University Nursing Research Module 4: Literature Review and Analysis

This nursing research assignment, completed by a student, centers on a review of literature concerning preterm birth. The assignment includes a PINCH table summarizing several research articles, focusing on topics like screening tools for substance abuse in pregnant women, risk factors associated with preterm birth, and the prediction of preeclampsia. The student analyzes the research, identifying gaps in the literature, such as limitations in sample sizes and the lack of comprehensive screening methods. The assignment explores various study designs, including randomized controlled trials and cohort studies, highlighting the importance of understanding preterm birth complications and the need for improved nursing care and screening methods to mitigate risks. The paper also discusses the significance of variables like gestational age, maternal health, and the implementation of angiogenic factors in predicting preterm preeclampsia.

Running head: NURSING RESEARCH
NURSING RESEARCH
Name of the Student:
Name of the University:
Author Note:

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Title Page
CONHI approved (on MSN student
website)

Module 4 Assignment: Pinch Table Template and Analysis Paper
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PINCH Table
Research Problem (identify a gap in the literature); detailed and citation
included:_________________________________________________________________
Author(s)
last name
and year
Study Purpose Sample
(N=xx) and
Demograph
ics
Describe
the sample
in detail.
Study Design
type(describe
in detail)
&Variables
(List variables
and label as
Research, IV,
DV) Define
your variables.
Measurement
methods of
variables
(tools,
surveys or
scales). Give
detailed
descriptions,
reliability and
validity.
Major Study
Findings /
Results
(include
some
statistics
and whether
they are
significant or
not)
Notes
Goodman
&Wolff ,2013
).
The study aims to
review the existing
screening tools that
can be utilized in
both the healthcare
settings for both the
prenatal and the
women. The paper
also addresses the
challenges that are
possibly raised in
The screening
was conducted
using various
screening tools.
The study designed
included a qualitative
approach using
questions.
The validity
consisted of cross-
nationality, and in
terms of paternal
parents.
It can be
concluded from
the study that
linking of
substance abuse
screening to the
treatment to
obstetric care
helped to
improve perinatal
outcomes. It also

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situations where
women after
screening are
declared positive for
drug and alcohol
abuse.
resulted in
significant cost
savings.
Shaw, Lilo,
Storfer-Isser,
Ball, Proud,
Vierhaus&Hor
witz, 2014)
This paper aims to
identify the factors of
potential risk that are
evidently related to
the depression
symptoms along with
the occurrence of
anxiety and post-
traumatic stress. This
is carried out in
mothers with
premature babies
those who are
hospitalized in the
neonatal intensive
care unit.
The sample
population
consisted of 135
English- and
Spanish-
speaking
mothers. These
mothers should
have infants
born of age 26
and 34 age and
should weigh
1000grams and
born in the
Lucile Packard
Children’s and
El Camino
Hospitals in
northern
California or
transferred
within 72 hours.
The babies
should not have
any health
complications.
The study design
followed a random-
controlled trial
method. The
independent
variables were the
mothers with the
preterm infants and
the dependable
variable are the
symptoms of
posttraumatic stress.
The methods of
variables used in
the study were the
Socio-
demographic/Self-
Reported Health
Variable. The
Illness Health
Severity Index
(IHSI), Stanford
Acute Stress
Reactions
Questionnaire
(SASRQ) and the
The Beck Anxiety
Inventory (BAI)
was used in the
study.
The results showed
that with only one
the exception, a
single variable, no
maternal socio-
demographic
variable was
effective in
differentiating
mothers who
resulted to be
positive from those
who were negative.
The mothers who
were from the US
background had
more chances of
being screened
positive showing
significance of p
= .05. the race,
ethnicity, native
language, and years
of maternal
education showed
no significant
differences between
the two groups.
Absence of

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statistical
significance was
found among the
two groups with
respect to
pregnancy history
and the Infant
Health Severity
Index.
Myers,
Kenny,
McCowan,
Chan, Dekker,
Poston, 2013.
To carry out an
assessment of the
performance of
clinical risk factors,
uterine artery
Doppler and
angiogenic markers
for predicting
preterm pre-
eclampsia in the
nulliparous women.
The sample
consisted to
3529 womwn
who had
developed pre‐
eclampsia.
Data for clinical risk
factor was secured.
Measurement of
plasma placental
growth factor (PlGF),
soluble endoglin and
soluble fms‐like
tyrosine kinase‐1
(sFlt‐1) was done at
14–16 weeks of
gestation. The
researchers
considered
developing
Prediction models
with the help of
multivariable
stepwise logistic
regression.
Doppler or the
other angiogenic
markers were
implemented. An
area under a
receiver operating
characteristic
curve (AUC) was
used for the study.
187 (5.3%)
developed pre‐
eclampsia of
whom 47 (1.3%)
delivered
preterm. A
sensitivity of
45% (95% CI
0.31–0.59) (5%
false‐positive
rate) and post‐test
probability of
11% (95% CI 9–
13) were
observed using
clinical risk
variables and
PlGF
measurement.
Pereira, A.,
Leal, C., de
Gama, S.,
Bomingues,
The aim of the study
was to find out the
rate of preterm birth
variation as denoted
The study
included 266
hospitals from
which a total of
The variables were
analyzed which
followed a three-
level hierarchical
The outcome
variables were the
incidence of
prematurity.
The results
revealed no
significant
difference

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R., Schilithz,
A. and Bastos,
M. (2014).
by geographic
region, childbirth
healthcare provision
and subgroups of
gestational.
Additionally risk
factors were
identified for
spontaneous/pPROM
and providerinitiated
preterm birth
23,940
puerperal
women were
selected with
24061 live
births
methodology. The
researchers
considered
performing non-
conditional multiple
logistic regression for
both spontaneous and
provider-initiated
preterm birth.
Further
categorization was
done as
spontaneous/pPRO
M or provider-
initiated.
between the
broad geographic
region or type of
childbirth
healthcare.
However late
preterm was the
largest category,
at 74 % of
preterms, or 8.5
% of all birth.
Review of Literature
Title: Risk associated with pre-term Birth
Literature points out that a labor and delivery nurse must be knowledgeable about the increased risks of pre-term children to
suffer poor health conditions such as cerebral palsy, developmental delay, vision problems and hearing impairment, and the measures
by which these can be screened and prevented. It was therefore considered necessary to carry out a review of literature on the different
screening tools that would help in screening preterm parturition. The review of literature was carried out by retrieving articles on the
selected topic published in the last five years from reliable and authentic electronic databases. The rationale for undertaking the review
was that there remains a scarcity of studies conducted on the different methods that can be utilized for screening preterm parturition
(Katz et al., 2013). The review was carried out for finding ways in which assessment of risks of preterm labor could be enabled.

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The situation of preterm birth reflects the changes in the cervix where there is regular contraction. There is thinning of the
cervix walls which helps in opening of the birth canal for the baby (Zeitlin et al., 2013).The studies have been conducted in the
hospital settings where the mother have been admitted to gave birth to these preterm babies. The independent variables in the studies
were the mothers with preterm infants and the dependent factors where the factors that were associated with cause of preterm birth
along with the several screening tools that were used to measure the amount of drug and alcohol abuse in these women (Goodman &
Wolff, 2013).
The studies related to preterm birth is of increasing significance due to the fact that the fetus did not receive ample time to
develop completely, hence there might be occurrences of complications in the infant such as cerebral palsy or learning disability,
which might be present throughout the lifetime of the child (Katz et al., 2013). The research was conducted in a quasi-experimental
method along with qualitative studies. The research approach was deductive in nature.
The research was important in terms that it was necessary to identify the potential risk factors and the markers that are
associated with preterm labor. The setting consisted of the pregnant women who were both inpatients and the outpatients. The major
variables were the age and origin of these women along with their hormonal levels, BMI, smoking status, blood pressure, and blood
glucose levels (Howson et al., 2013). The main aim revolved around ways to implement methods for decreasing the risks related too
preterm labour that in turn deteriorates the infant health.
In another study by Shaw et al. (2014), screening tools but implemented however it failed to include the markers related with
screening. In a research conducted by Myers et al. (2013), it contained gaps in sample size that decreased the credibility since there

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were statistical differences. Apart from this the researchers did not assess the presence of discomfort or distress in the patients that
hampered the credibility of results. Another study conducted by Periera et al., (2014), investigated the variation of rate of preterm birth
with the geographical position and the child healthcare. The results revealed no significant difference between the broad geographic
region and type of childbirth healthcare. However late preterm was the largest category, at 74 % of preterms, or 8.5 % of all birth. The
outcome variables were the incidence of prematurity, which was further categorized as spontaneous/pPROM or provider-initiated.
The cohort study conducted failed to utilize biomarkers such as observation of the vagina, patient characteristics which could
have been derived from the lab results. This created a research gap. In another study, the point of care test was not conducted, which
again determines the literature gap. Research conducted by Myers et al. (2013), possess gaps in sample size that limited the ability of
the test to detect statistical difference. Additionally the researchers did not assess the presence of discomfort or distress in the patients
that reducerd the credibility of results.
The ROL added significant knowledge on the topic of risks of pre-term birth. It has been understood as a result of the review
that there is a need of further studies that can highlight the appropriate screening tools addressing the concern. The best intervention
for prevention of preterm birth complications is still to be understood. Discussing the prevention of preterm delivery, appropriate
nursing care might lower the rate of mortality due to preterm birth complications.

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References
Goodman, D. J., & Wolff, K. B. (2013). Screening for substance abuse in women's health: a
public health imperative. Journal of midwifery & women's health, 58(3), 278-287.
Howson, C. P., Kinney, M. V., McDougall, L., & Lawn, J. E. (2013). Born too soon: preterm
birth matters. Reproductive health, 10(1), S1.
Katz, J., Lee, A. C., Kozuki, N., Lawn, J. E., Cousens, S., Blencowe, H., ...& Adair, L. (2013).
Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-
income countries: a pooled country analysis. The Lancet, 382(9890), 417-425.
Myers, J. E., Kenny, L. C., McCowan, L. M. E., Chan, E. H. Y., Dekker, G. A., Poston, L., ... &
SCOPE consortium. (2013). Angiogenic factors combined with clinical risk factors to
predict preterm pre‐eclampsia in nulliparous women: a predictive test accuracy
study. BJOG: An International Journal of Obstetrics &Gynaecology, 120(10), 1215-
1223.
Pereira, A., Leal, C., de Gama, S., Bomingues, R., Schilithz, A. and Bastos, M. (2014).
Determining gestational age based on information from the Birth in Brazil study. Cad
Saude Publica, 30(1), pp.S1-S12.
Shaw, R. J., Lilo, E. A., Storfer-Isser, A., Ball, M. B., Proud, M. S., Vierhaus, N. S., ...&Horwitz,
S. M. (2014). Screening for symptoms of postpartum traumatic stress in a sample of
mothers with preterm infants. Issues in Mental Health Nursing, 35(3), 198-207.
Zeitlin, J., Szamotulska, K., Drewniak, N., Mohangoo, A. D., Chalmers, J., Sakkeus, L., ...&
Euro‐Peristat Preterm Study Group. (2013). Preterm birth time trends in Europe: a study
of 19 countries. BJOG: An International Journal of Obstetrics &Gynaecology, 120(11),

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1356-1365.