Unit 4: Finding

Problems and
Writing
Questions
 Unit 4: Finding Problems and
Writing Questions
Introduction to the Topic:
This unit focuses on the process of
identifying research problems and creating
researchable questions. Critically analyzing
a research question is key to determining if it
is appropriate evidence for nursing practice.
Traditional
Evolution
of the
Research
Question

Figure 4.1
 Nursing Research Concepts
• Abstract ideas that must be narrowed to
researchable questions for study
• Common categories for nursing research:
– Patient-sensitive concepts
– Staff-member-sensitive concepts
– Organizationally sensitive concepts
Sources of Research Problems
• Clinical practice observations
• Educational experiences
• Consumer/customer feedback and personal
experience
• Theoretical models and frameworks
Sources of Research Questions
• Professional literature
• Performance improvement studies
• Research reports and priorities
• Social issues
 The Research Question
• Specifically identifies the key elements to
be studied
• Guides the design and methodology
• Carefully constructed and refined
 Classifications of Questions
• Descriptive
– Studies a subject of interest in a defined population or
setting
• Analytic
– Studies that compare interventions and outcomes
 Classifications of Questions
• Prospective
– Studies that are planned and carried out in the future
under control of the researcher
• Retrospective
– Studies that use existing secondary data to answer a
research question
 The PICO Approach
• Population: Who is the patient, or what is
the population of interest?
• Intervention: What is the planned nursing
intervention?
• Comparison: What is the comparison
intervention?
• Outcome: What is the outcome of
interest?
 Problem Statements
• Statements of the gap between what is
known and unknown
• Articulate the area of concern and provide
support for the extent of the problem
• Focus the research process on a known
nursing practice problem
 Purpose Statements
• Objective statement indicating the general
goal of the study
• Describe the direction of the inquiry
• Contain the key variables to be studied,
their possible relationships, and the nature
of the population of interest
 A Qualitative Example
Problem statement
“I have been surprised to find
that while the neonatal
literature presents a
description of what happens
when parents in the neonatal
unit are excluded from their
babies’ pain management, it
does not provide a picture of
what happens when they are
involved.”
Purpose statement
“To fill this gap, I began a
study to answer the following
research question: ‘How do
parents interact with babies
and nurses around the
provision of comfort care in a
neonatal intensive care unit
where information and training
in comfort care have been
provided?”
 A Quantitative Example
Problem statement
“To date, we have been unable
to find any research that
compares the relative
contribution of (i) essential
clinical indicators of diabetes
regulation, (ii) coping styles,
and (iii) perceived social
support to the variation in
diabetes-related distress
among adults with type 2
diabetes.”
Purpose statement
“The main aim of this study
was to investigate the extent to
which (i) clinical indicators
such as Hgb A1c, diabetes
treatment, diabetes-related
complications, disease
duration and BMI, (ii) coping
styles, and (iii) perceived
support from healthcare
professionals and family are
related to diabetes-related
distress.”
 Research Questions
• Specify the population of interest
• Identify the variables to be measured
• Describe the comparison group
• Relate the outcome of interest
• Sometimes include the measurement
Research Requires All Three…
• Problem Statements
– Identify a gap in knowledge that requires
disciplined study
• Purpose Statements
– Declarations of intent of the study
• Research Questions
– Identify the specifics of who, what, when, and
how in a study
 The Critical Reader
• Development gets more specific
• The purpose, problem, and question are
explicit and easy to find
• These statements are unbiased
• The design is described
• The population, variables, and setting are
described
• The purpose and design are congruent
 FINER Criteria
• Used for evaluating the desirability of a
research question
– Feasible
– Interesting
– Novel
– Ethical
– Relevant
 Feasibility of the Study
• Appraised prior to developing the study
design
• Evaluate:
– Requires resources
– Ethical considerations
– Specific variables to be studied
– Availability of the population
– Potential access to the setting
 An Example…
Does the use of teach-back as a method of
validating discharge understanding
decrease diagnosis-related readmissions in
patients with heart failure, as compared with
patients who receive standard discharge
instructions?
 An Example…
What is the population?
Patients with heart failure
What is the intervention?
Teach-back method of validating discharge
instructions
What is the comparison group?
Those receiving standard discharge instructions
What is the outcome of interest?
Diagnosis related readmissions
 Conclusions
• A research problem starts the research
process
• The purpose statement clearly identifies
what the study will accomplish
• The research question makes the
elements of the study explicit
• All three are needed to translate research
into practice