Summary of literature review
The lack of research exploring the feelings and attitudes of the non-English speaking Pakistani women concerning parent education forms the basis of the research proposal.
There is no current research paper or book that explores this issue but instead researchers tend to concentrate on the stereotypical work, labelling the women as not interested individuals. Communication and cultural/religion plays an enormous part when delivering care to the non-English speaking population, and maternity services faces similar problems. With wide use of interpreters these issues can be resolved but yet very little is done to combat such problems especially parent education. There are a number of research papers that explore and explain the problems faced by health professionals but no time has been spent to investigate what the non-English speaking women think about parent education and whether it is beneficial to them. It is a time for change, for parent education to become a valuable service for the non-English speaking women. We have no time to spend concentrate on stereotypical work and negative assumptions but to put research into practice, to deliver the best possible pre-natal care to women regardless of their background, English or non-English speaking (Changing Childbirth)
Midwifery poses many questions requiring answers. These questions cover such a diverse range of subjects that there is no one-research approach that will suit them all (Rees, 1996). Fortunately, there are many research designs to choose from to obtain answers. Qualitative and quantitative research methods are two types of approaches, which are used in nursing research (NHS Executive, 1998). However, for the above proposed question qualitative design shall be used taking a phenomenological approach.
"Qualitative research involves broadly stated questions about human experiences and realties, studied through sustained contact with people in their natural environments, generating rich, descriptive data that helps us to understand their experiences and attitudes" (Rees, 1996, P375 & Dingwall et al, 1998).
Rees (1997) asserts that rather than presenting the results in the form of statistics, qualitative research produces words in the form of comments and statements. Its aim is to find out peoples feelings and experiences from their own point of view rather than from that of the researcher. Bates (1995) & Morse (1996) support in saying that qualitative research has a greater validity since it is an holistic approach to research that does not reduce participants to functioning parts and it has become more acceptable in nursing and midwifery over the last 10 years.
The comments made about qualitative research justifies the reason it will be used in investigating if the non-English speaking Pakistani women want parent education. This approach will allow the women to present their views and opinions on parent education; both negative and positive issues will be drawn out answering the proposed question.
The idea of qualitative research is not to collate numbers but able to understand how women feel and what they want achieved. The only way to achieve this is to interview the women from the Pakistani background using the qualitative method and the tool being semi- structured interviews (Bluff, 1997).
By presenting the women with a questionnaire that has set questions will restrict them from saying only what they are asked for thus limiting their views and opinions. Another problem the research may be faced with is translating the questionnaires in to different languages and wondering whether the women would complete them. Some women are illiterate in their own language it would be time consuming and costly if the researcher had to complete each questionnaire for the woman. Qualitative approach helps to avoid such situations. Cutliffe (1997) argues that qualitative methodology needs to be rigorous, systematic with the emphasis on the processes and meanings and the researcher needs to be clear about his/her chosen methodology.
Phenomenological studies, in which human experiences are, examined through the detailed descriptions of the people being studied, in this case the non-English Pakistani women. Understanding the "lived experiences marks the phenomenology as a philosophy based on the work of Husserl, Schuler, Sartre and Merlau-Ponty (Nieswiadomy, 1993) as much as it is a method of research. As a method, it involves studying a small number of subjects through extensive and prolonged engagement to develop patterns and relationships of meaning. Through this process the researcher "brackets" his/her own experiences to avoid bias in order to understand those of the informants (Nieswiadomy, 1993). Ashworth (1996) argues that an important methodological principle of any research base on the attempt to describe the life-world of another person is that the researcher must begin by bracketing, or setting aside prior assumptions about the nature of the experience being studied.
With this approach, the findings will not be generalised but build upon limited research and forma unique interpretation of events (Creswell, 1994). The work of Dunwoody & Walters (1990) asserts that the knowledge and understanding gained by adopting a phenomenological perspective can help midwives to fulfil the definition of a midwife, to be with woman and facilitate improvements in practice. Incorporated within the philosophy of midwifery is the provision of individualised care based on the physical, social, psychological, emotional, spiritual and educational needs of women. Care therefore emphasises the whole person rather than one particular element. Phenomenology therefore attempts to understand all aspects of a phenomena in preference to concentrating on one specific concept and therefore has a reverence for caring for the whole that is admirably suited to midwifery (Robinson, 2000)
In order, to obtain the relevant information, whether what are the needs of non-English speaking Pakistani women, a qualitative design is very much suited purely for the reason discussed. Firstly, the concept is "immature" due to the conspicuous lack of theory and previous research; this is very true when exploring the womens attitudes with regards to parent education. Secondly, a notion that the available theory may be inaccurate, inappropriate, incorrect or biased, therefore a need exists to explore and describe the phenomena and to develop theory, lastly the nature of the phenomena may not be suited to quantitative measures. These are reasons to justify the use of qualitative design (Creswell, 1994, P146).
It is not good enough, though, to assume that findings for the sample will be replicated in the rest of the population, so therefore the sample in the first place needs to be carefully selected if there is to be any confidence that the findings from the sample are similar to those found among the rest of the category under investigation.
Social researchers have been using two types of sampling techniques. The first is known as probability sampling, the second as non-probability. Probability sampling, as the name suggests, is based on the idea that the people or events that are chosen as the sample because the researcher has some notion of the probability that these will be representative cross-section of the people or events in the whole population being studied. On the other hand non-probability sampling is conducted without such knowledge about whether those included in the sample are representative of the overall population.
Because the researcher will not a have sufficient knowledge about the sample to undertake probability sampling and may not know how many people make up the population, under these circumstances, the researcher will turn to the forms of non-probability sampling as the basis for selecting the sample. The crucial and defining characteristics of non-probability sampling whatever from it takes, is that the choice of people or events to be included in the sample is definitely not a random selection. Streubert & Carpenter (1995) point out that there is no need to randomly select individuals because manipulation and control are not the purpose of the exercise. By using the non-probability sampling, this does not mean the researcher will know absolutely nothing about the women but not enough to use the probability sampling.
Purposive sampling is a form of non-probability sampling (Polit & Hunglar, 1999, P284. This is the type of sampling that will be used to select the women. With this type, the sample is "hand-picked" for the research. As mentioned earlier, the researcher already will know something about the specific people or events and deliberately will select non-English speaking Pakistani women who have had some exposure to parent education in one form or another because they are seen as instances that are likely to produce the most valuable data. The women will be multigravida and should be able to read the Urdu language because the leaflet and the consent form will be written in this language. In effect, they are selected with a specific purpose in mind, and that purpose reflects the particular qualities of the women chosen and their relevance to the topic of investigation.
Dane (1990) points out the advantage of purposive sampling is that it allows the researcher to home in on people or events, which have good grounds in what they believe, will be critical for the research. Instead of going for the typical instances, a cross-section or a balanced choice, the researcher will be able to concentrate on instances which display wide variety possible even focus on extreme cases to illuminate the research question at hand. In this sense it might not only be economical but might also be informative in a way that conventional probability sampling can not be (Descombe, 1998). With a non-probability sampling methods the researcher feels that it is not feasible to include a sufficiently large number of examples in the study, this very much goes hand in hand with qualitative research. The aim of the study is to explore the quality of the data not the quantity (Nachmias, 1996).
There are, however, some sound theoretical reasons why most qualitative research uses non-probability-sampling techniques and good practical reasons why qualitative researcher deals with small numbers of instances to be researched. There are infact two things, which can be said about sample size in qualitative research. Firstly, it is unlikely to be known with precision or certainty at the start of a research project. Second, the sample size will generally be very small. Both points can be unnerving. They go against the grain as far as conventional survey approaches are concerned, and open up the prospect of accusations of sloppy and biased research design. The researcher is quite explicit about the use of non-probability sampling (Miles & Huberman, 1994). Another point is that phenomenology is well suited to purposeful sampling. This type of sampling permits the selection of interviewees whose qualities or experiences permit an understanding of the phenomena in question, and are therefore valuable. This is the strength of purposive sampling.
It is for this reason purely, that the researcher has decided to interview 10 non-English speaking Pakistani women. This small sample size is quite in keeping with the nature of qualitative data. LioBondo-Wood & Haber (1998) argues that results based on a small sample (under 10) tend to be unstable so for this reason a sample of 10 women has been chosen.
One justification for using the non-probability purposive sampling is that it stems from the idea that the research process is one of "discovery" rather than testing of hypotheses. It is a strategy where Lincoln & Guba (1985) describe as emergent and sequential. Almost like detective, the researcher follows a trail of clues, which leads the researcher in a particular direction until the questions have been answered and things can be explained (Robson, 1993).
It is appropriate to discuss briefly, as to why the researcher has chosen the women from the Mirpuri background. Mirpuri people are from Pakistan but from a town called Mirpur, Mirpiri language can only be spoken but not written, it is a dialect derived from the Urdu language. The women will be selected from an area in Birmingham called Alum Rock. Because of the very fact, Alum Rock consists of the Pakistani community from the Mirpuri background; it is only fair to conduct the research in this area. It is not only a familiar area to the researcher, but during a long placement here the researcher found that parent education was a problem, uptake was quite poor and promotion was lacking.