qualitative research examples in nursing

Introduction to qualitative nursing research

This type of research can reveal important information that quantitative research can’t.

Qualitative research is valuable because it approaches a phenomenon, such as a clinical problem, about which little is known by trying to understand its many facets.
Most qualitative research is emergent, holistic, detailed, and uses many strategies to collect data.
Qualitative research generates evidence and helps nurses determine patient preferences.

Research 101: Descriptive statistics

Differentiating research, evidence-based practice, and quality improvement

How to appraise quantitative research articles

All nurses are expected to understand and apply evidence to their professional practice. Some of the evidence should be in the form of research, which fills gaps in knowledge, developing and expanding on current understanding. Both quantitative and qualitative research methods inform nursing practice, but quantitative research tends to be more emphasized. In addition, many nurses don’t feel comfortable conducting or evaluating qualitative research. But once you understand qualitative research, you can more easily apply it to your nursing practice.

What is qualitative research?

Defining qualitative research can be challenging. In fact, some authors suggest that providing a simple definition is contrary to the method’s philosophy. Qualitative research approaches a phenomenon, such as a clinical problem, from a place of unknowing and attempts to understand its many facets. This makes qualitative research particularly useful when little is known about a phenomenon because the research helps identify key concepts and constructs. Qualitative research sets the foundation for future quantitative or qualitative research. Qualitative research also can stand alone without quantitative research.

Although qualitative research is diverse, certain characteristics—holism, subjectivity, intersubjectivity, and situated contexts—guide its methodology. This type of research stresses the importance of studying each individual as a holistic system (holism) influenced by surroundings (situated contexts); each person develops his or her own subjective world (subjectivity) that’s influenced by interactions with others (intersubjectivity) and surroundings (situated contexts). Think of it this way: Each person experiences and interprets the world differently based on many factors, including his or her history and interactions. The truth is a composite of realities.

Qualitative research designs

Because qualitative research explores diverse topics and examines phenomena where little is known, designs and methodologies vary. Despite this variation, most qualitative research designs are emergent and holistic. In addition, they require merging data collection strategies and an intensely involved researcher. (See Research design characteristics .)

Although qualitative research designs are emergent, advanced planning and careful consideration should include identifying a phenomenon of interest, selecting a research design, indicating broad data collection strategies and opportunities to enhance study quality, and considering and/or setting aside (bracketing) personal biases, views, and assumptions.

Many qualitative research designs are used in nursing. Most originated in other disciplines, while some claim no link to a particular disciplinary tradition. Designs that aren’t linked to a discipline, such as descriptive designs, may borrow techniques from other methodologies; some authors don’t consider them to be rigorous (high-quality and trustworthy). (See Common qualitative research designs .)

Sampling approaches

Sampling approaches depend on the qualitative research design selected. However, in general, qualitative samples are small, nonrandom, emergently selected, and intensely studied. Qualitative research sampling is concerned with accurately representing and discovering meaning in experience, rather than generalizability. For this reason, researchers tend to look for participants or informants who are considered “information rich” because they maximize understanding by representing varying demographics and/or ranges of experiences. As a study progresses, researchers look for participants who confirm, challenge, modify, or enrich understanding of the phenomenon of interest. Many authors argue that the concepts and constructs discovered in qualitative research transcend a particular study, however, and find applicability to others. For example, consider a qualitative study about the lived experience of minority nursing faculty and the incivility they endure. The concepts learned in this study may transcend nursing or minority faculty members and also apply to other populations, such as foreign-born students, nurses, or faculty.

Qualitative nursing research can take many forms. The design you choose will depend on the question you’re trying to answer.


Action research	Education	Conducted by and for those taking action to improve or refine actions	What happens to the quality of nursing practice when we implement a peer-mentoring system?
Case study	Many	In-depth analysis of an entity or group of entities (case)	How is patient autonomy promoted by a unit?
Descriptive	N/A	Content analysis of data
Discourse analysis	Many	In-depth analysis of written, vocal, or sign language	What discourses are used in nursing practice and how do they shape practice?
Ethnography	Anthropology	In-depth analysis of a culture	How does Filipino culture influence childbirth experiences?
Ethology	Psychology	Biology of human behavior and events	What are the immediate underlying psychological and environmental causes of incivility in nursing?
Grounded theory	Sociology	Social processes within a social setting	How does the basic social process of role transition happen within the context of advanced practice nursing transitions?
Historical research	History	Past behaviors, events, conditions	When did nurses become researchers?
Narrative inquiry	Many	Story as the object of inquiry	How does one live with a diagnosis of scleroderma?
Phenomenology	Philosophy Psychology	Lived experiences	What is the lived experience of nurses who were admitted as patients on their home practice unit?

A sample size is estimated before a qualitative study begins, but the final sample size depends on the study scope, data quality, sensitivity of the research topic or phenomenon of interest, and researchers’ skills. For example, a study with a narrow scope, skilled researchers, and a nonsensitive topic likely will require a smaller sample. Data saturation frequently is a key consideration in final sample size. When no new insights or information are obtained, data saturation is attained and sampling stops, although researchers may analyze one or two more cases to be certain. (See Sampling types .)

Some controversy exists around the concept of saturation in qualitative nursing research. Thorne argues that saturation is a concept appropriate for grounded theory studies and not other study types. She suggests that “information power” is perhaps more appropriate terminology for qualitative nursing research sampling and sample size.

Data collection and analysis

Researchers are guided by their study design when choosing data collection and analysis methods. Common types of data collection include interviews (unstructured, semistructured, focus groups); observations of people, environments, or contexts; documents; records; artifacts; photographs; or journals. When collecting data, researchers must be mindful of gaining participant trust while also guarding against too much emotional involvement, ensuring comprehensive data collection and analysis, conducting appropriate data management, and engaging in reflexivity.

Data usually are recorded in detailed notes, memos, and audio or visual recordings, which frequently are transcribed verbatim and analyzed manually or using software programs, such as ATLAS.ti, HyperRESEARCH, MAXQDA, or NVivo. Analyzing qualitative data is complex work. Researchers act as reductionists, distilling enormous amounts of data into concise yet rich and valuable knowledge. They code or identify themes, translating abstract ideas into meaningful information. The good news is that qualitative research typically is easy to understand because it’s reported in stories told in everyday language.

Evaluating a qualitative study

Evaluating qualitative research studies can be challenging. Many terms—rigor, validity, integrity, and trustworthiness—can describe study quality, but in the end you want to know whether the study’s findings accurately and comprehensively represent the phenomenon of interest. Many researchers identify a quality framework when discussing quality-enhancement strategies. Example frameworks include:

Trustworthiness criteria framework, which enhances credibility, dependability, confirmability, transferability, and authenticity
Validity in qualitative research framework, which enhances credibility, authenticity, criticality, integrity, explicitness, vividness, creativity, thoroughness, congruence, and sensitivity.

With all frameworks, many strategies can be used to help meet identified criteria and enhance quality. (See Research quality enhancement ). And considering the study as a whole is important to evaluating its quality and rigor. For example, when looking for evidence of rigor, look for a clear and concise report title that describes the research topic and design and an abstract that summarizes key points (background, purpose, methods, results, conclusions).

Application to nursing practice

Qualitative research not only generates evidence but also can help nurses determine patient preferences. Without qualitative research, we can’t truly understand others, including their interpretations, meanings, needs, and wants. Qualitative research isn’t generalizable in the traditional sense, but it helps nurses open their minds to others’ experiences. For example, nurses can protect patient autonomy by understanding them and not reducing them to universal protocols or plans. As Munhall states, “Each person we encounter help[s] us discover what is best for [him or her]. The other person, not us, is truly the expert knower of [him- or herself].” Qualitative nursing research helps us understand the complexity and many facets of a problem and gives us insights as we encourage others’ voices and searches for meaning.

When paired with clinical judgment and other evidence, qualitative research helps us implement evidence-based practice successfully. For example, a phenomenological inquiry into the lived experience of disaster workers might help expose strengths and weaknesses of individuals, populations, and systems, providing areas of focused intervention. Or a phenomenological study of the lived experience of critical-care patients might expose factors (such dark rooms or no visible clocks) that contribute to delirium.

Successful implementation

Qualitative nursing research guides understanding in practice and sets the foundation for future quantitative and qualitative research. Knowing how to conduct and evaluate qualitative research can help nurses implement evidence-based practice successfully.

When evaluating a qualitative study, you should consider it as a whole. The following questions to consider when examining study quality and evidence of rigor are adapted from the Standards for Reporting Qualitative Research.



o What is the report title and composition of the abstract? o What is the problem and/or phenomenon of interest and study significance? o What is the purpose of the study and/or research question?	→ Clear and concise report title describes the research topic and design (e.g., grounded theory) or data collection methods (e.g., interviews) → Abstract summarizes key points including background, purpose, methods, results, and conclusions → Problem and/or phenomenon of interest and significance is identified and well described, with a thorough review of relevant theories and/or other research → Study purpose and/or research question is identified and appropriate to the problem and/or phenomenon of interest and significance

o What design and/or research paradigm was used? o Is there evidence of researcher reflexivity? o What is the setting and context for the study? o What is the sampling approach? How and why were data selected? Why was sampling stopped? o Was institutional review board (IRB) approval obtained and were other issues relating to protection of human subjects outlined?	→ Design (e.g., phenomenology, ethnography), research paradigm (e.g., constructivist), and guiding theory or model, as appropriate, are identified, along with well-described rationales → Design is appropriate to research problem and/or phenomenon of interest → Researcher characteristics that may influence the study are identified and well described, as well as methods to protect against these influences (e.g., journaling, bracketing) → Settings, sites, and contexts are identified and well described, along with well-described rationales
o What data collection and analysis instruments and/or technologies were used? o What is the method for data processing and analysis? o What is the composition of the data? o What strategies were used to enhance quality and trustworthiness?	→ Sampling approach and how and why data were selected are identified and well described, along with well-described rationales; participant inclusion and exclusion criteria are outlined and appropriate → Criteria for deciding when sampling stops is outlined (e.g., saturation) and rationale is provided and appropriate → Documentation of IRB approval or explanation of lack thereof provided; consent, confidentiality, data security, and other protection of human subject issues are well described and thorough → Description of instruments (e.g., interview scripts, observation logs) and technologies (e.g., audio-recorders) used is provided, including how instruments were developed; description of if and how these changed during the study is given, along with well-described rationales → Types of data collected, details of data collection, analysis, and other processing procedures are well described and thorough, along with well-described rationales → Number and characteristics of participants and/or other data are described and appropriate → Strategies to enhance quality and trustworthiness (e.g., member checking) are identified, comprehensive, and appropriate, along with well-described rationales; trustworthiness framework, if identified, is established from experts (e.g., Lincoln and Guba, Whittemore et al.) and strategies are appropriate to this framework

o Were main study results synthesized and interpreted? If applicable, were they developed into a theory or integrated with prior research? o Were results linked to empirical data?	→ Main results (e.g., themes) are presented and well described and a theory or model is developed and described, if applicable; results are integrated with prior research → Adequate evidence (e.g., direct quotes from interviews, field notes) is provided to support main study results

o Are study results described in relation to prior work? o Are study implications, applicability, and contributions to nursing identified? o Are study limitations outlined?	→ Concise summary of main results are provided and thorough, including relation to prior works (e.g., connection, support, elaboration, challenging prior conclusions) → Thorough discussion of study implications, applicability, and unique contributions to nursing is provided → Study limitations are described thoroughly and future improvements and/or research topics are suggested

o Are potential or perceived conflicts of interest identified and how were these managed? o If applicable, what sources of funding or other support did the study receive?	→ All potential or perceived conflicts of interest are identified and well described; methods to manage potential or perceived conflicts of interest are identified and appear to protect study integrity → All sources of funding and other support are identified and well described, along with the roles the funders and support played in study efforts; they do not appear to interfere with study integrity

o What is the report title and composition of the abstract?

o What is the problem and/or phenomenon of interest and study significance?

o What is the purpose of the study and/or research question?

→ Clear and concise report title describes the research topic and design (e.g., grounded theory) or data collection methods (e.g., interviews)

→ Abstract summarizes key points including background, purpose, methods, results, and conclusions

→ Problem and/or phenomenon of interest and significance is identified and well described, with a thorough review of relevant theories and/or other research

→ Study purpose and/or research question is identified and appropriate to the problem and/or phenomenon of interest and significance

o What design and/or research paradigm was used?

o Is there evidence of researcher reflexivity?

o What is the setting and context for the study?

o What is the sampling approach? How and why were data selected? Why was sampling stopped?

o Was institutional review board (IRB) approval obtained and were other issues relating to protection of human subjects outlined?

→ Design (e.g., phenomenology, ethnography), research paradigm (e.g., constructivist), and guiding theory or model, as appropriate, are identified, along with well-described rationales

→ Design is appropriate to research problem and/or phenomenon of interest

→ Researcher characteristics that may influence the study are identified and well described, as well as methods to protect against these influences (e.g., journaling, bracketing)

→ Settings, sites, and contexts are identified and well described, along with well-described rationales

o What data collection and analysis instruments and/or technologies were used?

o What is the method for data processing and analysis?

o What is the composition of the data?

o What strategies were used to enhance quality and trustworthiness?

→ Sampling approach and how and why data were selected are identified and well described, along with well-described rationales; participant inclusion and exclusion criteria are outlined and appropriate

→ Criteria for deciding when sampling stops is outlined (e.g., saturation) and rationale is provided and appropriate

→ Documentation of IRB approval or explanation of lack thereof provided; consent, confidentiality, data security, and other protection of human subject issues are well described and thorough

→ Description of instruments (e.g., interview scripts, observation logs) and technologies (e.g., audio-recorders) used is provided, including how instruments were developed; description of if and how these changed during the study is given, along with well-described rationales

→ Types of data collected, details of data collection, analysis, and other processing procedures are well described and thorough, along with well-described rationales

→ Number and characteristics of participants and/or other data are described and appropriate

→ Strategies to enhance quality and trustworthiness (e.g., member checking) are identified, comprehensive, and appropriate, along with well-described rationales; trustworthiness framework, if identified, is established from experts (e.g., Lincoln and Guba, Whittemore et al.) and strategies are appropriate to this framework

o Were main study results synthesized and interpreted? If applicable, were they developed into a theory or integrated with prior research?

o Were results linked to empirical data?

→ Main results (e.g., themes) are presented and well described and a theory or model is developed and described, if applicable; results are integrated with prior research

→ Adequate evidence (e.g., direct quotes from interviews, field notes) is provided to support main study results

o Are study results described in relation to prior work?

o Are study implications, applicability, and contributions to nursing identified?

o Are study limitations outlined?

→ Concise summary of main results are provided and thorough, including relation to prior works (e.g., connection, support, elaboration, challenging prior conclusions)

→ Thorough discussion of study implications, applicability, and unique contributions to nursing is provided

→ Study limitations are described thoroughly and future improvements and/or research topics are suggested

o Are potential or perceived conflicts of interest identified and how were these managed?

o If applicable, what sources of funding or other support did the study receive?

→ All potential or perceived conflicts of interest are identified and well described; methods to manage potential or perceived conflicts of interest are identified and appear to protect study integrity

→ All sources of funding and other support are identified and well described, along with the roles the funders and support played in study efforts; they do not appear to interfere with study integrity

Jennifer Chicca is a PhD candidate at the Indiana University of Pennsylvania in Indiana, Pennsylvania, and a part-time faculty member at the University of North Carolina Wilmington.

Amankwaa L. Creating protocols for trustworthiness in qualitative research. J Cult Divers. 2016;23(3):121-7.

Cuthbert CA, Moules N. The application of qualitative research findings to oncology nursing practice. Oncol Nurs Forum . 2014;41(6):683-5.

Guba E, Lincoln Y. Competing paradigms in qualitative research . In: Denzin NK, Lincoln YS, eds. Handbook of Qualitative Research. Thousand Oaks, CA: SAGE Publications, Inc.;1994: 105-17.

Lincoln YS, Guba EG. Naturalistic Inquiry . Thousand Oaks, CA: SAGE Publications, Inc.; 1985.

Munhall PL. Nursing Research: A Qualitative Perspective . 5th ed. Sudbury, MA: Jones & Bartlett Learning; 2012.

Nicholls D. Qualitative research. Part 1: Philosophies. Int J Ther Rehabil . 2017;24(1):26-33.

Nicholls D. Qualitative research. Part 2: Methodology. Int J Ther Rehabil . 2017;24(2):71-7.

Nicholls D. Qualitative research. Part 3: Methods. Int J Ther Rehabil . 2017;24(3):114-21.

O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: A synthesis of recommendations. Acad Med . 2014;89(9):1245-51.

Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice . 10th ed. Philadelphia, PA: Wolters Kluwer; 2017.

Thorne S. Saturation in qualitative nursing studies: Untangling the misleading message around saturation in qualitative nursing studies. Nurse Auth Ed. 2020;30(1):5. naepub.com/reporting-research/2020-30-1-5

Whittemore R, Chase SK, Mandle CL. Validity in qualitative research. Qual Health Res . 2001;11(4):522-37.

Williams B. Understanding qualitative research. Am Nurse Today . 2015;10(7):40-2.

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Helen Noble 1 ,
Joanna Smith 2
1 School of Nursing and Midwifery, Queens's University Belfast , Belfast , UK
2 Department of Health Sciences , University of Huddersfield , Huddersfield , UK
Correspondence to : Dr Helen Noble School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK; helen.noble{at}qub.ac.uk

https://doi.org/10.1136/eb-2013-101603

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The aim of this paper is to equip readers with an understanding of the principles of qualitative data analysis and offer a practical example of how analysis might be undertaken in an interview-based study.

What is qualitative data analysis?

What are the approaches in undertaking qualitative data analysis.

Although qualitative data analysis is inductive and focuses on meaning, approaches in analysing data are diverse with different purposes and ontological (concerned with the nature of being) and epistemological (knowledge and understanding) underpinnings. 2 Identifying an appropriate approach in analysing qualitative data analysis to meet the aim of a study can be challenging. One way to understand qualitative data analysis is to consider the processes involved. 3 Approaches can be divided into four broad groups: quasistatistical approaches such as content analysis; the use of frameworks or matrices such as a framework approach and thematic analysis; interpretative approaches that include interpretative phenomenological analysis and grounded theory; and sociolinguistic approaches such as discourse analysis and conversation analysis. However, there are commonalities across approaches. Data analysis is an interactive process, where data are systematically searched and analysed in order to provide an illuminating description of phenomena; for example, the experience of carers supporting dying patients with renal disease 4 or student nurses’ experiences following assignment referral. 5 Data analysis is an iterative or recurring process, essential to the creativity of the analysis, development of ideas, clarifying meaning and the reworking of concepts as new insights ‘emerge’ or are identified in the data.

Do you need data software packages when analysing qualitative data?

Qualitative data software packages are not a prerequisite for undertaking qualitative analysis but a range of programmes are available that can assist the qualitative researcher. Software programmes vary in design and application but can be divided into text retrievers, code and retrieve packages and theory builders. 6 NVivo and NUD*IST are widely used because they have sophisticated code and retrieve functions and modelling capabilities, which speed up the process of managing large data sets and data retrieval. Repetitions within data can be quantified and memos and hyperlinks attached to data. Analytical processes can be mapped and tracked and linkages across data visualised leading to theory development. 6 Disadvantages of using qualitative data software packages include the complexity of the software and some programmes are not compatible with standard text format. Extensive coding and categorising can result in data becoming unmanageable and researchers may find visualising data on screen inhibits conceptualisation of the data.

How do you begin analysing qualitative data?

Despite the diversity of qualitative methods, the subsequent analysis is based on a common set of principles and for interview data includes: transcribing the interviews; immersing oneself within the data to gain detailed insights into the phenomena being explored; developing a data coding system; and linking codes or units of data to form overarching themes/concepts, which may lead to the development of theory. 2 Identifying recurring and significant themes, whereby data are methodically searched to identify patterns in order to provide an illuminating description of a phenomenon, is a central skill in undertaking qualitative data analysis. Table 1 contains an extract of data taken from a research study which included interviews with carers of people with end-stage renal disease managed without dialysis. The extract is taken from a carer who is trying to understand why her mother was not offered dialysis. The first stage of data analysis involves the process of initial coding, whereby each line of the data is considered to identify keywords or phrases; these are sometimes known as in vivo codes (highlighted) because they retain participants’ words.

View inline

Data extract containing units of data and line-by-line coding

When transcripts have been broken down into manageable sections, the researcher sorts and sifts them, searching for types, classes, sequences, processes, patterns or wholes. The next stage of data analysis involves bringing similar categories together into broader themes. Table 2 provides an example of the early development of codes and categories and how these link to form broad initial themes.

Development of initial themes from descriptive codes

Table 3 presents an example of further category development leading to final themes which link to an overarching concept.

Development of final themes and overarching concept

How do qualitative researchers ensure data analysis procedures are transparent and robust?

In congruence with quantitative researchers, ensuring qualitative studies are methodologically robust is essential. Qualitative researchers need to be explicit in describing how and why they undertook the research. However, qualitative research is criticised for lacking transparency in relation to the analytical processes employed, which hinders the ability of the reader to critically appraise study findings. 7 In the three tables presented the progress from units of data to coding to theme development is illustrated. ‘Not involved in treatment decisions’ appears in each table and informs one of the final themes. Documenting the movement from units of data to final themes allows for transparency of data analysis. Although other researchers may interpret the data differently, appreciating and understanding how the themes were developed is an essential part of demonstrating the robustness of the findings. Qualitative researchers must demonstrate rigour, associated with openness, relevance to practice and congruence of the methodological approch. 2 In summary qualitative research is complex in that it produces large amounts of data and analysis is time consuming and complex. High-quality data analysis requires a researcher with expertise, vision and veracity.

Cheater F ,
Robshaw M ,
McLafferty E ,
Maggs-Rapport F

Competing interests None.

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Nursing Research Guide

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What is qualitative research?

Qualitative research in Nursing approaches a clinical question from a place of unknowing in an attempt to understand the complexity, depth, and richness of a particular situation from the perspective of the person or persons impacted by the situation (i.e., the subjects of the study).

Study subjects may include the patient(s), the patient's caregivers, the patient's family members, etc. Qualitative research may also include information gleaned from the investigator's or researcher's observations.

While typically more subjective than quantitative research (which focuses on measurements and numbers), qualitative research still employs a systematic approach.

Qualitative research is generally preferred over quantitative research (which on measurements and numbers) when the clinical question centers around life experiences or meaning.

Adapted from:

Wilson, B., Austria, M.J., & Casucci, T. (2021 March 21). Understanding Quantitative and Qualitative Approaches
Chicca, J. (2020 June 5). Introduction to qualitative nursing research. American Nurse Journal.

Where can I find qualitative research?

Qualitative research can be found in numerous databases. Some good starting options are:

CINAHL Ultimate Journal articles and eBooks in nursing and allied health.
MEDLINE (EBSCOhost Web) Journal articles in medicine, life sciences, health care, and biomedical research.
APA PsycINFO Articles from journals, newspapers, and magazines, along with eBooks in nearly every social science subject area.
PubMed Citation search of journal articles and books in health and life sciences.

How can I find qualitative research?

Cinahl and/or medline.

Start at the Advanced Search screen.
Add a search term that represents the topic you are interested in into one (or more) of the search boxes.
Scroll down until you see the Limit your results section.
Qualitative - High Sensitivity (broadest category/broad search)
Qualitative - High Specificity (narrowest category/specific search)
Qualitative - Best Balance (somewhere in between)
Select or click the search button.

APA PsycINFO

Start at the Advanced Search screen.
Use the Methodology menu to select Qualitative .

APA PsychINFO qualitative research limiter.

Use the drop-down menu next the Enter search term box to set the search to MeSH Terms
Qualitative Research
Nursing Methodology Research

How can I use keywords to search for qualitative research?

Try adding adding a keyword that might specifically identify qualitative research. You could add the term qualitative to your search and/or your could add different types of qualitative research according to your specific needs and/or research assignment.

For example, consider the following types of qualitative research in light of the types of questions a researcher might be trying to answer with each qualitative research type:

Clinical question: What happens to the quality of nursing practice when we implement a peer-mentoring system?
Clinical question: How is patient autonomy promoted by a unit?
Clinical question: What is the nursing role in end-of-life decisions?
Clinical question: What discourses are used in nursing practice and how do they shape practice?
Clinical question: How does Filipino culture influence childbirth experiences?
Clinical question: What are the immediate underlying psychological and environmental causes of incivility in nursing?
Clinical question: How does the basic social process of role transition happen within the context of advanced practice nursing transitions?
Clinical question: When and why did nurses become researchers?
Clinical question: How does one live with a diagnosis of scleroderma?
Clinical question: What is the lived experience of nurses who were admitted as patients on their home practice units?

Adapted from: Chicca, J. (2020 June 5). Introduction to qualitative nursing research . American Nurse Journal.

Need more help?

Finding relevant qualitative research can be both difficult and time consuming. Once you conduct a search, you will need to review your search results and look at individual articles, their subject terms, and abstracts to determine if they are truly qualitative research articles. And that's a determination that only you can make.

If you still need help after trying the search strategies and tips suggested on this research guide, we encourage you to schedule an in-person or Zoom research appointment . Health Services librarian Rachel Riffe-Albright is a great bet, but any librarian would be happy to help!

Additonal resources on qualitative research

The following are research guides created by other academic libraries. While you likely will not have access to any of their linked resources, the tips and tricks shared may be useful to you as you search for qualitative research:

What is Qualitative Research? from UTA Libraries at University of Texas Arlington
Finding Qualitative Research Articles from Ashland University Library
Finding Qualitative Research Articles from the Health Sciences Library at University of Washington
Advanced Search Guide: Qualitative and Quantitative Studies from Southern Connecticut State University Library
Finding Qualitative and Quantitative Studies in CINAHL from Southern Connecticut State University Library
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Types of Research within Qualitative and Quantitative

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Aspects of Quantative (Empirical) Research

♦ Statement of purpose—what was studied and why.

♦ Description of the methodology (experimental group, control group, variables, test conditions, test subjects, etc.).

♦ Results (usually numeric in form presented in tables or graphs, often with statistical analysis).

♦ Conclusions drawn from the results.

♦ Footnotes, a bibliography, author credentials.

Hint: the abstract (summary) of an article is the first place to check for most of the above features. The abstract appears both in the database you search and at the top of the actual article.

Types of Quantitative Research

There are four (4) main types of quantitative designs: descriptive, correlational, quasi-experimental, and experimental.

samples.jbpub.com/9780763780586/80586_CH03_Keele.pdf

Types of Qualitative Research

	Attempts to shed light on a phenomena by studying indepth a single case example of the phenomena. The case can be an individual person, an event, a group, or an institution.
	To understand the social and psychological processes that characterize an event or situation.
	Describes the structures of experience as they present themselves to consciousness, without recourse to theory, deduction, or assumptions from other disciplines
	Focuses on the sociology of meaning through close field observation of sociocultural phenomena. Typically, the ethnographer focuses on a community.
	Systematic collection and objective evaluation of data related to past occurrences in order to test hypotheses concerning causes, effects, or trends of these events that may help to explain present events and anticipate future events. (Gay, 1996)

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Understanding Nursing Research

Primary Research

What is Quantitative Research?

How do i tell if my article has quantitative research, qualitative research.

Experimental Design
Is it a Nursing journal?
Is it Written by a Nurse?
Systematic Reviews and Secondary Research
Quality Improvement Plans

There are two kinds of research: Quantitative and Qualitative

Quantitative is research that generates numerical data. If it helps, think of the root of the word "Quantitative." The word "Quantity" is at its core, and quantity just means "amount" or "how many." Heart rates, blood cell counts, how many people fainted at the jazz festival-- these are all examples of quantitative measures.

Qualitative , on the other hand, is a more subjective measurement. Think of the root of the word again, this time it's "Quality." If someone is called a quality person or someone's selling a high quality product, they're being measured in subjective terms, rather than concrete, objective terms (like numbers.) Qualitative research includes things like interviews or focus groups.

Just like when we examine whether or not our article is an example of Primary Research, the best way to examine what kind of data your article uses is by reading the article's Abstract, Methodologies, and Results sections. That will tell you how the research was conducted and what kind of data (qualitative or quantitative) was collected.

An example of what to look for in the Abstract can be seen here:

You can see that data was evaluated (66% of students were in compliance with school immunization requirements), a strategy was implemented (letters and emails were sent to student's parents/guardians), and at the end of the study, new quantitative data is reported (99.6% of students were in compliance with vaccination requirements).

Finding qualitative research can be trickier, since it can often take more time to collect. Examples of qualitative data include things like interview transcripts, focus group feedback, and journal entries detailing people's experiences and feelings. The easiest way to search for a qualitative study is to include the word "qualitative" as a keyword in your database search along with the search terms about the topic you're interested in.

Check out the video below to see an example of searching for qualitative research in CINAHL.

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Last Updated: Aug 21, 2024 10:40 AM
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150 Qualitative and Quantitative Nursing Research Topics for Students

Do not be lazy to spend some time researching and brainstorming. You can either lookup for the popular nursing research topics on social media networks or news or ask a professional writer online to take care of your assignment. What you should not do for sure is refuse to complete any of your course projects. You need every single task to be done if you wish to earn the highest score by the end of a semester.

In this article, we will share 150 excellent nursing research topics with you. Choose one of them or come up with your own idea based on our tips, and you’ll succeed for sure!

Table of Contents

Selecting the Top Ideas for Your Essays in Healthcare & Medicine

Would you like to learn how to write a research paper topic for nursing students? We will share some tips before offering lists of ideas.

Start with the preliminary research. You can get inspired on various websites offering ideas for students as well as academic help. Gather with your classmates and brainstorm by putting down different themes that you can cover. You should take your interests into consideration, but still, remember that ideas must relate to your lessons recently covered in class. You have to highlight keywords and main phrases to use in your text.

Before deciding on one of the numerous nursing school research topics, you should consult your tutor. Make sure that he or she approves the idea. Start writing only after that.

50 Popular Nursing Research Topics

Are you here to find the most popular research topics? They change with each new year as the innovations and technologies move on. We have collected the top discussed themes in healthcare for you.

Problems Encountered by the Spouses of the Patients with Dyslexia
Ethics in Geriatrics
Checklist for the Delivery Room Behavior
Parkinson Disease: Causes and Development
Exercises Used to Improve Mental Health
Effective Tips for Antenatal Treatment
Syndrome of the Restless Legs: How to Treat It
Behavior Assessment in Pediatric Primary Care
Why Can Mother’s Health Be under the Threat During the Child Birth?
Recommendations for Creating Strong Nursing Communities
Alzheimer’s Disease and Proper Treatment
Pre-Term Labor Threats
Music Therapy and Lactation
Influence of Ageism on Mental Health
Newborn Resuscitation Practices
Effective Therapy for Bladder Cancer
Approaches to Improving Emotional Health of Nurses
Skin-to-skin Contact by mothers and Its Consequences
Does a Nurse Have a Right to Prescribe Drugs?
Research on Atrial Fibrillation
Pros & Cons of Water Birth
Prevention Measures for Those Who Have to Contact Infectious Diseases
Stroke Disease and Ways to Cure It
The Role of Governmental Policies on the Hiring of Healthcare Professionals
Demands for the Critical Care
Joint Issue Research in Elderly Population
Why Should Nurses and Healthcare Workers Cooperate?
The Role of Good Leadership Skills in Nursing Profession
How to Minimize the Threat of Cardiovascular Problems
What Should a Nurse Do When an Elderly Refuses to Eat?
Main Reasons for the Depression to Occur
Methods Used to Detect an Abused Elderly Patient
Treatment and Prevention of Acne and Other Skin Problems
Consequences of the So-Called “Cold Therapy”
End-of-Life Care Interventions That Work
Risk factors for Osteoporosis in Female Population
Alcohol Addiction and How to Get Rid of It
Emerging Ethical Problems in Pain Management
Psychiatric Patient Ethics
How to Teach Female Population about Menopause Management
Reasons for Aged Patients to Use Alcohol in Nursing Homes
Family Engagement in Primary Healthcare
Do the Race and Gender of a Patient Play a Role in Pain Management?
PTSD in the Veterans of the United States Army
How to Prepare a Nurse for Primary Healthcare
The Correlation between Teen Aggression and Video Games
Outcomes of Abdominal Massage in Critically Sick Population
Developing an Effective Weight Loss Program: Case Study
Comparing and Contrasting Public Health Nursing Models in Various Regions
Mirror Therapy for Stroke Patients Who Are Partially Paralyzed

50 Interesting Nursing Research Topics

Do you wish to impress the target audience? Are you looking for the most interesting nursing research topics? It is important to consider time and recently covered themes. People tend to consider a topic an interesting one only if it is relevant. We have prepared the list of curious ideas for your project.

Reasons for Hypertensive Diseases
Self-Care Management and Sickle Cell Grown-Up Patients
Schizophrenia Symptoms, Treatment, and Diagnostics
Acute Coronary Syndrome Care
Getting Ready with Caesarean Section
What Are Some of the Cold and Cough Medicines?
Why Do Patients Suffer from Anxiety Disorders?
Use of the Forbidden Substances in Medicine
How to Make Wise and Safe Medical Decisions
CV Imaging Procedure
Complementary vs. Alternative Therapy
Can Some Types of Grains Prevent Cardiovascular Diseases?
Restrictions of Medical Contracts
How to Cope with High Levels of Stress
Legal Threats with Non-English Patients
The Basics of Palliative Care
Clinical Cardiology Innovations
How to Reduce Body Temperature in Household Conditions
What Causes Type II Diabetes?
Ways to Control Blood Pressure at Home
Dental/Oral Health in the US
Is There a Gender Bias in Nursing Profession?
Gyno Education for the Young Girls
Bipolar Disorder and Its Main Symptoms
Methods Used to Recover after Physical Traumas
The Principles of Sports Medicine
The Gap between Female and Male Healthcare Professionals
Increasing the Efficiency of Asthma Management in Educational Establishments
Different Roles of Clinical Nurses
Case Study: Successful Treatment of Migraine
In-depth Analysis of the Ovarian Disorder
Distant Intensive Treatment Until Questions
Proper Treatment of Sleep Disorders
How to Overcome Stressful Situations during Night Shifts
Effective Methods to Prevent Breast Cancer
Future of Healthcare & Medicine (Based on Modern Innovations)
Approaches to Treating Insomnia
Reproductive Endocrinology
Diversity in the Field of Medicine
Issues Associated with Menopause
Causes and Effects of the Vaginal Atrophy
Is Child’s Health Insurance a Right or a Privilege?
Best Practices for Nursing Practitioners
What Does the Phenomenon of Phantom Pains Stand for?
Ethical Aspects of Infertility
Protocol for Headache Treatment
Moral Aspects of Euthanasia
Treatment of Homeless People
Why Should Healthcare System Be Made Free Everywhere in the World?
Pain Restrictions Evaluation

50 Good Nursing Research Topics

Here is one more list of the nursing topics for research paper. We hope that at least one of these ideas will inspire you or give a clue.

Advantages of Pet Therapy in Kids with the Autism Disorder
Contemporary Approaches to Vaccinating Teenagers
eHealth: The Effectiveness of Telecare and eCare
Burn-Out in the Nursing Profession: Effective Ways to Handle Stress
Healing of Bone Injuries
Providing Spiritual Care: Does It Make Sense?
Rheumatoid Arthritis: Opioid Usage
Symptoms in ER That Cannot Be Explained by Medicine
Contemporary Neonatal Practices
Disorders with the Sexual Heath of an Average Woman
Typical Causes of Headache
Top Measures Used to Prevent Pregnancy
Strategies Used by Government to Finance Healthcare System
The Possible Consequences of Abortion for Women
Evaluation of Childbirth Efficacy
Quality Evaluation Techniques in Healthcare & Medicine
Maternal Practices in Urban Areas
Childcare Services Integration in Primary Medicine
Rules for Pregnant Women Who Suffer from Obesity
Mental Causes of Anorexia Nervosa
Self-Instruction Kits
Post-Natal Period Recommendations
Midwifery Continuous Treatment & Care
Case Study: Analyzing Positive Birth Experience
Issues Related to the Gestational Weight Gain
The Importance of Healthy Nutrition and Hydration
What Are the Obligations of Every Nurse in Any Situation?
Causes, Symptoms, and Treatment of ADHD
Management of Disease and Prevention Methods
The Importance of Kid and Teen Vaccination
Termination of Pregnancy: Risks for Female Health
Obligations of Every Pharmacist
How to Prevent Child Obesity
How to Stick to the Safe Sex Culture
What Are the Main Symptoms of Autism?
Ethics of the Healthcare Sales Promotion Campaigns
Pros and Cons of Telemedicine
Ethics in Pediatric Care
Therapies Used to Treat Speech Disorders
Medical Uniform Code Principles
Psychological Sides of Infant Treatment
Reasons for Seizures to Happen in Young Adolescents
Healthcare Home Service and Self-Medicine
How to Deal with Various Types of Eating Disorders
Treatment of Patients in Prison
Patient Security and Human Factors
Bad Habits and Illnesses Impacted by Social Media and Pop Culture
Apology Legislation and Regulations
Antibiotic Resistance in Small Kids
Nursing Marijuana Management & Control

You should also know that there are qualitative and quantitative nursing research topics. If you decide to base your study on numbers and figures, you should think about the second category. In quantitative research papers, writers must provide statistical data and interpret it to defend a thesis statement or find a solution to the existing problem.

Keep in mind that you can always count on the help of our professional essay writers. They will come up with the good nursing research topics and even compose the whole paper for you if you want.

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Open access
Published: 13 September 2024

The phenomenon of yoga in the imagination of Turkish nursing students: "The way to place goodness in the heart"

Özüm Erki̇n 1 ,
Aynur Çeti̇nkaya 2 &
Begüm Güler 3

BMC Nursing volume 23 , Article number: 655 ( 2024 ) Cite this article

Metrics details

The aim of the research is to shed light on the experiences of a group of nursing students enrolled in a yoga elective course who practiced yoga regularly for 14 weeks, regarding yoga and the phenomenon of doing yoga, with a qualitative approach.

This qualitative study was conducted at a public university in Izmir, Turkey. The study sample consisted of 61 students enrolled in the 1st-year yoga course at the Department of Nursing, Faculty of Health Sciences. Except for two students, 59 of them participated in the study. Participants attended a face-to-face yoga course once a week for 1.5 h over a 14-week period. Each session comprised 30 min of theoretical instruction and 60 min of practice. In data collection, an interview form containing five questions was used to understand nursing students' experiences and thoughts about practicing yoga. In addition, A4 sized papers in different colors were presented to the participants. The participants were asked to draw and/or cut a shape by choosing the paper in the color that most evokes yoga. Then they were asked to explain why they chose this color and why they drew this shape. Participants were given one hour. After the data were collected, the pictures drawn by the participants and their descriptions of their drawings were transferred to the computer and included in the analysis. Qualitative data were hand-coded by the researchers. Within in-vivo coding, code names were formed from the participants' expressions. The findings analyzed by content analysis were interpreted with the literature under the themes by presenting quotations.

It was determined that the participants used nature figures (sun, cloud, tree, sky, flower) (f = 75), people doing yoga (f = 12), and sound, light and other figures (bird sound, wave sound, candle, light bulb, traffic light, heart, eye, left key, peace, swing, India, circle, etc.) (f = 29) in the shapes they drew and cut out on A4 sized papers in different colors to describe their experiences and thoughts about practicing yoga. The participants mostly chose blue-green-yellow colors ( n = 41). With qualitative question analysis, a list of codes was created from the answers given by the students to the questions for the phenomenon of “doing yoga” (number of codes = 98). After the analysis of the data, four categories were reached. The category names and frequency numbers explaining the phenomenon of practicing yoga were distributed as “symbol of health and serenity (f = 345)”, “the way to place goodness in your heart (f = 110)”, “the most effective way to meet the self (f = 93)” and “no guarantee of relaxation (f = 71)”, respectively.

Conclusions

The results indicate that yoga is perceived by nursing students as a multifaceted practice that evokes a range of emotional and physical responses. Most participants associate yoga with symbols of health, serenity, and self-awareness, often using natural elements and blue-green-yellow the colors to represent these feelings. However, there is also recognition that yoga may not guarantee relaxation for everyone, as some students reported difficulties in meditation, physical discomfort, and challenges in focusing. The study highlights the variability in how individuals experience yoga, emphasizing both its positive effects on well-being and the potential challenges in practice. These findings suggest that while yoga is widely valued for its calming and health-promoting benefits, it may not be universally effective in achieving relaxation or mindfulness.

Peer Review reports

Introduction

Yoga is a practice that has been subject to many different interpretations and translations over thousands of years. Patanjali's phrase "Yogas Chitta Vrittis Nirodha" translates to "Yoga is the cessation of the fluctuations of the mind" in English [ 1 ]. Hagen & Hagen (2024) have emphasized that yoga is commonly understood in society as a tool for mental calmness and balance[ 2 ]. This provides a comprehensive model for personal development, contributing to the individual's balanced harmony in every aspect—mental, physical, emotional, and spiritual [ 3 , 4 ]. By developing inner awareness as well as meta-awareness, yoga offers a roadmap for individuals to see and understand their own state and surroundings more clearly [ 5 ]. Yoga enhances physical functionality by alleviating pain and discomfort, thereby reducing physical ailments. Moreover, yoga offers physical health benefits, including increased strength and flexibility, as well as improved posture [ 6 , 7 , 8 , 9 , 10 ].

According to Bhavanani (2014), yoga extends beyond mere physical or mental health; it also addresses emotional, social, and spiritual needs [ 11 ]. By increasing personal awareness, it can strengthens both inner attachment and social connections [ 6 , 9 , 12 ]. Research shows that participants' self-confidence increases during yoga practice, and they might gain better skills to manage their mental health. This underscores not only the physical advantages of yoga but also its significant contributions to mental and emotional well-being [ 8 , 9 , 13 , 14 ]. Yoga can fosters heightened bodily awareness, elevates mood, and enhances overall well-being. It also promotes self-acceptance, personal fulfillment, and social harmony. This holistic process provides psychological relief and mental tranquility, aiding in the management of common mental health issues such as anxiety and depression [ 11 ].

Today, young adults increasingly experience stress, pressure, and mental health issues [ 15 ]. Research links young people's stress levels to high demands at school and the pressure to meet these demands [ 16 ]. Additionally, lack of physical activity and sleep problems also can contribute to their difficulties in coping with these issues [ 17 , 18 ]. Academic expectations from parents, especially those from middle-class families, can further increase the pressure on young people, leading them to evaluate their self-worth solely based on their achievements. This adds to the existing academic pressures, causing young people to worry more about future educational and career opportunities [ 19 ].

Yoga can physically contribute to nervous system balance by decreasing stress-related sympathetic activity and stimulating the parasympathetic system. Consequently, it can positively impact stress and mental health issues, particularly in young people. Nursing students, who often undergo a stressful educational period, can also benefit from these effects [ 20 , 21 , 22 , 23 , 24 ]. Therefore, it is recommended to integrate mindfulness programs, including breathing techniques, meditation, and yoga, into the nursing curriculum [ 21 , 22 ]. In the literature, a yoga course was integrated into the nursing curriculum in Turkey for the first time by Erkin and Aykar (2021) [ 20 ]. Most studies with students in the field of yoga in the literature are quantitative, although yoga has been studied in college students using qualitative methods, no studies found in nursing. This is one of the starting points of this research. The aim of the research is to shed light on the experiences of a group of nursing students enrolled in a yoga elective course who practiced yoga regularly for 14 weeks, regarding yoga and the phenomenon of doing yoga, with a qualitative approach. This qualitative study tries to fill this gap in the literature by explaining the imaginary meanings that nursing students attending yoga courses attribute to the yoga experience.

Design and participants

The research, designed in a qualitative type, was conducted during the 2018–2019 academic year. In line with the qualitative research approach, a purposeful sampling method was used. The qualitative method sees the experience of reality as subjective, varying from person to person. Moreover, it is a reliable method for studying a little known or understood area. Therefore, a qualitative descriptive design was adopted to explore students’ knowledge and perspectives [ 25 ].

Participants attended a face-to-face yoga course once a week for 1.5 h over a 14-week period. Each session comprised 30 min of theoretical instruction and 60 min of practice. The content of the yoga course is detailed in Table 1 . The theoretical component included a weekly 30-min PowerPoint presentation covering topics such as the history of yoga, meditation, breathing techniques (pranayama), yoga poses (asanas), chakras, mindfulness, and compassion. The practical sessions were conducted in a tranquil and dimly lit room, following a structured 60-min schedule: 15 min of pranayama (e.g., ocean breath, equal breathing, cooling breath, humming bee breath, alternate nostril breath, kapalbhati pranayama), 30 min of hatha yoga asanas involving gentle stretching and strengthening exercises with each pose held for 5–10 breaths and repeated five times, 5 min of meditation, and 10 min of shavasana. These sessions were led by a yoga instructor (first author) registered with the Yoga Alliance. No home practice was required. According to the course rules, students were allowed up to 20% absenteeism. At the end of the 14-week period, it was determined that students were absent for an average of 1.5 weeks. There was only one change in the planned yoga protocol. Although it was initially planned to use one breathing technique every two weeks, all breathing techniques were combined based on the students’ feedback and used in the sessions after students learned all the techniques (after the 6th week). Class attendance was encouraged through messages in a WhatsApp group. However, attendance was not included in the scoring.

The sample of the research was planned to consist of first-year students enrolled in the elective course "Yoga" in the Nursing Department of the Faculty of Health Sciences at İzmir Democracy University in Izmir ( N = 61). Two students did not participate in the study because the topic and objectives did not interest them. Data were collected from a total of 59 nursing students on a voluntary basis. After the yoga course, the last week interviews were conducted with 59 participants who voluntarily agreed to participate in the study. Of the participants (n:59), 40 were female and 19 were male, with ages ranging from 18 to 21. Forty-six participants described their health perception as "good," nine as "very good," and four as "poor." (Appendix 1).

Data collection

Data collection was conducted using a structured interview form alongside a creative activity where participants were asked to draw a picture and write a text representing the concept of doing yoga. Data were collected through structured interviews guided by a pre-developed interview Schedule (see Appendix 1). The structured interview form developed for this study included seven open-ended questions and prompts designed to elicit detailed responses from the participants regarding their experiences with the yoga course. Prior to commencing data collection with the main participant group, the interview schedule was pilot tested with five nursing students who met the inclusion criteria but were not part of the final sample. This pilot testing allowed for refinement of the interview questions and ensured clarity and comprehensiveness.

After obtaining the necessary permissions for the research, the students engaged in the yoga course were comprehensively briefed on the study’s objectives, content, methodology, and the individuals responsible for its execution. The last week of "Yoga" course (14th week), students asked to draw a picture and write a text representing the concept of doing yoga. Each student was given colored A4 papers and, for those who wished to use them, colored pencils in the classroom environment. Before starting to draw, students were asked to write their gender on the back of the paper, but not their name or surname. In addition to the picture they drew, they were asked to write their thoughts about yoga and what they drew regarding the concept of doing yoga on a separate piece of paper or in appropriate spaces on their drawing paper. Besides students filled the interview form. They also filled out a structured interview form to capture their experiences and thoughts about practicing yoga. Participants were given one hour to complete the task. After the data were collected, the drawings and their related descriptions made by the participants were digitized and included in the analysis [ 26 ]. For security purposes, the data were stored in Google Drive™ accessible to authors.

To examine subjective experiences, the techniques of "drawing" and "description" were used together, attempting to integrate the strengths of both methods. Participants were provided with A4 papers in different colors and asked to choose the color that most reminded them of yoga. Starting from the theme of "The meaning of doing yoga for them," participants were asked to draw pictures representing their perceptions and to write descriptions related to their drawings. In a similar approach referred to as "projective technique" in the literature, the drawing is accepted as a tool for reflecting emotions. Projection means expression and is based on the assumption that "an individual's behavior is a reflection of their personality" [ 26 , 27 ].

Data analysis and interpretation process

The data were analyzed using an inductive approach. Inductive analysis involves coding the data to categorize it, identifying relationships between these categories, and reaching a holistic picture based on this. The key point in data analysis in this study was to create categorical labels embedded in the data [ 26 , 27 ]. In this study, a code list was developed, data were coded, categories were created, and data were reported within these categories. Data analysis was conducted by the researchers through coding. For some themes, in-vivo coding, which is included in the qualitative research methodology of grounded theory, was used as an inductive coding process. In vivo coding involves creating a theme tag using the code that comes directly from the data, i.e., the participant's own expressions [ 28 ].

All these processes were carried out in collaboration with two field experts (ÖE, AÇ). Similar codes were grouped together to form a certain number of categories and reported to establish the main idea in the data. Comparing codes and categories with the literature aimed to contribute to the validity of the data analysis. At the end of the data collection phase, a conceptual model related to the topic was developed by the researchers [ 26 ]

The research team acknowledges the importance of reflexivity in qualitative research. The first researcher, who has a PhD degree in public health nursing with 16 years of experience in nursing, is an instructor of yoga courses for undergraduate nursing students. The researcher maintained a critical awareness of their own biases and assumptions that could potentially influence the data analysis throughout the research process. We aimed to minimize bias by employing a systematic thematic analysis approach and by regularly discussing the emerging themes with a second author, who is a specialist on qualitative research and has a qualitative PhD thesis in public health nursing. This cooperation contributed to ensuring the findings’ objectivity and reliability. Regretfully, it was not possible to get direct participant input on the findings because of the anonymous nature of the data collection process. The third researcher, who is a master’s degree student in public health nursing with 3 years of clinical experience in nursing, is an instructor of yoga. Nonetheless, we think that the utilization of rich participant quotes in conjunction with the iterative analytic process guarantees that the results truly reflect the participants’ experiences with the yoga course.

Ethics approval and consent to participate

Before starting data collection, information about the research was provided to the school administration, permission was obtained, and contact was made with the participants. Approval was obtained from the Ethics Committee of Manisa Celal Bayar University (02/12/2019, no:20.478.486). Participation was based on voluntariness and willingness, and students were informed about sensitive points related to the teacher-student relationship (such as participation or non-participation in the research not affecting their performance evaluations, etc.). Written informed consent to participate was obtained from all of the participants in this study.

Research validity and reliability

In qualitative research, the researcher investigating the problem is at the center of the research. The main measurement tool in the research is the researcher themselves. Therefore, the issue of objectivity has always been at the center of methodological debates in social sciences. In qualitative research, the concept of "trustworthiness" is considered instead of validity and reliability [ 27 ]. Various criteria of trustworthiness were considered in the processes of this research.

During the data analysis phase, in the creation of the code list, and in the interpretation of the findings, a comprehensive perspective was attempted to be reflected through a thorough literature review on the subject. All records in the data collection and analysis processes were kept systematically. Quotations were made from all data sources. The frequencies of the drawings and descriptions were determined, and those with high frequencies and those that were strikingly related to the topic were included. The data collection and data analysis processes were reported in detail as far as space limitations allowed, and original quotations from the data were included. Furthermore, in the quotations, descriptions written by the participants in their own handwriting were also used.

The number of participants in the study was 56. This number is considered sufficient for an in-depth exploration of the research topic. Students were instructed to create an illustration and compose a text depicting the concept of practicing yoga. Each student received colored A4 paper, and colored pencils were provided for those who wished to use them within the classroom setting. Prior to beginning their drawings, students were asked to indicate their gender on the back of the paper, ensuring that they did not include their name or surname. Alongside their drawings, students were required to write their reflections on yoga and describe what they had drawn related to the practice of yoga, either on a separate sheet of paper or in suitable spaces on their drawing paper. Additionally, students completed an interview form. Participants were allotted one hour to finish the assignment. This approach allowed for a thorough and comprehensive examination of the participants’ perspectives. To enhance transferability, purposive sampling was employed in the study. In purposive sampling, participants are selected to have specific characteristics relevant to the research topic. This approach ensured that the participants’ perspectives would represent the research topic effectively. To ensure dependability, interview questions, data collection, and analysis were consistently applied throughout the entire research process. In this study, to achieve confirmability, all stages of the research were described openly and transparently, aiming to reduce the impact of researcher bias. All transcripts and notes used in the study were stored for reference.

The reporting process of the study adhered to the COREQ (CONsolidated criteria for Reporting Qualitative research) guidelines, as outlined by Tong et al. (2007) [ 29 ]. The study follows CLARIFY 2021 guidelines for reporting yoga research [ 30 ].

Participants expressed their experiences and thoughts about practicing yoga by drawing and cutting shapes on A4-sized papers of different colors. It was determined that they used nature figures (sun, cloud, tree, sky, flower) (f = 75), figures of people practicing yoga (f = 12), and other figures such as sound, light, and others (bird sound, wave sound, candle, light bulb, traffic light, heart, eye, key, peace, swing, India, circle, etc.) (f = 29). Participants mostly chose blue-green-yellow colors ( n = 41).

A code list was created from the responses of students to questions about the concept of "practicing yoga" through qualitative question analysis (number of codes = 98). After analyzing the data, four categories were reached. The categories describing the concept of practicing yoga were distributed as follows in terms of symbols and frequency numbers: "symbol of health and tranquility (f = 345)", "the way to place goodness in your heart (f = 110)", "the most effective way to meet oneself (f = 93)", and "no guarantee of relaxation (f = 71)" (Fig. 1 ).

Concepts and codes identified in the qualitative analysis of nursing students' perception of the phenomenon of "practicing yoga"

Category 1. Symbol of health and serenity (f = 345)

The subcategories that received the most references from nursing students in explaining the phenomenon of practicing yoga under this category are "Serenity and Peace (f = 169)", "Comfort (f = 120)", "Health, Well-being, Happiness, and Energy (f = 56)". Below is the picture and description of the participant related to the subcategory "Symbol of Health and Serenity" (Fig. 2 ): "The reason for choosing the shape of a cloud and the color blue is that it brings me peace, reminds me to take deep breaths and be grateful. It reminds me that there are beautiful things in life and that I need to enjoy life." Additionally, "when you start doing yoga, your thoughts change, you feel rested, and your heart fills with peace." Participant 7, Female.

Cloud figure (blue) -participant 7

Participant 22 wrote the following in the interpretation of the figure they drew (Fig. 3 ): "The color blue always makes me feel happy and peaceful. I chose this color because yoga makes me feel peaceful and happy. For example, when I feel restless and unhappy, going to the beach, seeing the sea, seeing blue calms me down. Also, when I think of yoga, I imagine an endless deep blue sea. A sea with birds flying over it and a deep blue sky. A painting with sunny weather" Participant 22.

Interpretation by participant 22 (blue)

Participant 35's drawn figure is a butterfly, and their description is as follows (Fig. 4 ): “When I think of yoga, I think of a butterfly. Because when I do yoga, I feel as free and light as a butterfly. I imagine my wings taking me wherever I want inside. The green color relaxes me and makes me happy. The wings of the butterfly in my soul's greenery take me to purity…”.

Butterfly figure (green) -participant 35

Participant 9, in the chosen color and the comment on their drawing, expressed the following regarding the sub-category "Symbol of Health and Serenity" (Fig. 5 ): "I chose this color for its energy. Since energy is important in yoga, I chose orange. I chose this shape because I believe yoga is best done in a natural environment. Yoga reminds me of serenity, the feeling of being in emptiness, and relaxation (Fig. 5 )."

Tree figure and comment (orange) -participant 9

Participant 19, in the chosen figure and the comment on their drawing, stated the following (Fig. 6 ): "Because yoga reminds me of mental and physical health. In my opinion, health is manifested in the combination of blue and green colors. That is, balance in nature is something that exists in the soul and body." Participant 19 depicted a ladder figure in combination with blue and green, defining yoga as "soul and body therapy" (Fig. 6 ).

The place where the moon meets the sun (turquoise)-participant 19

Category 2. The way to place goodness in your heart (f = 110)

The meaning of the phenomenon of doing yoga by participant 11, an 18-year-old female nursing student, was labeled as "being aware of placing goodness in heart" as the category tag. This category, referred to 110 times by the participants, includes the subcategories of "Purification (f = 65)" and "Being a virtuous person (f = 45)". Participants mentioned virtues such as "patience, tolerance, love for all creatures, flexibility, equality, non-prejudice, peace, optimism, freedom" contributing to the concept.

Participant 51, an 18-year-old male who described his health as poor, used the light bulb figure to express "happiness, peace, security" and commented, "It causes positive effects on people" (Fig. 7 ). Participant 51 expressed the following regarding the subcategory " The way to place goodness in your heart" in the figure and comment (Fig. 7 ): "The light bulb illuminating the environment is connected to yoga. Yoga enlightens a person's mind."

Light bulb (yellow) -participant 51

Participant 39, a 19-year-old male, mentioned that practicing yoga leads to "thinking more compassionately." Participant 21, a female, stated, "Yoga is something that requires patience."

Here is the drawn peace figure and comment by participant 46, related to this category (Fig. 8 ). This participant said, "I chose pink because it opens up and gives peace. Of course, there is also light pink, not just dark pinks. I chose this sign because where there is yoga, there is love for all living beings, and where there is love, peace is inevitable."

Peace figure (pink) -participant 46

Category 3. The most effective way to meet yourself (f = 93)

For nursing students, practicing yoga means creating "awareness" and is the most effective way to meet oneself (f = 93). Participant 43, a 19-year-old female with a poor health perception, described feeling "calmer, more aware, and internally peaceful" when practicing yoga, as shown in Fig. 9 . Under the category of "the most effective way to meet oneself," Participant 43's figure and comment about yoga are as follows (Fig. 9 ): "…I chose this color because it gives me peace. The other colors make me restless, but this color makes me feel like I can breathe. Yellow is like an endless void to me. A color that makes me experience everything with all its reality. It's like a sky where you can escape from the chaos of the world and get lost in it…".

The world and heart (yellow) -participant 43

Participant 8 chose a cloud figure, describing yoga as "like rising above the clouds" and wrote the following about yoga practice: "Finding oneself in life, being at peace with oneself… [someone who starts practicing yoga] starts to know themselves, their love for life increases." Participant 8, Female.

Participant 33, a female who chose yellow for its calmness and non-straining quality, described the effect of yoga as "self-discovery" and wrote the following (Fig. 10 ): "You awaken your sleeping mind and body, and find the 'self' within you." Participant 33, Female.

Flower and human (yellow)- participant 33

The statement from participant 48 is as follows (Fig. 11 ): "In this image, what I want to convey is; the individual who practices yoga finds themselves, reaches their essence, and becomes aware of their own existence after a long and perhaps short journey. I chose the color orange because it reminds me that energy exists, is alive, and can be transmitted at any moment. For me, yoga is an indicator of energy. After yoga, the body revives and rejuvenates."

The road (orange)- participant 48

Category 4. No guarantee of relaxation (f = 71)

Among the nursing students ( n = 59), 16 (27.1%) indicated that they do not recommend yoga. The subcategories of this category include "difficulty in relaxing during meditation/emptying the mind (f = 23)", physical complaints (f = 21)", "difficulty in focusing (f = 18)", and "negative perceptions (f = 9)". Participants used expressions such as "headache, neck pain, back pain, dizziness, exhausting, feeling bad, difficult, fear, nervousness, inability to relax, disbelief" in relation to this category. A 19-year-old male participant, participant 41, stated about yoga, "I cannot meditate, I do not feel comfortable." Participant 44, a 19-year-old female participant who rated her health as poor, stated during yoga, "I cannot fully control my breathing and do meditation, I cannot empty my mind, so I cannot achieve complete peace."

Yoga, often conceptualized in the Western world as a physical practice [ 31 ], is considered a practice that can calm the mind and access a higher state of consciousness where individual and universal consciousness merge, using the body [ 32 ], in yoga traditions, the physical, mental, and spiritual dimensions of the individual are intricately connected [ 1 ]. When we relate the benefits of yoga to traditional yoga theories and systems, it can be interesting to explore its connection with the chakra system and colors. The main focus of yoga can be to regulate the functioning of chakras while awakening the associated energies [ 33 , 34 ]. It was thought that the free association of the students' drawings and descriptions could provide guidance in determining their experiences related to the concept of yoga. In this study, where the experiences of nursing students who took the elective yoga course were evaluated with a qualitative approach, participants mostly chose blue, green, and yellow-colored papers, symbolizing nature. When viewed from the perspective of the chakra-yoga system explained in the yoga course, it was thought that the participants might have resonated with certain energy centers or chakras. Blue, green, and yellow colors are respectively associated with the throat chakra, heart chakra, and solar plexus chakra [ 35 ]. The throat chakra is associated with communication, speech power, intellectual development, creativity, and expression [ 36 ]. Participants 7 and 22, who currently perceive their health as good, and participant 19, who chose blue and turquoise colors, may reflect a desire for in-depth communication and original expression, or a need for improvement in these areas. During yoga practice, especially breathing exercises and poses focusing on the throat region can be worked on this chakra, thus enhancing students' capacity for clearer communication and expressing inner truths [ 37 , 38 ].

The philosophy of yoga emphasizes the importance of harmony and unity with nature, which is why many yoga asanas (poses) are named after elements from nature, such as the tree pose, which symbolizes the stability and balance of a tree through its strong roots and upward-reaching branches [ 39 ]. In this study, visuals related to yoga such as the sun, clouds, trees, sky, and flowers were found. Participant 9 recalling and drawing a tree figure during yoga experiences indicates their awareness of this symbolic relationship. Research has shown that spending time in nature has positive effects on people's mood and mental health [ 40 , 41 ]; similarly, many yoga philosophies emphasize the importance of being in harmony with nature [ 42 ]. Therefore, a student's preference for a natural environment while practicing yoga and associating this practice with a tree in nature is thought to reflect both the healing power of nature and the relationship of yoga poses with elements in nature. This symbiotic relationship reminds us of how interconnected humans are with nature and how yoga practice can strengthen this connection. This aspect of yoga can also encourage individuals to strengthen their relationship with nature and adopt a more respectful attitude towards the environment. This can be seen as a reflection of the principle of 'ahimsa' or non-harming, which is one of the foundational principles of yoga philosophy [ 43 ].

Deep breathing practices are fundamental components of yoga and meditation. Consciously controlling breathing can activate the parasympathetic nervous system and trigger the relaxation response [ 44 , 45 ]. Additionally, breath awareness is part of mindfulness practice and brings the individual into the present moment. Feeling gratitude helps a person recognize the positive aspects of their life and develop a more positive life perspective [ 46 ]. Gratitude practice can improve mental health and allow for greater enjoyment of life [ 47 ]. Participant 7's choice of a cloud shape and blue color is explained by the feeling of tranquility it brings, reminding them to take deep breaths and be thankful, and to remember that there are beautiful things in life that they should enjoy. Participant 7's statement confirms this. The shape of a cloud and the choice of the color blue directing them to take deep breaths, be thankful, remember that there are beautiful things in life, and enjoy life, can contribute to the participant's spirituality [ 48 ]. Such an approach can be balancing both mentally and emotionally, especially for students under academic pressure [ 49 ].

Yoga, meditation, and breathwork (pranayama) practices can be effective in creating a deep sense of peace by bringing individuals to the present moment and calming their inner dialogue [ 50 , 51 ]. Participant 22's statement, " The color blue always makes me feel happy and peaceful. I chose this color because yoga makes me feel peaceful and happy. For example, when I feel restless and unhappy, going to the beach, seeing the sea, and seeing blue calms me down ," also indicates the participant's association of yoga practice with feelings of peace and happiness, demonstrating the potential of yoga experience to provide inner tranquility and balance. Furthermore, the participant's desire to go to the beach and see the sea may refer to the healing and calming effect of nature [ 52 ]. Participant 19 states, " Yoga reminds me of spiritual and physical health. For me, health lives in the colors blue and green, meaning it is something in nature and in the spirit of nature ," and Participant 35 says, " When I think of yoga, I think of a butterfly because when I do yoga, I feel as light as a butterfly. I think my wings take me wherever I want inside me. The color green relaxes me, makes me happy, and the green inside me takes me to purity. " These statements may be associated with the heart chakra represented by the color green. This chakra is considered the center of love, compassion, and connection [ 36 ], and therefore, the association of green with this chakra may symbolize the participant's feelings of relaxation and happiness during yoga practice [ 48 ]. The phrase " the green inside me takes me to purity " in Participant 35's statement indicates that green represents purity and healing in the heart chakra, and the opening of this chakra allows the person to feel more peaceful and purer [ 53 ]. In this context, Participant 35's positive feelings toward green and the sense of relaxation may be a result of balancing and opening the heart chakra, contributing to their emotional experiences such as lightness and tranquility in yoga practices [ 54 ].

Participant 51, despite describing their health as poor, mentioning positive effects such as " Happiness, peace, trust " through the figure of a light bulb during yoga practices, can be explained by the illuminating effect of yoga on the mind. Just as a light bulb illuminates its surroundings, yoga enlightens the individual's mental and spiritual state, capable of transforming negative thoughts and emotions into positive ones. This contributes to achieving a general state of well-being and a positive mood by providing both physical and mental relaxation [ 55 ]. Participant 39 mentioned the effect of " thinking more humanely " while practicing yoga. Participant 21 commented that " yoga requires patience ." Participant 46 chose pink because " It opens up and gives peace within me, where there is yoga, there is love for all living beings, and where there is love, peace is inevitable. " Yoga can facilitates a tranquil mental state, reducing stress and tension, thereby promoting harmonious relationships and fostering peace within individuals and their social interactions. Central to yoga philosophy are humanism and the pursuit of a peaceful life [ 56 ] qualities reflected in participants' experiences, affirming yoga's role in cultivating positive personal and societal outcomes.

In the chakra system, colors and their associated energy centers are believed to promote balance and harmony in our daily lives and physical well-being [ 33 ]. Students' selection of these colors related to chakras may reflect their own energy balances and personal development needs, often unconsciously. Yoga practice can equips individuals with tools to enhance the harmony and integrity of these energy centers [ 57 ]. Participant 43, with a negative perception of health, reported becoming " A calmer person, awareness increases, and inner peace occurs; I chose this color (yellow) because it gives me peace. While other colors make me uneasy, when I look at this color, it feels like it gives me breath, and it continues to an endless void. Yellow, for me, is like escaping from the chaos of the world and getting lost in an endless sky ." Participants finding the color yellow soothing and describing it as providing a sense of freedom and freshness like an endless sky can be associated with the solar plexus chakra, typically represented by the color yellow [ 35 ]. This chakra is linked to self-confidence, willpower, and self-realization. [ 58 ]. Participant 33 described the experince of yoga with a flower and human figure as " Self-discovery ," stating, " you awaken your sleeping mind and body and find the 'self' within ." Participant 8 drawn a cloud figure, describing yoga as " like rising above the clouds," saying, "finding yourself in life, being at peace with yourself… [someone who starts practicing yoga] begins to know themselves, their love for life increases ."These statements and figures reinforce the basic themes of "self-discovery" and "being at peace with oneself" in yoga practice [ 59 ], indicating an important relationship between one's yoga practice, personal growth, and quest for inner peace [ 60 ]. Participant 48 believes that " After a long and perhaps short journey of practicing yoga, individuals find themselves, reach their essence, and become aware of their existence. I chose this color (orange) because it reminds me that energy exists, is alive, and can be transmitted at any moment. For me, yoga is a sign of energy; after yoga, the body revitalizes and refreshes. " The choice of orange suggests a strong relationship between yoga practice and energy, as this color, can be associated with the Sacral chakra, symbolizes vitality, creativity, and emotional balance [ 36 ].

In this study, there seem to be mixed views among some participants regarding yoga practice. While yoga and meditation are generally recommended as tools for reducing stress and enhancing personal well-being [ 24 , 61 , 62 ], some students (participants 41–44) have reported not finding this practice beneficial. For example, some participants have advised against practicing yoga due to physical discomfort (head, neck, and back pain, dizziness), inability to empty the mind during meditation, difficulty in focusing, and negative perceptions. The comments of participants 41 and 44 are thought to indicate their individual experiences regarding their inability to meditate and the discomfort they feel during yoga practice. Yoga and meditation practices can create different experiences in each individual; while they can be relaxing and healing for some, they can be challenging and discomforting for others [ 63 ]. This suggests that yoga and meditation can not universal solutions but practices that should be compatible with an individual's personal preferences, experiences, and health conditions [ 26 ].

Participants' health conditions can influence their experiences during yoga practice. Participants who feel unwell or have a specific health problem may find the practice challenging. This underscores the importance for educators and health professionals to provide stress management and relaxation techniques tailored to individual needs [ 64 ].

Limitations

The qualitative data collected in this study regarding the phenomenon of yoga is in Turkish. However, selecting an international journal for publication and translating the text into English may have limited the full conveyance of the figures and participants' expressions to the readers due to the unique cultural characteristics of the language. The concepts of yoga and chakras, meditation, and similar topics, which were theoretically as well as practically conveyed to the participants during the 14-week course content, may have influenced the participants' views on the phenomenon of yoga. The use of a qualitative design tradition in the research both limited the generalizability of the findings and contributed to the originality of the study.

This study has identified four themes that explain the phenomenon of practicing yoga. These are respectively; "symbol of health and tranquility", "way to place goodness in the heart", "most effective way to meet the self", and "no guarantee of relaxation" themes. The findings will contribute to a more comprehensive understanding of student experiences and ultimately understand their positive and negative experiences. By delving into the student perspective, this research aims to provide valuable insights for educators and healthcare professionals. Most of the research on the phenomenon of practicing yoga is conducted abroad, and it is a less studied area in Turkey. Although yoga, which is becoming increasingly popular in our country, is known to be a practice that makes a person feel good; research on how individuals feel about practicing yoga and how they think about it is specific to the subject. Participants associated practicing yoga with symbols and colors found in nature, emphasizing the importance of its effects on the body, mind, and spirituality. In addition, findings regarding the experiences of individuals practicing yoga, a practice that is also becoming increasingly popular in Turkey, have been obtained. Although it is seen that qualitative approaches such as in-depth interviews and content analysis are used in almost all of the qualitative studies on the subject [ 48 , 65 , 66 ], no study has been found that examines individuals' perceptions by drawing pictures and interpreting them. In this respect, the current research's unique research method can contribute to the literature.

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The authors extend their sincere gratitude to the nursing students who willingly took part in this study. Their participation is greatly valued and appreciated.

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Department of Public Health Nursing, Faculty of Health Sciences, Izmir Democracy University, Izmir, Turkey

Özüm Erki̇n

Department of Public Health Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey

Aynur Çeti̇nkaya

Begüm Güler

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ÖE and AÇ contributed to study design. AÇ contributed to analyze data. ÖE, AÇ and BG write the manuscript. All authors read and approved the final manuscript.

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Ethical approval for the study was obtained from Manisa Celal Bayar University Non-invasive Clinical Research Ethics Committee (Decision no:20.478.486, Date:02/13/2019). We adhered to the principles of the Declaration of Helsinki and relevant guidelines. Written informed consent was obtained from all participants in this study. Participants were ensured to provide their consent voluntarily and without coercion. Written informed consent to participate was obtained from all of the participants in this study. Before the research, the purpose of the study was explained to the students and that they could leave the study at any time. At the beginning of the study, it was informed that participation in the study was voluntary and that no grade would be given. The evaluation of this course consisted of 10 open-ended questions as part of the year-end assessment. Students were asked to name 10 yoga poses they knew, describe the posture, explain the benefits, indicate the indications and contraindications, and identify the associated chakras. The grade distribution of the students was as follows: AA (n:31), BA (n:16), BB (n:6), CB (n:6). Necessary precautions were taken to protect the confidentiality of the data, the identity information of the participants was not included in the data collection tools and all personal details in the data collection forms were kept confidential. The identifying images or other personal details of participants are presented in a way that does not compromise anonymity.

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Erki̇n, Ö., Çeti̇nkaya, A. & Güler, B. The phenomenon of yoga in the imagination of Turkish nursing students: "The way to place goodness in the heart". BMC Nurs 23 , 655 (2024). https://doi.org/10.1186/s12912-024-02288-y

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A Practical Guide to Writing Quantitative and Qualitative Research Questions and Hypotheses in Scholarly Articles

Edward barroga.

1 Department of General Education, Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan.

Glafera Janet Matanguihan

2 Department of Biological Sciences, Messiah University, Mechanicsburg, PA, USA.

The development of research questions and the subsequent hypotheses are prerequisites to defining the main research purpose and specific objectives of a study. Consequently, these objectives determine the study design and research outcome. The development of research questions is a process based on knowledge of current trends, cutting-edge studies, and technological advances in the research field. Excellent research questions are focused and require a comprehensive literature search and in-depth understanding of the problem being investigated. Initially, research questions may be written as descriptive questions which could be developed into inferential questions. These questions must be specific and concise to provide a clear foundation for developing hypotheses. Hypotheses are more formal predictions about the research outcomes. These specify the possible results that may or may not be expected regarding the relationship between groups. Thus, research questions and hypotheses clarify the main purpose and specific objectives of the study, which in turn dictate the design of the study, its direction, and outcome. Studies developed from good research questions and hypotheses will have trustworthy outcomes with wide-ranging social and health implications.

INTRODUCTION

Scientific research is usually initiated by posing evidenced-based research questions which are then explicitly restated as hypotheses. 1 , 2 The hypotheses provide directions to guide the study, solutions, explanations, and expected results. 3 , 4 Both research questions and hypotheses are essentially formulated based on conventional theories and real-world processes, which allow the inception of novel studies and the ethical testing of ideas. 5 , 6

It is crucial to have knowledge of both quantitative and qualitative research 2 as both types of research involve writing research questions and hypotheses. 7 However, these crucial elements of research are sometimes overlooked; if not overlooked, then framed without the forethought and meticulous attention it needs. Planning and careful consideration are needed when developing quantitative or qualitative research, particularly when conceptualizing research questions and hypotheses. 4

There is a continuing need to support researchers in the creation of innovative research questions and hypotheses, as well as for journal articles that carefully review these elements. 1 When research questions and hypotheses are not carefully thought of, unethical studies and poor outcomes usually ensue. Carefully formulated research questions and hypotheses define well-founded objectives, which in turn determine the appropriate design, course, and outcome of the study. This article then aims to discuss in detail the various aspects of crafting research questions and hypotheses, with the goal of guiding researchers as they develop their own. Examples from the authors and peer-reviewed scientific articles in the healthcare field are provided to illustrate key points.

DEFINITIONS AND RELATIONSHIP OF RESEARCH QUESTIONS AND HYPOTHESES

A research question is what a study aims to answer after data analysis and interpretation. The answer is written in length in the discussion section of the paper. Thus, the research question gives a preview of the different parts and variables of the study meant to address the problem posed in the research question. 1 An excellent research question clarifies the research writing while facilitating understanding of the research topic, objective, scope, and limitations of the study. 5

On the other hand, a research hypothesis is an educated statement of an expected outcome. This statement is based on background research and current knowledge. 8 , 9 The research hypothesis makes a specific prediction about a new phenomenon 10 or a formal statement on the expected relationship between an independent variable and a dependent variable. 3 , 11 It provides a tentative answer to the research question to be tested or explored. 4

Hypotheses employ reasoning to predict a theory-based outcome. 10 These can also be developed from theories by focusing on components of theories that have not yet been observed. 10 The validity of hypotheses is often based on the testability of the prediction made in a reproducible experiment. 8

Conversely, hypotheses can also be rephrased as research questions. Several hypotheses based on existing theories and knowledge may be needed to answer a research question. Developing ethical research questions and hypotheses creates a research design that has logical relationships among variables. These relationships serve as a solid foundation for the conduct of the study. 4 , 11 Haphazardly constructed research questions can result in poorly formulated hypotheses and improper study designs, leading to unreliable results. Thus, the formulations of relevant research questions and verifiable hypotheses are crucial when beginning research. 12

CHARACTERISTICS OF GOOD RESEARCH QUESTIONS AND HYPOTHESES

Excellent research questions are specific and focused. These integrate collective data and observations to confirm or refute the subsequent hypotheses. Well-constructed hypotheses are based on previous reports and verify the research context. These are realistic, in-depth, sufficiently complex, and reproducible. More importantly, these hypotheses can be addressed and tested. 13

There are several characteristics of well-developed hypotheses. Good hypotheses are 1) empirically testable 7 , 10 , 11 , 13 ; 2) backed by preliminary evidence 9 ; 3) testable by ethical research 7 , 9 ; 4) based on original ideas 9 ; 5) have evidenced-based logical reasoning 10 ; and 6) can be predicted. 11 Good hypotheses can infer ethical and positive implications, indicating the presence of a relationship or effect relevant to the research theme. 7 , 11 These are initially developed from a general theory and branch into specific hypotheses by deductive reasoning. In the absence of a theory to base the hypotheses, inductive reasoning based on specific observations or findings form more general hypotheses. 10

TYPES OF RESEARCH QUESTIONS AND HYPOTHESES

Research questions and hypotheses are developed according to the type of research, which can be broadly classified into quantitative and qualitative research. We provide a summary of the types of research questions and hypotheses under quantitative and qualitative research categories in Table 1 .

Quantitative research questions	Quantitative research hypotheses
Descriptive research questions	Simple hypothesis
Comparative research questions	Complex hypothesis
Relationship research questions	Directional hypothesis
	Non-directional hypothesis
	Associative hypothesis
	Causal hypothesis
	Null hypothesis
	Alternative hypothesis
	Working hypothesis
	Statistical hypothesis
	Logical hypothesis
	Hypothesis-testing
Qualitative research questions	Qualitative research hypotheses
Contextual research questions	Hypothesis-generating
Descriptive research questions
Evaluation research questions
Explanatory research questions
Exploratory research questions
Generative research questions
Ideological research questions
Ethnographic research questions
Phenomenological research questions
Grounded theory questions
Qualitative case study questions

Research questions in quantitative research

In quantitative research, research questions inquire about the relationships among variables being investigated and are usually framed at the start of the study. These are precise and typically linked to the subject population, dependent and independent variables, and research design. 1 Research questions may also attempt to describe the behavior of a population in relation to one or more variables, or describe the characteristics of variables to be measured ( descriptive research questions ). 1 , 5 , 14 These questions may also aim to discover differences between groups within the context of an outcome variable ( comparative research questions ), 1 , 5 , 14 or elucidate trends and interactions among variables ( relationship research questions ). 1 , 5 We provide examples of descriptive, comparative, and relationship research questions in quantitative research in Table 2 .

Quantitative research questions
Descriptive research question
	- Measures responses of subjects to variables
	- Presents variables to measure, analyze, or assess
	What is the proportion of resident doctors in the hospital who have mastered ultrasonography (response of subjects to a variable) as a diagnostic technique in their clinical training?
Comparative research question
	- Clarifies difference between one group with outcome variable and another group without outcome variable
	Is there a difference in the reduction of lung metastasis in osteosarcoma patients who received the vitamin D adjunctive therapy (group with outcome variable) compared with osteosarcoma patients who did not receive the vitamin D adjunctive therapy (group without outcome variable)?
	- Compares the effects of variables
	How does the vitamin D analogue 22-Oxacalcitriol (variable 1) mimic the antiproliferative activity of 1,25-Dihydroxyvitamin D (variable 2) in osteosarcoma cells?
Relationship research question
	- Defines trends, association, relationships, or interactions between dependent variable and independent variable
	Is there a relationship between the number of medical student suicide (dependent variable) and the level of medical student stress (independent variable) in Japan during the first wave of the COVID-19 pandemic?

Hypotheses in quantitative research

In quantitative research, hypotheses predict the expected relationships among variables. 15 Relationships among variables that can be predicted include 1) between a single dependent variable and a single independent variable ( simple hypothesis ) or 2) between two or more independent and dependent variables ( complex hypothesis ). 4 , 11 Hypotheses may also specify the expected direction to be followed and imply an intellectual commitment to a particular outcome ( directional hypothesis ) 4 . On the other hand, hypotheses may not predict the exact direction and are used in the absence of a theory, or when findings contradict previous studies ( non-directional hypothesis ). 4 In addition, hypotheses can 1) define interdependency between variables ( associative hypothesis ), 4 2) propose an effect on the dependent variable from manipulation of the independent variable ( causal hypothesis ), 4 3) state a negative relationship between two variables ( null hypothesis ), 4 , 11 , 15 4) replace the working hypothesis if rejected ( alternative hypothesis ), 15 explain the relationship of phenomena to possibly generate a theory ( working hypothesis ), 11 5) involve quantifiable variables that can be tested statistically ( statistical hypothesis ), 11 6) or express a relationship whose interlinks can be verified logically ( logical hypothesis ). 11 We provide examples of simple, complex, directional, non-directional, associative, causal, null, alternative, working, statistical, and logical hypotheses in quantitative research, as well as the definition of quantitative hypothesis-testing research in Table 3 .

Quantitative research hypotheses
Simple hypothesis
	- Predicts relationship between single dependent variable and single independent variable
	If the dose of the new medication (single independent variable) is high, blood pressure (single dependent variable) is lowered.
Complex hypothesis
	- Foretells relationship between two or more independent and dependent variables
	The higher the use of anticancer drugs, radiation therapy, and adjunctive agents (3 independent variables), the higher would be the survival rate (1 dependent variable).
Directional hypothesis
	- Identifies study direction based on theory towards particular outcome to clarify relationship between variables
	Privately funded research projects will have a larger international scope (study direction) than publicly funded research projects.
Non-directional hypothesis
	- Nature of relationship between two variables or exact study direction is not identified
	- Does not involve a theory
	Women and men are different in terms of helpfulness. (Exact study direction is not identified)
Associative hypothesis
	- Describes variable interdependency
	- Change in one variable causes change in another variable
	A larger number of people vaccinated against COVID-19 in the region (change in independent variable) will reduce the region’s incidence of COVID-19 infection (change in dependent variable).
Causal hypothesis
	- An effect on dependent variable is predicted from manipulation of independent variable
	A change into a high-fiber diet (independent variable) will reduce the blood sugar level (dependent variable) of the patient.
Null hypothesis
	- A negative statement indicating no relationship or difference between 2 variables
	There is no significant difference in the severity of pulmonary metastases between the new drug (variable 1) and the current drug (variable 2).
Alternative hypothesis
	- Following a null hypothesis, an alternative hypothesis predicts a relationship between 2 study variables
	The new drug (variable 1) is better on average in reducing the level of pain from pulmonary metastasis than the current drug (variable 2).
Working hypothesis
	- A hypothesis that is initially accepted for further research to produce a feasible theory
	Dairy cows fed with concentrates of different formulations will produce different amounts of milk.
Statistical hypothesis
	- Assumption about the value of population parameter or relationship among several population characteristics
	- Validity tested by a statistical experiment or analysis
	The mean recovery rate from COVID-19 infection (value of population parameter) is not significantly different between population 1 and population 2.
	There is a positive correlation between the level of stress at the workplace and the number of suicides (population characteristics) among working people in Japan.
Logical hypothesis
	- Offers or proposes an explanation with limited or no extensive evidence
	If healthcare workers provide more educational programs about contraception methods, the number of adolescent pregnancies will be less.
Hypothesis-testing (Quantitative hypothesis-testing research)
	- Quantitative research uses deductive reasoning.
	- This involves the formation of a hypothesis, collection of data in the investigation of the problem, analysis and use of the data from the investigation, and drawing of conclusions to validate or nullify the hypotheses.

Research questions in qualitative research

Unlike research questions in quantitative research, research questions in qualitative research are usually continuously reviewed and reformulated. The central question and associated subquestions are stated more than the hypotheses. 15 The central question broadly explores a complex set of factors surrounding the central phenomenon, aiming to present the varied perspectives of participants. 15

There are varied goals for which qualitative research questions are developed. These questions can function in several ways, such as to 1) identify and describe existing conditions ( contextual research question s); 2) describe a phenomenon ( descriptive research questions ); 3) assess the effectiveness of existing methods, protocols, theories, or procedures ( evaluation research questions ); 4) examine a phenomenon or analyze the reasons or relationships between subjects or phenomena ( explanatory research questions ); or 5) focus on unknown aspects of a particular topic ( exploratory research questions ). 5 In addition, some qualitative research questions provide new ideas for the development of theories and actions ( generative research questions ) or advance specific ideologies of a position ( ideological research questions ). 1 Other qualitative research questions may build on a body of existing literature and become working guidelines ( ethnographic research questions ). Research questions may also be broadly stated without specific reference to the existing literature or a typology of questions ( phenomenological research questions ), may be directed towards generating a theory of some process ( grounded theory questions ), or may address a description of the case and the emerging themes ( qualitative case study questions ). 15 We provide examples of contextual, descriptive, evaluation, explanatory, exploratory, generative, ideological, ethnographic, phenomenological, grounded theory, and qualitative case study research questions in qualitative research in Table 4 , and the definition of qualitative hypothesis-generating research in Table 5 .

Qualitative research questions
Contextual research question
	- Ask the nature of what already exists
	- Individuals or groups function to further clarify and understand the natural context of real-world problems
	What are the experiences of nurses working night shifts in healthcare during the COVID-19 pandemic? (natural context of real-world problems)
Descriptive research question
	- Aims to describe a phenomenon
	What are the different forms of disrespect and abuse (phenomenon) experienced by Tanzanian women when giving birth in healthcare facilities?
Evaluation research question
	- Examines the effectiveness of existing practice or accepted frameworks
	How effective are decision aids (effectiveness of existing practice) in helping decide whether to give birth at home or in a healthcare facility?
Explanatory research question
	- Clarifies a previously studied phenomenon and explains why it occurs
	Why is there an increase in teenage pregnancy (phenomenon) in Tanzania?
Exploratory research question
	- Explores areas that have not been fully investigated to have a deeper understanding of the research problem
	What factors affect the mental health of medical students (areas that have not yet been fully investigated) during the COVID-19 pandemic?
Generative research question
	- Develops an in-depth understanding of people’s behavior by asking ‘how would’ or ‘what if’ to identify problems and find solutions
	How would the extensive research experience of the behavior of new staff impact the success of the novel drug initiative?
Ideological research question
	- Aims to advance specific ideas or ideologies of a position
	Are Japanese nurses who volunteer in remote African hospitals able to promote humanized care of patients (specific ideas or ideologies) in the areas of safe patient environment, respect of patient privacy, and provision of accurate information related to health and care?
Ethnographic research question
	- Clarifies peoples’ nature, activities, their interactions, and the outcomes of their actions in specific settings
	What are the demographic characteristics, rehabilitative treatments, community interactions, and disease outcomes (nature, activities, their interactions, and the outcomes) of people in China who are suffering from pneumoconiosis?
Phenomenological research question
	- Knows more about the phenomena that have impacted an individual
	What are the lived experiences of parents who have been living with and caring for children with a diagnosis of autism? (phenomena that have impacted an individual)
Grounded theory question
	- Focuses on social processes asking about what happens and how people interact, or uncovering social relationships and behaviors of groups
	What are the problems that pregnant adolescents face in terms of social and cultural norms (social processes), and how can these be addressed?
Qualitative case study question
	- Assesses a phenomenon using different sources of data to answer “why” and “how” questions
	- Considers how the phenomenon is influenced by its contextual situation.
	How does quitting work and assuming the role of a full-time mother (phenomenon assessed) change the lives of women in Japan?

Qualitative research hypotheses
Hypothesis-generating (Qualitative hypothesis-generating research)
	- Qualitative research uses inductive reasoning.
	- This involves data collection from study participants or the literature regarding a phenomenon of interest, using the collected data to develop a formal hypothesis, and using the formal hypothesis as a framework for testing the hypothesis.
	- Qualitative exploratory studies explore areas deeper, clarifying subjective experience and allowing formulation of a formal hypothesis potentially testable in a future quantitative approach.

Qualitative studies usually pose at least one central research question and several subquestions starting with How or What . These research questions use exploratory verbs such as explore or describe . These also focus on one central phenomenon of interest, and may mention the participants and research site. 15

Hypotheses in qualitative research

Hypotheses in qualitative research are stated in the form of a clear statement concerning the problem to be investigated. Unlike in quantitative research where hypotheses are usually developed to be tested, qualitative research can lead to both hypothesis-testing and hypothesis-generating outcomes. 2 When studies require both quantitative and qualitative research questions, this suggests an integrative process between both research methods wherein a single mixed-methods research question can be developed. 1

FRAMEWORKS FOR DEVELOPING RESEARCH QUESTIONS AND HYPOTHESES

Research questions followed by hypotheses should be developed before the start of the study. 1 , 12 , 14 It is crucial to develop feasible research questions on a topic that is interesting to both the researcher and the scientific community. This can be achieved by a meticulous review of previous and current studies to establish a novel topic. Specific areas are subsequently focused on to generate ethical research questions. The relevance of the research questions is evaluated in terms of clarity of the resulting data, specificity of the methodology, objectivity of the outcome, depth of the research, and impact of the study. 1 , 5 These aspects constitute the FINER criteria (i.e., Feasible, Interesting, Novel, Ethical, and Relevant). 1 Clarity and effectiveness are achieved if research questions meet the FINER criteria. In addition to the FINER criteria, Ratan et al. described focus, complexity, novelty, feasibility, and measurability for evaluating the effectiveness of research questions. 14

The PICOT and PEO frameworks are also used when developing research questions. 1 The following elements are addressed in these frameworks, PICOT: P-population/patients/problem, I-intervention or indicator being studied, C-comparison group, O-outcome of interest, and T-timeframe of the study; PEO: P-population being studied, E-exposure to preexisting conditions, and O-outcome of interest. 1 Research questions are also considered good if these meet the “FINERMAPS” framework: Feasible, Interesting, Novel, Ethical, Relevant, Manageable, Appropriate, Potential value/publishable, and Systematic. 14

As we indicated earlier, research questions and hypotheses that are not carefully formulated result in unethical studies or poor outcomes. To illustrate this, we provide some examples of ambiguous research question and hypotheses that result in unclear and weak research objectives in quantitative research ( Table 6 ) 16 and qualitative research ( Table 7 ) 17 , and how to transform these ambiguous research question(s) and hypothesis(es) into clear and good statements.

Variables	Unclear and weak statement (Statement 1)	Clear and good statement (Statement 2)	Points to avoid
Research question	Which is more effective between smoke moxibustion and smokeless moxibustion?	“Moreover, regarding smoke moxibustion versus smokeless moxibustion, it remains unclear which is more effective, safe, and acceptable to pregnant women, and whether there is any difference in the amount of heat generated.”	1) Vague and unfocused questions
			2) Closed questions simply answerable by yes or no
			3) Questions requiring a simple choice
Hypothesis	The smoke moxibustion group will have higher cephalic presentation.	“Hypothesis 1. The smoke moxibustion stick group (SM group) and smokeless moxibustion stick group (-SLM group) will have higher rates of cephalic presentation after treatment than the control group.	1) Unverifiable hypotheses
		Hypothesis 2. The SM group and SLM group will have higher rates of cephalic presentation at birth than the control group.	2) Incompletely stated groups of comparison
		Hypothesis 3. There will be no significant differences in the well-being of the mother and child among the three groups in terms of the following outcomes: premature birth, premature rupture of membranes (PROM) at < 37 weeks, Apgar score < 7 at 5 min, umbilical cord blood pH < 7.1, admission to neonatal intensive care unit (NICU), and intrauterine fetal death.”	3) Insufficiently described variables or outcomes
Research objective	To determine which is more effective between smoke moxibustion and smokeless moxibustion.	“The specific aims of this pilot study were (a) to compare the effects of smoke moxibustion and smokeless moxibustion treatments with the control group as a possible supplement to ECV for converting breech presentation to cephalic presentation and increasing adherence to the newly obtained cephalic position, and (b) to assess the effects of these treatments on the well-being of the mother and child.”	1) Poor understanding of the research question and hypotheses
Research objective			2) Insufficient description of population, variables, or study outcomes

a These statements were composed for comparison and illustrative purposes only.

b These statements are direct quotes from Higashihara and Horiuchi. 16

Variables	Unclear and weak statement (Statement 1)	Clear and good statement (Statement 2)	Points to avoid
Research question	Does disrespect and abuse (D&A) occur in childbirth in Tanzania?	How does disrespect and abuse (D&A) occur and what are the types of physical and psychological abuses observed in midwives’ actual care during facility-based childbirth in urban Tanzania?	1) Ambiguous or oversimplistic questions
Research question			2) Questions unverifiable by data collection and analysis
Hypothesis	Disrespect and abuse (D&A) occur in childbirth in Tanzania.	Hypothesis 1: Several types of physical and psychological abuse by midwives in actual care occur during facility-based childbirth in urban Tanzania.	1) Statements simply expressing facts
Hypothesis	Disrespect and abuse (D&A) occur in childbirth in Tanzania.	Hypothesis 2: Weak nursing and midwifery management contribute to the D&A of women during facility-based childbirth in urban Tanzania.	2) Insufficiently described concepts or variables
Research objective	To describe disrespect and abuse (D&A) in childbirth in Tanzania.	“This study aimed to describe from actual observations the respectful and disrespectful care received by women from midwives during their labor period in two hospitals in urban Tanzania.”	1) Statements unrelated to the research question and hypotheses
Research objective			2) Unattainable or unexplorable objectives

a This statement is a direct quote from Shimoda et al. 17

The other statements were composed for comparison and illustrative purposes only.

CONSTRUCTING RESEARCH QUESTIONS AND HYPOTHESES

To construct effective research questions and hypotheses, it is very important to 1) clarify the background and 2) identify the research problem at the outset of the research, within a specific timeframe. 9 Then, 3) review or conduct preliminary research to collect all available knowledge about the possible research questions by studying theories and previous studies. 18 Afterwards, 4) construct research questions to investigate the research problem. Identify variables to be accessed from the research questions 4 and make operational definitions of constructs from the research problem and questions. Thereafter, 5) construct specific deductive or inductive predictions in the form of hypotheses. 4 Finally, 6) state the study aims . This general flow for constructing effective research questions and hypotheses prior to conducting research is shown in Fig. 1 .

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Research questions are used more frequently in qualitative research than objectives or hypotheses. 3 These questions seek to discover, understand, explore or describe experiences by asking “What” or “How.” The questions are open-ended to elicit a description rather than to relate variables or compare groups. The questions are continually reviewed, reformulated, and changed during the qualitative study. 3 Research questions are also used more frequently in survey projects than hypotheses in experiments in quantitative research to compare variables and their relationships.

Hypotheses are constructed based on the variables identified and as an if-then statement, following the template, ‘If a specific action is taken, then a certain outcome is expected.’ At this stage, some ideas regarding expectations from the research to be conducted must be drawn. 18 Then, the variables to be manipulated (independent) and influenced (dependent) are defined. 4 Thereafter, the hypothesis is stated and refined, and reproducible data tailored to the hypothesis are identified, collected, and analyzed. 4 The hypotheses must be testable and specific, 18 and should describe the variables and their relationships, the specific group being studied, and the predicted research outcome. 18 Hypotheses construction involves a testable proposition to be deduced from theory, and independent and dependent variables to be separated and measured separately. 3 Therefore, good hypotheses must be based on good research questions constructed at the start of a study or trial. 12

In summary, research questions are constructed after establishing the background of the study. Hypotheses are then developed based on the research questions. Thus, it is crucial to have excellent research questions to generate superior hypotheses. In turn, these would determine the research objectives and the design of the study, and ultimately, the outcome of the research. 12 Algorithms for building research questions and hypotheses are shown in Fig. 2 for quantitative research and in Fig. 3 for qualitative research.

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EXAMPLES OF RESEARCH QUESTIONS FROM PUBLISHED ARTICLES

EXAMPLE 1. Descriptive research question (quantitative research)
- Presents research variables to be assessed (distinct phenotypes and subphenotypes)
“BACKGROUND: Since COVID-19 was identified, its clinical and biological heterogeneity has been recognized. Identifying COVID-19 phenotypes might help guide basic, clinical, and translational research efforts.
RESEARCH QUESTION: Does the clinical spectrum of patients with COVID-19 contain distinct phenotypes and subphenotypes? ” 19
EXAMPLE 2. Relationship research question (quantitative research)
- Shows interactions between dependent variable (static postural control) and independent variable (peripheral visual field loss)
“Background: Integration of visual, vestibular, and proprioceptive sensations contributes to postural control. People with peripheral visual field loss have serious postural instability. However, the directional specificity of postural stability and sensory reweighting caused by gradual peripheral visual field loss remain unclear.
Research question: What are the effects of peripheral visual field loss on static postural control ?” 20
EXAMPLE 3. Comparative research question (quantitative research)
- Clarifies the difference among groups with an outcome variable (patients enrolled in COMPERA with moderate PH or severe PH in COPD) and another group without the outcome variable (patients with idiopathic pulmonary arterial hypertension (IPAH))
“BACKGROUND: Pulmonary hypertension (PH) in COPD is a poorly investigated clinical condition.
RESEARCH QUESTION: Which factors determine the outcome of PH in COPD?
STUDY DESIGN AND METHODS: We analyzed the characteristics and outcome of patients enrolled in the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA) with moderate or severe PH in COPD as defined during the 6th PH World Symposium who received medical therapy for PH and compared them with patients with idiopathic pulmonary arterial hypertension (IPAH) .” 21
EXAMPLE 4. Exploratory research question (qualitative research)
- Explores areas that have not been fully investigated (perspectives of families and children who receive care in clinic-based child obesity treatment) to have a deeper understanding of the research problem
“Problem: Interventions for children with obesity lead to only modest improvements in BMI and long-term outcomes, and data are limited on the perspectives of families of children with obesity in clinic-based treatment. This scoping review seeks to answer the question: What is known about the perspectives of families and children who receive care in clinic-based child obesity treatment? This review aims to explore the scope of perspectives reported by families of children with obesity who have received individualized outpatient clinic-based obesity treatment.” 22
EXAMPLE 5. Relationship research question (quantitative research)
- Defines interactions between dependent variable (use of ankle strategies) and independent variable (changes in muscle tone)
“Background: To maintain an upright standing posture against external disturbances, the human body mainly employs two types of postural control strategies: “ankle strategy” and “hip strategy.” While it has been reported that the magnitude of the disturbance alters the use of postural control strategies, it has not been elucidated how the level of muscle tone, one of the crucial parameters of bodily function, determines the use of each strategy. We have previously confirmed using forward dynamics simulations of human musculoskeletal models that an increased muscle tone promotes the use of ankle strategies. The objective of the present study was to experimentally evaluate a hypothesis: an increased muscle tone promotes the use of ankle strategies. Research question: Do changes in the muscle tone affect the use of ankle strategies ?” 23

EXAMPLES OF HYPOTHESES IN PUBLISHED ARTICLES

EXAMPLE 1. Working hypothesis (quantitative research)
- A hypothesis that is initially accepted for further research to produce a feasible theory
“As fever may have benefit in shortening the duration of viral illness, it is plausible to hypothesize that the antipyretic efficacy of ibuprofen may be hindering the benefits of a fever response when taken during the early stages of COVID-19 illness .” 24
“In conclusion, it is plausible to hypothesize that the antipyretic efficacy of ibuprofen may be hindering the benefits of a fever response . The difference in perceived safety of these agents in COVID-19 illness could be related to the more potent efficacy to reduce fever with ibuprofen compared to acetaminophen. Compelling data on the benefit of fever warrant further research and review to determine when to treat or withhold ibuprofen for early stage fever for COVID-19 and other related viral illnesses .” 24
EXAMPLE 2. Exploratory hypothesis (qualitative research)
- Explores particular areas deeper to clarify subjective experience and develop a formal hypothesis potentially testable in a future quantitative approach
“We hypothesized that when thinking about a past experience of help-seeking, a self distancing prompt would cause increased help-seeking intentions and more favorable help-seeking outcome expectations .” 25
“Conclusion
Although a priori hypotheses were not supported, further research is warranted as results indicate the potential for using self-distancing approaches to increasing help-seeking among some people with depressive symptomatology.” 25
EXAMPLE 3. Hypothesis-generating research to establish a framework for hypothesis testing (qualitative research)
“We hypothesize that compassionate care is beneficial for patients (better outcomes), healthcare systems and payers (lower costs), and healthcare providers (lower burnout). ” 26
Compassionomics is the branch of knowledge and scientific study of the effects of compassionate healthcare. Our main hypotheses are that compassionate healthcare is beneficial for (1) patients, by improving clinical outcomes, (2) healthcare systems and payers, by supporting financial sustainability, and (3) HCPs, by lowering burnout and promoting resilience and well-being. The purpose of this paper is to establish a scientific framework for testing the hypotheses above . If these hypotheses are confirmed through rigorous research, compassionomics will belong in the science of evidence-based medicine, with major implications for all healthcare domains.” 26
EXAMPLE 4. Statistical hypothesis (quantitative research)
- An assumption is made about the relationship among several population characteristics ( gender differences in sociodemographic and clinical characteristics of adults with ADHD ). Validity is tested by statistical experiment or analysis ( chi-square test, Students t-test, and logistic regression analysis)
“Our research investigated gender differences in sociodemographic and clinical characteristics of adults with ADHD in a Japanese clinical sample. Due to unique Japanese cultural ideals and expectations of women's behavior that are in opposition to ADHD symptoms, we hypothesized that women with ADHD experience more difficulties and present more dysfunctions than men . We tested the following hypotheses: first, women with ADHD have more comorbidities than men with ADHD; second, women with ADHD experience more social hardships than men, such as having less full-time employment and being more likely to be divorced.” 27
“Statistical Analysis
( text omitted ) Between-gender comparisons were made using the chi-squared test for categorical variables and Students t-test for continuous variables…( text omitted ). A logistic regression analysis was performed for employment status, marital status, and comorbidity to evaluate the independent effects of gender on these dependent variables.” 27

EXAMPLES OF HYPOTHESIS AS WRITTEN IN PUBLISHED ARTICLES IN RELATION TO OTHER PARTS

EXAMPLE 1. Background, hypotheses, and aims are provided
“Pregnant women need skilled care during pregnancy and childbirth, but that skilled care is often delayed in some countries …( text omitted ). The focused antenatal care (FANC) model of WHO recommends that nurses provide information or counseling to all pregnant women …( text omitted ). Job aids are visual support materials that provide the right kind of information using graphics and words in a simple and yet effective manner. When nurses are not highly trained or have many work details to attend to, these job aids can serve as a content reminder for the nurses and can be used for educating their patients (Jennings, Yebadokpo, Affo, & Agbogbe, 2010) ( text omitted ). Importantly, additional evidence is needed to confirm how job aids can further improve the quality of ANC counseling by health workers in maternal care …( text omitted )” 28
“ This has led us to hypothesize that the quality of ANC counseling would be better if supported by job aids. Consequently, a better quality of ANC counseling is expected to produce higher levels of awareness concerning the danger signs of pregnancy and a more favorable impression of the caring behavior of nurses .” 28
“This study aimed to examine the differences in the responses of pregnant women to a job aid-supported intervention during ANC visit in terms of 1) their understanding of the danger signs of pregnancy and 2) their impression of the caring behaviors of nurses to pregnant women in rural Tanzania.” 28
EXAMPLE 2. Background, hypotheses, and aims are provided
“We conducted a two-arm randomized controlled trial (RCT) to evaluate and compare changes in salivary cortisol and oxytocin levels of first-time pregnant women between experimental and control groups. The women in the experimental group touched and held an infant for 30 min (experimental intervention protocol), whereas those in the control group watched a DVD movie of an infant (control intervention protocol). The primary outcome was salivary cortisol level and the secondary outcome was salivary oxytocin level.” 29
“ We hypothesize that at 30 min after touching and holding an infant, the salivary cortisol level will significantly decrease and the salivary oxytocin level will increase in the experimental group compared with the control group .” 29
EXAMPLE 3. Background, aim, and hypothesis are provided
“In countries where the maternal mortality ratio remains high, antenatal education to increase Birth Preparedness and Complication Readiness (BPCR) is considered one of the top priorities [1]. BPCR includes birth plans during the antenatal period, such as the birthplace, birth attendant, transportation, health facility for complications, expenses, and birth materials, as well as family coordination to achieve such birth plans. In Tanzania, although increasing, only about half of all pregnant women attend an antenatal clinic more than four times [4]. Moreover, the information provided during antenatal care (ANC) is insufficient. In the resource-poor settings, antenatal group education is a potential approach because of the limited time for individual counseling at antenatal clinics.” 30
“This study aimed to evaluate an antenatal group education program among pregnant women and their families with respect to birth-preparedness and maternal and infant outcomes in rural villages of Tanzania.” 30
“ The study hypothesis was if Tanzanian pregnant women and their families received a family-oriented antenatal group education, they would (1) have a higher level of BPCR, (2) attend antenatal clinic four or more times, (3) give birth in a health facility, (4) have less complications of women at birth, and (5) have less complications and deaths of infants than those who did not receive the education .” 30

Research questions and hypotheses are crucial components to any type of research, whether quantitative or qualitative. These questions should be developed at the very beginning of the study. Excellent research questions lead to superior hypotheses, which, like a compass, set the direction of research, and can often determine the successful conduct of the study. Many research studies have floundered because the development of research questions and subsequent hypotheses was not given the thought and meticulous attention needed. The development of research questions and hypotheses is an iterative process based on extensive knowledge of the literature and insightful grasp of the knowledge gap. Focused, concise, and specific research questions provide a strong foundation for constructing hypotheses which serve as formal predictions about the research outcomes. Research questions and hypotheses are crucial elements of research that should not be overlooked. They should be carefully thought of and constructed when planning research. This avoids unethical studies and poor outcomes by defining well-founded objectives that determine the design, course, and outcome of the study.

Disclosure: The authors have no potential conflicts of interest to disclose.

Author Contributions:

Conceptualization: Barroga E, Matanguihan GJ.
Methodology: Barroga E, Matanguihan GJ.
Writing - original draft: Barroga E, Matanguihan GJ.
Writing - review & editing: Barroga E, Matanguihan GJ.

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What is Evidence Based Medicine?

Evidence-Based Medicine: What It Is and What It Isn't Sackett, D.L., Rosenberg, W.M.C., Gray, J.A.M., Hayes, R.B., & Richardson, W.S. (1996). Evidence-based medicine: What is its and what is isn't. British Medical Journal, 312(7023), 71-72.

EBM is "the conscientious use of current best evidence in making clinical decisions about patient care". This original definition is attributed to this article by Sackett, et al.

Step One: Develop a PICO Question

Ask a good question by using the PICO(T) format described below:

Using this format can be instructive and it is now available as a search option in CINAHL! P atient, Population, or Problem I ntervention or Treatment C omparison or Control O utcome or Objective T imeframe (this element is not always included)

Types of Questions: Etiology, Diagnostic, Prevention, Prognosis/Prediction, Therapy, Qualitative

Prevention Example : For patients with systolic heart failure (P) do exercise programs (I) reduce the future risk of hospital admission due to heart failure (O) compared with patients without exercise programs (C)? Therapy Example: In patients with chronic wounds (P) what is the effect of topical negative pressure (TNP) (I) on promoting healing (O) compared with traditional moisturized gauze (C) dressing?

Steps Two through Five

Step Two: Acquire the most relevant, most current, best evidence. See Evidence Hierarchy

Step Three : A ppraise the evidence.

Step Four: Apply all evidence with clincial experience, patient preferences and values in making a practice decision or change.

Step Five : Access the practice decision or change.

PICO Continued (Examples)

Etiology : Are ____(P), who have ____ (I) at ____(increased/decreased)risk for/of_____(O) compared with____(P) with/without_____(C)? Diagnostic: Are(Is)____(I) done on _____(P)more accurate in diagnosis of _____(O)compared to ______(C)?

Qualitative: How do ____ (P), perceive the ____ (I) on ____ (O) compared to _____ (C)?

Prognosis/Prediction: Does ____ (I) influence ____ (O) in patients who have ____ (P)?

TRIP Database PICO Wizard: You may find this helpful. Click on the PICO Search button for help building a PICO question.

Definitions

Systematic Review: A systematic review tries to identify, appraise, select and synthesize all RCTs (randomized control trials) relevant to a specific clinical question. Stringent guidelines are set in order to draw a conclusion about whether or not there is conclusive evidence about a specfic treatment or topic. Randomized Control Trial: An RCT is a clinical trial in which the subjects are randomly distributed into groups that are either subjected to the experimental procedure (such as use of a drug) or that serve as controls. It is the research design considered to provide the most reliable evidence for evaluating the effectiveness of an intervention. Meta-Analysis: A meta-analysis is a review that combines the quantitative (numbers) results from different studies on a defined intervention in order to obtain a quantitative estimate of the overall effect of the particular intervention. A meta-analysis produces a stronger conclusion than can be provided by any individual study.

Practice Guideline: Clinical Practice Guidelines are practice recommendations based on rigorous review of the best evidence on a specific topic.

Cohort Study: A study designed to determine the relationship between a condition and a characteristic shared by some members of a group. The population selected is healthy at the beginning of the study. Some of the members of the group share a particular characteristic, such as cigarette smoking. The researcher follows the population group over a period of time, noting the rate at which a condition, such as lung cancer, occurs in the smokers and in the nonsmokers.

Case Control Study: A study where previously existing incidents of a medical condition are used in lieu of gathering new information. A group of patients with a particular disease or disorder, such as myocardial infarction, is compared with a control group of persons who have not had that medical problem. The two groups, matched for age, sex, and other personal data, are examined to determine which possible factor (e.g., cigarette smoking, coffee drinking) may account for the increased disease incidence in the case group.

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COMMENTS

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The aim of the research is to shed light on the experiences of a group of nursing students enrolled in a yoga elective course who practiced yoga regularly for 14 weeks, regarding yoga and the phenomenon of doing yoga, with a qualitative approach. This qualitative study was conducted at a public university in Izmir, Turkey. The study sample consisted of 61 students enrolled in the 1st-year yoga ...
A Practical Guide to Writing Quantitative and Qualitative Research
INTRODUCTION. Scientific research is usually initiated by posing evidenced-based research questions which are then explicitly restated as hypotheses.1,2 The hypotheses provide directions to guide the study, solutions, explanations, and expected results.3,4 Both research questions and hypotheses are essentially formulated based on conventional theories and real-world processes, which allow the ...
PICO Research
It is the research design considered to provide the most reliable evidence for evaluating the effectiveness of an intervention. Meta-Analysis: A meta-analysis is a review that combines the quantitative (numbers) results from different studies on a defined intervention in order to obtain a quantitative estimate of the overall effect of the ...

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Qualitative research designs

Sampling approaches

Data collection and analysis

Evaluating a qualitative study

Application to nursing practice

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The phenomenon of yoga in the imagination of Turkish nursing students: "The way to place goodness in the heart"

Conclusions

Introduction

Design and participants

Data collection

Data analysis and interpretation process

Ethics approval and consent to participate

Research validity and reliability

Category 1. Symbol of health and serenity (f = 345)

Category 2. The way to place goodness in your heart (f = 110)

Category 3. The most effective way to meet yourself (f = 93)

Category 4. No guarantee of relaxation (f = 71)

Limitations

Acknowledgements

Human ethics and consent to participate declarations

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Additional information

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