Identifying Nursing Research Problems

1. Identifying Nursing Research Problems

2. Recognizing Problems • The research process usually starts with a question prompted by a problem or unusual situation in practice that needs to be explored.All nurses can identify clinical situations where the outcomes are unsatisfactory. For example, certain types of patient wounds do not heal as well or as quickly as expected. Certain patients respond differently to different types of analgesia. Positioning makes a difference in recovery for some patients. These are situations that need further examination and improvement.Conversely, nurses often relate stories about specific patients who experienced better outcomes than expected. Some patients were able to sit out of bed longer and earlier after surgery. Some patients and families learned a specific procedure more easily than others. These, too, are situations that a nurse might want to explore in greater depth.The critical care environment also lends itself to scrutiny, whether related to staffing, patient workload, leadership and management issues. For how many ventilator patients can a nurse safely provide care? How does the managerial style of nurse managers affect functioning of the unit? What are the characteristics of nurses or units successfully using self-scheduling strategies? What is the best and most appropriate way for critical care nurses to delegate non nursing tasks?

3. Sources of nursing research problems 1. Personal experience 2. Literature review 3. Existing theories 4. Previous research (replication studies) A replication study involves repeating a study with all the essential elements of the original studies held intact.

4. Problem statement • A problem statement is an expression of the dilemma or disturbing situation that needs investigation for the purposes of providing understanding and direction. • It identifies the nature of the problem that is being addressed in the study and typically, its context and significance • It should be broad to include central concern and narrow in scope to serve as a guide to study design

5. Purpose of the Study • The purpose of the study must indicate WHY the study was done. This is a very brief statement or two by which the researcher indicates the reasons, or objectives, he or she has for doing the study. What uses or contributions will the results of the study make? Frequently, “If”–“Then” logic is used.

6. Difference between the problem and the purpose of the study • Problem statement of a study contains WHAT will be examined by the researcher, or the content of the study • Purpose statement contains the WHY of the study which will be conducted

7. Example • Women Account for an increasing percentage of adults with human immunodeficiency virus (HIV)…Most of these HIV-infected women are in their childbearing years. As a result, approximately 7,000 infants are exposed prenatally each year… All infants exposed to HIV prenatally are at risk for development problems… Little is known about the quality of parental care giving for infants of mothers with HIV, because few studies have examined parenting in this vulnerable group…The purpose of this report is to describe the development of infants of mothers with HIV and to determine the extent to which child charactersitics, parental caregiver characteristics, family charactersitics, and parenting quality influence development (Holditch-Davis, Miles, Burchinal, O’Donnell, McKinney &Lim, 2002 in Polit and Beck 2004

9. Research problem considerations • 1. Factors to consider when you decide if a certain topic is appropriate for a scientific study are: • 1. Ethical issues • 2. Significance to Nursing: • Questions like these are usually asked to answer this significance of the study question • 1. Will clients of health care professionals benefit from the findings of this study? • 2. Will the body of nursing knowledge be increased as a result of this study? • 3. Can nurses use the results?

10. Research problem considerations/ cont • 3. Personal motivation: interest creates enthusiasm for the project • 4. Researcher qualification • 5. Feasibility of study: it is the considerations that a researcher thinks about for the possibility of conducting the study

11. Feasibility of study • a. Time? • b. Cost? • c. Equipment and supplies? • d. Administrative support? • e. Peer support? • f. Availability of subjects?

12. Problem Statement Criteria • 1. Written in interrogative sentence form • 2. Includes the population • 3. Includes the variables • 4. Empirically testable

13. 1. Written in interrogative sentence form • Example 1: • Declarative form: the problem of this study is to determine the relationship between the number of hours that baccalaureate nursing students have studied and their anxiety levels before the midterm exams • Interrogative form: Is there a relationship between the number of hours that baccalaureate nursing students have studied and their anxiety levels before the midterm exams?

14. 1. Written in interrogative sentence form • Example 2: • The problem of this study is to examine the relationship between gender and the amount of postoperative analgesia prescribed to clients undergoing abdominal surgery. • Interrogative form: Is there a relationship between gender and the amount of postoperative analgesia prescribed to clients undergoing abdominal surgery?

15. 1. Written in interrogative sentence form • Example 3: • Declarative form: The problem of this study is to investigate the relationship between decubitus ulcer and turning of patients • Interrogative form: Is the incidence of decubitus ulcer reduced by more frequent of patients?

16. Includes the population • The population is delimited to the main group of interest. • Examples: Neonatal intensive care nurses, Baccalaureate nursing students.

17. Includes the variables • Problems can be: • One-variable studies (univariate study), Example: sources of work stress. • Used as beginning step in research projects

18. Two variable studies (bivariate study): • more than one variable. • A further step to know how these stressors affect nurses and whether there is anything that could be done to decrease stressors. • An independent and dependent variable:

19. Example of bivariate studies: • Is there a correlation between the number of sources of stress reported by nurses in a thoracic intensive care?

20. Multiple-variable studies • Multivariate studies • When more than two variables are studied. It is the interaction of variables that is of interest

21. Empirically testable • Testable problem statements contain variables that can be measured by the researcher. Empirical data

22. Other important issues in writing research problems • No ethical and value issues in research problems. Examples: Should nurses wear white uniforms? What is the best way to teach nursing research? • Avoid statements that begin with should, and what is; and words like “cause” and “effect”

23. Examples of problem statement format • Correlational: Is there a correlation between X (independent variable) and Y (dependent variable) in the population? • Comparative: Is there a difference in Y (dependent variable) between people in the population who have X characteristics (independent variable) and those who do not have X characteristics?

24. Examples of problem statement format /cont • Experimental study: • Is there a difference in Y (dependent variable) between group A who received X (independent variable( and group B who did not receiveX?