pregnant and preg gust 2001 and nancy intentions are highly correlated. In addition, preg The ED was nancies ending in abortion are commonly considered study because unintended and the majority of women experiencing an un- r primary pregnant wo- about the pregnancy intended pregnancy report feeling unhappy or very unhappy Violence indicators. The main risk factor of interest in- Information concerning prior childhood physical assault care til much later e majority of or nonurgent cluded self-reported measures of past and current violence. 70% had gnancy. Thus, (yes/no) or childhood sexual assault (CSA) (yes/no) were not low-income y others, as a measured by the questions: Before you were 16 years old, did anyone slap, push, or hurt you in any way? and When you were growing up, that is, before you were 16 years old, did
CHILDHOOD VIOLENCE AND UNINTENDED PREGNANCY anyone ever force you to have sex? For the small group of factons, pasto women enrolled who were under 16 years of age, the violence Indicator questices were modified and read: Has slapped, pushed, or hurt you in any way and Has anyone bests, as appro ever forced you to have sex? over 16 years of age usling the question, Since you ears old, exual assault (yes/no) was captured for the women main effects o has anyone ever forced you to have sex when you (1 yes: 0 no) t wane tor In addition, ineimate partner physical vio- moderating ef lence (yes/no) was measured using the question How many and stress ( titmes, since you were 16, have youı been slapped, pushed, or or current viol hurt by a partner? The peesence (yes/no) and amount of abort the preg current physical violence during the pregnancy was identified effect of depre using the question: Since your last menstrual period, during and sadness any uer fight did you get pushed, slapped,or hurt in gmur chili Rosiliency moderators of interest. The main objective of childhood sex this assessment was to explore the moderating influence of toms; (3) wome two psychological factors related to low resiliency, carrent with current de depressive symptoms, and current psychosncial stress, and history of chil one social factor related to high resiliency-socal support sive symptoms on the relationship between violence and experiencing sad assess the signi ness or wanting to abort the pregnancy Recent depressive symptoms were measured using the justing for race ter for Epidemiologic Stadies Depression Scale (CFS-D) were not includ The CES-D, developed by the National Institutes of Health, is significance at a 20-item, self-reported scale to identify current depressive In the multi symptoms and has been used extensively among pregnant condounders t womn After appropriate items were reversed, a total CES ween violenc D score for each woman was calcalated and a summary score American vs. n of 16 indicated current depressive symptoms (yes/no) (high school gr (Croebachs alpha 0874) A CES-D score of 16 or greater is married; yes/n commonly used in the Sterature to identify persons with high 3 or higher, y levels of depressive symptoms (yes/no), and h Current stress was measured using the Cohens Perceived no). The mari Stress Scate (PSS) The PSS, developed by Cohen, Kamarck, ported current and Mermelstein, measures the degree to which certain sitta others. SPsS ve ations in the past month were appraised as stressful The four-item scale has been validated in low-income African American women and found to huve high reliability (Cronbactys alpha 0.651). Cutolfs for the PSS have not been We found d created: therefiore, values and created dichotomous cutoffs to assess the mod- the current pre erating effect of high versus low stress. Given the sample an UP pregnan distribution, women were classified as having a high PSS abort the pregn score if the summary score was 7.0 or higher and women were rican classified as having a low PSS score if the summary score was terval (CI]: 1.26- less than 7.0 for this sample, we determined median sad (compared OR-1.24, 95% Social suppart was measured using twe questions negard- the past year ( ing the self reported number of people each woman reported that she could count on in times of need and the number of he close friends. Given the distribution in these data, women or wanting to a were classified as having high social support if the sum mary 95% a 182 score was 5.0 or higher, and women were classified as having (OR-1.68, 95% a low social suppoert if the summary score was less than 5.0 A higher pr wanting to abor CI: 1.03-1.87) or Women reporting sadness or wanting to abort the preg- nancy were compared with women who were happy or planned to continue the pregnancy to term on demographic (28.1% vs. 22.2% women reportin women reporting
675 D PREGNANCY mall group of e, the violence Has anyone Has anyone factors, past or current violence indicators, and the resiliency factors of interest. Initially, significance of direct effects was assessed using t-tests, Wilcoxon rank sum, and Chi-squared tests, as appropriate. Logistic regression analyses were conducted to examine the for the women main effects of violence indicators and the resiliency moder- e you were 16 ators on risk of sadness or wanting to abort the pregnancy sex when you (1-yes; 0-no). Interaction terms were created to examine the r physical vio moderating effect of depressive symptoms (1 -yes; 0 no) n, How many and stress (1-high:0= low) on prior childhood sexual assault ed, pushed, or or current violence and experiencing sadness or wanting to nd amount of abort the pregnancy. For example, to examine the moderating was identified effect of depressive symptoms on childhood sexual assault period, during and sadness or wanting to abort the pregnancy, the following ped, or hurt in groups were created: (1) women experiencing at least one episode of childhood sexual assault and current depressive symptoms; (2) women experiencing at least one episode of in objective of childhood sexual assault without current depressive symp- g influence of toms; (3) women without a history of childhood sexual assault liency, current with current depressive symptoms; and (4) women without a ial stress, and history of childhood sexual assault without current depres- support- sive symptoms. Logistic regression models were created to eriencing sad- assess the significance of each interaction term on experienc- ing sadness or wanting to abort the pregnancy (yes/no) ad- using the justing for race, education, and marital status. Age and parity Scale (CES-D) were not included in the multivariate models given the lack of cial red es of Health, is ent depressive significance at the univariate level. In the multivariate models, we chose to assess the role of d, a total CES tween violence and pregnancy intention: race (African ummary score American vs. non-African American), educational attainment graduate; yes/no), marital status (single/never 16 or greater is married; yes/no), problem drinking (using a TWEAK score of sons with high 3 or higher, yes/no), receiving assistance in the past year (yes/no), and having at least one child living at home (yes/ ens Perceived no). The marital status variable included women who re- hen, Kamarck, ported currently single and never married compared with all oms (yes/no) (high school ch certain situ others. SPSS version 19.0 was used to analyze these data. stressful.7 The
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Answer #1

Q. No. 1. Answer : sample : it is should be selected from the population.

* First we need to identify the ppopulation. Here 14-40years woman are the population.

* then from them target population. Here pregnant women are target population.

* next from them accessible population. Here who are coming to ed department.

* next from accessible population we can select the sample. Here urban low income pregnant women who are at high risk is the samples.

Yes we need to collect the demographics like

age in between 14-40 yrs.

Place of living rural or urban .

Income status.

Educational level.

Q. No. 2. Answer. Yes sample is the representative of the target population.

* but exact sample size should be selected.

* it must be necessary.

* so that we can make more reliable and valid.

Q. No. 3. Answer :

Research design is the plan of the study where to collect and when and how and what is the analysis of the study.

* here it is a non experimental descriptive research design.

* because here characteristics of individuals selected like age, income, educational status, rural and urban.

* and it is occurring under natural phenomenon with out any manipulation.

So it is non experimental descriptive research design.

Q. No 4. Answer :

By providing good antenatal care and security we can protect the human subjects.

Q. No. 5.answer:

The instruments which are used reliable and valid, because here they used chi square test, and t-test.

* and the Value is 0.651, if value will come 0.70 is acceptable level of reliability according test re test method, so the study value is near to that.

So that it was reliable and valid.  

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