analysis of a qualitative paper on mothers decision making about vaccines for infants

1.   Problem

What is the problem the study was conducted to resolve?

The media has created a lot of issues about the controversies about vaccination.  This study is being conducted to better understand how parents make the decision to vaccinate their children.  It was also performed to demonstrate the role of trust between the healthcare worker and the mother in making decisions about vaccination.

Why is the problem an important one for nursing to study?

Nursing practice play a very important role in vaccination.  It is important that individuals engaged in nursing know the various attitudes mothers can develop towards vaccination and their knowledge levels, so that a more conducive environment is created to encourage them to vaccinate and protect their child from several diseases. Nurses should develop a trustworthy and positive relationship with the mother and provide information that would be essential to change negative behavior.

2.   Study Purpose

What is the purpose of the study?

The purpose of this study is to demonstrate the manner in which decisions about vaccination depend hugely on attitude, knowledge and a trustworthy relationship between the healthcare worker and the mother

3.   Research Question

What is the research question?  If it is not stated, what would you say the research question is?

No clear research question is stated.  However, I feel a good research question would be “What is the role of attitudes, knowledge, decision-making and trust about vaccination for the infants?”.

Would you say that the question is stated broadly enough for a qualitative study?

The study would be analyzing all the factors that would play a role on the mother’s decision to vaccinate the child.  These include attitudes (through social interactions and behavior), knowledge (that can be strongly influenced by the healthcare system) and decision-making (that included sources of information, promoters of accepting vaccination and inhibitors of accepting vaccination).

4.   Study Design

What qualitative method is used?

The study was a qualitative study conducted to comprehensively determine the various attitudes the mother can develop regarding vaccinating their child.  The role of the promoters and inhibitors of vaccination are also studied.  Open ended interviews were conducted in 2 phases.  In the first phase, questions were asked to assess their attitudes about vaccination and sources they used to obtain information.  In the second phase, similar questions were being asked.  This study helps to assess the role the medical system has on changing the attitudes and behaviors.

In what way is the method used an appropriate one for this study?

Quantitative studies only try to prove a certain hypothesis.  Quantitative studies go deeper into the theme and try to determine the factors and the role each and every factor played.  In this study detailed open-ended interviews were conducted and detailed data analysis instruments were used to study each and every factor.

5.   Subjects and Setting

In what way is the method of obtaining subjects appropriate?

The subjects were obtained from purposeful sampling (i.e. those who fulfilled certain criteria were selected for the study).  From this sample, the subjects were chosen randomly.  Such a type of sampling method is preferred for qualitative research because the main aim of the study is to obtain subjects capable of providing a lot of information and who are capable of answering the questions.

In what way is the size of the sample used adequate?

The size of the sample was sufficiently large.  The subjects were enrolled until no new issues arose during sampling.  These issues included no new data regarding a category, having a category with well-developed properties and variations, and relationships between the categories are confirmed.

In what way was the setting in which data were collected an appropriate one for this study?

The researchers interviewed the mother shortly after birth because parents make a decision about vaccination shortly after birth.  The researchers wanted the mothers to actively participate in the decision-making process at the time of the interview.  Besides, the researchers also wanted to know the extent to which mothers make decisions about vaccination during pregnancy.

6.   Data Collection Methods

In what way were the data collection procedures used consistent with the purpose of the qualitative approach selected?

The data was collected in 2 phases, the first – 1 to 3 days after birth, and the second – 3 to 6 months later.  The second interview re-examined the knowledge and attitudes that developed about vaccination, and source used to gain more information.  This was the time around which the parents would have given 1 set of vaccines to the baby.  Hence, the knowledge gained, and the change in attitudes and behavior could be measured.

In what way are the data collection procedures appropriate for this study?

The mothers were interviewed by interviewer’s who did not participate in the medical care of the subjects.  Data was collected by personal interview in 2 phases.  Knowledge and attitudes were being studied in each phase and compared.  Hence, the role of medical care system could be studied.

In what way were the steps taken to protect the rights of subjects adequate?

Permission was taken from the appropriate review board before the study.  The identity of no subject is revealed.  2 women who did not have time to take part in the study were allowed to drop out.

What evidence is there that data saturation was achieved?

During the sampling, mothers were enrolled until no new issues or concepts were being identified by the interviewers.

7.   Data Analysis Procedures

In what way(s) are the data analysis procedures appropriate for the data collected?

The data analysis system used a technique to classify mother in to four types.  Using this kind of classification, the manner in which the attitudes can be changed and knowledge provided can be determined.  The intervention varies for each group.

In what way(s) are the data analysis procedures consistent with the qualitative method used?

The data analysis procedure involved identifying themes within the mother’s responses.  The themes were employed to develop a structured classification of codes.  The coded data was used to define new relationships.  The entire data analysis was being reviewed and cross-checked a number of times.  The analysis procedure was systematic and verifiable.  Accurate methods were being used to compare both the groups.

8.   StrengthsLimitations

What are two major strengths of the scientific merit of this study?

1.      It is a quantitative study that seeks at drawing a hypothesis, rather than proving one.  It determines the roles of certain factors such as attitudes, knowledge, decision-making and trust.

2.      Mothers could be categorized into several types, and based on each type, they could be better approached and healthcare programs could be tailor made

What are two major limitations of the scientific merit of this study?

1.      The study does not prove any hypothesis.  It was conducted to determine the manner in which decision-making was influenced.  Further studies were needed to confirm the findings of this study.

2.      Survey and data analysis methods were complex and may have been erroneous.

To what extent are the study findings valid?

Some of the limitations of the study include generalizability and validity of the study findings.  The study was performed in English-speaking sample of mother living in one geographic area.   The participants were selected randomly, and hence the frequencies of attitudes could not be predicted.  However, reliable methods were being used, and the findings of the study were credible and were consistent with previous studies.


Benin, A. L., Wisler-Scher, D. J., Colson, E., Shapiro, E.D., & Holmboe, E. S. (2006). Qualitative Analysis of Mothers’ Decision-Making about Vaccines for Infants: The Importance of Trust, Pediatrics, 117(5), 1532-1541.

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