Developing a research problem and hypothesis: Nursing

Nurse Jory works in the community health clinic. In the past year, there’s been an increase in the number of clients not showing up for their appointments and Nurse Jory wants to understand why.

Research is a systematic process of validating, refining, and generating knowledge. It is used by members of the healthcare team, such as nurses, to answer questions that come up when caring for clients.

A research problem is a specific area of knowledge that needs further investigation and it is sometimes phrased as a question. Nurse Jory wants to understand more about situations that impact clinic attendance, so they use the question, “What reasons do clients give for not keeping their scheduled appointments at the community health clinic?”

Next, the research purpose is generated from the research problem. The research purpose is a single sentence that explains what you are looking to learn by completing the research study. So, Nurse Jory’s research purpose is “The purpose of this research study is to explore barriers to appointment attendance.”

After the research problem and purpose statement comes the research hypothesis, by identifying the research variables. Research variables are the concepts that are measured, manipulated, or controlled in a study. Oftentimes, researchers want to know how one variable affects another variable. For example, a researcher may want to know how daily exercise impacts blood pressure.

Now, there are different types of variables to consider, including independent variables, dependent variables, extraneous variables, confounding variables, and demographic variables. First are the independent and dependent variables. So, let’s go back to the exercise and blood pressure example. The independent variable is not affected by the other variables, so in this case, the amount of exercise you get does not depend on blood pressure, so it’s independent. The dependent variable will change based on other variables in the study, in this case, your blood pressure might change depending on the amount of exercise you get. In research studies, we observe how changes in the independent variable affect the dependent variable.

After talking with their co-workers, Nurse Jory decides to focus on the effects of stress on appointment attendance. So, while constructing their study, Nurse Jory identifies the independent variable as stress, since it may influence the dependent variable, which is appointment attendance.

Sometimes, there are also extraneous variables. Extraneous variables may impact the dependent or independent variable even though they are not part of the study.

Confounding variables are a type of extraneous variable that only affect the dependent variable. In the exercise example, a low-sodium diet is a confounding variable since, like exercise, it can change blood pressure, but it is not a part of the study.

In Nurse Jory’s research, there might be factors other than stress that impact clinic appointment attendance, like distance between the client’s home and clinic or the client’s work schedule.

Finally, there are demographic variables, sometimes referred to as “demographics”. These variables describe characteristics of the study participants like age or gender. This information can be used during data analysis to draw conclusions, like saying participants age 45-54 had increased appointment attendance compared to clients age 35-44. Demographic variables can also be useful when you are reporting the findings of your study to describe the sample. For example, “20% of the total sample size was under the age of 30.” Sometimes, demographic variables can be considered extraneous variables because the characteristics of the sample end up affecting other variables.

After the research problem and purpose statement have been created and the variables are understood, next comes the research hypothesis. A research hypothesis is a prediction that will be tested during the study. It is created for all experimental and quasi-experimental research as well as some descriptive and correlational studies. The research hypothesis has a narrower focus than the research problem and purpose statement and helps to guide the study design. The hypothesis is usually presented as an “if” and “then” statement of how one variable may affect the other, like, “If clients increase their daily exercise by 10 minutes per day, their blood pressure will change.”

Now, there are different types of hypotheses that can be used depending on what is being studied. First there are simple or complex hypotheses. A simple hypothesis is when there are only two variables, one independent and one dependent. A complex hypothesis, on the other hand, has more than one independent or dependent variable. So the statement, “If clients increase their daily exercise by 10 minutes per day, their blood pressure will change,” is a simple hypothesis with exercise as the independent variable and blood pressure as the dependent variable. However, the statement, “If clients increase their daily exercise by 10 minutes per day and lower their sodium intake, their blood pressure will change,” is a complex hypothesis because there are two independent variables, exercise and sodium intake.