CRITICAL APPRAISAL CHECKLIST FOR QUALITATIVE RESEARCH

NAME: Li Jing (Alice)

Section: 1

Guide Questions Answers

Yes, there is. Because
1. Is there congruity between the stated philosophical
perspective and the research methodology? Explain（有）
 The present qualitative study was conducted to examine woman’s perceptions of the childbirth stressors,
and with the following specific research questions: How did you feel when entering the labor ward? How
was your time in the maternity ward? What were the factors in your delivery that made you stressed?
 The need for the study has been adequately substantiated, because in the instruction, the research
described the background of this research. One is that negative birth experience can lead to poor birth
outcomes, mood disorder and complications such as postpartum depression, fear of childbirth as well as
2. Was the research question clear? Was the need for the disturb the relationship between mother and child. As an alternative, current study are more focused on
study adequately substantiated? （研究“必要性”是否被 the following factors affecting stressors including individual social characteristics, social status,
证实） expectations of the mother, prenatal education, maternal awareness, pain perception, type of delivery and
the like. On the contrast, there is a few researches to study the most important woman’s perceptions of
stressors in delivery ward. Hence, it’s needy to do this research.

3. Is there congruity between the research methodology  The present qualitative study was conducted to examine woman’s perceptions of the childbirth stressors,
with a conventional content analysis approach.
and the research question or objectives? Explain （ 有 ， 即
Content analysis is a method of research that converts qualitative data into quantitative figures, which is done
“研究方法”是否适合用来解决“研究问题”）
by making effective interpretations through reading and coding the qualitative data. In this research,a total of
126 primary codes were extracted as a result of the initial encoding, and then the main codes were named
 based on similarities between the initial codes. Finally, the qualitative findings were summarized in 4 categories and 2 themes.
Hence, once researchers finished the coding, they will see the strong repetitive words, phrases and these become
themes and categories, which will answer research questions. A coding scheme will increase the validity of a
certain study and make is easier to interpret customer feedback.Thus there is congruity between the research
methodology and the research question or objectives.

 The data collection method was a in-depth and semi-structured. The tool used in this study was a semi-
structured and researcher-made questionnaire. The interviews were continued with the same questions
after several pilot interviews and confirmation by the research team. A semi-structured interview, followed
by a questionnaire as a “topic guide” ,  is a type of interview in which the interviewer asks a particular set
of predefined questions and the participants express their opinions based on the questions.
 The women were first given explanations about the study and the inclusion criteria were checked. Then,
4. Is there congruity between the research methodology the individual interviews were conducted in the case of their consent. The interview lasted from 15 to 30
and the methods used to collect data? Explain（有，即“数 min. Interviewees’ voices were digitally recorded in the case of their consent and then transcribed by the
据收集方法”是否符合“研究方法”） researcher after the completion.
 Hence, throughout the process of data collection, a semi-structured interview with questionnaires can
assist the researcher to obtain in-depth statements of preferences, opinions and experience and are
useful for gathering a large range of views and responses from very diverse targets. So, there is congruity
between the research methodology and the methods used to collect data.

5. What was the design of the study? How were the data  Te present study is a qualitative research conducted with a conventional content analysis approach.
collected (one time (cross-sectional) or repeated over  The data were collected by cross-sectional study, and a cross-sectional study is as a snapshot of a particular
group of people at a given point in time. In this study, researchers collect data on a few different variables
time (longitudinal)? What were the limitations of the
to see how differences in maternal age, education, and social class, And researchers interviewed 13
data collection methods? Explain
different women based on one specific point that what your perception of stressors in delivery room are.
 What’s more this study described what is happening at the present moment.
 One of the limitations of our study was that the interviews were conducted in public rooms for postpartum
women due to the lack of a private room for them. Another limitation was the insufficient number of
participants involved in this research to conclude.

 In the present study, purposive sampling was performed with maximum variation in maternal age,
education, and social class and continued until data saturation. Next, 13 mothers were interviewed after
the childbirth.
6. How was the sample selected (eligibility criteria)?  The inclusion criteria of this research include being primigravida women, singleton fetus, hospitalization at
Explain week 37 and above, and lack of chronic medical diseases or pregnancy complications. If the mother
refused to continue during the interview, she would be excluded.

7. Is there congruity between the research methodology  There are four criteria were used to examine the accuracy of data in the present study including credibility,
conformability, dependability, and transferability. And researchers use different specific methods to
and the representation and analysis of data? Explain（ 有 ，
increase these four aspects. For example, researchers said that “we used long working on the subject,
即“数据分析方法”与“研究方法”有关系吗）
dedicated time to data collection, member matching, external check to gain credibility”. in order to
increase the conformability, the researcher abandoned the assumptions and thoughts, and carefully
documented all stages of the research. For increasing the dependability of data, there are two methods:
1)external observers were asked for assistance in addition to the research team members.;2) The code-
recode method was also used during the data analysis; enhance thing data transferability was finished via
the rich, detailed, and step-by-step descriptions. All these analysis methods improve the accuracy and the
validity of a certain study data, in other words, there is congruity between the research methology and
the representation and analysis of data.
  Yes, there is congruity between the research methodology and the interpretation of results. At the
8. Is there congruity between the research methodology
and the interpretation of results? Explain
beginning, the researchers summary the results that the outcomes of the present study resulted in 2
themes of human and environmental stressors and four categories; namely, personal factors, care staf-
related factors, environmental factors, and equipment-related factors. Then researcher discussed one by
one, meanwhile, during the discussion, researchers also acknowledge that these results support the
previous studies in the literature review, meanwhile, researchers cited the previous opinions to prove it.
Absolutely, researchers give some novel views based on the previous study. For example, the findings
indicated that personal factors, including (1) Hearing troubles, (2) Fear of therapies, (3) Fear of childbirth,
(4) Fear of harm to self-health, and (5) Fear of fetal health, is one of the most important stressors. At the
same time, the researchers also cite a study of pregnant women in Australia, which revealed that lack of
selfconfdence at birth, fear of the unknown, internalization of other women’s negative stories about tear
of the perineum, and labor pains were common concerns for primigravida mothers.

9. Is there a statement locating the researcher culturally or

theoretically? Explain（ 有 ， 作者是否阐明他的价值观 ， 信
仰，以及是否说明他的价值观和信仰对本研究的影响）
10. Is the influence of the researcher on the research, and  At first, researchers respect participant’s willing,for example, during the process of collection data, if the
mother refused to continue during the interview, she could leave out anytime and also would be
vice- versa, addressed? Explain（研究人员与实验参与者
excluded.
之间的关系是否得到解决？有没有在数据收集过程中 ，
研究员是否批判性的审视自己的角色？ 有没有报告研究  During the interview, whenever the researcher felt that there was a need for a deeper understanding of
the issue, questions were asked to elaborate.
人员对研究过程中发生的事件的反应）
 Before the interview ,the women were first given explanations about the study and the inclusion criteria
were checked.
  And participants signed a research consent form., meanwhile, interviewees’ voices were digitally recorded
in the case of their consent.

 Yes, they are presented. When the researchers indicate the research results, they used the participant’s
words as the basis data of conclusion. For example, “personal factors” category consists of 5
subcategories: (1)Hearing troubles, (2) Fear of therapies, (3) Fear of childbirth, (4) Fear of harm to self-
11. Are participants, and their voices, adequately health, and (5) Fear of fetal health. Participant 11 said “I was scared of its pain as it was my first
represented? Explain（有，即参与者代表们的一些回答） experience”. And participant 8 said “I was afraid if I wouldn’t be able to give birth”. Hence, their voice were
adequately presented in the study and their voice were also digitally recorded under their consent, which
make the data more convenient.

 Yes, the research ethical is according to current criteria. This research was approved by the Ethics
12. Is the research ethical according to current criteria or, Committee of Hamadan University of Medical Sciences under code (IR.UMSHA.REC.1396.887) and project
for recent studies, and is there evidence of ethical NO 970114101. And participants signed a research consent form.
approval by an appropriate body? Explain（ 即， A statement
on the ethical approval process）

13. Do the conclusions drawn in the research report flow  Yes, the conclusion drawn in the research report flow from the analysis, or interpretation, of the data.
from the analysis, or interpretation, of the data?( 有 ， 即
the relatonship between conclusion and participant’s
words or views)
Because researchers used a semi-structured interview as well as researcher-made questionnaire to collect
data. And after that, a total of 126 primary codes were extracted as a result of the initial encoding, and
then the main codes were named based on similarities between the initial codes. At this stage, 34 main
codes and 12 subcategories were obtained. The integration and classification processes continued and the
main categories were created. Finally, the qualitative findings were summarized in 2 themes(Human
stressors and Environmental stressors )and 4 categories (personal factors, care staf-related factors,
environmental factors , equipment-related factors). In other words,  coding is the best way to  evaluate,
interpret and draw conclusions in qualitative research.
  The outcomes of the present study resulted in 2 themes of human and environmental stressors and four
categories; namely, personal factors, care staf-related factors, environmental factors, and equipment-
14. What were the findings? Explain(还需要再解释一下) related factors. Although ignoring them and increasing stress during childbirth may jeopardize the
childbirth consequences, most of them are ignored and overlooked.

15. Did the authors put their findings in the context of the
broader literature on this topic? Explain （是否被大量引
用）
16. What relevance do the findings have to nursing practice?
（研究结果与护理实践之间的关系）
17. Discuss how the findings can be applied to practice. （如
何应用到实践里）