Define the terms independent, dependent, and extraneous variables; and, directional, nondirectional hypotheses, and null hypotheses. Write one directional and one null hypothesis

Week 3 assignment 3.4

Approved Resources to Use in Writing Discussion Posts:

· The course textbook,

Grove, S. K. & Gray, S. G. (2019). Understanding nursing research: Building an evidence-based practice (7th ed.). Elsevier.

· any published peer-reviewed full-text article from the CINAHL database 

· org, or .gov website with published credible information. 

· The use of AI is not permitted in this DQ.

· All sources must be published within the last 5 years.

· This post must be a minimum of 250 words.

For your initial post, complete the following:

· After reading Chapter 5, please complete the following discussion question:

1. In your own words, define the terms independent, dependent, and extraneous variables; and, directional, nondirectional hypotheses, and null hypotheses.

2. Write one directional and one null hypothesis for a research study you would be most interested in conducting.

· Please consider your selection of variables carefully and write your hypothesis in the proper format.

,

Week 3 Reading Textbook

Reference:

Grove, S. K. & Gray, S. G. (2019). Understanding nursing research: Building an evidence-based practice (7th ed.). Elsevier.

CHAPTER 5

Examining Research Problems, Purposes, and Hypotheses

We are constantly asking questions to gain a better understanding of ourselves and the world around us. This human ability to wonder and ask creative questions is the first step in the research process. By asking questions, clinical nurses, researchers, and educators are able to identify significant research topics and problems to direct the generation of research evidence for practice. A research topic is a concept or broad issue that is important to nursing, such as acute pain, chronic pain management, coping with illness, and health promotion. Each topic contains numerous research problems that might be investigated through quantitative and qualitative studies. For example, chronic pain management is a research topic that includes research problems such as “What is it like to live with chronic pain?” and “What strategies are useful in coping with chronic pain?” Different types of qualitative studies have been conducted to investigate these problems or areas of concern in nursing (Creswell & Poth, 2018). Quantitative studies have been conducted to address problems such as “What is an accurate and concise way to assess chronic pain?” and “What interventions are effective in managing chronic pain?”

The problem provides the basis for developing the research purpose. The purpose is the goal or focus of a study that guides the development of the objectives, questions, or hypotheses that further focus the intent of the study (Fig. 5.1). Objectives, questions, or hypotheses can be developed to bridge the gap between the more abstractly stated problem and purpose and the detailed design for conducting the study. However, many studies do not include objectives, questions, or hypotheses and are guided by the study problem and purpose. The study purpose, objectives, questions, and hypotheses include the variables, relationships among the variables, and often the population to be studied. In qualitative research, the purpose and sometimes broadly stated research questions or objectives guide the study of selected research concepts.

FIG 5.1 Linking research problem, purpose, and objectives, questions, or hypotheses.

This chapter includes content that will assist you in identifying problems and purposes in a variety of quantitative and qualitative studies. Objectives, questions, and hypotheses are discussed, and the different types of study variables are introduced. Also presented are guidelines that will assist you in critically appraising the problems, purposes, objectives, questions, hypotheses, and variables or concepts in published quantitative and qualitative studies.

What are research problems and purposes?

A research problem is an area of concern in which there is a gap in the knowledge needed for nursing practice. Research is required to generate essential knowledge to address the practice concern, with the ultimate goal of providing evidence-based nursing care (Brown, 2018; Melnyk & Fineout-Overholt, 2015). The research problem in a study (1) indicates the significance of the problem; (2) provides a background for the problem; and (3) includes a problem statement (Box 5.1). The significance of a research problem indicates the importance of the problem to nursing and health care and to the health of individuals, families, and communities. The background for a problem briefly identifies what we know about the problem area, and the problem statement identifies the specific gap in the knowledge needed for practice. Not all published studies include a clearly expressed problem, but the problem usually can be identified in the first page of the report.

Box 5.1

Elements of the research problem

•  Significance: Importance of the problem to nursing and health care

•  Background: Key knowledge that is known from previous research

•  Problem statement: Identified gap in the knowledge needed for practice

The research purpose is a clear concise statement of the specific goal or focus of a study. In quantitative studies, the goal of a study might be to identify and describe variables, examine relationships in a situation, determine the effectiveness of an intervention, or determine outcomes of health care (Shadish, Cook, & Campbell, 2002). In qualitative studies, the purpose might be to describe perceptions of a phenomenon and give it meaning, develop a theory of a health situation or issue, explore relevant concepts and concerns in nursing, or describe aspects of a culture (Creswell & Poth, 2018). The purpose includes the variables or concepts, the population, and sometimes the setting for the study. A clearly stated research purpose can capture the essence of a study in a single sentence and is essential for directing the remaining steps of the research process. In a research report, the purpose is usually identified and often follows the problem statement (see Fig. 5.1). The guidelines for critically appraising the problems and purposes in studies are presented as follows.

Critical appraisal guidelines

Problems and Purposes in Studies

1. Is the problem clearly and concisely expressed early in the study?

2. Does the problem include the significance, background, and problem statement (see Box 5.1)?

3. Does the purpose clearly express the goal or focus of the study?

4. Is the purpose focused on the study problem statement?

5. Are the study variables and population identified in the purpose?

The research problem and purpose from the study by Ruiz-González and colleagues (2016, p. 13) about the “long-term effects of an intensive-practical diabetes educational program on HbA1c and self-care” are presented as Research Example 5.1. This example is critically appraised using the identified guidelines.

Research example 5.1

Problem and Purpose of a Quantitative Study

Research Study Excerpt

Problem Significance

Diabetes mellitus is a disease that affects 246 million people world-wide (Steinsbekk, Rygg, Lisulo, Rise, & Fretheim, 2012) and has a high prevalence in the Spanish population… According to the World Health Organization, adequate control of the disease unequivocally requires educating patients and developing their skills to manage their treatment and prevent complications.

(Ruiz-González et al., 2016, p. 13)

Problem Background

Education is achieved through diabetes education programs (DEPs)… DEPs are available in various formats and types… and have been widely proven to be useful in improving biological, psychosocial, and behavioral parameters (Steinsbekk et al., 2012). Recent meta-analyses of controlled studies (Hopkins et al., 2012…) have shown improvements ranging from .52% to .81% in levels of hemoglobin (HbA1c)… and also shown considerable improvement in other areas such as self-efficacy and knowledge.

(Ruiz-González et al., 2016, p. 13)

Problem Statement

Despite there are many important variables in education and it is important to consider patient’s profile…, few studies have included them in the same DEP or have assessed their long-term effects. In addition, the effectiveness of DEPs should be determined by their influence on both biomedical and psychosocial variables.

(Ruiz-González et al., 2016, p. 14)

Research Purpose

The purpose of this study was to implement an intensive and practical DEP and evaluate its long-term effects and its impact on psychosocial variables.

(Ruiz-González et al., 2016, p.13)

Critical Appraisal

Research Problem

Ruiz-González et al. (2016) presented a clear concise research problem with the relevant areas of (1) significance, (2) background, and (3) problem statement. Diabetes is a significant, complex, chronic illness that requires extensive knowledge to manage effectively. A clear background of the problem was provided by citing findings from two meta-analyses (Hopkins et al., 2012; Steinsbekk et al., 2012) that summarized studies focused on the effectiveness of DEPs on the management of type 1 and type 2 diabetes. The discussion of the problem concluded with a concise problem statement that indicated the gap in the knowledge needed for practice and provided a basis for the study purpose.

Research Purpose

The research purpose frequently is reflected in the title of the study, stated in the abstract, and restated after the literature review. Ruiz-González and associates (2016) included the purpose of their study in all three places. However, the statements of the purpose in the article were varied, which can be confusing to readers. The researchers clearly identified the DEP intervention (independent variable) that was implemented to determine its long-term effects on psychosocial variables (dependent variables). The purpose would have been more complete if it had included the biomedical dependent variables and the population studied, which was adults with type 1 diabetes.

Ruiz-González and colleagues (2016) found that the DEP intervention was effective in improving biomedical and psychological variables, but more psychological strategies are needed in this intervention to motivate adults to make real lifestyle changes. This type of study supports the Quality and Safety Education for Nurses (QSEN, 2017; Sherwood & Barnsteiner, 2017) pre-licensure competency to ensure safe, quality, and cost-effective research-based health care that actively involves patients and families in their care process.

Identifying the problem and purpose in quantitative and qualitative studies

Quantitative and qualitative research approaches enable nurses to investigate a variety of research problems and purposes. Examples of research problems and purposes for different types of quantitative and qualitative studies are presented in this section.

Problems and Purposes in Types of Quantitative Studies

Example research problems and purposes for the different types of quantitative research—descriptive, correlational, quasi-experimental, and experimental—are presented in Table 5.1. If little is known about a topic, researchers usually start with descriptive and correlational studies and progress to quasi-experimental and experimental studies as knowledge expands in an area. An examination of the problems and purposes in Table 5.1 will reveal the differences and similarities among the types of quantitative research. The research purpose usually reflects the type of study that was conducted (Gray, Grove, & Sutherland, 2017). The purpose of descriptive research is to identify and describe concepts or variables, identify possible relationships among variables, and delineate differences between or among existing groups, such as males and females or different ethnic groups.

Table 5.1

Quantitative research topics, problems, and purposes

Type of research Research problem and purpose

Descriptive research Title of study: “Hand hygiene opportunities in pediatric extended care facilities [ECF].” (Buet et al., 2013, p. 72)

Problem: “The population in pediatric ECFs is increasingly complex, and such children are at high risk of healthcare-associated infections (HAIs), which are associated with increased morbidity, mortality, resources use, and cost (Burns et al., 2010) [problem significance]… The Centers for Disease Control and Prevention (CDC)… and the World Health Organization (WHO, 2009) have published evidence-based guidelines confirming the causal relationship between poor infection control practices, particularly hand hygiene (HH), and increased risk of HAIs [problem background]. However, most of the HH research has been focused in adult long term care facilities and acute care settings and findings from such studies are unlikely to be applicable to HH in pediatric ECFs given the different care patterns, including the relative distribution of different devices” [problem statement] (Buet et al., 2013, pp. 72 − 73).

Purpose: “The purpose of this observational study was to assess the frequency and type of HH opportunities initiated by clinical (e.g., physicians and nurses) and non-clinical (e.g., parents and teachers) care givers, as well as evaluate HH adherence using the WHO’s ‘5 Moments for HH’ observation tool” (Buet et al., 2013, p. 73).

Correlational research Title of study: “Emergency department [ED] weekend presentation and mortality in patients with acute myocardial infraction [AMI]” (de Cordova et al., 2017, p. 20).

Problem: “Each year in EDs across the United States, 8 million people are evaluated for symptoms that are consistent with AMI, and approximately 400,000 people die [problem significance]… Patients who present to the ED with an AMI require immediate interventions and treatments to increase their chances of survival… The recommended guidelines, according to the American Heart Association and the American College of Cardiology for the management of a patient with AMI includes diagnostic 12-lead electrocardiogram and biochemical markers, administration of aspirin, thrombolytic therapy within 30 minutes of arrival, and/or percutaneous coronary interventions (PCIs) within 90 minutes of arrival [problem background]… Few research teams have specifically examined patient mortality for the patient with AMI in the ED” and for those presenting to the ED on weekends and holidays [problem statement] (de Cordova et al., 2017, pp. 20 − 21).

Purpose: “… the purpose of this study was to determine if a weekend and holiday presentation is associated with an increase in mortality among patients with AMI presenting to the ED in New Jersey” (de Cordova et al., 2017, p. 21).

Quasi-experimental research Title of study: “Methods and design of a 10-week multi-component family meals intervention: A two group quasi-experimental effectiveness trial” (Rogers et al., 2017, p. 1).

Problem: There is an “ongoing childhood obesity public health crisis [problem significance]… American Academy of Pediatrics recommends participation in family meals as a childhood obesity prevention strategy due to the literature demonstrating a protective effect on participation in healthy mealtime routines on child and weight [problem background].… In addition, the majority of current research fails to examine the child health impact of family meals beyond BMI [body mass index]… Future research, specifically intervention work, would also benefit from expansion of the target age range to include younger children (4-7 year olds), who are laying the foundation of their eating patterns and are capable of participating in family meal preparations” [problem statement] (Rogers et al., 2017, pp. 1 − 2).

Purpose: The purpose of this study was to determine the effectiveness “of a 10-week multi-component family meals intervention aimed at eliciting positive changes in child diet and weight status” (Rogers et al., 2017, p. 1).

Experimental research Title of study: “Effects of oral care with glutamine in preventing ventilator-associated pneumonia in neurosurgical intensive care unit patients” (Kaya et al., 2017, p. 10).

Problem: “Ventilator-associated pneumonia (VAP) is one of the most frequent nosocomial infections in intensive care unit patients [problem significance]…. One of the measures to prevent the development of VAP is applying good oral care… In recent studies, glutamine was reported to be an essential amino acid that is critical for the regulation of protein synthesis, respiratory fueling, and nitrogen shuttling [problem background]…. Different products and protocols in oral care has been the subject for research. However, the number of studies about glutamine is limited” [problem statement] (Kaya et al., 2017, pp 10 − 11).

Purpose: The purpose of this study was “to determine the effects of oral care with glutamine in preventing ventilator-associated pneumonia in patients admitted to neurosurgical intensive care unit” (Kaya et al., 2017, p. 10).

Buet and colleagues (2013) conducted a descriptive study to identify the HH opportunities and adherence among clinical and nonclinical caregivers in extended pediatric care facilities. These researchers followed the World Health Organization (WHO) “5 Moments for Hand Hygiene” (WHO, 2009): before touching a patient, before clean or aseptic procedures, after body fluid exposure or risk, after touching a patient, and after touching patient surroundings. Researchers found that HH opportunities were numerous for clinical and nonclinical caregivers, but adherence to HH was low, especially for nonclinical individuals. HH evidence-based guidelines must be followed to prevent healthcare-associated infections.

The purpose of correlational research is to examine the type (positive or negative) and strength of relationships or associations among variables. Positive relationships (designated by a plus [+] sign) indicate that variables change in the same direction; they either increase or decrease together. For example, the more cigarettes an adult smokes each day, the greater his or her risk of lung cancer. Negative relationships (designated by a minus [−] sign) indicate that variables change in the opposite direction; as one variable increases, the other variable decreases. For example, the more minutes that a middle-aged adult exercises each week, the lower the BMI. The strength of relationships varies from − 1 to 0 to + 1, with − 1 indicating a perfect negative relationship, 0 indicating no relationship, and + 1 indicating a perfect positive relationship between variables (Grove & Cipher, 2017). Types of relationships are discussed in more detail in the section on hypotheses.

de Cordova, Johansen, Martinez, and Cimiotti (2017, p. 20) conducted a correlational study to determine if “weekend and holiday presentation was associated with increased mortality in EDs [emergency departments] among patients with AMI [acute myocardial infarction].” The researchers clearly identified the problem and purpose for this study (see Table 5.1). de Cordova and colleagues found that weekend and holiday presentations to the ED for AMI were associated with increased mortality, and further research is needed regarding ED resources during the week, weekend, and holidays to promote quality care.

Quasi-experimental studies are conducted to determine the effect of a treatment or independent variable on designated dependent or outcome variables (Shadish et al., 2002). Rogers and colleagues (2017) developed a quasi-experimental study to examine the effectiveness of a multicomponent family meals intervention called Simple Suppers on elementary school children’s (age, 4 − 10 years) diet and weight status. The research problem and purpose for this study are presented in Table 5.1. The researchers might have provided more detail on the problem significance and background in the article. However, they presented the intervention Simple Suppers and the outcomes to be measured in detail. Rogers et al. (2017) recommended further research to determine the effectiveness of this Simple Supper intervention developed for underserved families with elementary school-age children.

Experimental studies are conducted in highly controlled settings using a structured design to determine the effect of one or more independent variables on one or more dependent variables (Gray et al., 2017). Kaya and colleagues (2017, p. 11) conducted a “randomized, controlled, experimental study to determine the effects of oral care with glutamine in preventing ventilator-associated pneumonia in patients admitted to neurosurgical intensive care unit [ICU] in New Jersey.” They found that providing oral care with glutamine had no significant effect on the incidence of VAP in the neurosurgical ICU patients. Kaya et al. (2017) recommended additional research with a larger sample size over a longer time period.

Problems and Purposes in Types of Qualitative Studies

The problems formulated for qualitative research identify areas of concern that require investigation to gain new insights, expand understanding, and improve comprehension of the whole. The purpose of a qualitative study indicates the focus of the study, which may be a concept such as pain, an event such as loss of a child, or a facet of a culture such as the healing practices of a specific Native American tribe. In addition, the purpose often indicates the qualitative approach used to conduct the study (Creswell, 2014; Creswell & Poth, 2018; Munhall, 2012). Table 5.2 includes examples of research problems and purposes for the types of qualitative research—phenomenological, grounded theory, exploratory-descriptive, and ethnographic—commonly found in the nursing literature and included in this text.

Table 5.2

Qualitative research topics, problems, and purposes

Type of research Research problem and purpose

Phenomenological research Title of study: “Severe childhood autism: The family lived experience” (Gorlin et al., 2016, p. 580).

Problem: “Autism is the most prevalent developmental disability in the United States, affecting approximately 1 in 68 children (Center for Disease Control [CDC], 2014). Approximately one-third of the children with autism are considered to have ‘severe autism’ with significant functional challenges [problem significance]… There has been an effort to clarify autism severity based on a more holistic approach that focuses on the child’s daily needs within the context of the family instead of solely on symptoms [problem background]… In many of these studies, however, the severity of the child with autism is not identified… Additionally many of the phenomenological studies rely on the response of one family member, usually the mother to portray the family experience… Extended family members or others considered as family have not been included in the studies reviewed” [problem statement] (Gorlin et al., 2016, pp. 580 − 582).

Purpose: “The aim or purpose of this research was to interpret the meaning of the lived experience of families who live with a child who has severe autism” (Gorlin et al., 2016, p. 582).

Grounded theory research Title of study: “A grounded theory study of how nurses integrate pregnancy and full-time employment: Becoming someone different” (Quinn, 2016, p. 170).

Problem: “According to the U.S. Department of Labor (2010), there are approximately 1.7 million nurses in the United State, 40% of whom are women within the childbearing ages of 20-45 years, and more than 65% are employed full-time [problem significance]… Research from 1990 to 2000 reported mostly unfavorable findings related to attitudes surrounding pregnant employees in the workplace… Some employers conversely, embrace their pregnant employees and view them as valuable members of their work teams [problem background]… Nursing, as an international industry, has not explored how its female workforce (i.e., nurses) integrates pregnancy and employment” [problem statement] (Quinn, 2016, pp. 170 − 171).

Purpose: “The purpose of this research was to explore how primiparous U.S. nurses integrated pregnancy and full-time employment” (Quinn, 2016, p. 170).

Exploratory-descriptive qualitative research Title of study: “Women’s perceptions of biases and barriers in their myocardial infarction triage experience” (Arslanian-Engoren & Scott, 2016, p. 166).

Problem: “Every 10 minutes a woman dies from a myocardial infarction (MI). Yet, symptoms of impending MI in women are less likely to be recognized than in men [problem significance]…. Investigators have examined the cardiac triage decisions of ED nurses, who are often the first healthcare provider to evaluate and triage women for MI and initiate guideline recommendations. Results indicated that nurses do not always recognize women’s cardiac symptoms and their practice does not consistently adhere to MI evidence-based guidelines [problem background]… Less is known about the personal experiences of women within the ED healthcare system that may affect the accuracy or timeliness of nurses’ cardiac triage decisions” [problem statement] (Arslanian-Engoren & Scott, 2016, pp. 166 − 167).

Purpose: “Therefore, the purpose of this study was to examine the cardiac triage experiences of women who presented to the ED with an acute MI” (Arslanian-Engoren & Scott, 2016, p. 167).

Ethnographic research Title of study: “Perceptions and experiences of using a nipple shield among parents and staff: An ethnographic study in neonatal units” (Flacking & Dykes, 2017, p. 1).

Problem: “Breast milk mediates unequalled beneficial effects regarding nutritional, immunological, and cognitive outcomes in preterm infants (< 37 gestational weeks, gw), therefore international recommendations state that infants should be exclusively breastfed for the first 6 months of life [problem significance]… Although research shows that preterm infants display rooting, efficient areolar grasp, and repeated short sucking bursts from 29 weeks, and occasional long sucking bursts and repeated swallowing from 31 weeks, the transition from tube feeding to exclusive breastfeeding at the breast takes time [problem background]… However, the use of nipple shields is very controversial and study results are contradictory. Furthermore, no study has previously explored the parents’ and staffs’ perspective and experiences of using a nipple shield in neonatal units” [problem statement] (Flacking & Dykes, 2017, pp. 1 − 2).

Purpose: The purpose of this ethnographic study “ is to explore perceptions and experiences of using a nipple shield among parents and staff in neonatal units” (Flacking & Dykes, 2017, p. 2).

ED, Emergency department; gw, gestational weeks.

Phenomenological research is conducted to promote a deeper understanding of complex human experiences as they have been lived by the study participants (Creswell & Poth, 2018). Gorlin, McAlpine, Garwick, and Wieling (2016) conducted a phenomenological study to examine the experiences of families living with a child with severe autism. The research problem and purpose for this study were clearly developed in the article and are presented in Table 5.2. Gorlin and colleagues’ (2016, p. 596) study findings “illuminated the extensive hardships and challenges of families who have a child with severe autism; identified needed resources; and illuminated how families formed hybrid families for additional support.”

In grounded theory research, the problem identifies the area of concern, and the purpose indicates the focus of the theory to be developed to account for a pattern of behavior of those involved in the study (Charmaz, 2014). For example, Quinn (2016, p. 170) conducted “a grounded theory study of how nurses integrate pregnancy and full-time employment.” The problem and purpose were clearly stated in this study and are presented in Table 5.2. Quinn (2016, p. 173) found that “Becoming someone different emerged as the basic social process of how RNs (registered nurses) integrate full-time employment and pregnancy. Four categories—looking different, feeling different; expectations while expecting; connecting differently; and transitioning labor—were identified from the data analysis.”

Exploratory-descriptive qualitative research is being conducted by several researchers to describe unique concepts, issues, health problems, or situations that lack clear description or definition. Kim, Sefcik, and Bradway (2017) conducted a systematic review to describe the characteristics of exploratory-descriptive qualitative studies, which often provide the basis for future qualitative and quantitative research. Arslanian-Engoren and Scott (2016) conducted an exploratory-descriptive qualitative study of “women’s perceptions of biases and barriers in their myocardial infarction (MI) triage experience.” The research problem and purpose for this study were clearly presented in t

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