This assignment will discuss in a critical way the impact of unplanned teenage pregnancy and sexually transmitted diseases (STI’s) that result in when teenagers fail use protection during sex. According to World Health Organisation (WHO) 2019, nearly 16 million girls aged between 15 and 19 are teenage mothers (Kiani et al., 2019). Teenage mothers are affected, socially, mentally, and physically during the process of being pregnant to giving birth. Teenage pregnancies sometimes result from peer pressure, sexual abuse, low socio economic status and lack of knowledge regarding sex and the use of contraceptives to prevent unplanned pregnancies (Kaphagawani & Kalipeni, 2017). Moreover, lack of support from family, community causes individuals to take part in risky behaviours, resulting in unplanned pregnancies. The writer will generate a question to help with the literature research, using databases, PICO and Boolean operators, in order to come up with risks behaviour literature that will answer the question. To research papers, qualitative and quantitative related to unplanned teenage pregnancy will be selected and critiqued separately using Holland and Rees (2010) framework for Critiquing. Ingham- Bloomfield framework critique will be used as well. Furthermore, the paper will discuss the strengths and limitations of the quantitative and qualitative papers, gaps and the writer will try and answer the literature search question. The assignment will discuss what the findings contribute to Karen nursing practice in UK, and it may also highlight the need for healthcare dissertation help in addressing these complex issues.
Three databases were used during the literature research, and these are British nursing database (BND), Cumulative Index for Nursing and Allied Healthcare Literature (CINAHL) and Medline. BND are the most useful databases for nursing and midwifery used for research in UK, and also the database supports research, practice, education for nurses and other healthcare providers. BND provides full text coverage, abstracting an indexing for hundreds of titles, (DMU LIBRARY, 2019) BND covers articles published in the UK, Canada and Australia and it covers 10 subjects i.e. drug and alcoholism, nursing, (DMU library 2019).
According to Mazurek, et al., (2011), CINHAL is a good literature database when conducting a review of evidence; CINHAL covers topics in the nursing field. CINHAL is an electronic database for nurses and has controlled vocabulary which is in English-language. According to (Bell, (2015), Medline, (PubMed, covers medicine, health and behavioural sciences and is still valid and maintained by the United States of America centre and can be used for retrieving technological information, such new material and publications (Bell, 2015).
According to Polit & Beck, (2018), PICO searching tool was used in order to come up with the research question; P was the problem and in the research. This will result in unplanned pregnancy, teenage pregnancy and STI’s knowledge. I was the intervention from family members, community nurse and GPs in order to try and prevent unplanned pregnancy. C stood for comparison. For example, different family planning methods, i.e. use of condoms, the pill. O stood for outcome results that were achieved after the research was done, whether it was qualitative or quantitative. The outcome was unplanned teen age, is on the rise, and increases the risk of STI’s and HIV, other social problems that are associated with teenage problems. Boolean operators were used to generate the research question. The key search terms used were unplanned teenage pregnancy, birth control STI’s and impact in order to generate research question.
Two papers were identified in the research, qualitative paper, and evaluation of home-based contraceptive and sexual health care for teenagers. The papers were chosen because they described how the research was done in teenage homes, in the natural setting. Home-based nurse led sexual health service was convenient for the teenage themes such as experiences of the services, privacy, flexibility, facilitative attitudes and ongoing support, empowering on methods of contraceptives were identified and discussed. The nurses led the home-based research gathered sensitive information, made teen age mothers valued and not stigmatised. According to De Melo et al., (2014) anthropological research is the study of human behaviour, and societies. This involves observing and interacting with teenage mothers and also observing how they interact with the babies. Moreover, Cruz & Higginbottom, 2013) states that, qualitative research involves ethnographic whereby the researcher observes, interact, and study participant’s behaviour in their own homes. Ethnography helps the researcher to understand the problem of unplanned teenage pregnancy and to help teenage mothers choose contraceptives that suits them (Parahoo, 2014). Qualitative research participants are given questionnaires, or interviewed as a group or individuals.
According to (Parahoo, 2014), qualitative research is about gathering the data, measuring data, quantitative looks at correlation, mean, compares data. Quantitative measures concepts or variables for example height, or age. It is also about studying representative sample of the population, 7672 participants to place, and this number presented America. Surveys and correlations that are measures were used during the quantitative research.
The quantitative paper entitled family influences on adolescent birth control and condom use, likelihood of sexual transmitted infections, was selected, (Kao & Manczak, 2012). In quantitative research variables is a concept that can be measured, through data analysis for example, independent variables such as personal factor which included gender, age, were used during the research (Parahoo, 2014). Parents’ involvement in in their teenage lives was also assessed by responses in relation to the activities they the parents participated in and topics that they discussed with their mothers or fathers. Also adolescent discussed how close they were to their parents- connectivity. Answers gathered during the research was analysed and presented as data using the statistical package for the social sciences (SPSS), (Kao and Manczak 2012).
The following section will be a critique for qualitative study, the focus, background, aim, methodology, tool of data collection, method of data analysis and presentation, sample and ethical considerations. On the qualitative paper the topic of concern is about the use of home-based contraceptives and social healthcare for teenage mothers, in order to prevent second unplanned pregnancy. Some teenage mothers have experienced second unplanned pregnancy this is an important topic for research because unplanned pregnancies are of great concern to teenage mother’s health therefore a medical model might be used. That is to provide implant or family-planning pills to prevent second unplanned pregnancy, and the social policy in the UK. The background is that they are higher rates of unplanned pregnancies in UK as compared to other European countries, (Office for National statistics 2015). There is also evidence of increased abortions of repeat pregnancy in women who are below 19 years old (Collier, 2009). Unplanned pregnancy is associated with risks such as inconsistent contraception use, social isolation, and lack of access to sexual health services. Unplanned pregnancies affect social, mental health of the teenagers due to the stress associated with being a teenage mother (Xaxier et al., 2018). Teenage mothers tend to have low educational attainment and are unemployed, making them being disadvantaged economically (Odimegwu & Mwananzi, 2016). The seriousness of the study has been done by previous researchers, and there has been an increase in number of teenage pregnancy worldwide (WHO, 2019). It is a serious topic and evidence of previous studies key variables have been defined in an attempt to measure them, and these can be measured by identifying the number of teenage mothers will use contraceptives and those with unplanned second pregnancy. There is a thorough review of the literature outline current knowledge on teenage pregnancy. The variables identified and these can be measured (Hayter et al., 2016). The aim of qualitative was clear, to evaluate home-based contraceptives and advise on sexual health care for teenage mothers. The study researched and recorded experiences of teenage mothers using a nurse laid, home-based contraceptive surface designed to prevent repeat unplanned pregnancies. The aim of the data collection is to evaluate home-based contraceptives and advise on sexual health care on teenage mothers the method which was used to collect data a purposive approach was used to recruit participants. There have not been any studies of bombastic consent contraceptives. New female teenage mothers between 16 and 17, using sexual health care services for the first time, females between 16 and 19 years who had used the services in the last two years. The method was suitable since it involved home-based contraception and sexual health advice in the service users’ home. The data was purposive approach, which is meaningful and categorised between the ages 16 to 19. The recruiters were told about the research, give consent and agreed to the interview process (Parahoo, 2014). The table shows how many people were recruited, 40 participants in two years, which was a small group. This is shown in the table 1. The method of data collection was that participants were recruited through nurse led home-based sexual care services, and these where female patients aged between 16 to 19 and females between 16 to 19 with used the nurse led or and home-based sexual care services in the last two years, data was categorised 16- 19 years. The recruiters were told beforehand the papers of the study and they gave their consent. The interview took place in the service users homes and this worked well because patients reported that they were made to feel worthy, given privacy and were made to take control on informed choices about contraceptives. The tool worked well because teenage mothers felt valued and respected and empowered to make decisions regarding the use of contraceptives in their own home without going to their GP. Writing notes. E approach phenomenal, ethnographic or grounded theory, overbroad quality qualitative design. Yes, it does make the statement of the aim to evaluate through observing and interaction of teenage mothers in their own environment. Data collected by using semi structured interviews, which were conducted in the service user’s home. Questions asked were open, and prompts were used by the researcher. Answers provided recorded digitally. Method of data analysis and presentation, was clear, data was analysed using the framework analysis approach (Ricci and Spencer, 1994). Pillar in qualitative research, the researcher tended to provide credibility by pointing out that the process was closely monitored and the scripts were read by two researchers and the research team was involved in refining themes. The research pointed out that, credibility is an important factor for meaningful and trustworthy studies. Teenage mothers felt that, they were given privacy, ease, empowerment, making decisions regarding their sexual health. Moreover, they were happy taking control over their sexual life and were grateful for the process which addressed second and unplanned pregnancy. A sample size of 40 teenage mothers over a period of two years was studied. This included, first time mothers and those with used the services in the last two years. The participants were recruited through the nurse led home-based sexual health care services. Unfortunately, the study was limited in that; the method was not appropriate because it did not take into account participants who preferred homebirth or those who had given birth in public hospital or private healthcare sectors. The sample would have been broadened to include teenage mothers from the travelling community. Furthermore, the Sample does not take into consideration people from the LGBT community. It is in an appropriate research question, because unplanned teen age, pregnancy is of great concern worldwide. On the other hand, sample does not suffer from bias because digitally recorded, read by two researchers and the entire team analysed the results. Consent was sought from the NHS ethics and research governance approval before the research was done. Written consent was given by the participants and confidentiality is maintained in order to protect the identities of the teenage mothers.
The quantitative framework of critique will use Holland and Rees framework tool (2014) which will look at the focus, background, aim, methodology, tool of data collection, methods of data analysis, sample, ethical considerations, main findings, conclusions and recommendations, are overall strengths and limitations and application to practice (Holland & Rees, 2014).
The focus of the article is the impact of unprotected sex among teenagers, there are three variables, and these are birth control, condom use and likelihood of sexually transmitted diseases, (STI’’s). Variables are concepts that can be measured for example, birth control. Background the researcher argues that the topic is crucial while, age, gender, ethnicity and family dynamics play a role in influencing sexual behaviours of teenagers. Teen age engaging in unprotected sex is a problem worldwide. Rouvier et al., (2011) suggest that, prior communication with family members, place the role, encouraging patients or teenagers to engage in safe sex. Teenagers with parents with some form of education were likely to use condoms and birth control contraceptives. Variables in this study include the use of birth control, condom. The aim of the data collection is the influence of family on adolescent birth control and condom use likelihood of such as transmitted infections. Variables can be measured when there is evidence of decrease in STI’s, unplanned pregnancies. The aim is to find the influence of family members on the use of contraceptives in order to reduce pregnancy and STI ‘is and HIV. The study as a secondary analysis of the national representative, data was collected during three waves within a quantitative approach. It is a correlation study, a linear relationship between two quantitative variables. For example, use of condom will likely reduce STI infections and HIV aids. It is suitable given the aim of the study. Stop method for data collection was a secondary analysis across three first waves. Data has been previously used of all four waves, and sample of over 20,000 students (Harris, 2009). There is no rationale given for the choice of tool. An alternative tool could have been used for the research. However, this could have been expensive and time-consuming due to the size of America.
Method of data analysis and presentation was performed using the statistical package for social sciences (SPSS). The results are clearly explained in the results section, African-American were likely to report sexual acquired infections. The family plays an important role in advising and helping teenagers reducing STI’s by not taking risks. Families who had acquired education, communicated with teenage children on the use of minimising sexual transmitted infections. There are no other methods of representations such as graphs or pie charts. There is evidence of tables2 and 3. The simple used was of secondary analysis, which meant that the researcher to accept the results done by others. The method for was to investigate adolescent development in health behaviours over four waves (Harris, 2009). There is no evidence to say the results were biased because it was a secondary analysis. The study was approved by the ethical committee, IRB review through the University of Michigan health science the traditional review board. Consent was sought and confidentiality was maintained during the initial research. The research was rigorous in planning, arranging to meet family members, that of collecting and then analysing by asking other team members to check if it is done ethically. The researchers found out that family members influence teenage behaviour by advising on the use of contraception. The main results were that adolescent report any history of STI’s or HIV aids to their family members, family support network, helped teenagers to make informed decisions and hypothesis was stated they did not say if it was rejected or supported. Recommendations not clear.
The similarities between the two papers was research where conducted in the student or teenage home. Consent was sought and granted for interviews, confidentiality is maintained and that participants reassured that their names will be revealed. There is evidence that family influence plays a part in encouraging teenagers to use contraception, and the likelihood of reducing sexual transmitted diseases. The similarities between the two papers are to highlight physical, social, and mental problems associated with teenage pregnancy or sexual infections. The family and nurses all have a duty of care to advice teenagers on the need to use contraceptives.
On the other hand, difference between the two research papers was that one was conducted UK and the other one in America and the size sample’s deferred because of the different population from the researchers. The researchers do not explain any statistical techniques or other methods of presentations such as tables or pie charts. 40 participants took part in the survey over a period of two years
Both addressing sexual health issues on teenagers, the impact of unplanned pregnancy.
Use of contraceptives such as condoms prevent STI’s and HIV.
Empowering teenagers to make informed choices on contraception methods.
Educating teenagers on the contraception, health promotion
Advocating for confidentiality, promoting privacy,
Both researchers sought consent from the participants and ethics body
Communication with teenagers is important in reducing teenager pregnancy
Teenage pregnancy is associated with poverty, social, mental and physical health issues.
Discuss what the findings contributes to the current nursing practice in the UK
Setting in the UK and America
Qualitative used secondary data, could not control the variable,
Difficulties in recruiting new mothers and other commitments.
Qualitative does not mention influence of the family
Hayter, M., Jones, C., Owen, J. and Harrison, C., 2016. A qualitative evaluation of home-based contraceptive and sexual health care for teenage mothers. Primary health care research & development, 17(3), pp.287-297.
Holland, K. and Rees, C. (2010) Nursing Evidence Based Practice skills. Oxford university press.
Kao, T.S.A. and Manczak, M., 2013. Family influences on adolescents’ birth control and condom use, likelihood of sexually transmitted infections. The Journal of School Nursing, 29(1), pp.61-70.;
Kaphagawani, N.C. and Kalipeni, E., 2017. Sociocultural factors contributing to teenage pregnancy in Zomba district, Malawi. Global public health, 12(6), pp.694-710.
Kiani, M.A., Ghazanfarpour, M. and Saeidi, M., 2019. Adolescent Pregnancy: A Health Challenge. International Journal of Pediatrics, 7(7), pp.9749-9752.
Rouvier, M., Campero, L., Walker, D. and Caballero, M., 2011. Factors that influence communication about sexuality between parents and adolescents in the cultural context of Mexican families. Sex Education, 11(02), pp.175-191.
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