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Identifying a Researchable Problem

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1 Identifying a Researchable Problem
How to Turn a Problem Into a Research Project Identifying a Researchable Problem Research Committee Module #4 1 CNE Available This module, “How to Turn a Problem Into a Research Project” is part of a continuing education series developed by members of the ANNA Research Committee. Created by Heather Beanlands, PhD, RN There is no conflict of interest in the creation of this education program.

2 Objectives Describe the phases of the research process.
Identify sources of research problems. Describe the process of formulating a research problem. Describe the elements of a “researchable” problem. At the completion of this module the learner will be able to: 1) Describe the phases of the research process; 2) Identify sources of research problems; 3) Describe the process of formulating a research problem; and, 4) Describe the elements of a “researchable” problem.

3 What is research? A systematic process of inquiry Goal directed
Focused on uncovering new knowledge to help understand phenomena, answer questions, or address problems In order to begin to identify research problems is it first necessary to understand what is meant by the term research and to have an understanding of how the research problem fits into the whole research process. A number of different definitions for research exist however common to all of them is an agreement that research is systematic, disciplined and focused on gathering information to understand a phenomena, answer questions or solve research problems. The systematic nature of the research process means that research is undertaken in a methodological fashion using a rigorous approach to collect information (data) about a phenomena or research problem and to analyze and interpret that information in order to begin to answer questions or solve problems. Since research is directed at ultimately helping us to answer a question or address a problem, it is critical that we are as clear as possible about the research problem we are interested in. Thus, developing a problem statement is a critical first step in the research process.

4 What makes research nursing research?
Nursing research is “a scientific process that validates and refines existing knowledge and generates new knowledge, which directly and indirectly influences nursing practice” Nurses are interested in developing, evaluating and implementing research evidence that is important to us as professionals. This definition by Burns and Grove suggests that nursing research is a systematic inquiry which is directly or indirectly related to nursing practice. This broad view of nursing research suggests that the focus of research in nursing is shaped by phenomena of interest to nurses such as individual and family response to illness as well as nurses roles in impacting care. In addition, nursing research might also address other domains of practice including education, administration and multidisciplinary collaboration. When planning a research project it is important to choose a topic that has relevance to your area of interest and that has the potential to add to our understanding of an important nursing issue. This topic will ultimately be refined into a problem statement that can be used to direct the research process. (Burns & Grove, 2005, p. 3)

5 Approaches to research in nursing
Quantitative Research Used to describe or test relationships among variables or to evaluate the effect of one variable on another Variables are “measured” using standard data collection tools and data are numerical (numbers) Qualitative Research Used when little is known about a phenomenon Focused on developing a rich, holistic description of phenomena Data are non numerical (i.e., dialogue, observation, etc.) While a variety of research approaches or designs exist to address research problems, it is important to distinguish between two broad approaches to research commonly described in nursing - quantitative and qualitative. A complete description of each and comparison of the two is beyond the scope of this module. Other modules, which address approaches to critiquing quantitative and qualitative research, provide more detail with regard to the methodological considerations for each. The choice of a research approach depends to a great extent on the nature of the research problem you have identified. Some research problems need to be answered using a quantitative approach, for example determining the incidence of vascular access infections in your unit, or evaluating the effect of a new patient education program on knowledge. On the other hand, qualitative research is appropriate to address other research topics such as the experience of receiving a diagnosis of CKD or the process of returning to dialysis after a failed transplant.

6 Phases of the research process
Thinking -identifying problem & purpose -reviewing literature Planning -Choosing study design & planning approach to sample, data collection etc. Implementing - Recruiting participants & collecting data Analyzing - analyze data and interpret findings Informing -disseminating results (journal articles, presentations etc.) The research process, like the scientific process and the nursing process, involves a series of distinct steps or phases that begins with identifying the problem of interest, and moves through stages of planning and implementing the study, to analyzing and reporting the results. Although the research process is often described in a linear, sequential fashion the steps may overlap. For example, the research problem and purpose identified in the “thinking” phase serve to direct the planning phase. However, as planning unfolds it may become apparent that the problem/purpose may need to be refined because of issues of feasibility. For example, your purpose may be to test the effect of a foot care education program for people newly diagnosed with diabetes who are on hemodialysis. However, as you begin to plan your study you determine that the number of people on hemodialysis who have been newly diagnosed with diabetes is very small, and therefore, you may need to extend your study to examine the effect of the program for all people with diabetes or for newly diagnosed diabetics on all forms of renal replacement therapy. The research approach you choose (qualitative versus quantitative) will also inform the sequence of the research process. In general, quantitative research tends to progress in a linear fashion through the steps of the research process while qualitative approaches tend to have a more fluid process (e.g., data collection and analysis may occur simultaneously so that one informs the other). No matter what research approach you take, the research process always starts with identifying the research problem (the thinking phase). (Norwood, 2000)

7 Identifying the research problem
Critical first step in research process Directs the entire research process and decisions you will make Being clear about the problem you wish to address will assist in focusing your study Start with a broad area of interest/concern which is gradually refined until you have a research problem A research problem is a gap in our knowledge that we need more information about and that information is gained through the research process. A research problem can be a situation or issue we would like to know more about, an area of concern or frustration. Research problems come from a variety of sources including observations you make in clinical practice, concerns raised by colleagues, discrepancies or gaps in the literature and/or theory. When first starting to identify research problems, begin with a broad topic that is of interest to you and relevant to your practice. You will gradually refine this as you work through the “thinking phase” of the research process.

8 Steps in identifying a research problem
5. Identify the purpose for your study 4. Identify a research problem 3. Narrow your topic 1. Outline areas of interest 2. Choose a topic Observe your environment Be curious Ask questions Read about your interests Talk to your Colleagues Find out what others are doing The process of identifying a research problem is a creative and interactive one. It should start by identifying a broad area of interest based on your practice experiences, what you have read, observed or wondered about. Choosing something that is of interest and relevant to you is critical. Since it takes time to work through the research process, choosing a topic of interest will help you maintain your energy and enthusiasm for your project. Moving from a broad area of interest to a specific research problem requires some reflection, information gathering, and dialogue. Allow yourself plenty of time for this process.

9 Areas of Interest 1 Start with an area you are familiar with
Begin broadly and think of things that interest you in your practice What do you find frustrating? Perplexing? What do you think works well? What could be improved? Be creative and try to “think outside the box” Brainstorm about general areas of interest Write down all your thoughts and ideas Choosing a research topic and narrowing it down to a research problem and question is a creative process. Try to start out with some broad general ideas about things that you wonder about in your practice. Choosing a topic in an area you are familiar with will help you make decisions about the need for further research in the area, as well as the feasibility of particular research approaches. This is a creative, brainstorming stage. Consider all your ideas and try not to rule any thing out (you will do this later as you narrow your topic). Having an inquiring mind is a good place to start in choosing a research topic. Try to approach your practice as if you are seeing things for the first time. Think about some of the routines you have in your work place and ask yourself why you do things a particular way or if there is way things could be improved. Topic ideas could include things you have seen or heard, for example you have overheard patients on the transplant waiting list say that having a transplant will change their lives and you wonder about how transplant affects quality of life. Topics of interest might also come to you from what others have observed, described or questioned. For example, you read an article about the role of the multidisciplinary team in a dialysis facility and you wonder about how it would work in your CKD clinic. As you work through this module try to think about your own areas of interest. You might want to take a moment now to brainstorm about topics, issues or concerns of interest to you. Write down all of your ideas.

10 Potential topics: Some examples
Quality of life after kidney transplant Body image concerns for adolescents with CKD Role of the multidisciplinary team in managing stages 1-3 CKD Experiences of people with early CKD Foot care interventions for people with diabetes on dialysis Safety issues for elderly dialysis patients This is a broad list of topics that might lend themselves to research of interest to nephrology nurses. Currently these topics are written in very broad terms and need to be refined in order to be researchable. The next step in the process is to choose one area of interest and begin to refine your topic.

11 Choosing your topic 2 Choose one area of interest as a topic you will focus on To help you select a topic consider: Significance/relevance: Is this an important problem for nurses/nursing practice? Is it timely? Gaps: What is already known about the topic? Have others already examined this issue? Is more research needed? Interest: Is this something you would like to explore further? The next step in problem identification process is to choose your focus and to narrow your topic. The ultimate goal is to identify research problems, so begin to refine your topic to ensure that you are focusing on an area that is significant for nursing practice. Talking to your colleagues about your ideas is a good way to get some feedback about the significance of your topic. Do they think this is a relevant issue? How common do they think the problem is? Do they think studying this issue will add new knowledge or help to improve practice? In selecting a topic to pursue you also want to consider what is already known about the issue. A brief review of the literature at this point will help you identify whether this is a topic that has been well researched or one about which little is known. Consider the topics of interest you have identified and rank order them in terms of significance and interest. Choose the one that you would most like to focus on.

12 Narrowing your topic 3 Refine your topic by becoming more specific about what you are interested in Pose some questions about your topic to help you narrow your focus Polit & Beck (2008) suggest some question stems to use to assist in refining your topic What is going on with…. What is the meaning of… What influences or causes… What is the process by which…. What factors contribute to…. How effective is….. Once you have chosen the area of interest, you need to begin to narrow this down into something that is researchable. The best way to do this is to begin to ask yourself some questions about the topic that can help you narrow down what it is you are interested in. A research topic can be approached from a number of different perspectives, and it is helpful at this point to begin to identify what specific aspects of your topic you are interested in and what is not of interest. At this point you might also begin to define what you mean by the terms you are using to help you narrow your focus. It is not necessary to find a dictionary definition, but rather be clear to develop a working definition of what you mean by the terms you are using. For example, if you identified quality of life post kidney transplant you may want to ask yourself what you mean by quality of life? Are you interested in adults or children? Then begin to ask yourself some questions to help you refine your topic such as “What influences quality of life post transplant?” “What is the meaning of quality of life for adults post transplant?” “What factors contribute to poor quality of life outcomes post transplant?” “How effective are nursing interventions at improving quality of life post transplant?” Now, consider the topic you have selected and begin to narrow it down by brainstorming possible questions.

13 Narrowing your topic: Choosing a researchable question
Narrow down the questions you have posed by eliminating those that are not researchable According to Brink & Wood (2001) researchable questions are Focused on fact not opinion – answers will help to describe or explain a phenomenon “Now” questions - deal with current, significant issues Relevant - Generate useable information Action oriented - usually require you to do something and provide direction for the rest of the research process. Many of the questions you have posed about your topic will lend themselves to research while others may not. In continuing to refine your topic, it is necessary to rule out those questions that are not amenable to research. The goal of research is to provide information to help us understand, describe or explain a topic of interest. Researchable questions provide answers that do this by requiring us to gather information about observable phenomena resulting in “facts” rather than opinions. Try to avoid asking questions that start with “should,” as this will likely elicit opinions rather than facts. For example, the question “Should all nephrology nurses obtain certification?” will elicit opinion, but will not provide us with answers that help us to understand the relevance of certification. This question could be reworded to say “What are the supports and barriers to certification for nephrology nurses?” In general, questions that elicit a “yes” or “no” answer are not researchable because they don’t provide direction for the research process. For example, the question, “Is living with kidney disease stressful?” is likely to result in a “yes” or “no” answer (or possibly maybe) however, as a researcher this does not provide you with direction for your next step. Another way to phrase this question is “What aspects of kidney disease are stressful for patients and their families?” Consider the questions you posed about your topic area. Can you eliminate some that are not researchable?

14 Identifying the research problem
4 To decide on your research problem consider the potentially researchable questions about your topic you identified earlier Select one that you would like to explore in more depth In choosing your focus consider Your interests The literature Feasibility of studying the problem The questions that you have posed all focus on the same general topic area, but they may reflect a different dimension of the topic (i.e., research problem) and thus will need to answered using different approaches. The questions you have identified may all be relevant to your topic however, in order to ensure that your research plan is focused and appropriate, it is important to choose one question that you think should be addressed first. Start by rank ordering the “researchable questions” you have identified in terms of relevance/significance. Also consider which interests you the most. Discussions with your colleagues can also help you prioritize your questions and narrow down your problem. Returning to the literature is also advisable at this point. The literature review does not need to be extensive but rather should be done to help you narrow down your problem. Reviewing the literature will help you see whether others have examined a similar problem and if so what they have found. A brief review of the literature will also help you to identify gaps and inconsistencies that support the need for further research related to your problem. Finally, feasibility issues may be uncovered in the literature that help you rule out a potential problem.

15 Identifying the research problem
To finalize the research problem consider: Significance “Researchability” Nature of the problem Ethical considerations Feasibility Time Funding for the study Researcher expertise Availability of participants Availability of facility and equipment In addition to your interest, the decision to select a problem for further study is based on a determination of significance, “researchability” and feasibility of the problem. As we have discussed the significance of the problem reflects its relevance to practice. Researchability will depend to some extent on the nature of the problem. Some problems are not amenable to research such as those dealing with moral or ethical issues. Feasibility is an important consideration. Although you may have identified a problem that is potentially researchable you may not be able to complete the research due to limitations in resources including time, funding, equipment, and potential participants. An important consideration in determining the feasibility of conducting a study is your own expertise as a researcher. Having knowledge of the topic area and study population is invaluable in helping you make decisions about how to approach the research problem. It is equally important to consider what experience you have with research and different research methods. New researchers are encouraged to seek mentorship of more senior researchers with expertise in the methods they are interested in, and to choose research problems which are clear and focused on one or two key issues. Think about the question you have chosen to focus on and consider if it is researchable and feasible. If not, refine your question or return to your list of researchable questions to identify another topic. (Polit & Beck 2008))

16 Identifying the study purpose
5 Clear, concise statement of the goal, aim, focus, or objective of the study (Burns & Grove, 2005) Should include a description of “what” = variables or phenomena of interest “who” = sample or participants “where” = setting The final step in the problem identification stage is to articulate the study purpose. Writing a purpose statement helps you be clear about what you want your study to accomplish. Think about why you want to do this study. Are you interested in getting more information about a phenomenon that has not been well explored? Determining relationships among variables? Testing the effectiveness of a new intervention? In your purpose statement be as clear as possible about what it is you will be studying among what group of people and in what setting. For example, “The purpose of this study is to examine supports and barriers to certification among nurses working in hospital-based dialysis units in the United States.” This initial purpose statement may evolve as you delve further into the literature or begin to work through the planning phase of the research process. Write a preliminary purpose statement for the research problem you have been working on.

17 Moving from the problem to a research project: Next steps
Reviewing and critiquing the literature related to your problem Find out what is known Identify approaches to studying the problem Consider theoretical approaches to studying the problem Further refine your problem & purpose Move to the planning phase of your study Throughout the problem identification process, you have been using the literature to help you to narrow your topic into a focused problem that is potentially researchable. Once you have settled on a research problem that is significant and you are interested in exploring, you need to review and critique the literature in greater depth to get a thorough understanding of what is known about your topic, what the gaps or inconsistencies are, and what the next steps should be in studying this issue. The literature review will also help you consider feasibility issues (e.g. have other researchers had difficulties in recruiting in your population?) as well as potential approaches to addressing these issues and designing your study. Module 2 in this series addresses “how to do a literature review,” and you may find it helpful to review this again at this point. Librarians are excellent resources, and if you have access to one you may find it helpful to share your preliminary problem and purpose with them to get some advice about how to proceed with reviewing the literature related to your topic. As you work through your literature review, keep your research problem in mind and continue to refine it and revise it as you learn more about the topic. Once you have reviewed the literature and refined your study problem, then you can move on to the planning phase and begin to identify approaches to designing your research project. The approaches you take in the planning phase depend on the nature of your research problem. A detailed discussion of this phase is beyond the focus of this module. Once you have identified your research problem and have some general ideas about the approach (e.g., will your study take a qualitative or quantitative approach), you might find it helpful to consult a basic research text (some examples are provided in the reference list at the end of this module). Consulting with a colleague with research expertise might also be helpful as you move through the planning process.

18 Summary Identifying a researchable problem is the first step in the research process and ultimately guides the remaining steps. Research problems describe knowledge gaps that need to be addressed in order to understand or improve practice. Research problems can be derived from observations, dialogue with others, and/or the literature. In summary, identifying a researchable problem is the first step in the research process and ultimately guides the remaining steps. Research problems describe knowledge gaps that need to be addressed in order to understand or improve practice. Research problems can be derived from observations, dialogue with others, and/or the literature.

19 Summary (cont.) A good research problem is relevant, current and “researchable.” Choose a problem that is of interest to you. Identifying a “researchable” problem is a creative process that requires time for reflection. Seeking input from others and referring to the literature will help to narrow your problem down. A clear and focused problem statement provides direction for the next steps of the research process - the planning phase. A good research problem is relevant, current, and “researchable.” Choose a problem that is of interest to you. Identifying a “researchable” problem is a creative process that requires time for reflection. Seeking input from others and referring to the literature will help to narrow your problem down. And, a clear and focused problem statement provides direction for the next steps of the research process – the planning phase.

20 Example: Identifying a research problem
The following example is intended to help walk you through the process of moving from a general area of interest to a researchable problem.

21 Area of interest The number of adults over 65 on dialysis is growing
Aging is often associated with physical and mental changes that may put older persons’ safety at risk Physiological and psychosocial stressors associated with dialysis may also place people at risk for safety concerns Elderly people on dialysis may therefore be particularly vulnerable to safety issues. These statements highlight some observations about a general topic area (safety issues for elderly patients on dialysis) and suggest that this is an area we may need to know more about. However, based on these statements it is not clear what the research problem is nor what the focus of a research study related to this topic should be. In order to start to narrow the topic, the next step is to brainstorm questions about this issue.

22 Narrowing the topic Consider the potential topic “Safety issues among elderly on dialysis” Take a minute and brainstorm questions about this topic What do you think needs to be known about this topic? Write down everything that comes to mind - don’t rule anything out at this point In order to narrow your topic you should consider the potential topic “safety issues among elderly on dialysis.” Take a minute and brainstorm questions about this topic. Ask yourself, “What do you think needs to be known about this topic?” Then, write down everything that comes to mind – don’t rule anything out at this point.

23 Safety issues for elderly on dialysis:
Example Questions Is safety an important concern for elderly on dialysis? What are the common safety issues for elderly on dialysis? Are there different safety issues for elderly on peritoneal versus hemodialysis? How common are falls in elderly dialysis patients? What factors contribute to falls? Should nurses assess safety issues among elderly dialysis patients? Here are some examples of questions related to safety for elderly on dialysis. Consider each of these and rule out any that you think are not researchable.

24 Identifying researchable problems
In reviewing the questions from the previous slide Question # 2 “ What are the common safety issues for elderly on dialysis?” was selected as the focus. Questions # 3 & 4 have potential but may require us to answer question 2 first. Questions # 1 and 5 were excluded because they elicit “yes/no” answers or opinion and therefore are not researchable. When reviewing the questions you posed, rule out any that are not researchable. In this case questions 1 & 5 are likely to lead to opinion and are thus not considered researchable. Next rank order the remaining questions in terms of priority and relevance. While questions 3 and 4 are potentially researchable they depend to some extent on the answer to question 2. For example we need to know the common safety concerns for elderly dialysis patients before we begin to examine whether they are different for hemo versus PD. Similarly, if falls are not identified as a safety concern then we may have difficulty answering question 4. Therefore it was decided to focus on question number 2.

25 What are the safety concerns among elderly on dialysis?
A brief review of the literature focusing on “safety” “dialysis” and “elderly” uncovered Research focusing on safety of various medications and dialysis delivery methods among all age groups No literature was found that examined safety concerns unique to older people on dialysis Therefore, this was identified as a potential gap in the literature and a decision was made to continue to focus on this problem As you narrow your topic down a cursory search of the literature can help you determine if you might be on the right track or whether you need to refine your focus. In this case a brief review of the literature identified that limited attention has been paid to safety issues unique to elderly dialysis patients and supported the need to examine this topic further.

26 What are the safety concerns among elderly on dialysis?
To focus your topic further pose additional questions to help you be clear on what you are interested in. For example: What is meant by safety concerns? How do you define “elderly”? Whose perspective are you interested in the patient? Family? Nurses? Other health care professionals? Are you interested in safety issues in the dialysis unit? At home? Are you interested in safety concerns for elderly on all forms of dialysis? In order to refine your research problem further continue to pose questions that help you become clear in your own mind about how you are viewing the problem and its characteristics. These questions are examples of how our topic of safety concerns could be further narrowed.

27 Problem statement & purpose
Elderly patients on dialysis may be at increased risk for physical injury while at home as result of the aging process and the consequences of CKD and dialysis. However, little is known about safety concerns for elderly individuals on dialysis who live at home Therefore, the purpose of this study is to explore concerns that individuals over 65 on all forms of dialysis have about their safety while at home. As you can see, this problem and purpose has become more specific by clarifying the what – safety concerns while at home, the “who” - people over 65 on all forms of dialysis and the “where”- at home. This problem statement will help to guide a more comprehensive review and critique of the literature which may result in further refinement of the problem and will ultimately guide the approach to designing a research study addressing this problem.

28 References Burns, N., & Grove, S. (2005).  The practice of nursing research: Conduct, critique and utilization (5th ed.).  St. Louis: Elsevier Saunders. Leedy, P., & Ormrod, J.E. (2005). Practical research: Planning and design (8th ed.). New Jersey: Pearson Prentice Hall. Norwood, S. (2000). Research strategies for advanced practice nurses. New Jersey: Prentice Hall

29 References Polit, D., & Beck, C.T. (2008). Nursing Research: Generating and asssessing evidence for practice (8th ed.). Philadelphia: Lippincott Williams and Wilkins. Wood, M., & Ross-Kerr, J. (2006). Basic steps in planning nursing research: From question to proposal (6th ed.). Boston: Jones and Bartlett.


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