Chapter 5

Research Problems, Purposes, and Hypotheses

Research Topics
• Major concepts
• Focus on key issues for practice, education, and administration
• Examples: chronic pain, acute pain, self-care, coping, health promotion, respiratory pathology,
staffing, nursing shortage

What Is a Research Problem?

• Definition: area of concern; gap in knowledge needed for practice
• Significance: current, important area of concern for profession
• Background: one or two key studies that have been conducted related to problem

Problem Statement
• Justification of need
– Knowledge gap
– Conflicting findings
– Group of individuals not previously studied
• Current
• Significance for nursing

Key Phrases for Problem

• Little is known about or few studies have been done regarding...
• Findings of previous studies are conflicting regarding...
• Hispanic or low-income individuals have not been studied…

Sources of Research Problems

• Nursing practice
• Researcher and peer interaction
• Literature review
• Theory
• Research priorities

Purpose Statement
• Clear, concise statement
• Goal, aim, focus, or objective of study
• Includes variables, population, and setting

Purpose of Study
• To describe...
• To determine differences between groups...
• To examine relationships among...
• To determine the effect of...

Example Research Problem: Effectiveness of Guided Imagery on Smoking Cessation

• Area of concern: prevalence of smoking
• Population: adult smokers
• Significant problem: prevalence of smoking in adults
• Background: effectiveness of guided imagery for treating health problems
• Problem statement: a gap in knowledge about whether guided imagery would be useful for
smoking cessation (Wynd, 2005)

Example Research Purpose: Effectiveness of Guided Imagery on Smoking Cessation

• The purpose of this study was to examine the effect of the nursing intervention guided imagery
on smoking cessation and long-term abstinence (Wynd, 2005)

Example of Study Outcomes: SCU vs. ICU for Chronically Ill Patients
• Cost, patient satisfaction, length of stay, complications, and readmissions were examined for
chronically ill patients in SCU compared with those in ICU
• Findings showed that the SCU setting produced better outcomes for the patients (Rudy, et al,
1995)

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Examining Study Feasibility
• Time commitment
• Money commitment
• Researchers’ expertise
• Availability of subjects, facility, and equipment
• Ethical considerations

Critiquing the Problem and Purpose

• Example Research Problem: Effects of Hypoglycemia on Children with HI
• …one cause of hypoglycemia is congenital hyperinsulinism (HI). Children with HI are exposed to
various degrees of hypoglycemia ….Infants and children with HI are at an increased risk of
developmental delay....
• …issues of severity and duration of hypoglycemia and the effect of these two factors on
development (Steinkrauss, et al, 2005, pp. 109, 112)

Critique of Example Research Problem: Effects of Hypoglycemia on Children with HI

• Type of study: quantitative descriptive study
• Research topics: hypoglycemia, HI, developmental delay in children, developmental outcome
• Population: children with HI
• Setting: not specified

Example Research Purpose: Effects of Hypoglycemia on Children with HI

• The purpose of this study was to describe the effects of hypoglycemia on development in a group
of children with HI (Steinkrauss, et al, 2005, p. 109)

Qualitative Study Purpose

• Identifies areas of concern
• Gains new insights
• Is focus of study
• Identifies qualitative approach and assumptions
• Differs among each qualitative methodology because of philosophical orientations

Critique of Problem: Medically Fragile Children

• Type of study: qualitative-phenomenological
• Research topics: medically fragile children, dependency on technology, daily routine of life
• Population: medically fragile children dependent on technology
• Setting: school setting
• Significant, clearly stated problem(Rehm & Rohr, 2002)

Example of Research Purpose: Medically Fragile Children

• The purpose of this study was to explore family, child, and organizational consequences resulting
from school attendance of children who are MFTD (Rehm & Rohr, 2002, p. 345)

Problems and Purposes in Outcomes Research

• Should refine or generate relevant knowledge for nursing practice
• Theory of Planned Behavior

(Ajzen, 2002)

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Significance of Study Problem and Purpose
• Should build on previous research
• Should influence nursing practice
• Promotes theory testing or development
• Addresses nursing research priorities

Feasibility of Problem and Purpose

• Researcher expertise
– Education and position
• Money commitment
– Funding source
• Feasibility of Problem and Purpose (cont’d)
• Availability of subjects, facilities, and equipment
– Adequate sample size, setting, tools
• Ethical considerations
– Rights of human subjects were protected

Critiquing Guidelines for Problems and Purposes

• Is problem clear and concise?
• Is problem limited in scope?
• Is problem narrow to focus study?
• Does problem identify variables, population, and setting?
• Are problem and purpose able to generate knowledge?
• Is study feasible?
• Is study ethical?

Narrowing Study Focus

• Problem
• Purpose
• Hypothesis

Research Objectives
• Definition: declarative statements that focus on identification and description of variables or
concepts and sometimes on determination of relationships of variables

Example of Research Objectives: Hyperinsulinism

• The objectives of this study were “[a] to describe the frequency and extent of developmental
delay in a cohort of children with HI, [b] to identify differences in developmental outcome among
types of hyperinsulinism, and [c] to identify associations between hypoglycemia history and
developmental outcome” (Steinkrauss et al, 2005, p. 113)

Research Questions
• Definition: interrogative statements that focus on what variables or concepts are to be described
and what relationships might exist among them

Example Research Questions: Hypertension

• What percentage of a sample of working African American women has hypertension?
• What is the relationship of blood pressure status to three stress-related variables, anger, coping
resources, and strain?
• Is there a significant difference in demographic and health-related variables among women with
different blood pressure status?
(Webb & Beckstead, 2002, pp. 385-386)

What Are Hypotheses?

• Formal statements of expected relationships among variables

Types of Hypotheses
• Associative vs. causal
• Simple vs. complex
• Nondirectional vs. directional
• Null vs. research

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Associative vs. Causal Hypotheses
• Associative
– Relationship between variables
• Causal
– Cause-and-effect relationship between variables
• Group differences
– Naturally occurring
– Researcher controlled

Relationships

A ----------------------- B

Reciprocal causality relationship

A <----- (+) ---------B

Positive relationship

A <------(–) --------- B

Negative relationship

Examples of Associative Hypotheses

• An increase in variable X is associated with an increase in variable Y in a specified population
• An increase in variable X is associated with a decrease in variable Y in a specified population

Diagram of an Associative Hypothesis

• This hypothesis predicts positive relationship or associations among the variables of dyspnea,
fatigue, and sleep difficulty for patients with COPD
• A positive relationship means that the variables change together—they increase or decrease
together

Diagram of an Associative Hypothesis

• This hypothesis predicts relationship among 3 variables (dyspnea, fatigue, and sleep difficulty)
and the variable functional performance but does not identify type of relationship

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Diagram of an Associative Hypothesis

• The hypothesis uses independent variables of dyspnea, fatigue, and sleep difficulty to predict
functional performance in COPD patients

Example of a Causal Hypothesis: Blood Pressure

• Persons who participate in nurse-managed home telemonitoring (HT) plus usual care or who
participate in nurse-managed community-based monitoring (CBM) plus usual care will have
greater improvement in blood pressure (BP) from baseline to 3 months’ follow-up than will
persons who receive usual care only (Artinian et al, 2001, p. 191)

Diagram of a Causal Hypothesis

• The independent variables are the two types of nurse-managed BP monitoring (HT and CBM),
and the dependent variable is BP control
• The causal arrow shows the relationship among these variables

Simple vs. Complex Hypotheses

• Simple hypothesis: two variables
• Complex hypothesis: more than two variables

Examples of Simple Hypotheses: Cardiac Patients and Spouses

• Higher levels of perceived control would be associated with less emotional distress in spouses of
patients recovering from cardiac disease
• Perceived control could be enhanced in spouses of cardiac patients by cardiopulmonary
resuscitation (CPR) training (Moser & Dracup, 2000, p. 271)

Diagram of a Simple Hypothesis

• This hypothesis states that a negative or inverse relationship exists between two variables

Diagram of a Simple Hypothesis

• This hypothesis predicts that the independent variable (CPR) causes an increase in the
dependent variable (perceived control)

Relationships
• Multi-causality relationships
A
B D
C

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Relationships
• Multiple outcomes relationships

B
A C
D

Example of Complex Hypothesis: CHIP

• Both men and women who participated in the CHIP (Cardiac Home Information Program)
intervention would have lower levels of psychological distress, higher levels of physical
functioning, and fewer adverse symptoms than would women and men who did not participate in
such a program (Moore & Dolansky, 2001, p. 94)

Nondirectional vs. Directional Hypotheses

• Nondirectional hypothesis
– Relationship exists between variables, but hypothesis does not predict nature of
relationship

• Directional hypothesis
– Nature (positive or negative) of interaction between two or more variables is stated
– These are developed from theoretical framework, literature, or clinical practice

Example of Nondirectional Hypothesis

• Attitudes of pediatric nurses toward mentally retarded clients are related to number of years in
practice

Example of Directional Hypothesis

• Attitudes of pediatric nurses toward mentally retarded clients are more favorable than those of
medical surgical nurses

Null vs. Research Hypotheses

• Null hypothesis
– States there is no difference or relationship between variables
– Is also called statistical hypothesis

• Research hypothesis
– States what researcher thinks is true
– There is a relationship between two or more variables

Example of Null Hypothesis

• There is no difference in reported pain experienced by cancer patients with chronic pain who
listen to music with positive suggestion of pain reduction and those who do not

Example of Research Hypothesis

– Cancer patients with chronic pain who listen to music with positive suggestions of pain
reduction have less reported pain than those who do not listen to music

Testable Hypothesis
• This hypothesis is clearly stated without the phrase “There is no significant difference”
• This should be testable in real world
• Variables are measurable or able to be manipulated
• Relationship between variables is either supported or not supported
• Causal link between independent and dependent variables is evaluated using statistical tests

Test Yourself:
What Types of Hypotheses Are These?
• Rates of use of health care facilities by ethnic minorities are higher in facilities with bilingual
health care staff
• There is a positive relationship between nurse attitudes toward AIDS patients and number of
AIDS patients they have cared for
• There is a relationship between social distance in families and burden of caregiving for chronically
ill adults
• There is no difference between attitudes of men and women toward caring for people with AIDS

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Critiquing Objectives, Questions, and Hypotheses
• Are objectives, questions, or hypotheses formally stated and clearly focused in study?
• Are objectives, questions, or hypotheses based on the purpose?
• Are objectives, questions, or hypotheses linked to study framework?
• Are objectives or questions answered by study? Are hypotheses tested in study?

What Are Variables?

• Qualities, properties, or characteristics of people, things, or situations that are manipulated or
measured in research

Characteristics of Variables
• Are at a more concrete level than concepts
• Represent only a portion of the concept
• Several variables may be used to represent one concept

Types of Variables
• Independent variables
• Dependent variables
• Research variables or concepts
• Extraneous variables
• Demographic variables

Independent Variable
• Independent variable is the stimulus or activity manipulated or varied by the research to cause
an effect on dependent variables
• It is also called the treatment or experimental variables

Dependent Variable
• Dependent variable is the outcome or response the researcher wants to predict or explain
• Changes in the dependent variable are presumed to be caused by the independent variable

Research Variable or Concept

• These are the qualities, properties, or characteristics identified in the research purpose and
objectives or questions that are observed or measured in a study
• They are used when the intent is to observe or measure variables as they exist in a natural
setting without manipulation

Extraneous Variables
• They can interfere with obtaining clear understanding of relational or causal dynamics in the
study
• They can be recognized or unrecognized and controlled or uncontrolled
• If the variable is not recognized until the study is in process or cannot be controlled, it is called a
confounding variable
• An environmental variable is an uncontrolled variable relating to the setting

Demographic Variable
• Contain sample characteristics of subjects
• May include age, education, gender, ethnic origin, income, medical diagnosis, etc.
• Demographic data are analyzed to develop sample characteristics

Operationalization
• Definition: translating downward to more concrete level
• Moves from concept to variable to measures

Operationalizing Variables
• Conceptual definition
– Abstract meaning of a variable that usually is based on theory
• Operational definition
– Way of defining a variable that makes it measurable or manipulable in real world

Steps of Operationalization
• Identify variables used to represent concepts in framework
• Develop operational definitions for each variable
– Indicates method of measurement or observation
– Must be consistent with conceptual definition

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Operationalizing a Dependent Variable
• Conceptual definition of smoking cessation:
– A future-oriented, health-promoting behavior that results in a smoke-free
lifestyle and improved health

• Operational definition of smoking cessation:

– Smoking rates that were monitored through use of self-report data and validated by
corroborating reports from friends and family members. Participants who varied in their
answers from their significant contacts or could not be reached by telephone were
considered ongoing smokers and were included in the resulting relapse rates.

Critiquing Study Variables

• Are independent, dependent, or research variables clearly identified in study?
• Are variables measured in study consistent with variables identified in the purpose, questions, or
hypotheses?
• Are variables reflective of study framework?
• Are variables clearly defined both conceptually and operationally?
• Is conceptual definition consistent with operational definition?
• Are demographic variables summarized?
• Were extraneous variables identified and controlled as necessary in study?
• Did any uncontrolled extraneous variables influence findings?

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