Young Adult Couples' Decision Making Regarding Emergency Contraceptive Pills - Essay Example

?Research Article Critique The article under review reports a study over the low use of emergency contraceptive pills in young couples. This study was carried out by Beaulieu and colleagues on “Young adult couples’ decision making regarding emergency contraceptive pills”. The work was published in the journal of nursing scholarship in 2011(Beaulieu et al.). The concern over the presence of cases of unwanted pregnancies motivated the study regarding the reluctance of young couples in using Emergency contraceptive pills. The researchers constructed sets of salient conditions to guide the research. These conditions touch on contraceptive use, decision making among couples, views between men and women over the use of ECPs, a woman’s autonomy, and relationship power. To enhance the validity and credibility of the study, the researchers employed the use of face to face interview as a research method. Qualitative research was most appropriate for this social research (Weinberg, 2002). Open ended questions were employed to collect data which comprised of personal views. Despite the availability of other research method, the researcher chose face to face interview. This was recommendable because this method enables the research to create a rapport with participants. The authors have clearly stated objectives of the study using an explanatory title, in the abstract, introduction and through the arguments stated in the report. The title briefly summarizes the whole topic. By reading the topic, a reader automatically gets a good snapshot of the entire study. The authors introduce the topic of unwanted pregnancies by providing definitions and reasons for its occurrences. They later state the reasons why it was necessary to explore this subject, and the necessary steps and methodology utilized during the study. He also introduces all concepts discussed in the report clearly using simple language. All the supporting literature is recent, hence, relating the issue with current discussions and ongoing debate regarding contraceptive use. They also state the importance of this study by stating the concerns surrounding the issue. Despite the fact that ECPs safely prevent unwanted pregnancies, it is confusing why young couples refrain from using them. These contraceptives also suit the needs of young people and are available for their use. So it remains unclear why young people do not avail themselves for their use. This study was different from past studies because past studies centered on women as the primary decision makers of regarding contraceptive use. However, this study took a different perspective of focusing on the couple, and not just women. Couple dynamics looks at the dominance of men in reproductive health decision making. Men dominate these decisions because they too, do not want unplanned pregnancies and experience the pressure for sex. To give the article more credibility, information is provided from other fields that relate to the study. Information is concerned with developmental antecedents, which influence decision making in relationships. In this analysis, the authors connect the article theme to other factors that are fundamental to providing more insight to readers as to the importance of the study (Beaulieu et al., 2011). The article is written in simple and clear language, which makes it easy to read and understand for anyone with basic education. The author has portrayed facts in an organized and clear manner, supporting every argument with appropriate resources. These resources provide in depth information on the subject and prove the information’s credibility. The article has been organized into section, each section covering a specific aspect of the study. In addition, there is congruence among different sections. All the sections serve to build up arguments that support the study. Right from the abstract and the introduction, the author has introduced participants in the study; mentioning the people concerned over the issue, past studies and reports over the issue, past documentations, and participants in the study. The author mentions that he sought approval from the human research committee at the University of California before conducting the study. This indicates that the study is ethically acceptable as it conforms to any regulations that the state place regarding human studies. The study was conducted using grounded theory methods for the interpretation of qualitative data. This theory aims at developing a comprehensive explanation of data in an attempt to explain human behavior from the participant’s perspectives. This methodology seems most appropriate for this study as it focuses on a given number of people to offer an explanation for a general population. It allows thoroughness and explicitness during the study. The original aim of using this methodology was to develop a theory to explain human behavior. However, the theory also allows the study to focus on developing a theoretical narrative to explain interaction processes and meanings. A study of this nature requires suitable documentation of participants that provides all the relevant characteristics useful to the study. For a qualitative research, it is important for the researcher to document certain characteristics such as the ages of participants, races and education levels (Weinberg, 2002). The researcher obtained participants by snowball sampling and recruiting from public notices. For a willing participant to be accepted, they must have been English speakers, involved in a heterosexual relationship, be between the ages of eighteen to twenty five, have essential awareness of the Emergency Contraceptive Pill and have partners who were willing to participate too. The study involved twenty two couples between the ages of eighteen to twenty five. The couples should have been married but intimately involved for more than six months. Their racial identities consisted of three Hispanics, four African Americans, thirty four Caucasians and three Asians. All of them had prior knowledge of the contraceptives though not all of them had used the pills in their current relationships. This participant background is sufficient and relevant to the scope of the study. The researchers use a rigorous procedure to obtain results of the study, explaining each step he takes, and the importance of the step to the study. They put to test all the four condition, ensuring that participants answer questions related to the four conditions clearly. Using these conditions and responses, they develop a theoretical perspective using the grounded theory. The perspective, “the grounded theorizing”, explains all the variables of the study that guides it to its conclusions regarding the use of Emergency pills. The researchers extensively collected data, making use of all the necessary data collection methods, verification and processing. The researchers’ audio taped and transcribed the interviews in verbatim. This allows readers to capture authenticated reports from participants and compare them to the findings of the study. Additionally, it promotes the originality of the study. For easy verification, the researchers started data analysis simultaneously with the collection. In addition, they were also following the principles of grounded theory in data collection and analysis. After they collected the first batch of data, analysis began immediately. This analysis included memo and open coding strategies, which was useful in developing theoretical conceptualizations. Through this analysis, it would be possible for other people to audit the findings as it is easy for them to follow the step to step analysis. The researcher also used axial coding to aid in identifying core study categories and their affiliation to the study. To illustrate the rigor involved in the data collection and analysis, the researcher collects additional data from new participants after completing with the first batch of participants. This permitted theoretical sampling, and verification of the concepts developed with the first batch of participants. To do this effectively, the researchers revised the interview guide and collected similar data from the new participants. To confirm and verify conceptualization, the researchers carried out member checking. They confirmed the results by checking them with subsequent couples. They also constructed salient categories of research, which were helpful in characterizing the young couple’s experiences with the emergency pills (Beaulieu et al., 2011). They later discuss each category of the research, linking to the core elements of the study by using the data he collected from participants. It is also important to note that all questions related to the objective of the study. The researchers asked couples regarding the decision making of emergency contraceptive use. This discouraged any ambiguity that could have emerged. They also scheduled the interviews in such a way that participants were able to be forthright, and avoid providing answers that were influenced by other participants or their partners. In such studies, it is imperative to obtain honest answers from participants. Therefore, researchers should schedule interviews with individual participant, the couple, and or the group too. This allows the researcher to obtain true and unbiased information from participants. The data analysis was precise, clear and compatible with the tenets of the theory used. The researchers clearly explain the research findings by relating the findings to the initially set objectives. For example, he links the intimacy findings to Erikson’s developmental theory and stages. The researchers had initially mentioned the developmental complexities that would affect a couple’s decision making regarding emergency contraceptive use. They stick to the subject of research by linking all findings to it. Since the focus of the study was identifying reasons for none or under use of emergency pills, the researchers successfully connect the research findings to this goal. In addition, they explain the responses from the participants in relation to why they took or did not take the pills. The researchers links the study objectives to all the conditions that had initially been set such as partner support, women autonomy over their bodies, conflicting views and relationship power. The researchers use their findings to support the conclusions of the study. In the discussion section, they explain the varying views about emergency contraceptive use by couples. Reference is made data in the discussion of results. Additionally, they use other documented resources and studies to affirm the findings. For example, citation is made on past similar studies regarding the study categories. The following are cited, (Whitley, 1990; Kearns et al, 2003) in the explanation of the influence of partner support in the decision making process. However, the researchers do not relate the conclusions of the report to the findings of the study. The report’s conclusions focus on the objectives of the study by offering a summary of the report. It also offers recommendation for practitioners and providers of emergency pills to enable them understand the low usage of the contraceptives by referring to the findings. They assert that nurses with an interest in contraceptive use in young women must be aware of couple dynamics whenever they engage the young people in discussions regarding contraceptives. Clinicians on the other hand, must assess the relationship’s characteristics before involving a partner in such discussions. The research was successful in developing theoretical concepts related to the conditions of the study. The objective of the study was to offer an explanation for the low use of emergency pills in young couples despite the pills being suitable for them. However, the focus was on their decision making regarding this objective, because of this, the researchers geared the study towards developing themes and theories that explain this phenomenon. The methodology used, the ground theory, enabled them to establish concepts that aided the formation of these themes. After the analysis, the researchers developed a product of analysis and called it ‘grounded theorizing’. This product represented an acknowledgement that it is still possible to develop post modern theoretical concepts on contraceptive use in young couples. The researchers represented the concepts in a diagram containing its elements. The theory is that the decision to use or not use emergency pill depends on a mixture of four conditions; a couples’ divergence views on ECPs, relationship power, a woman’s independence over her body and the changing locus of accountability. The central agreement with these conditions is that even though people in the perfect world view this decision as a joint responsibility, in reality, it is mostly a woman’s responsibility. Despite the influence a man may have on the woman’s decision, she makes the final decision on whether to take or not take it. In order to come up with this theory, the researchers have clearly explained the relationship between the four conditions and their contribution to the study. The first condition is the changing locus of responsibility. In the perfect world, participants agreed that the responsibility lied on both of them. However, this changed in reality as most of them recorded an imbalance in the decision, quoting that the woman was solely responsible for taking the pill or not. Some women reported that they would take the pill with or without their partner’s knowledge. Even in situations where couples agreed to share responsibility over the decision, the couple still disagreed on what it meant. Men felt that their responsibility would only equate to ensuring their partners taking the pill, but it all depends on the woman as she is the one who takes it. Another condition contributing to the low use of emergency pills is the relationship power. The researchers connect these two conditions by asserting that power and trust are interwoven in the changing locus of responsibility. Power is a fundamental factor in relationships, as women demand more control over power to make reproductive decisions. On the hand, men feel vulnerable as they are left to experience whatever consequences come up due to their partner’s decisions. Men say they are unable to manipulate their partners’ decisions considering contraceptive use because there was no emotional attachment in their relationships. This inability results into feelings of vulnerability in men, making them lack confidence in their partner’s arbitration. The third fact is the woman’s autonomy, which the researcher links to the previous factor. The woman’s awareness of her body influences her ability to decide what contraceptive to use, and when to use it. This relates to power the woman has over the decision to use contraceptives. While some women consider contraceptives as burdens, they recognize their power in controlling contraceptives. Women felt like they had full control over their bodies and they were the only ones responsible for anything they decide to do with it. Most of the women participants argued that they would not be with men who would force them to do whatever they didn’t want do with their bodies. Another factor affecting the contraceptive use decision is the fact that some couples may have conflicting views regarding the functioning of these pills. Some men thought these pills were abortifacients, which is not the case. Once the confusion was cleared, the men opened up to their partners using emergency pills. The researcher connected these factors by using information from the interview with participants. The researcher interviewed the participants by asking about their views on the four conditions that influence a couple’s decision making. The authors have blended the study objectives with the findings and provided information that supports the objectives of the study. It is easy for readers to understand and recognize the concepts highlighted in the article. The authors have clearly introduced the topic of study and offered clear explanations to enable the reader understand what the article is all about. The researchers have organized the information into sections, enabling readers to focus on particular aspects of the report at a particular time. The reader also finds it easy to refer and relate the information to the topic. It is easy for readers to relate findings and discussions of the study to the topic. The subtopics also offer readers with an overview of what the article is all about, making it easy for them to understand the phenomenon without having to read through the whole article. In addition to this, article is relevant to similar future studies as it provides loopholes within the study, such as the focus on the varied cultural and socio-economic backgrounds of couples. The author argues that this has enormous influence on the relationship of couples, their perception about the emergency pill and their ability to make informed decisions. Another area that requires future studies is the availability and accessibility of the pills. This study was carried out in places where the pills were easily accessible and available to young couples. This ruled out inaccessibility as a reason for the low utilization. However, the authors feel that further studies should be conducted on areas with limited accessibility in order determine other possible explanations for the low contraceptive underuse. The aim of this article was to provide information for use in the nursing practice. Therefore, the findings should be relevant to the nursing field, especially to the recognition of the decision making between young couples. The author fails to make a clear and in depth connection between the findings and the nursing field. These results make it easy for people to understand the decision making process, but does not offer substantial help to the nursing field. The report also fails to relate the findings to nursing theories. Instead, it links the findings to developmental and psychological knowledge. The authors assert that concordance to views among couples regarding the use of contraceptives may be as a result of the varying cultural and socio-economic backgrounds. This observation is true; however, it does not offer the nursing field solutions to the problem. It would have been more useful if the researcher had focused on relating the findings to offering nursing solutions such as educating the young couples on the usefulness of the pills. The few recommendations that the report offers are not comprehensive enough to cover the field of reproductive health. The article offers advice to clinicians and nurses on how to handle couples whenever they come for reproductive health attention. However, it fails to offer suggestions on how to get the couples to seek these services. Understanding the theoretical perspectives and concepts stated in the report, helps nurses and clinicians to understand the trends that young couples use when deciding on contraceptives. This is the first successful step into encouraging young people to seek professional advice into reproductive health. References Burns, N. & Grove, S. K. (2010). Understanding nursing research: Building an evidence-based practice. (5th ed.). Philadelphia: Saunders Beaulieu, R., Kool, M.S., Kennedy, P.H. & Humphreys, J. (2010). Young Adult Couples’ decision making regarding emergency contraceptive pills. Journal of Nursing scholarship. 43(1), 41-48. Weinberg, Darin.(2002). Qualitative research methods. Massachusetts: Wiley-Blackwell. Read More