HOW TO BUILD A REFERENCE FRAMEWORK GUIDE

The reference framework includes context, concepts, problem approach, objectives and
justification.

The following is a summary of how a reference framework is built based on the research home care
competence of family caregivers of people with chronic noncommunicable disease.

According to the World Health Organization, in recent years there has been a global alarm about
the increase in chronic noncommunicable disease (NCDs), especially in developing countries 1. In
Colombia, NCDs caused 71% of deaths in all ages and both sexes in 2014, whereas acute illness,
infections, maternal-perinatal death, homicides, accidents and suicides, all them added caused
29% of deaths2. These diseases are complex, prolonged over time and, generally, demand a care
that must be safe, continuous and comprehensive. 3, 4

Along with this reality, the system intention is to reduce the cost of care by compelling the
passage of services from greater to less complexity, and from health institutions to home, a step
that occurs without adequate preparation of families to assume this responsibility. 5, 6

Preparation for care is a concept that has been approached from different disciplines, and which
relates to training, education or preparation activities in specific care skills. 7, 8, 9 Such preparation is
necessary to assume the tasks of care in a particular and common setting, such as home. 10, 11
Preparation for home care is related to available information, ability to provide physical care and
emotional support to the assisted being, adequacy of spaces and routines of care, and satisfaction
of the needs of the person in charge of care assistance. 12, 13, 14 This has been theoretically
developed as one of the predictors in what is called caregiver role tension, which is related to the
caregiver care burden and quality of life.15

Defining how to prepare for home care requires a look from the perspective of the user and the
institution itself. Home care requires a systematic support and instruction that guides and directs
care, with the necessary details to be able to make harmonious the transition between specialized
services and home daily life. The family caregiver, whether to support the sick person or to
supplement or replace his/her ability to care, should have a simple and complete information
about the required home care.16

From a professional point of view, training for home care is generated as a transition and
discharge plan, which is a standardized guide that must have sequential steps established,
organized and previously defined to care, in a comprehensive and safe way, a patient within an
institution or health service, and also to leave the institution with guarantee of therapeutic
continuity. 17 For the institution this transition plan, or hospital discharge, is an organized process
since it guides the continuous and safe care of the patients who receive services inside its walls, or
through the institution in a different scenario. In institutions that treat people with NCDs, a
transition and discharge plan is particularly vital for the patients care since they receive activities
guidelines that they do not know and often face complex therapeutics. 18

Home care requires that the patient and his / her family caregiver have instruction and support to

María Eugenia Serrano Gómez

Beatriz Sánchez Herrera
strengthen their ability. In the Colombian context and after a search carried out using the
metasearch tool in 20 years, in English and Spanish, under the descriptors "discharge plan",
"preparation", "competence" and "education" crossed with the Boolean AND descriptor with "home
care", there were no available reports that alluded to an orderly mechanism for the management
of patients with chronic diseases by their family caregivers. Since guidelines on care for family
caregivers have proven to be fundamental, in regards with reducing the burden of caring for
people with NCDs in the world19, it is important to seek mechanisms to promote their
implementation.

Strengthening the competence of home care by family caregivers of people with NCDs is an
essential process to support patients, minimize risks, avoid unnecessary complications and
guarantee treatment continuity. Timely preparation to strengthen care capacity decreases
unnecessary hospitalization costs. 20, 21

It is considered that the study responds to the country health needs, providing inputs to the
service for the Colombian environment, constituting itself as a response of effective articulation
between assistance, education and service, facing a sensitive and growing health problem for
caring people.

It is part of the social commitment of the research group with the municipality of Chia, which has
rural and urban areas, which report an increased morbidity and mortality due to NCDs conditions.

Now, the problem or the research central question must be defined. Next, there is an example:

STEPS TO DETERMINE THE RESEARCH PROBLEM –EXAMPLE-

STEP APPLICATION RESULT

Describe in detail the problematic area, the topic you The problematic area is people with chronic
would like to study. illness care.

Set the limits of what you could study. Which
categories does the selected topic have and which
one do you want to attend to?
From that interest, check who the experts are, what
has been done and what theoretical guidelines exist
in what you chose. Then define what you would like
to go deep into.
Identify gaps or lacks in the research knowledge base
and outline a proposal that meets what is required;
that is, state why you will do it.
Family impact of caring for people with
chronic disease.
The family caregiver as a family key member
when living care processes of a person with
chronic disease.
Home care competence of a family caregiver
of a person with chronic disease.

Ask the research question. Establish a question that
you consider should be resolved and include where
possible who, what, when and where. This must not
be a yes/no question, but must be objective and
precise.
How is the home care competence of a group
of family caregivers of people with chronic
disease who live in the municipality of Chia,
La Balsa jurisdiction, in the second half of
2015?
In your case, you should point out what your research area is and frame it in the context in which it
will be done.

COMPLETE THE FOLLOWING TABLE

Describe the problematic area.

Set the limits of what you could study.

Define what you would go deep into, what has

been done, and who the experts are.

State your proposal identifying knowledge

gaps.

Establish a question that you consider should

be resolved.

GENERAL OBJECTIVE

The general objective of an investigation responds to the question posed in the problem, that is, it
contains all the variables that are being studied. It should state the action that will be carried out to
solve the question (verb in infinitive), and space and time limits should be set out. It needs to be
measurable, quantifiable and realistic.

Example: To describe the home care competence of a group of family caregivers of people with
chronic disease who live in the municipality of Chia, in the second half of 2015.

Example of objectives:
 FUENTE: Balestrini M. Cómo se elabora el proyecto de investigación. Caracas: Consultores
Asociados; 2006.

State the general objective of your study.

SPECIFIC OBJECTIVES

Specific objectives define how to develop the general objective to reach it, they show achievement
indicators for each step, and they have an interdependent character that responds to what and
what for, although sometimes this second condition is implicit. Specific objectives must be
contained within the general one.

Example: To characterize family caregivers and people with chronic disease who are cared for in
their homes and who live in the municipality of Chia, La Balsa jurisdiction, in the second half of
2015 to know their care conditions (socio-demographic aspects, perception of burden, and ICT
support and appropriation for care).
 To evaluate the care competence of a group of family caregivers of people with chronic disease
who are cared for in their homes, live in the municipality of Chia, La Balsa jurisdiction, in the
second half of 2015 to define their knowledge level, uniqueness, instrumental and procedural
management skills, minimum conditions availability degree, volume of anticipation and the support
and relations network.

State the specific objectives of your study.

JUSTIFICATION

To justify a research, it is necessary to answer three simple questions about its usefulness,
importance and novelty.

What is it Explain the benefits of the project to society. Point out what the research is useful
useful for? for.

Why is it
Explain why you, as a professional, are conducting this study and what will be the
important
contribution to the discipline.
?

What
Document what has been studied on the topic so far and why, what you propose,
makes it
which is still missing, is something new.
novel?

JUSTIFY YOUR STUDY

What is it useful
for?
 Why is it
important?

What makes it
novel?

CONCEPTS OF THE STUDY

According to the several dictionaries, concept is an abstract idea or mental image, a thought
expressed in words. To develop a research project, it is necessary to explicit the concepts of the
study to be conducted, which must be expressed in the research problem (quantitative research) or
must be redefined in the way in which they are understood or defined by the target community
(qualitative research).

EXAMPLE OF THE STUDY CONCEPTS

Competence for home care

This research resumes the concept of home care competence of the group of Chronic Patient Care
of the National University of Colombia, which establishes that the ability, skill and preparation of the
family caregiver of a person with chronic disease are the ones that help to exert the work of
protecting at home. This competence includes the level of knowledge, uniqueness (caregiver
personal conditions), instrumental capacity, welfare circumstances for the enjoyment of care,
degree of anticipation, as well as social and interaction networks.

Family caregiver

Adult person, with kinship or closeness bond, who assumes the care responsibilities of a person
with chronic disease. This person performs or monitors activities of daily life seeking to compensate
the existing dysfunctions of the care recipient.

Family caregiver who live in the municipality of Chía, La Balsa jurisdiction

Adult persons who exercise the role of family caregiver and have their housing place in the
municipality of Chia, La Balsa jurisdiction, during the second half of 2015.

State your study concepts

SELF-ASSESSMENT

At the end of a reference framework, it is necessary to point out that each piece of research must
be consistent with the other. That is, it is necessary to review whether there is a relationship
between the title, the problem, the objectives and the justification. This internal coherence is part
of a wellstructured project. That is, it is advisable to check whether there is a relationship between
title, problem, objectives and justification. This internal coherence is part of a well-structured
project.

Next you will find a format approved by the Nursing and Rehabilitation School of La Sabana
University that helps you to assess your work up to this point:

1. INTRODUCTION

1.1. It clearly shows the nature and purpose of the work, including its scope
Sí □ No □ N/A □
and limitations.

Comments:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
________________________________________________________________

2. REFERENCE FRAMEWORK

It presents the state of the art at national and international levels, which
shows the advances achieved by other researches regarding the research Sí □ No □
problem.
2.1. PROBLEM RESEARCH

2.1.1. The research problem is defined clearly and concretely. Sí □ No □ N/A □

2.1.2. It is relevant and coherent with the theoretical framework. Sí □ No □ N/A □

2.1.3 It clearly defines the research area and topic. Sí □ No □ N/A □

2.1.4. The question expresses a relation between two or more concepts. Sí □ No □ N/A □

2.1.5 The research problem identifies and formulates, clearly and Sí □ No □ N/A □
adequately, one or more research questions.
2.2 JUSTIFICATION

2.2.1. It argues the work nature and scope. Sí □ No □ N/A □

2.2.2. It shows the current state of knowledge of the problem. Sí □ No □ N/A □

2.2.3. It presents the social, theoretical and disciplinary relevance of the N/A □
Sí □ No □
Project.

2.2.4. It considers the viability or feasibility of the study development

(availability of diverse type of resources (financial, human, material, scope, Sí □ No □
N/A □
consequences, data access, time, etc.)
Comments:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
________________________________________________________________

2.3 GENERAL OBJECTIVE

2.3.1. General description of the goals sought in the research (What for?) Sí □ No □ N/A □

2.3.2. It is clearly formulated and consistent with the problem to be N/A □

Sí □ No □
investigated.

2.3.3. It is achievable with the proposed methodology. Sí □ No □ N/A □

Comments:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
________________________________________________________________

2.4. SPECIFIC OBJECTIVE

2.4.1. They present by-products of the research. Sí □ No □ N/A □

2.4.2. They are accurate. Sí □ No □ N/A □

2.4.3. They are measurable / evaluable and observable. Sí □ No □ N/A □

2.4.4. Its fulfillment contributes to the achievement of the general N/A □

Sí □ No □
objective.

Comments:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________