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Post Graduate Health & Nursing: The Research Question

Coming up with a good question

Formulating a strong research question can be more challenging than anticipated and often involves extensive preliminary research. However, once you’ve settled on a well-crafted question, you’ll notice that your research process becomes significantly smoother.

 

It can be a balancing act:

Topic: Something that you are interested in; but be prepared to tweak it to fit other criteria, so don't get overly attached to it.

Scope: Not too broad and not too narrow

Originality: Original, but not so unique that there is very little research out there, you need to find your niche, your gap in the literature.

Hulley et al. (2007) are credited for the implementation of the FINER criteria (outlined in some of the articles linked below) which encourages the researcher to consider whether their question is:

 

Feasible

Interesting to the investigator

Novel

Ethical

Relevant

Hulley, S. B., Cummings, S. R., Browner, W. S., Grady, D. G, & Newman, T. B. (2007). Designing clinical research. Lippincott Williams & Wilkins.  

Further Reading

PICO & Search Frameworks

PICO

One of the things you will see mentioned a lot in the world of systematic reviews, is PICO (particularly in health areas).  This is a framework for structuring a research question.  It can help to ensure that you clearly define the research question, it helps you to organise the concepts into a comprehensive search strategy, and assists with the defining of inclusion and exclusion criteria which in turn improves the consistency and transparency of a review.

PICO stands for:

For our hypothetical research question looking at: Effectiveness of social media interventions on the eating behaviours of teenagers, our PICO might look something like:

P Adolescents 
I Social media
C N/A
O Improved eating behaviours 

For this particular question we don't have a comparator as we aren't comparing two interventions - this is not uncommon, so really in this case, we'd be using a PIO structure.  Sometimes the I might stand for area of Interest. There are other variations on PICO for example:

  • PICOT: where T stands for timeframe.  
  • PICOC: where stands for context
  • PECO: where E stands for Exposure

Many of you will be doing non-clinical reviews and/or reviews on qualitative topics, in which case, PICO might not fit your needs.  Don't worry, there are other frameworks out there to consider, see the box in this guide called "Alternative Question Frameworks" .

Further Reading

Alternative Question frameworks

The PEO structure can be more suited for qualitative research because it looks more at an issue of interest (exposure) than an intervention.

 

    Example: How do nurses in rural healthcare setting perceive their work-life balance?
Population who the study will be focused on Nurses in rural healthcare settings
Exposure  the area of interest / issue / experience work-life balance experience/perceptions
Outcomes The impact of the exposure on the population How is it affecting these nurses' professional/personal lives?  Does anything need to be improved?

The PCC structure is recommended for scoping reviews by JBI as it "clearly identifies the focus and context of the review" (Peters et al., 2020)

 

    Example: How do social norms influence adolescents' attitudes and behaviors toward climate change action and mitigation
Population Who the study will be focused on  Adolescents
Concept the area of interest / issue / experience / outcomes Peer influence on attitudes and behaviours
Context geographic location / social or cultural factors / setting (e.g. hospital, primary healthcare, community) School or community-based climate change education / climate change response or action.

Peters, M. D. J., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis, 18(10), 2119-2126. https://doi.org/10.11124/jbies-20-00167

The ECLIPS framework can be useful when you are researching specifically for the purposes of a policy or service implementation or improvement.

    Example: Interprofessional communication for post-operative patients
Expectation What you are wanting the research to inform or improve Implementation of interprofessional communication procedures 
Client group Population you are aiming to help or improve outcomes for Post-operative patients with multiple complications
Location Area within the healthcare system that this service or policy will be used Hospital
Impact What is the change of service/policy being researched and what measurements of success might be Improved health outcomes for patients
Professionals Staff involved Physicians and nurses
Service area The specific area of service being targeted. Inpatients

 

The SPICE framework can be useful when the focus is qualitative research for the purposes of a policy or service implementation or improvement.

    Example: The perceptions of Kiwi teenagers towards vaping promotion and prevention information.
Setting  The setting or context Aotearoa New Zealand
Perspective  The perspectives of a particular population (e.g. clients, stakeholders) Teenagers
Intervention/area of interest/exposure The action being taking for the population  Vaping prevention
Comparison Comparison with an alternative or existing action Vaping promotion
Evaluation (outcomes) Evaluation of the outcome or the measurement of success Ways to improve vaping cessation or prevention education for New Zealand's teenagers.

The SPIDER framework can be useful for qualitative or mixed methods research that is looking at the experiences of a sample rather than a population as a whole.

    Example: How do first-time mothers perceive the support they receive from midwives during home births in terms of their birth experience?
Sample Sample of the population or group of participants First-time mothers
Phenomenon of Interest Issue, topic, service being explored Home birth support received from midwives
Design of research Techniques used to gather the data. Focus Groups
Evaluation (outcomes) The outcomes or outcome measures of the study. Home birth experience 
Research type Research method being followed, e.g. qualitative, ethnographic. Qualitative