Article 3 Assignment: Analysis of a Randomized Controlled Trial

This assignment analyzes a research article, focusing on a randomized controlled trial (RCT) conducted by Toohill et al. (2014), which investigated the impact of a psychoeducation intervention by midwives on reducing childbirth fear in pregnant women. The assignment delves into the study's methodology, highlighting the use of a multi-site randomized controlled trial and the importance of controlling for variables to ensure the validity of the results. It examines the statistical analysis, including the calculation of confidence intervals and p-values, to determine the effectiveness of the intervention. The findings revealed a statistically significant reduction in childbirth fear in the intervention group. The assignment emphasizes the positive implications of the research, such as improving labor outcomes and fostering effective patient-provider relationships. The assignment also provides a critical evaluation of the study design and the significance of the findings within the context of maternal health and midwifery practices. This assignment is available on Desklib, a platform offering a wide array of AI-powered study tools and resources for students.

Running head: ARTICLE 3 ASSIGNMENT
Article 3 assignment
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1ARTICLE 3 ASSIGNMENT
Answer 1:
The RCT by Toohill et al. (2014) aimed to evaluate the effect of psychoeducation
intervention by midwives in reducing childbirth fear in pregnant women. As childbirth fear has
been associated with adverse maternal outcomes like poor post partum mental health and high
rate of cesarean, focusing on effective antennal intervention to reduce fear levels is importance.
Hence, this research is significant. For conducting the research, participants were selected by
means of multisite randomized controlled trial. Stratification was done by hospital site and
allocation to groups. The uniqueness of RCT study is that except intervention, no other
conditions should differ in treatment and control group. The outcomes of the trial in both group
is then compared to estimate treatment effect with confidence interval and P value (Bland and
Altman 2011). However, in this study, it is not clear whether groups were similar at the start of
the trial or not. This can be said because demographic, obstetric detail and birth preference were
collected, however it does gives idea about any considerations made to keep groups similar at the
start of the trial. In the end, the result findings also showed difference in education and
household income for participants. However, baseline characteristics of participants have been
studied (Toohill et al. 2014).
Answer 2
The validity of the research finding in clinical trial is understood by the method by which
the data is analyzed. Calculating the confidence interval and P value is one of the effective
statistical method to find out how precisely the treat effect was analyzed (Stewart, Dahm and
Scales 2011). In the research by Toohill et al. (2014), psychoeducation was the main intervention
and primary outcome of the research was reduction in childbirth fear. Secondary outcome

2ARTICLE 3 ASSIGNMENT
measures include self-efficacy, post-natal depression and decisional conflict in participants. The
analysis of the study findings revealed significant difference in group with respect to score for
fear of birth. The intervention group reported about reduction in childbirth fear at 36 weeks
compared to those in control group. Statistically significant differences in fear was found
evidence by P value greater than 0.001. 95% confidence interval for change difference was
calculated revealing significant effect of treatment. The benefits of the research are that
statistically significant research outcomes were found for the intervention evaluated. This would
have positive implications for overcoming challenges of labor and building their ability to cope
with physiological and emotional challenges of labor. The use of psycho-education intervention
in health care setting would facilitate effective and caring relationship with women to reduce
their child birth fear during late pregnancy (Schwartz et al. 2015).

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Reference
Bland, J.M. and Altman, D.G., 2011. Comparisons against baseline within randomised groups
are often used and can be highly misleading. Trials, 12(1), p.264.
Schwartz, L., Toohill, J., Creedy, D.K., Baird, K., Gamble, J. and Fenwick, J., 2015. Factors
associated with childbirth self-efficacy in Australian childbearing women. BMC pregnancy and
childbirth, 15(1), p.29.
Stewart, S.B., Dahm, P. and Scales Jr, C.D., 2011. How to appraise the effectiveness of
treatment. Indian journal of urology: IJU: journal of the Urological Society of India, 27(4),
p.525.
Toohill, J., Fenwick, J., Gamble, J., Creedy, D.K., Buist, A., Turkstra, E. and Ryding, E.L., 2014.
A Randomized Controlled Trial of a Psycho‐Education Intervention by Midwives in Reducing
Childbirth Fear in Pregnant Women. Birth, 41(4), pp.384-394.

4ARTICLE 3 ASSIGNMENT
Answer 2