Selecting and formulating the research question
The first step in the process is the selection of the research area, topic and question. Although the terms are often used interchangeably, Punch (2006) believes that they are a hierarchy of concepts with different levels of abstraction. The research area and topic are more general than the research question. A research question or problem is a question about an issue that researchers examine to gain new information. It differs from data collection questions that are at the lowest level of abstraction. The latter are the steps to gather data in order to answer the research question. The conclusions of any study are intended to answer the research question. The question should be explicit as well as meaningful and coherent (Mantzoukas, 2008).
Examples
An area of research may be ‘the experience of chronic pain’, or ‘living with diabetes’. A topic would be a more specific aspect of the area, for instance, ‘old people’s experience of chronic pain and their coping strategies’ or ‘chronic back pain and changes in identity’. The research question or problem might be phrased: ‘How do old people experience and cope with pain?’ or ‘The relationship between chronic illness and self perception.’
A data collection question is much more specific, such as ‘How did you feel when you had that asthma attack?’ or ‘Tell me how you coped with your pain?’ These are not research questions but interview questions.
Nurses and other health researchers often notice problems in their work setting which they feel need investigation so that solutions or remedies for unsatisfactory situations or behaviour may be found. Sometimes the topic emerges from the literature linked to a particular area of professional work where gaps in knowledge can be identified. Nursing/midwifery and other health research studies contribute to existing knowledge and enhance understanding of the area under investigation. Knowledge and understanding of an issue are not always enough, however; health professionals also seek solutions to problems in the clinical setting.
Personal observation and experience, as well as discussion with others, guide individuals towards the topic for research. Events and interactions often provide an interest or a puzzle and generate the wish to know more. The research question is a statement about what they want to find out and stems directly from a problem experienced in the clinical area or in their personal and professional lives. Holliday (2007) argues that research questions develop during the process of the research; they vary on a continuum from the broader and more general to the very specific and might be changed. Many health researchers have a question from the beginning of the study based on their clinical work.
It is important that the problem is related to professional work; for instance if nurses are working in the field of paediatrics it would be inappropriate (though not wrong) for them to undertake a project with old people, however much it might arouse their interest. A nurse on a ward for confused elderly people who had worried about accidents and falls might explore nurses’ perspectives on the care of old people and the problems involved in their care. A midwife who notices the reluctance of some women to breastfeed might use this as an area of investigation.
Certain criteria should be considered when identifying a research problem:
- The question must be researchable.
- The topic must be relevant and appropriate.
- The work must be feasible within the allocated time span and resources.
- The research should be of interest to the researcher.
The question must be researchable
Health researchers are often confronted with an important ethical or philosophical dilemma that cannot be solved through research. A moral or philosophical question is not researchable; for instance, the question of whether nurses or doctors should become involved in euthanasia is answerable only in philosophical but not in research terms.
Although the research problem need not be a practical one, it must nevertheless result in findings and outcomes. Research could not answer the question whether health professionals ‘should’ use euthanasia, but the topic of nurses’ perceptions of euthanasia would be researchable. ‘Do’ and ‘should’ questions are difficult to answer. ‘Do new mothers have feelings of inadequacy?’ would become ‘What are the feelings of new mothers about coping with their babies?’ to transform it into a research question.
Examples of researchable questions and topics
Fathers’ perspectives on the chronic illness of their children.
Nurse practitioners’ interactions with general practitioners.
How do people experience and cope with chronic pain?
The experience of a Caesarian section for first-time mothers.
(These questions would be more specific in the design of a study.)
The topic should be relevant and appropriate
Relevance means that the research is linked to clinical practice or professional issues. The question might also be important for patients or clients, the health professions or for society in general, and the answer will advance theoretical nursing and healthcare knowledge. The results should be applicable to practice, education or management, legitimising existing practices or leading the way towards change.
The work must be feasible
Health professionals are sometimes overambitious, especially if they are new to research. Rather than reflecting on the time the study may take and some of the detailed procedures and the complexity of analysis, they want to start the study straight away, before they have a thorough knowledge of methodology. Learning about methodology should be one of the first steps in research.
Time can become a problem in qualitative research because it is eaten up by transcribing, coding and categorising data. A simple small-scale study using a well-documented research strategy is far less time consuming than a complex piece of triangulation.
The research should be feasible in terms of resources and accessibility of participants, and researchers should identify whose resources will be used. The topic might be inappropriate because of major ethical and access problems which cannot be overcome, such as superiors not giving permission to do the research, or patients’ vulnerability. The research should also be feasible in terms of participant numbers or availability. Last but not least, it must be within the researcher’s knowledge and capability and the time frame available.
The research should be of interest to the researcher
If the topic is interesting, it can stimulate and motivate rather than generate boredom during the course of the study, and it can be sustained only if the researcher is fully involved. The storyline of the project is not merely controlled by the participants but it reflects the interest of the researcher.
The selection of the focus takes time, reflection and discussion with others who have knowledge in the field of study. Students in particular should discuss the focus of their work with their tutors and supervisors. All too often, new researchers in qualitative research choose a question that is designed to deal with factual issues and needs a survey rather than a qualitative approach.
Example
A nurse decides to research the availability of counselling services in the area. He or she decides to ask questions from patients and nurses in the community about access to these services. A qualitative study would not be useful, as a questionnaire is more appropriate to elicit this detailed information about facts. If however the experience of the counselling services by patients is the topic of the research, a qualitative study would be useful.
Quantitative researchers focus on a very specific area and plan every detail before the start of the study, while qualitative researchers initially formulate the question in more general terms and develop and focus it during the research process. Qualitative researchers generally begin with a broad question and become more specific in the process of the research, responding to what they hear and find in the setting (progressive focusing). The research design is evolutionary rather than strictly pre-defined. This needs flexibility on the part of researchers.
Example
A community nurse might be interested in the perspectives of diabetic patients on their condition. As many of her clients are elderly patients with diabetes, she decides that the focus of the study should be their experience. However, on searching the literature on this topic, she might find that a large number of studies exist on the perspectives of older people with diabetes, but nobody might yet have examined children’s experiences or those of their parents. The final aim of the project then could be ‘to explore the experience and management of diabetes by children and their parents’ (or similar).
Practical issues
Beginners, such as pre-registration students, might undertake a simple study suitable to show that they understand the research process and can produce a valid and useful project. We advise novice researchers not to carry out research involving patients except in exceptional circumstances, for instance if they have long nursing experience, special expertise in their field and expert supervision. For inexperienced researchers it is particularly important to be clear and straightforward. The clearer the question, the clearer is the outcome of the study.
The research design and choice of approach
The research design needs to be appropriate for the chosen topic and research question. The design of the study depends entirely on the topic to be studied and on the developing research question. There is of course no reason why researchers may not choose to develop a qualitative research project but the method must fit the problem or question.
The literature review
After identifying the research question, investigators review the important literature consisting of the information published and closely related to the area of the project, including both primary and secondary sources. Primary sources are produced by researchers who developed original work on a subject or researched this topic. For the researcher this means searching for the topic area in research and academic journals and books. Secondary information consists of reports, summaries or references to original work originating from a person other than the researcher. Library catalogues and on-line data bases are useful locations for research in the general area of the researcher’s topic; Hansen (2006) adds government reports and conferences to the list of places for finding relevant literature. The literature reviewed before the start of the inquiry and during the process would include foundational early texts and up-to-date references. The literature search involves searching data bases and journals which are of relevance for the topic area.
Researchers review the literature for the following reasons at the beginning:
- To find out what is already known about the subject and acknowledge those who have worked in this area
- To identify gaps in knowledge
- To describe how the study contributes to existing knowledge of a topic area
- To avoid duplicating other people’s work
- To assist in defining the research question
- To place their research in the context of other studies
- To show that they have reflected on the research question
Punch (2006) points out the specific importance of certain aspects:
Through reading reports (articles and books) researchers can identify what knowledge about the subject of their study already exists, the way in which it was generated, and the methods that were adopted. They may find a large number of studies on the particular topic and decide to avoid it, not wishing to focus on issues that others have thoroughly examined at an earlier stage. There is little justification for researchers to keep to their original research question if the topic has already been addressed exhaustively and adequately elsewhere. However, the literature sometimes points to problems within the subject area that have not yet been investigated.
Examples
A Scottish nurse researcher wishes to examine the topic of interprofessional mentorship and finds that several research studies have been carried out in the United States. He did however not find studies in Scotland and proceeds to investigate this.
A physiotherapist seeks to gain perspectives on a specific chronic illness condition. Many professionals have written about this condition, but there is no study about the perceptions and experience of patients themselves. Although much literature exists in the field, the researcher is justified in carrying out a study with patient participants if this is new and has not been done before.
A simple detailed description of the literature is not enough. It must be critically reviewed and evaluated, even in the initial literature review; researchers appraise others’ work within the context of what they themselves intend to do.
The use of literature in qualitative research
Although the literature review is not extensive in a qualitative proposal, researchers need to know from the beginning how other writers’ work is used in a piece of qualitative research; they also must be aware that the initial literature review is not exhaustive as it should not direct the study since researchers initially take an inductive approach.
There is a debate about the place of the literature in qualitative research. We know that in quantitative studies researchers read the literature about a topic area and give a detailed evaluative report in the literature review before they start the fieldwork. In the early days of qualitative investigations, researchers were encouraged to start without a literature review so that they would not be directed in their research, as it was believed that a detailed review would invalidate the qualitative research study; indeed Glaser (2004) and earlier writings strongly advise against any type of literature review on the specific topic in the beginning of the study, and advocate instead a wider view which includes the areas around a study rather than specifically addressing the particular topic area. However, some sort of trawl and search for literature should be carried out, because an answer to the question may already exist in the public domain. In any case, researchers’ minds are not a tabula rasa, a blank sheet, especially not when they are already experienced professionals. Although it is inappropriate to start with a fully developed theoretical model and an in-depth literature review, it is dangerous to start without any prior ideas of what has already been done in the field. The introductory literature review (or overview) should not be seen to direct the research. However, as Haverkamp and Young (2007) point out, the literature review for a research project is not about the knowledge researchers already possess but how they make use of what they know while carrying out a study.
Researchers do not start the study with a rigid framework, hypotheses or fully developed theories for their research. In qualitative research a flexible conceptual framework is necessary, as the study is linked to other research and ideas about the topic. For instance, one of our students researched a specific topic in which gender and class were important aspects. His theoretical position on gender and class were developed from the beginning and formed a framework within which his study proceeded.
An overview of the literature often takes place prior to the study, but the literature search and review proceeds throughout . The literature might even become another source for data in the main body of the study, where it is guided by the findings and emerging themes of the researcher. The researchers compare or contrast their own findings with those of other studies and engage in an active debate and dialogue with results reported in the literature. This happens throughout the study. Metcalfe (2003) advises researchers that previous authors should be treated as ‘experts’ or authorities in the field in much the same way that witnesses are called to court to give evidence. The researcher must make a case for calling on the work of these authors and show that they have credibility. Hence it is not necessary to quote each single piece of research that has ever been done; it suffices if credible experts have been consulted in each major area of the research. Their studies and writing is to confirm or disconfirm (challenge) the findings and the argument that the researcher has established, indeed, they form ‘building blocks’ for the argument. The publications chosen, however, must demonstrate that the researcher does not show only one single point of view but has presented a balanced choice.
Often, a category or construct that researchers discover and develop is reflected in other disciplines or areas of knowledge. Ideas about the emerging concepts can then be followed up in the literature. A look at the nursing or health literature does not always suffice; psychological, educational or sociological literature might also be useful.
Example
An investigator finds that ‘returning to normal’ is a major issue for people who have had a myocardial infarction (MI). He or she then follows up the idea of ‘becoming normal, being normal, normalisation’ etc. in other fields of study. Research accounts about people with a disability or an illness condition, and how they try to achieve normality, can then become part of the dialogue between findings and literature in the study of MI patients.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
