Critical Appraisal of Research Paper

Critical Appraisal of Research Paper.


Evaluation Table

Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

Full APA formatted citation of selected article.Article #1Article #2Article #3Article #4
  Farré-Sender, B., Torres, A., Gelabert, E., Andrés, S., Roca, A., Lasheras, G., Valdés, M., & Garcia-Esteve, L. (2017). Mother–infant bonding in the postpartum period: Assessment of the impact of pre-delivery factors in a clinical sample. Archives of Women’s Mental Health21(3), 287-297.      Moehler, E., Brunner, R., Wiebel, A., Reck, C., & Resch, F. (2006). Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother–child bonding. Archives of Women’s Mental Health9(5), 273-278.  Nonnenmacher, N., Noe, D., Ehrenthal, J. C., & Reck, C. (2016). Postpartum bonding: The impact of maternal depression and adult attachment style. Archives of Women’s Mental Health19(5), 927-935.  Lehnig, F., Nagl, M., Stepan, H., Wagner, B., & Kersting, A. (2019). Associations of postpartum mother-infant bonding with maternal childhood maltreatment and postpartum mental health: A cross-sectional study. BMC Pregnancy and Childbirth19(1).
Evidence Level * (I, II, or III)  Level ILevel ILevel ILevel I
Conceptual Framework   Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**    Not mentioned        Not mentioned  Not mentioned    Not mentioned
Design/Method   Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).This was a longitudinal study where the participant’s demographic information was collected. Participants that did not attend the evaluations were excluded from the final studyThe participants were taken for lab for observation when their infants were 2 weeks, 6 weeks, 4 and 6 months respectively. The health status of infants and the mother’s socioeconomic status were recorded. Depression symptoms were measured at these intervals.The German version of SCID-I was used to assess the mental health status. Semi-structured interviews were conducted on this measure. Women without depression and those that missed the interviews were excluded from the study.The Childhood Trauma Questionnaire (CTQ) was used to assess Maternal childhood maltreatment up to the age of 18. Women who did not give birth to live children, who did not understand German language, and who were below the age of 18 years were excluded from the study. These self-reported questionnaires were filled and returned for assessment.
Sample/Setting   The number and characteristics of patients, attrition rate, etc.  250 pregnant women admitted to the perinatal psychiatric station were admitted for the study.  Initially, the study included 114 mothers of which 12 dropped and were excluded. One other chose not to continue and was excluded.107 participants took part in the study. They were interviewed for Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). The sample age ranged from 24-44 years and the infant age was between 12-17 weeks.725 women were in included in this study. They were to be aged 18 and above and possessed German reading skills. The participants must have given birth to live-born babies to participate.  
Major Variables Studied   List and define dependent and independent variablesDependent variable: pre-delivery factors Independent variable: maternal bondingDependent variable: depression symptoms Independent variable: mother-child bondingDependent variable: adult styles Independent variable: maternal attainmentDependent variable: postpartum mother-infant bonding with maternal childhood maltreatment Independent variable: postpartum mental health
Measurement   Identify primary statistics used to answer clinical questions (You need to list the actual tests done).ANOVA was used to test and analyze differences in PBQ scores.Maternal psychopathology was measured using SCL-90R. Maternal depression symptoms were also measured using EPDS. PBQ was used to measure maternal bonding.All analysis was done using We used the Statistical Package for Social Sciences (IBMTM SPSS® v. 22). Maternal depression was tested as a mediator of the dual attachment style.The study measured Pearson, point-biserial correlations between the outcome measure postpartum MIB and each of the other study variables. The data obtained was analyzed using the Statistical Package for Social Sciences, version (IBM® SPSS®).
Data Analysis Statistical or Qualitative findings   (You need to enter the actual numbers determined by the statistical tests or qualitative data).In a population of 25, MIB disorder prevalence with a cut off of 26 was 10.8% in factor 1, 2.4% in factor 2, 6% in factor 3, and 6% in factor 4.BPQ was 0.797 (Cronbach’s alpha), EPDS varied in the wees as follows (r = 0.28), six weeks (r = 0.39), four months (r = 0.35) and fourteen months (r = 0.28).Maternal PBQ was high (16)Higher MIB was recorded (β = .49, p < .001), (β = −.03, n.s.)
Findings and Recommendations   General findings and recommendations of the researchvarious factors are associated with the  others psychological state.There was a great link between depression and bonding. Future studies should focus on infant and child health and support in the first critical months.Depression partly led to the dual attachment style and its effects were not severe. Such a study should be done using a higher sample population.Most mothers showed emotional depression and neglect. These can be used to suggest ways to help them.
Appraisal and Study Quality     Describe the general worth of this research to practice.   What are the strengths and limitations of study?   What are the risks associated with implementation of the suggested practices or processes detailed in the research?   What is the feasibility of use in your practice?  The research can provide a future basis for treatment of MIB disturbances.   One limitation is the lower exploratory power of the used model. Also, there is a high likelihood of bias due to self-reporting.   No risks.Limitations: The sample was community based and linear correlation between depression symptoms and bonding.   No risks associated with its implication.   Coming up with preventive programs targeting maternal depression.The researchers are credible scholars in their field making their study more reliable.   The researcher’s wealth and practice in the subject is a strength to the study. Some limitations include the reduced possibility of testing outcomes due to the small sample, the study design does not allow for drawing causal conclusions.   Implementing such findings in the general population my not produce the desired outcomes.This is a rich research whose conclusions can be used in the general population.   One of the research’s strength is the concurrent consideration of diverse types of maternal childhood maltreatment in relation to postpartum MIB in a large population sample. The study’s limitation is the high level of education attainment show in the study can limit its generalizability in the population. There can also be bias given the self-reporting. The study can be used to help mothers to have higher resiliency
    Key findings       The symptoms of maternal depression in 2, 6 weeks, and 4 months postnatal, however at 14 months had not so good maternal bonding. Depression had significant effects in bonding.Dual attachment was partly caused by depression  Emotional neglect was the most prevalent outcome 13% mild-postpartum depression while 20% showed high severity.
    Outcomes       The findings can inspire preventive programs.Determining the factors of depression can help get appropriate ways to help mothers.Mothers can be support by identifying emotional neglect and depression.
General Notes/Comments       This was a great research since it is backed by solid evidence and methodology.This was a quality researched article but is less powerful due to the small sample.This was a well-done research.    

*These levels are from the Johns Hopkins Nursing Evidence-Based Practice: Evidence Level and Quality Guide

  • Level I

Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis

  • Level II

Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis

  • Level III

Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative systematic review with/without meta-synthesis

  • Level IV

Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence

  • Level V

Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence

**Note on Conceptual Framework

  • Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework.
  • As stated by Grant and Osanloo (2014), “Without a theoretical framework, the structure and vision for a study is unclear, much like a house that cannot be constructed without a blueprint. By contrast, a research plan that contains a theoretical framework allows the dissertation study to be strong and structured with an organized flow from one chapter to the next.”
  • Theoretical and conceptual frameworks provide evidence of academic standards and procedure. They also offer an explanation of why the study is pertinent and how the researcher expects to fill the gap in the literature.
  • Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two.


The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing dvidence-based practice: appendix C: evidence level and quality guide. Retrieved October 23, 2019 from

Grant, C., & Osanloo, A. (2014). Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your” House”. Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26.

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