Article critique

1. Guide: Ms. Deepak
Associate Professor (obstetrics and gynaecology
nursing)
Submitted by:
Mahima
MSc Nursing ( 2nd year)
220424008

2. POSITIVE MATERNAL MENTAL HEALTH IN PREGNANT WOMEN AND
ITS ASSOCIATION WITH OBSTETRIC AND PSYCHOSOCIAL FACTORS
(Alvaro Monterrosa, et.al 2023)

3.  The problem statement clearly identifies the main variables of interest: positive maternal
mental health, pregnancy, and obstetric psychosocial factors. This statement sets a clear
direction for the research, indicating that the study aims to investigate the relationship between
positive mental health in pregnant women and various obstetric psychosocial factors.

4.  OBJECTIVE : To estimate the frequency of Positive Maternal Mental Health
(PMMH) interpretation levels in pregnant women who attended prenatal
consultation and to identify their association with obstetric and psychosocial
factors.
 METHODS: A cross-sectional study that included pregnant women who
attended prenatal care at 12 or more weeks of gestation. The following scales
were applied: Positive Mental Health Questionnaire (PMHQ), Goldberg
Anxiety and Depression Scale, and Jong Gierveld Loneliness Scale.

5.  702 pregnant women were evaluated; 634 (90.3%) had flourishing PMMH,
and 68 (9.7%) had non-flourishing PMMH. Among the latter, all were at an
intermediate level, and none were languishing. Flourishing PMMH was more
frequent in adults (91.2%) compared to adolescents (75.0%) and in women
with higher education (93.0%) than in those with basic education
(83.9%). Nine out of ten pregnant women had flourishing PMMH, and none
had languishing PMMH. None of the obstetric factors were associated with
non-flourishing PMMH but with general loneliness, social loneliness, and
anxiety.

6. Researcher review Strength Weakness Recommendations
The article provides an overview of the
frequency of Positive Maternal
Mental Health (PMMH)
interpretation levels in pregnant
women who attended prenatal
consultation and to identify their
association with obstetric and
psychosocial factors.
• Identification of
Research Gap: It
highlights the lack
of studies
specifically focusing
on Positive Maternal
Mental Health
(PMMH), indicating
a clear research gap
in the field
Lack of Specificity:
While the introduction
discusses the importance
of mental health during
pregnancy, it could be
more specific about the
exact obstetric and
psychosocial factors
associated with PMMH.
Limited Evidence: The
introduction mentions
studies on PMH in
general population
samples but lacks direct
evidence or studies
focusing on pregnant
women, which weakens
the argument for the
importance of PMMH in
prenatal care.
Specific Focus: The
introduction could benefit
from a more specific focus
on the particular obstetric
and psychosocial factors
that may influence PMMH
during pregnancy, guiding
future research and
interventions more
effectively.
Need for Mental Health
Assessment: Governmental
and non-governmental
health entities are
recommended to include
mental health assessment in
antenatal care, focusing on
positive mental health
perspectives and intervening
early in non-flourishing
PMMH cases.

7. Researcher review Strength Weakness Recommendations
Methodology:
• cross-sectional descriptive study
•Sample size- 621 pregnant females
(12 or more weeks of gestation).
•Positive Mental Health Questionnaire
(PMHQ), Goldberg Anxiety and
Depression Scale, and Jong Gierveld
Loneliness Scale, were used.
•Pregnant females who have acute
obstetric diseases, physical or mental
pathologies that caused disability, were
excluded.
• This study has the
strength of being first
to provide data on
PMMH using PMHQ
(positive mental health
questionnaire) and
pointing out its
association with
loneliness, anxiety, and
depression. It provides
elements that
contribute to a
perspective of mental
health care change to
move from exploring
pathological
symptomatology to
strengthening coping
skills.
• The study has
limitations due to its
cross-sectional
design, which
establishes statistical
but not causal
relationships. There's
a possibility of
selection and recall
biases, leading to
overestimation or
underestimation of
results.
.

8. Researcher review Strength Weakness Recommendations
Sample Size Calculation:
The sample size calculation is
based on statistical principles,
ensuring adequate power to
detect meaningful
associations with a reasonable
margin of error, enhancing the
robustness of the study.
• Sampling Bias: The study
is conducted in a single
private institution in
Cartagena, Colombia,
which may not represent
the broader population of
pregnant women,
potentially limiting the
generalizability of the
findings.
Diversify Sample Sources:
Consider recruiting
participants from multiple
healthcare institutions and
geographic locations to
enhance the
representativeness and
generalizability of the
findings.

9. Researcher review Strength Weakness Recommendations
DATAANALYSIS
•Statistical analysis was
performed with EPI-INFO-7
•Quantitative data were analyzed
as means with standard
deviations, and qualitative data as
absolutes and percentages.
•The reliability of the scales was
estimated with Cronbach’s α for
PMHQ and Kuder Richardson for
Goldberg’s Anxiety and
Depression, and De Jong
Gierveld’s Loneliness scales
Reliability Assessment:
Calculating Cronbach’s α for
scales assessing
psychological constructs
ensures the reliability of
measurements, enhancing
the validity of the study's
findings.
Interpretation
Complexity: The extensive
range of statistical tests and
coefficients utilized may
make the interpretation of
results challenging for
readers without a strong
statistical background.
Discussion of Limitations:
Explicitly discuss the
limitations of the study,
including potential biases and
uncertainties, to provide a
balanced interpretation of the
findings and guide future
research directions.

10. Researcher view Strength Weakness Recommendation
DISCUSSION Comprehensive Analysis:
The discussion provides a
thorough examination of the
concept of positive mental
health (PMH) and its
application in pregnant
women, integrating various
theoretical frameworks and
previous research findings.
Practical Implications: The
discussion highlights practical
implications for prenatal care,
emphasizing the importance
of identifying and supporting
pregnant women with non-
flourishing PMH to prevent
adverse maternal and
perinatal outcomes.

11. Researcher view strength Weakness Recommendation
CONCLUSION :
Nine out of ten pregnant
women had flourishing
PMMH, and none had
languishing PMMH. None of
the obstetric factors were
associated with non-
flourishing PMMH but with
general loneliness, social
loneliness, and anxiety.
Clear Summary of
Findings: The conclusion
succinctly summarizes the
key findings of the study,
providing readers with a clear
understanding of the results.
Practical Implications: By
emphasizing the relevance of
psychosocial factors in
maternal well-being, the
conclusion offers practical
implications for prenatal care
providers, suggesting a
broader approach beyond
obstetric concerns.
Future Research Directions:
Suggesting avenues for future
research, particularly in
investigating the
effectiveness of interventions
targeting psychosocial factors
in prenatal care, would
enhance the conclusion's
academic impact and
potential for informing
clinical practice.

12. Thank you