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Identifying a Research Problem: A Step-by-Step Guide

The first and perhaps most important step in the research process is identifying a research problem. This step sets the foundation for all subsequent research activities and largely determines the success of your scholarly work.

This guide provides a comprehensive overview of the steps involved in identifying a research problem, from understanding its essence to employing advanced strategies for refinement.

Key Takeaways

• Remember: Grasping the definition and importance of a research problem isn't just a step—it's crucial for your academic success.
• Exploring various sources, like literature reviews and expert consultations, can guide you in formulating a solid research problem.
• A clear problem statement, aligned research objectives, and well-defined questions are crucial for a focused study.
• Evaluating the feasibility and potential impact of a research problem ensures its relevance and scope.
• Advanced strategies, including interdisciplinary approaches and technology utilization, can enhance the identification and refinement of research problems.

Understanding the Essence of Identifying a Research Problem

Defining the research problem.

A research problem is the focal point of any academic inquiry. It is a concise and well-defined statement that outlines the specific issue or question that the research aims to address. This research problem usually sets the tone for the entire study and provides you, the researcher, with a clear purpose and a clear direction on how to go about conducting your research.

Importance in Academic Research

It also demonstrates the significance of your research and its potential to contribute new knowledge to the existing body of literature in the world. A compelling research problem not only captivates the attention of your peers but also lays the foundation for impactful and meaningful research outcomes.

Initial Steps to Identification

To identify a research problem, you need a systematic approach and a deep understanding of the subject area. Below are some steps to guide you in this process:

• Conduct a thorough literature review to understand what has been studied before.
• Identify gaps in the existing research that could form the basis of your study.
• Consult with academic mentors to refine your ideas and approach.

Exploring Sources for Research Problem Identification

Literature review.

When you embark on the journey of identifying a research problem, a thorough literature review is indispensable. This process involves scrutinizing existing research to find literature gaps and unexplored areas that could form the basis of your research. It's crucial to analyze recent studies, seminal works, and review articles to ensure a comprehensive understanding of the topic.

Existing Theories and Frameworks

The exploration of existing theories and frameworks provides a solid foundation for developing a research problem. By understanding the established models and theories, you can identify inconsistencies or areas lacking in depth which might offer fruitful avenues for research.

Consultation with Academic Mentors

Engaging with academic mentors is vital in shaping a well-defined research problem. Their expertise can guide you through the complexities of your field, offering insights into feasible research questions and helping you refine your focus. This interaction often leads to the identification of unique and significant research opportunities that align with current academic and industry trends.

Formulating the Research Problem

Crafting a clear problem statement.

To effectively address your research problem, start by crafting a clear problem statement . This involves succinctly describing who is affected by the problem, why it is important, and how your research will contribute to solving it. Ensure your problem statement is concise and specific to guide the entire research process.

Setting Research Objectives

Setting clear research objectives is crucial for maintaining focus throughout your study. These objectives should directly align with the problem statement and guide your research activities. Consider using a bulleted list to outline your main objectives:

• Understand the underlying factors contributing to the problem
• Explore potential solutions
• Evaluate the effectiveness of proposed solutions

Determining Research Questions

The formulation of precise research questions is a pivotal step in defining the scope and direction of your study. These questions should be directly derived from your research objectives and designed to be answerable through your chosen research methods. Crafting well-defined research questions will help you maintain a clear focus and avoid common pitfalls in the research process.

How to Evaluate the Scope and Relevance of Your Research Problem

Feasibility assessment.

Before you finalize a research problem, it is crucial to assess its feasibility. Consider the availability of resources, time, and expertise required to conduct the research. Evaluate potential constraints and determine if the research problem can be realistically tackled within the given limitations.

Significance to the Field

Ask yourself: Does my research problem have a clear and direct impact on my field? How will it contribute to advancing knowledge? It should aim to contribute to existing knowledge and address a real-world issue that is relevant to your academic discipline.

Potential Impact on Existing Knowledge

The potential impact of your research problem on existing knowledge cannot be understated. It should challenge, extend, or refine current understanding in a meaningful way. Consider how your research can add value to the existing body of work and potentially lead to significant advancements in your field.

Techniques for Refining the Research Problem

Narrowing down the focus.

To effectively refine your research problem, start by narrowing down the focus . This involves pinpointing the specific aspects of your topic that are most significant and ensuring that your research problem is not too broad. This targeted approach helps in identifying knowledge gaps and formulating more precise research questions.

Incorporating Feedback

Feedback is crucial in the refinement process. Engage with academic mentors, peers, and experts in your field to gather insights and suggestions. This collaborative feedback can lead to significant improvements in your research problem, making it more robust and relevant.

Iterative Refinement Process

Refinement should be seen as an iterative process, where you continuously refine and revise your research problem based on new information and feedback. This approach ensures that your research problem remains aligned with current trends and academic standards, ultimately enhancing its feasibility and relevance.

Challenges in Identifying a Research Problem

Common pitfalls and how to avoid them.

Identifying a research problem can be fraught with common pitfalls such as selecting a topic that is too broad or too narrow. To avoid these, you should conduct a thorough literature review and seek feedback from peers and mentors. This proactive approach ensures that your research question is both relevant and manageable.

Dealing with Ambiguity

Ambiguity in defining the research problem can lead to significant challenges down the line. Ensure clarity by operationalizing variables and explicitly stating the research objectives. This clarity will guide your entire research process, making it more structured and focused.

Balancing Novelty and Practicality

While it's important to address a novel issue in your research, practicality should not be overlooked. A research problem should not only contribute new knowledge but also be feasible and have clear implications. Balancing these aspects often requires iterative refinement and consultation with academic mentors to align your research with real-world applications.

Advanced Strategies for Identifying a Research Problem

Interdisciplinary approaches.

Embrace the power of interdisciplinary approaches to uncover unique and comprehensive research problems. By integrating knowledge from various disciplines, you can address complex issues that single-field studies might overlook. This method not only broadens the scope of your research but also enhances its applicability and depth.

Utilizing Technology and Data Analytics

Leverage technology and data analytics to refine and identify research problems with precision. Advanced tools like machine learning and big data analysis can reveal patterns and insights that traditional methods might miss. This approach is particularly useful in fields where large datasets are involved, or where real-time data integration can lead to more dynamic research outcomes.

Engaging with Industry and Community Needs

Focus on the needs of industry and community to ensure your research is not only academically sound but also practically relevant. Engaging with real-world problems can provide a rich source of research questions that are directly applicable and beneficial to society. This strategy not only enhances the relevance of your research but also increases its potential for impact.

Dive into the world of academic success with our 'Advanced Strategies for Identifying a Research Problem' at Research Rebels. Our expertly crafted guides and action plans are designed to simplify your thesis journey, transforming complex academic challenges into manageable tasks. Don't wait to take control of your academic future. Visit our website now to learn more and claim your special offer! 

Struggling to Navigate the Complexities of Identifying a Research Problem?

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In conclusion, identifying a research problem is a foundational step in the academic research process that requires careful consideration and systematic approach. This guide has outlined the essential steps involved, from understanding the context and reviewing existing literature to formulating clear research questions. By adhering to these guidelines, researchers can ensure that their studies are grounded in a well-defined problem, enhancing the relevance and impact of their findings. It is crucial for scholars to approach this task with rigor and critical thinking to contribute meaningfully to the body of knowledge in their respective fields. 

Frequently Asked Questions

What is a research problem.

A research problem is a specific issue, inconsistency, or gap in knowledge that needs to be addressed through scientific inquiry. It forms the foundation of a research study, guiding the research questions, methodology, and analysis.

Why is identifying a research problem important?

Identifying a research problem is crucial as it determines the direction and scope of the study. It helps researchers focus their inquiry, formulate hypotheses, and contribute to the existing body of knowledge.

How do I identify a suitable research problem?

To identify a suitable research problem, start with a thorough literature review to understand existing research and identify gaps. Consult with academic mentors, and consider relevance, feasibility, and your own interests.

What are some common pitfalls in identifying a research problem?

Common pitfalls include choosing a problem that is too broad or too narrow, not aligning with existing literature, lack of originality, and failing to consider the practical implications and feasibility of the study.

Can technology help in identifying a research problem?

Yes, technology and data analytics can aid in identifying research problems by providing access to a vast amount of data, revealing patterns and trends that might not be visible otherwise. Tools like digital libraries and research databases are particularly useful.

How can I refine my research problem?

Refine your research problem by narrowing its focus, seeking feedback from peers and mentors, and continually reviewing and adjusting the problem statement based on new information and insights gained during preliminary research.

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• How to Define a Research Problem | Ideas & Examples

How to Define a Research Problem | Ideas & Examples

Published on November 2, 2022 by Shona McCombes and Tegan George. Revised on May 31, 2023.

A research problem is a specific issue or gap in existing knowledge that you aim to address in your research. You may choose to look for practical problems aimed at contributing to change, or theoretical problems aimed at expanding knowledge.

Some research will do both of these things, but usually the research problem focuses on one or the other. The type of research problem you choose depends on your broad topic of interest and the type of research you think will fit best.

This article helps you identify and refine a research problem. When writing your research proposal or introduction , formulate it as a problem statement and/or research questions .

Table of contents

Why is the research problem important, step 1: identify a broad problem area, step 2: learn more about the problem, other interesting articles, frequently asked questions about research problems.

Having an interesting topic isn’t a strong enough basis for academic research. Without a well-defined research problem, you are likely to end up with an unfocused and unmanageable project.

You might end up repeating what other people have already said, trying to say too much, or doing research without a clear purpose and justification. You need a clear problem in order to do research that contributes new and relevant insights.

Whether you’re planning your thesis , starting a research paper , or writing a research proposal , the research problem is the first step towards knowing exactly what you’ll do and why.

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As you read about your topic, look for under-explored aspects or areas of concern, conflict, or controversy. Your goal is to find a gap that your research project can fill.

Practical research problems

If you are doing practical research, you can identify a problem by reading reports, following up on previous research, or talking to people who work in the relevant field or organization. You might look for:

• Issues with performance or efficiency
• Processes that could be improved
• Areas of concern among practitioners
• Difficulties faced by specific groups of people

Examples of practical research problems

Voter turnout in New England has been decreasing, in contrast to the rest of the country.

The HR department of a local chain of restaurants has a high staff turnover rate.

A non-profit organization faces a funding gap that means some of its programs will have to be cut.

Theoretical research problems

If you are doing theoretical research, you can identify a research problem by reading existing research, theory, and debates on your topic to find a gap in what is currently known about it. You might look for:

• A phenomenon or context that has not been closely studied
• A contradiction between two or more perspectives
• A situation or relationship that is not well understood
• A troubling question that has yet to be resolved

Examples of theoretical research problems

The effects of long-term Vitamin D deficiency on cardiovascular health are not well understood.

The relationship between gender, race, and income inequality has yet to be closely studied in the context of the millennial gig economy.

Historians of Scottish nationalism disagree about the role of the British Empire in the development of Scotland’s national identity.

Next, you have to find out what is already known about the problem, and pinpoint the exact aspect that your research will address.

Context and background

• Who does the problem affect?
• Is it a newly-discovered problem, or a well-established one?
• What research has already been done?
• What, if any, solutions have been proposed?
• What are the current debates about the problem? What is missing from these debates?

Specificity and relevance

• What particular place, time, and/or group of people will you focus on?
• What aspects will you not be able to tackle?
• What will the consequences be if the problem is not resolved?

Example of a specific research problem

A local non-profit organization focused on alleviating food insecurity has always fundraised from its existing support base. It lacks understanding of how best to target potential new donors. To be able to continue its work, the organization requires research into more effective fundraising strategies.

Once you have narrowed down your research problem, the next step is to formulate a problem statement , as well as your research questions or hypotheses .

If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

Methodology

• Sampling methods
• Simple random sampling
• Stratified sampling
• Cluster sampling
• Likert scales
• Reproducibility

 Statistics

• Null hypothesis
• Statistical power
• Probability distribution
• Effect size
• Poisson distribution

Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
• Anchoring bias
• Explicit bias

All research questions should be:

• Focused on a single problem or issue
• Researchable using primary and/or secondary sources
• Feasible to answer within the timeframe and practical constraints
• Specific enough to answer thoroughly
• Complex enough to develop the answer over the space of a paper or thesis
• Relevant to your field of study and/or society more broadly

Research questions anchor your whole project, so it’s important to spend some time refining them.

In general, they should be:

• Focused and researchable
• Answerable using credible sources
• Complex and arguable
• Feasible and specific
• Relevant and original

Your research objectives indicate how you’ll try to address your research problem and should be specific:

A research aim is a broad statement indicating the general purpose of your research project. It should appear in your introduction at the end of your problem statement , before your research objectives.

Research objectives are more specific than your research aim. They indicate the specific ways you’ll address the overarching aim.

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• 1. Choosing a Research Problem
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In the social and behavioral sciences, the subject of analysis is most often framed as a problem that must be researched in order to obtain a greater understanding, formulate a set of solutions or recommended courses of action, and/or develop a more effective approach to practice. The research problem, therefore, is the main organizing principle guiding the analysis of your research. The problem under investigation establishes an occasion for writing and a focus that governs what you want to say. It represents the core subject matter of scholarly communication and the means by which scholars arrive at other topics of conversation and the discovery of new knowledge and understanding.

Alvesson, Mats and Jörgen Sandberg. Constructing Research Questions: Doing Interesting Research . London: Sage, 2013; Jacobs, Ronald L. “Developing a Dissertation Research Problem: A Guide for Doctoral Students in Human Resource Development and Adult Education.” New Horizons in Adult Education and Human Resource Development 25 (Summer 2013): 103-117; Chapter 1: Research and the Research Problem. Nicholas Walliman . Your Research Project: Designing and Planning Your Work . 3rd edition. Thousand Oaks, CA: Sage Publications, 2011.

Choosing a Research Problem / How to Begin

Do not assume that identifying a research problem to investigate will be a quick and easy task! You should be thinking about it during the beginning of the course. There are generally three ways you are asked to write about a research problem : 1) your professor provides you with a general topic from which you study a particular aspect; 2) your professor provides you with a list of possible topics to study and you choose a topic from that list; or, 3) your professor leaves it up to you to choose a topic and you only have to obtain permission to write about it before beginning your investigation. Here are some strategies for getting started for each scenario.

I.  How To Begin:  You are given the topic to write about

Step 1 : Identify concepts and terms that make up the topic statement . For example, your professor wants the class to focus on the following research problem: “Is the European Union a credible security actor with the capacity to contribute to confronting global terrorism?" The main concepts in this problem are: European Union, security, global terrorism, credibility [ hint : focus on identifying proper nouns, nouns or noun phrases, and action verbs in the assignment description]. Step 2 : Review related literature to help refine how you will approach examining the topic and finding a way to analyze it . You can begin by doing any or all of the following: reading through background information from materials listed in your course syllabus; searching the USC Libraries Catalog to find a recent book on the topic and, if appropriate, more specialized works about the topic; conducting a preliminary review of the research literature using multidisciplinary databases such as ProQuest or subject-specific databases from the " By Subject Area " drop down menu located above the list of databases.

Choose the advanced search option in the database and enter into each search box the main concept terms you developed in Step 1. Also consider using their synonyms to retrieve additional relevant records. This will help you refine and frame the scope of the research problem. You will likely need to do this several times before you can finalize how to approach writing about the topic. NOTE: Always review the references from your most relevant research results cited by the authors in footnotes, endnotes, or a bibliography to locate related research on your topic. This is a good strategy for identifying important prior research about the topic because titles that are repeatedly cited indicate their significance in laying a foundation for understanding the problem. However, if you’re having trouble at this point locating relevant research literature, ask a librarian for help!

ANOTHER NOTE:   If you find an article from a database that's particularly helpful, paste it into Google Scholar , placing the title of the article in quotes. If the article record appears, look for a "cited by" reference followed by a number [e.g., C ited by 37] just below the record. This link indicates how many times other scholars have subsequently cited that article in their own research since it was first published. This is an effective strategy for identifying more current, related research on your topic. Finding additional cited by references from your original list of cited by references helps you navigate through the literature and, by so doing, understand the evolution of thought around a particular research problem. Step 3 : Since social science research papers are generally designed to encourage you to develop your own ideas and arguments, look for sources that can help broaden, modify, or strengthen your initial thoughts and arguments. For example, if you decide to argue that the European Union is inadequately prepared to take on responsibilities for broader global security because of the debt crisis in many EU countries, then focus on identifying sources that support as well as refute this position. From the advanced search option in ProQuest , a sample search would use "European Union" in one search box, "global security" in the second search box, and adding a third search box to include "debt crisis."

There are least four appropriate roles your related literature plays in helping you formulate how to begin your analysis :

• Sources of criticism -- frequently, you'll find yourself reading materials that are relevant to your chosen topic, but you disagree with the author's position. Therefore, one way that you can use a source is to describe the counter-argument, provide evidence from your own review of the literature as to why the prevailing argument is unsatisfactory, and to discuss how your approach is more appropriate based upon your interpretation of the evidence.
• Sources of new ideas -- while a general goal in writing college research papers in the social sciences is to examine a research problem with some basic idea of what position you'd like to take and on what basis you'd like to defend your position, it is certainly acceptable [and often encouraged] to read the literature and extend, modify, and refine your own position in light of the ideas proposed by others. Just make sure that you cite the sources !
• Sources for historical context -- another role your related literature plays in formulating how to begin your analysis is to place issues and events in proper historical context. This can help to demonstrate familiarity with developments in relevant scholarship about your topic, provide a means of comparing historical versus contemporary issues and events, and identifying key people, places, and events that had an important role related to the research problem. Given its archival journal coverage, a good multidisciplnary database to use in this case is JSTOR .
• Sources of interdisciplinary insight -- an advantage of using databases like ProQuest to begin exploring your topic is that it covers publications from a variety of different disciplines. Another way to formulate how to study the topic is to look at it from different disciplinary perspectives. If the topic concerns immigration reform, for example, ask yourself, how do studies from sociological journals found by searching ProQuest vary in their analysis from those in political science journals. A goal in reviewing related literature is to provide a means of approaching a topic from multiple perspectives rather than the perspective offered from just one discipline.

NOTE: Remember to keep careful notes at every stage or utilize a citation management system like EndNotes or RefWorks . You may think you'll remember what you have searched and where you found things, but it’s easy to forget or get confused. Most databases have a search history feature that allows you to go back and see what searches you conducted previously as long as you haven't closed your session. If you start over, that history could be deleted.

Step 4 : Assuming you have done an effective job of synthesizing and thinking about the results of your initial search for related literature, you're ready to prepare a detailed outline for your paper that lays the foundation for a more in-depth and focused review of relevant research literature [after consulting with a librarian, if needed!]. How will you know you haven't done an effective job of synthesizing and thinking about the results of our initial search for related literature? A good indication is that you start composing the outline and gaps appear in how you want to approach the study. This indicates the need to gather further background information and analysis about the research problem.

II.  How To Begin:  You are provided a list of possible topics to choose from Step 1 : I know what you’re thinking--which topic on this list will be the easiest to find the most information on? An effective instructor would never include a topic that is so obscure or complex that no research is available to examine and from which to design an effective study. Therefore, don't approach a list of possible topics to study from the perspective of trying to identify the path of least resistance; choose a topic that you find interesting in some way, that is controversial and that you have a strong opinion about, that has some personal meaning for you, or relates to your major or a minor. You're going to be working on the topic for quite some time, so choose one that you find interesting and engaging or that motivates you to take a position. Embrace the opportunity to learn something new! Once you’ve settled on a topic of interest from the list provided by your professor, follow Steps 1 - 4 listed above to further develop it into a research paper.

NOTE: It’s ok to review related literature to help refine how you will approach analyzing a topic, and then discover that the topic isn’t all that interesting to you. In that case, choose a different topic from the list. Just don’t wait too long to make a switch and, of course, be sure to inform your professor that you are changing your topic.

III.  How To Begin:  Your professor leaves it up to you to choose a topic

Step 1 : Under this scenario, the key process is turning an idea or general thought into a topic that can be configured into a research problem. When given an assignment where you choose the topic, don't begin by thinking about what to write about, but rather, ask yourself the question, "What do I want to understand or learn about?" Treat an open-ended research assignment as an opportunity to gain new knowledge about something that's important or exciting to you in the context of the overall subject of the course.

Step 2 : If you lack ideas, or wish to gain focus, try any or all of the following strategies:

• Review your course readings, particularly the suggested readings, for topic ideas. Don't just review what you've already read, but jump ahead in the syllabus to readings that have not been covered yet.
• Search the USC Libraries Catalog for a recently published book and, if appropriate, more specialized works related to the discipline area of the course [e.g., for the course SOCI 335: Society and Population, search for books on "population and society" or "population and social impact"]. Reviewing the contents of a book about your area of interest can give you insight into what conversations scholars are having about the topic and, thus, how you might want to contribute your own ideas to these conversations through the research paper you write for the class.
• Browse through some current scholarly [a.k.a., academic, peer reviewed] journals in your subject discipline. Even if most of the articles are not relevant, you can skim through the contents quickly. You only need one to be the spark that begins the process of wanting to learn more about a topic. Consult with a librarian and/or your professor about what constitutes the core journals within the subject area of the writing assignment.
• Think about essays you have written for other courses you have taken or academic lectures and programs you have attended outside of class. Thinking back, ask yourself why did you want to take this class or attend this event? What interested you the most? What would you like to know more about? Place this question in the context of the current course assignment. Note that this strategy also applies to anything you've watched on TV or has been shared on social media.
• Search online news media sources, such as CNN , the Los Angeles Times , Huffington Post , MSNBC , Fox News , or Newsweek , to see if your idea has been covered by the media. Use this coverage to refine your idea into something that you'd like to investigate further, but in a more deliberate, scholarly way in relation to a particular problem that needs to be researched.

Step 3 : To build upon your initial idea, use the suggestions under this tab to help narrow , broaden , or increase the timeliness of your idea so you can write it out as a research problem.

Once you are comfortable with having turned your idea into a research problem, follow Steps 1 - 4 listed in Part I above to further develop it into an outline for a research paper.

Alderman, Jim. "Choosing a Research Topic." Beginning Library and Information Systems Strategies. Paper 17. Jacksonville, FL: University of North Florida Digital Commons, 2014; Alvesson, Mats and Jörgen Sandberg. Constructing Research Questions: Doing Interesting Research . London: Sage, 2013; Chapter 2: Choosing a Research Topic. Adrian R. Eley. Becoming a Successful Early Career Researcher . New York: Routledge, 2012; Answering the Question. Academic Skills Centre. University of Canberra; Brainstorming. Department of English Writing Guide. George Mason University; Brainstorming. The Writing Center. University of North Carolina; Chapter 1: Research and the Research Problem. Nicholas Walliman . Your Research Project: Designing and Planning Your Work . 3rd edition. Thousand Oaks, CA: Sage Publications, 2011; Choosing a Topic. The Writing Lab and The OWL. Purdue University;  Mullaney, Thomas S. and Christopher Rea. Where Research Begins: Choosing a Research Project That Matters to You (and the World) . Chicago, IL: University of Chicago Press, 2022; Coming Up With Your Topic. Institute for Writing Rhetoric. Dartmouth College; How To Write a Thesis Statement. Writing Tutorial Services, Center for Innovative Teaching and Learning. Indiana University; Identify Your Question. Start Your Research. University Library, University of California, Santa Cruz; The Process of Writing a Research Paper. Department of History. Trent University; Trochim, William M.K. Problem Formulation. Research Methods Knowledge Base. 2006.

Resources for Identifying a Topic

Resources for Identifying a Research Problem

If you are having difficulty identifying a topic to study or need basic background information, the following web resources and databases can be useful:

• CQ Researcher -- a collection of single-themed public policy reports that provide an overview of an issue. Each report includes background information, an assessment of the current policy situation, statistical tables and maps, pro/con statements from representatives of opposing positions, and a bibliography of key sources.
• New York Times Topics -- each topic page collects news articles, reference and archival information, photos, graphics, audio and video files. Content is available without charge on articles going back to 1981.
• Opposing Viewpoints In Context -- an online resource covering a wide range of social issues from a variety of perspectives. The database contains a media-rich collection of materials, including pro/con viewpoint essays, topic overviews, primary source materials, biographies of social activists and reformers, journal articles, statistical tables, charts and graphs, images, videos, and podcasts.
• Policy Commons -- platform for objective, fact-based research from the world’s leading policy experts, nonpartisan think tanks, and intergovernmental and non-governmental organizations. The database provides advanced searching across millions of pages of books, articles, working papers, reports, policy briefs, data sets, tables, charts, media, case studies, and statistical publications, including archived reports from more than 200 defunct think tanks. Coverage is international in scope.

Descriptions of resources are adapted or quoted from vendor websites.

Writing Tip

Not Finding Anything on Your Topic? Ask a Librarian!

Don't assume or jump to the conclusion that your topic is too narrowly defined or obscure just because your initial search has failed to locate any relevant studies. Librarians are experts in locating and critically assessing information and how it is organized. This information will help you develop strategies for analyzing existing knowledge in new ways. Therefore, always consult with a librarian before you consider giving up on finding information about what you want to investigate. If there isn't a lot of information about your topic, a librarian can help you identify a closely related topic to study. Use the Ask-A-Librarian link above to either chat with a librarian, send a general email to the librarians, or identify a subject expert librarian related to the course you are taking.

Another Writing Tip

A Research Problem is Not the Thesis Statement

A thesis statement and a research problem are two different parts of the introduction section of your paper. The thesis statement succinctly describes in one or two sentences, usually in the last paragraph of the introduction, what position you have reached about a topic. It includes an assertion that requires evidence and support along with your opinion or argument about what you are researching. There are three general types of thesis statements that are intended to set forth a claim that you will seek to validate through the research you describe in your paper :

1) analytical statements that break down and evaluate the topic;

2) expository statements that present facts and research about the topic; and,

3) argumentative statements that make a claim about the topic and defend that claim. An  argumentative thesis statement is the most common type of statement required in social sciences writing assignments.

Before the thesis statement, however, your introduction must include a statement about a problem in which you describe either a key area of concern, a condition to be improved upon, a difficulty to be eliminated, or a troubling issue that exists . The research problem describes something that can be empirically verified and measured; it is often followed by a set of questions that underpin how you plan to approach investigating that problem. In short, the thesis statement states your opinion or argument about the research problem and summarizes how you plan to address it.

Tips and Examples for Writing Thesis Statements. The Writing Lab and The OWL. Purdue University; Write a Strong Thesis Statement! The Writing Center, University of Evansville; Thesis Statements. The Writing Center. University of North Carolina; Tutorial #26: Thesis Statements and Topic Sentences. Writing Center, College of San Mateo; Creswell,  John W. and J. David Creswell. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches . 5th edition. Thousand Oaks, CA: SAGE Publications, 2017.

Still Another Writing Tip

Don't be a Martyr!

In thinking about what to study, don't adopt the mindset of pursuing an esoteric or overly complicated topic just to impress your professor but that, in reality, does not have any real interest to you. Choose a topic that is challenging but that has at least some interest to you or that you care about. Obviously, this is easier for courses within your major, but even for those nasty prerequisite classes that you must take in order to graduate [and that provide an additional tuition revenue for the university], try to apply issues associated with your major to the general topic given to you. For example, if you are an international relations major taking a GE philosophy class where the assignment asks you to apply the question of "what is truth" to some aspect of life, you could choose to study how government leaders attempt to shape truth through the use of nationalistic propaganda.

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The Research Problem & Statement

What they are & how to write them (with examples)

By: Derek Jansen (MBA) | Expert Reviewed By: Eunice Rautenbach (DTech) | March 2023

If you’re new to academic research, you’re bound to encounter the concept of a “ research problem ” or “ problem statement ” fairly early in your learning journey. Having a good research problem is essential, as it provides a foundation for developing high-quality research, from relatively small research papers to a full-length PhD dissertations and theses.

In this post, we’ll unpack what a research problem is and how it’s related to a problem statement . We’ll also share some examples and provide a step-by-step process you can follow to identify and evaluate study-worthy research problems for your own project.

Overview: Research Problem 101

What is a research problem.

• What is a problem statement?

Where do research problems come from?

• How to find a suitable research problem
• Key takeaways

A research problem is, at the simplest level, the core issue that a study will try to solve or (at least) examine. In other words, it’s an explicit declaration about the problem that your dissertation, thesis or research paper will address. More technically, it identifies the research gap that the study will attempt to fill (more on that later).

Let’s look at an example to make the research problem a little more tangible.

To justify a hypothetical study, you might argue that there’s currently a lack of research regarding the challenges experienced by first-generation college students when writing their dissertations [ PROBLEM ] . As a result, these students struggle to successfully complete their dissertations, leading to higher-than-average dropout rates [ CONSEQUENCE ]. Therefore, your study will aim to address this lack of research – i.e., this research problem [ SOLUTION ].

A research problem can be theoretical in nature, focusing on an area of academic research that is lacking in some way. Alternatively, a research problem can be more applied in nature, focused on finding a practical solution to an established problem within an industry or an organisation. In other words, theoretical research problems are motivated by the desire to grow the overall body of knowledge , while applied research problems are motivated by the need to find practical solutions to current real-world problems (such as the one in the example above).

As you can probably see, the research problem acts as the driving force behind any study , as it directly shapes the research aims, objectives and research questions , as well as the research approach. Therefore, it’s really important to develop a very clearly articulated research problem before you even start your research proposal . A vague research problem will lead to unfocused, potentially conflicting research aims, objectives and research questions .

What is a research problem statement?

As the name suggests, a problem statement (within a research context, at least) is an explicit statement that clearly and concisely articulates the specific research problem your study will address. While your research problem can span over multiple paragraphs, your problem statement should be brief , ideally no longer than one paragraph . Importantly, it must clearly state what the problem is (whether theoretical or practical in nature) and how the study will address it.

Here’s an example of a statement of the problem in a research context:

Rural communities across Ghana lack access to clean water, leading to high rates of waterborne illnesses and infant mortality. Despite this, there is little research investigating the effectiveness of community-led water supply projects within the Ghanaian context. Therefore, this study aims to investigate the effectiveness of such projects in improving access to clean water and reducing rates of waterborne illnesses in these communities.

As you can see, this problem statement clearly and concisely identifies the issue that needs to be addressed (i.e., a lack of research regarding the effectiveness of community-led water supply projects) and the research question that the study aims to answer (i.e., are community-led water supply projects effective in reducing waterborne illnesses?), all within one short paragraph.

Need a helping hand?

Wherever there is a lack of well-established and agreed-upon academic literature , there is an opportunity for research problems to arise, since there is a paucity of (credible) knowledge. In other words, research problems are derived from research gaps . These gaps can arise from various sources, including the emergence of new frontiers or new contexts, as well as disagreements within the existing research.

Let’s look at each of these scenarios:

New frontiers – new technologies, discoveries or breakthroughs can open up entirely new frontiers where there is very little existing research, thereby creating fresh research gaps. For example, as generative AI technology became accessible to the general public in 2023, the full implications and knock-on effects of this were (or perhaps, still are) largely unknown and therefore present multiple avenues for researchers to explore.

New contexts – very often, existing research tends to be concentrated on specific contexts and geographies. Therefore, even within well-studied fields, there is often a lack of research within niche contexts. For example, just because a study finds certain results within a western context doesn’t mean that it would necessarily find the same within an eastern context. If there’s reason to believe that results may vary across these geographies, a potential research gap emerges.

Disagreements – within many areas of existing research, there are (quite naturally) conflicting views between researchers, where each side presents strong points that pull in opposing directions. In such cases, it’s still somewhat uncertain as to which viewpoint (if any) is more accurate. As a result, there is room for further research in an attempt to “settle” the debate.

Of course, many other potential scenarios can give rise to research gaps, and consequently, research problems, but these common ones are a useful starting point. If you’re interested in research gaps, you can learn more here .

How to find a research problem

Given that research problems flow from research gaps , finding a strong research problem for your research project means that you’ll need to first identify a clear research gap. Below, we’ll present a four-step process to help you find and evaluate potential research problems.

If you’ve read our other articles about finding a research topic , you’ll find the process below very familiar as the research problem is the foundation of any study . In other words, finding a research problem is much the same as finding a research topic.

Step 1 – Identify your area of interest

Naturally, the starting point is to first identify a general area of interest . Chances are you already have something in mind, but if not, have a look at past dissertations and theses within your institution to get some inspiration. These present a goldmine of information as they’ll not only give you ideas for your own research, but they’ll also help you see exactly what the norms and expectations are for these types of projects.

At this stage, you don’t need to get super specific. The objective is simply to identify a couple of potential research areas that interest you. For example, if you’re undertaking research as part of a business degree, you may be interested in social media marketing strategies for small businesses, leadership strategies for multinational companies, etc.

Depending on the type of project you’re undertaking, there may also be restrictions or requirements regarding what topic areas you’re allowed to investigate, what type of methodology you can utilise, etc. So, be sure to first familiarise yourself with your institution’s specific requirements and keep these front of mind as you explore potential research ideas.

Step 2 – Review the literature and develop a shortlist

Once you’ve decided on an area that interests you, it’s time to sink your teeth into the literature . In other words, you’ll need to familiarise yourself with the existing research regarding your interest area. Google Scholar is a good starting point for this, as you can simply enter a few keywords and quickly get a feel for what’s out there. Keep an eye out for recent literature reviews and systematic review-type journal articles, as these will provide a good overview of the current state of research.

At this stage, you don’t need to read every journal article from start to finish . A good strategy is to pay attention to the abstract, intro and conclusion , as together these provide a snapshot of the key takeaways. As you work your way through the literature, keep an eye out for what’s missing – in other words, what questions does the current research not answer adequately (or at all)? Importantly, pay attention to the section titled “ further research is needed ”, typically found towards the very end of each journal article. This section will specifically outline potential research gaps that you can explore, based on the current state of knowledge (provided the article you’re looking at is recent).

Take the time to engage with the literature and develop a big-picture understanding of the current state of knowledge. Reviewing the literature takes time and is an iterative process , but it’s an essential part of the research process, so don’t cut corners at this stage.

As you work through the review process, take note of any potential research gaps that are of interest to you. From there, develop a shortlist of potential research gaps (and resultant research problems) – ideally 3 – 5 options that interest you.

Step 3 – Evaluate your potential options

Once you’ve developed your shortlist, you’ll need to evaluate your options to identify a winner. There are many potential evaluation criteria that you can use, but we’ll outline three common ones here: value, practicality and personal appeal.

Value – a good research problem needs to create value when successfully addressed. Ask yourself:

• Who will this study benefit (e.g., practitioners, researchers, academia)?
• How will it benefit them specifically?
• How much will it benefit them?

Practicality – a good research problem needs to be manageable in light of your resources. Ask yourself:

• What data will I need access to?
• What knowledge and skills will I need to undertake the analysis?
• What equipment or software will I need to process and/or analyse the data?
• How much time will I need?
• What costs might I incur?

Personal appeal – a research project is a commitment, so the research problem that you choose needs to be genuinely attractive and interesting to you. Ask yourself:

• How appealing is the prospect of solving this research problem (on a scale of 1 – 10)?
• Why, specifically, is it attractive (or unattractive) to me?
• Does the research align with my longer-term goals (e.g., career goals, educational path, etc)?

Depending on how many potential options you have, you may want to consider creating a spreadsheet where you numerically rate each of the options in terms of these criteria. Remember to also include any criteria specified by your institution . From there, tally up the numbers and pick a winner.

Step 4 – Craft your problem statement

Once you’ve selected your research problem, the final step is to craft a problem statement. Remember, your problem statement needs to be a concise outline of what the core issue is and how your study will address it. Aim to fit this within one paragraph – don’t waffle on. Have a look at the problem statement example we mentioned earlier if you need some inspiration.

Key Takeaways

We’ve covered a lot of ground. Let’s do a quick recap of the key takeaways:

• A research problem is an explanation of the issue that your study will try to solve. This explanation needs to highlight the problem , the consequence and the solution or response.
• A problem statement is a clear and concise summary of the research problem , typically contained within one paragraph.
• Research problems emerge from research gaps , which themselves can emerge from multiple potential sources, including new frontiers, new contexts or disagreements within the existing literature.
• To find a research problem, you need to first identify your area of interest , then review the literature and develop a shortlist, after which you’ll evaluate your options, select a winner and craft a problem statement .

Psst... there’s more!

This post was based on one of our popular Research Bootcamps . If you're working on a research project, you'll definitely want to check this out ...

I APPRECIATE YOUR CONCISE AND MIND-CAPTIVATING INSIGHTS ON THE STATEMENT OF PROBLEMS. PLEASE I STILL NEED SOME SAMPLES RELATED TO SUICIDES.

Very pleased and appreciate clear information.

Your videos and information have been a life saver for me throughout my dissertation journey. I wish I’d discovered them sooner. Thank you!

Very interesting. Thank you. Please I need a PhD topic in climate change in relation to health.

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How to identify and resolve research problems

Updated August 23, 2024

In this article, we’re going to take you through one of the most pertinent parts of conducting research: a research problem (also known as a research problem statement).

When trying to formulate a good research statement, and understand how to solve it for complex projects, it can be difficult to know where to start.

Not only are there multiple perspectives (from stakeholders to project marketers who want answers), you have to consider the particular context of the research topic: is it timely, is it relevant and most importantly of all, is it valuable?

In other words: are you looking at a research worthy problem?

The fact is, a well-defined, precise, and goal-centric research problem will keep your researchers, stakeholders, and business-focused and your results actionable.

And when it works well, it's a powerful tool to identify practical solutions that can drive change and secure buy-in from your workforce.

Free eBook: The ultimate guide to market research

What is a research problem?

In social research methodology and behavioral sciences , a research problem establishes the direction of research, often relating to a specific topic or opportunity for discussion.

For example: climate change and sustainability, analyzing moral dilemmas or wage disparity amongst classes could all be areas that the research problem focuses on.

As well as outlining the topic and/or opportunity, a research problem will explain:

• why the area/issue needs to be addressed,
• why the area/issue is of importance,
• the parameters of the research study
• the research objective
• the reporting framework for the results and
• what the overall benefit of doing so will provide (whether to society as a whole or other researchers and projects).

Having identified the main topic or opportunity for discussion, you can then narrow it down into one or several specific questions that can be scrutinized and answered through the research process.

What are research questions?

Generating research questions underpinning your study usually starts with problems that require further research and understanding while fulfilling the objectives of the study.

A good problem statement begins by asking deeper questions to gain insights about a specific topic.

For example, using the problems above, our questions could be:

"How will climate change policies influence sustainability standards across specific geographies?"

"What measures can be taken to address wage disparity without increasing inflation?"

Developing a research worthy problem is the first step - and one of the most important - in any kind of research.

It’s also a task that will come up again and again because any business research process is cyclical. New questions arise as you iterate and progress through discovering, refining, and improving your products and processes. A research question can also be referred to as a "problem statement".

Note: good research supports multiple perspectives through empirical data. It’s focused on key concepts rather than a broad area, providing readily actionable insight and areas for further research.

Research question or research problem?

As we've highlighted, the terms “research question” and “research problem” are often used interchangeably, becoming a vague or broad proposition for many.

The term "problem statement" is far more representative, but finds little use among academics.

Instead, some researchers think in terms of a single research problem and several research questions that arise from it.

As mentioned above, the questions are lines of inquiry to explore in trying to solve the overarching research problem.

Ultimately, this provides a more meaningful understanding of a topic area.

It may be useful to think of questions and problems as coming out of your business data – that’s the O-data (otherwise known as operational data) like sales figures and website metrics.

What's an example of a research problem?

Your overall research problem could be: "How do we improve sales across EMEA and reduce lost deals?"

This research problem then has a subset of questions, such as:

"Why do sales peak at certain times of the day?"

"Why are customers abandoning their online carts at the point of sale?"

As well as helping you to solve business problems, research problems (and associated questions) help you to think critically about topics and/or issues (business or otherwise). You can also use your old research to aid future research -- a good example is laying the foundation for comparative trend reports or a complex research project.

(Also, if you want to see the bigger picture when it comes to research problems, why not check out our ultimate guide to market research? In it you'll find out: what effective market research looks like, the use cases for market research, carrying out a research study, and how to examine and action research findings).

The research process: why are research problems important?

A research problem has two essential roles in setting your research project on a course for success.

1. They set the scope

The research problem defines what problem or opportunity you’re looking at and what your research goals are. It stops you from getting side-tracked or allowing the scope of research to creep off-course .

Without a strong research problem or problem statement, your team could end up spending resources unnecessarily, or coming up with results that aren’t actionable - or worse, harmful to your business - because the field of study is too broad.

2. They tie your work to business goals and actions

To formulate a research problem in terms of business decisions means you always have clarity on what’s needed to make those decisions. You can show the effects of what you’ve studied using real outcomes.

Then, by focusing your research problem statement on a series of questions tied to business objectives, you can reduce the risk of the research being unactionable or inaccurate.

It's also worth examining research or other scholarly literature (you’ll find plenty of similar, pertinent research online) to see how others have explored specific topics and noting implications that could have for your research.

Four steps to defining your research problem

Image credit: http://myfreeschooltanzania.blogspot.com/2014/11/defining-research-problem.html

1. Observe and identify

Businesses today have so much data that it can be difficult to know which problems to address first. Researchers also have business stakeholders who come to them with problems they would like to have explored. A researcher’s job is to sift through these inputs and discover exactly what higher-level trends and key concepts are worth investing in.

This often means asking questions and doing some initial investigation to decide which avenues to pursue. This could mean gathering interdisciplinary perspectives identifying additional expertise and contextual information.

Sometimes, a small-scale preliminary study might be worth doing to help get a more comprehensive understanding of the business context and needs, and to make sure your research problem addresses the most critical questions.

This could take the form of qualitative research using a few in-depth interviews , an environmental scan, or reviewing relevant literature.

The sales manager of a sportswear company has a problem: sales of trail running shoes are down year-on-year and she isn’t sure why. She approaches the company’s research team for input and they begin asking questions within the company and reviewing their knowledge of the wider market.

2. Review the key factors involved

As a marketing researcher, you must work closely with your team of researchers to define and test the influencing factors and the wider context involved in your study. These might include demographic and economic trends or the business environment affecting the question at hand. This is referred to as a relational research problem.

To do this, you have to identify the factors that will affect the research and begin formulating different methods to control them.

You also need to consider the relationships between factors and the degree of control you have over them. For example, you may be able to control the loading speed of your website but you can’t control the fluctuations of the stock market.

Doing this will help you determine whether the findings of your project will produce enough information to be worth the cost.

You need to determine:

• which factors affect the solution to the research proposal.
• which ones can be controlled and used for the purposes of the company, and to what extent.
• the functional relationships between the factors.
• which ones are critical to the solution of the research study.

The research team at the running shoe company is hard at work. They explore the factors involved and the context of why YoY sales are down for trail shoes, including things like what the company’s competitors are doing, what the weather has been like – affecting outdoor exercise – and the relative spend on marketing for the brand from year to year.

The final factor is within the company’s control, although the first two are not. They check the figures and determine marketing spend has a significant impact on the company.

3. Prioritize

Once you and your research team have a few observations, prioritize them based on their business impact and importance. It may be that you can answer more than one question with a single study, but don’t do it at the risk of losing focus on your overarching research problem.

Questions to ask:

• Who? Who are the people with the problem? Are they end-users, stakeholders, teams within your business? Have you validated the information to see what the scale of the problem is?
• What? What is its nature and what is the supporting evidence?
• Why? What is the business case for solving the problem? How will it help?
• Where? How does the problem manifest and where is it observed?

To help you understand all dimensions, you might want to consider focus groups or preliminary interviews with external (including consumers and existing customers) and internal (salespeople, managers, and other stakeholders) parties to provide what is sometimes much-needed insight into a particular set of questions or problems.

After observing and investigating, the running shoe researchers come up with a few candidate questions, including:

• What is the relationship between US average temperatures and sales of our products year on year?
• At present, how does our customer base rank Competitor X and Competitor Y’s trail running shoe compared to our brand?
• What is the relationship between marketing spend and trail shoe product sales over the last 12 months?

They opt for the final question, because the variables involved are fully within the company’s control, and based on their initial research and stakeholder input, seem the most likely cause of the dive in sales. The research question is specific enough to keep the work on course towards an actionable result, but it allows for a few different avenues to be explored, such as the different budget allocations of offline and online marketing and the kinds of messaging used.

Get feedback from the key teams within your business to make sure everyone is aligned and has the same understanding of the research problem and questions, and the actions you hope to take based on the results. Now is also a good time to demonstrate the ROI of your research and lay out its potential benefits to your stakeholders.

Different groups may have different goals and perspectives on the issue. This step is vital for getting the necessary buy-in and pushing the project forward.

The running shoe company researchers now have everything they need to begin. They call a meeting with the sales manager and consult with the product team, marketing team, and C-suite to make sure everyone is aligned and has bought into the direction of the research topic. They identify and agree that the likely course of action will be a rethink of how marketing resources are allocated, and potentially testing out some new channels and messaging strategies .

Can you explore a broad area and is it practical to do so?

A broader research problem or report can be a great way to bring attention to prevalent issues, societal or otherwise, but are often undertaken by those with the resources to do so.

Take a typical government cybersecurity breach survey, for example. Most of these reports raise awareness of cybercrime, from the day-to-day threats businesses face to what security measures some organizations are taking. What these reports don't do, however, is provide actionable advice - mostly because every organization is different.

The point here is that while some researchers will explore a very complex issue in detail, others will provide only a snapshot to maintain interest and encourage further investigation. The "value" of the data is wholly determined by the recipients of it - and what information you choose to include.

To summarize, it can be practical to undertake a broader research problem, certainly, but it may not be possible to cover everything or provide the detail your audience needs. Likewise, a more systematic investigation of an issue or topic will be more valuable, but you may also find that you cover far less ground.

It's important to think about your research objectives and expected findings before going ahead.

Ensuring your research project is a success

A complex research project can be made significantly easier with clear research objectives, a descriptive research problem, and a central focus. All of which we've outlined in this article.

If you have previous research, even better. Use it as a benchmark

Remember: what separates a good research paper from an average one is actually very simple: valuable, empirical data that explores a prevalent societal or business issue and provides actionable insights.

And we can help.

Sophisticated research made simple with Qualtrics

Trusted by the world's best brands, our platform enables researchers from academic to corporate to tackle the hardest challenges and deliver the results that matter.

Our CoreXM platform supports the methods that define superior research and delivers insights in real-time. It's easy to use (thanks to drag-and-drop functionality) and requires no coding, meaning you'll be capturing data and gleaning insights in no time.

It also excels in flexibility; you can track consumer behavior across segments , benchmark your company versus competitors , carry out complex academic research, and do much more, all from one system.

It's one platform with endless applications, so no matter your research problem, we've got the tools to help you solve it. And if you don't have a team of research experts in-house, our market research team has the practical knowledge and tools to help design the surveys and find the respondents you need.

Of course, you may want to know where to begin with your own market research . If you're struggling, make sure to download our ultimate guide using the link below.

It's got everything you need and there’s always information in our research methods knowledge base.

Scott Smith

Scott Smith, Ph.D. is a contributor to the Qualtrics blog.

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How to Identify an Appropriate Research Problem

By Mansureh Kebritchi, Ph.D.

A research problem is the heart of the study. It is a clear, definite statement of the area of concern or investigation and is backed by evidence (Bryman, 2007).  It drives the research questions and processes and provides the framework for understanding the research findings. To begin, you will need to know where to look for your research problem and how to evaluate when a research problem for success.

Where to Find a Research Problem

Ideas for research problems tend to come from two sources: real life and the scholarly arena.  First, identifying a research problem can be as simple as observing the complications and issues in your local workplace. You may encounter ongoing issues on a daily basis in your workplace or observe your colleagues struggle with major issues or questions in your field. These ongoing obstacles and issues in the workplace can be the catalyst for developing a research problem.  

Alternatively, research problems can be identified by reviewing recent literature, reports, or databases in your field. Often the section on “recommendations for future studies” provided at the end of journal articles or doctoral dissertations suggests potential research problems. In addition, major reports and databases in the field may reveal findings or data-based facts that call for additional investigation or suggest potential issues to be addressed. Looking at what theories need to be tested is another opportunity to develop a research problem.

How to Evaluate a Research Problem 

Once you find your potential research problem, you will need to evaluate the problem and ensure that it is appropriate for research. A research problem is deemed appropriate when it is supported by the literature and considered significant, timely, novel, specific, and researchable.  Stronger research problems are more likely to succeed in publication, presentation, and application.

Supported by the Literature

Your research problem should be relevant to the field and supported by a number of recent peer-reviewed studies in the field. Even if you identify the problem based on the recommendation of one journal article or dissertation, you will still need to conduct a literature search and ensure that other researchers support the problem and the need for conducting research to further address the problem.

Significant

Your research problem should have a positive impact on the field. The impact can be practical, in the form of direct application of the results in the field, or conceptual, where the work advances the field by filling a knowledge gap.  

Your research problem should be related to the current needs in the field and well-suited for the present status of the issues in your field. Explore what topics are being covered in current journals in the field. Look at calls from relevant disciplinary organizations. Review your research center agenda and focused topics. For example, the topics of the Research Labs at the Center for Educational and Instructional Technology Research including critical thinking, social media and cultural competency, diversity, and Science, Technology, Engineering, and Mathematics (STEM) in higher education are representative of the current timely topics in the field of education.  Identifying a current question in the field and supporting the problem with recent literature can justify the problem's timeliness.

Your research problem should be original and unique. It should seek to address a gap in our knowledge or application. An exhaustive review of the literature can help you identify whether the problem has already been addressed with your particular sample and/or context. Talking to experts in the research area can illuminate a problem.  Replication of an existing study warrants a discussion of value elsewhere, but the novelty can be found in determining if an already-resolved problem holds in a new sample and/or context.

Specific and Clear

Your research problem should be specific enough to set the direction of the study, raise research question(s), and determine an appropriate research method and design. Vague research problems may not be useful to specify the direction of the study or develop research questions.  

Researchable

Research problems are solved through the scientific method. This means researchability, or feasibility of the problem, is more important than all of the above characteristics. You as the researcher should be able to solve the problem with your abilities and available research methods, designs, research sites, resources, and timeframe. If a research problem retains all of the aforementioned characteristics but it is not researchable, it may not be an appropriate research problem.

References and More Information

Bryman, Alan. “The Research Question in Social Research: What is its Role?”  International Journal of Social Research Methodology  10 (2007): 5-20.

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Identifying your research question

Making informed decisions about what to study, and defining your research question, even within a predetermined field, is critical to a successful research career, and can be one of the hardest challenges for a scientist.

Being knowledgeable about the state of your field and up-to-date with recent developments can help you:

• Make decisions about  what to study within niche research areas
• Identify  top researchers  in your field whose work you can follow and potentially collaborate with
• Find  important journals to read regularly and publish in
• Explain to others  why your work is important by being able to recount the bigger picture

How can you identify a research question?

Reading regularly is the most common way of identifying a good research question. This enables you to keep up to date with recent advancements and identify certain issues or unsolved problems that keep appearing.

Begin by searching for and reading literature in your field. Start with  general interest  journals, but don’t limit yourself to journal publications only; you can also look for clues in the news or on research blogs. Once you have identified a few interesting topics, you should be reading the table of contents of journals and the abstracts of most articles in that subject area. Papers that are directly related to your research you should read in their entirety.

TIP Keep an eye out for  Review papers and special issues in your chosen subject area as they are very helpful in discovering new areas and hot topics.

TIP: you can sign up to receive table of contents or notifications when articles are published in your field from most journals or publishers.

TIP: Joining a journal club is a great way to read and dissect published papers in and around your subject area. Usually consisting of 5-10 people from the same research group or institute they meet to evaluate the good and bad points of the research presented in the paper. This not only helps you keep up to date with the field but helps you become familiar with what is necessary for a good paper which can help when you come to write your own.

If possible, communicate with some of the authors of these manuscripts via email or in person. Going to conferences if possible is a great way to meet some of these authors. Often,  talking with the author  of an important work in your research area will give you more ideas than just reading the manuscript would.

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Educational resources and simple solutions for your research journey

How to Identify Research Questions

A research question is based on an area of concern or a lacuna in the existing knowledge. The purpose of a research question is to give your work a clear direction and to steer you to focus on important aspects that need to be solved. Learning how to identify research questions that are both meaningful and well-defined is also important for publication success. In fact, while identifying a research question is the very first step in a research project, it is also one of the most challenging activities in research.

How to identify a research question ?

As a researcher, you might need to generate research questions for various projects or come up with a thesis research question or dissertation research question. Here are some points that need to be considered when identifying research questions.

• Originality

An original research question aims to resolve a problem that has not been addressed before. Unique research work will increase your chances of publication, which makes it critical to know how to find a research question. So, familiarize yourself with the work done so far to identify knowledge gaps in the area and ensure that your question does not overlap with something that has already been asked and answered. Note that even within well-studied topics, you can generate research questions that are original simply by delving into the finer aspects of the topic or attempting to untangle a long-standing problem.

A good research question should be important enough and relevant to the scholarly literature in your area of inquiry. When you begin identifying research questions, contextualize the problem in a broad sense and consider the advantages and potential outcomes of answering a particular research problem. Your work should offer something new to the existing literature in your field.

• Feasibility

When you generate research questions, don’t forget to consider the feasibility of the project. Weigh all the possible practical constraints. Consider if the question(s) can be answered within a reasonable time, with the resources, expertise, and funding you have at your disposal.

• Ethical and legal aspects

If you are dealing with animal or human subjects, political issues, etc., your research question will need to factor in ethical and/or legal requirements and implications.

Tips on how to identify research questions

When you generate research questions, it is also important to consider the most up-to-date trends in the subject area, along with your own observations or conjectures.

1. Read as much as you can

The answer to how to identify research questions lies in reading the right material and reading extensively. Reading regularly is the most basic way to find a good research question. Keep up to date with recent advancements and identify critical issues or unsolved problems. You could begin with popular science articles and blogs and, if something catches your interest, look up those topics in journals specializing in them.

Do not miss out on review papers and meta-analyses on your chosen subject area; they are very helpful in discovering hot topics and unanswered questions.

2. Refine your literature search

If you want to know how to identify the research problem and find an original or unique question in your field, perform an extensive literature search to identify gaps in research that have remained unaddressed. The best way to identify research questions is to conduct both forward and backward literature searches, i.e., look through the reference lists of relevant articles, as well as the papers that have cited them.

When you generate research questions, avoid relying only on a few search engines and databases. Use a combination of databases and generalist and specialist search engines. This makes the journey of identifying research questions easier.

If you’re wondering how to identify research questions in an article, extensive and relevant reading is the key. Given the importance of literature searching and reading,  R Discovery  could be your perfect companion. R Discovery is a literature discovery app that lets you identify and read the most relevant academic research papers from top journals and publishers, covering all major disciplines in the arts and sciences. You can even access the latest preprints, which bring to light the latest research before it is published. This tool allows you to survey highlights and summaries of papers; once you hit upon something exciting, you can read the full version.

3. Define your keywords

Selecting effective keywords are important for a targeted literature search. Identify the key concepts in the topic(s) you are considering. From these, tease out some important keywords, and be sure to include synonyms or alternative phrasing when using search engines or academic databases. This will help to generate good research questions.

When you feed in key terms in the R Discovery literature search tool, it “deep-dives” into the topics and shows up articles that you can sort by recency or relevance and then choose to read in full. Based on your search history, the app even offers a personalized feed. Such customized research reading can make the process of generating research questions much easier.

4. Frame the research question

You have now understood how to find research questions, but do you know how to frame them? Framing the question properly is as important as knowing how to identify research questions. Create lists, thought bubbles, or mind maps to help you do some brainstorming till you hit on a good research question. List ideas from general to specific and from broad to narrow.

Knowing the current status of the topic, including what is known and what is not, will help you refine the original problem statement to a defined and more specific version.

Putting it all together

A good research question is compelling and timely. To generate research questions that can ensure publication success, it is important to stay up to date with the latest in your field and allied fields, as well as generalist and specialist topics. Efficient literature discovery serves as the perfect springboard to jumpstart your foray into an exciting and rewarding research journey.

R Discovery is a literature search and research reading platform that accelerates your research discovery journey by keeping you updated on the latest, most relevant scholarly content. With 250M+ research articles sourced from trusted aggregators like CrossRef, Unpaywall, PubMed, PubMed Central, Open Alex and top publishing houses like Springer Nature, JAMA, IOP, Taylor & Francis, NEJM, BMJ, Karger, SAGE, Emerald Publishing and more, R Discovery puts a world of research at your fingertips.  

Try R Discovery Prime FREE for 1 week or upgrade at just US$72 a year to access premium features that let you listen to research on the go, read in your language, collaborate with peers, auto sync with reference managers, and much more. Choose a simpler, smarter way to find and read research – Download the app and start your free 7-day trial today !  

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Research Gap – Types, Examples and How to Identify

Table of Contents

Research Gap

Definition:

Research gap refers to an area or topic within a field of study that has not yet been extensively researched or is yet to be explored. It is a question, problem or issue that has not been addressed or resolved by previous research.

How to Identify Research Gap

Identifying a research gap is an essential step in conducting research that adds value and contributes to the existing body of knowledge. Research gap requires critical thinking, creativity, and a thorough understanding of the existing literature . It is an iterative process that may require revisiting and refining your research questions and ideas multiple times.

Here are some steps that can help you identify a research gap:

• Review existing literature: Conduct a thorough review of the existing literature in your research area. This will help you identify what has already been studied and what gaps still exist.
• Identify a research problem: Identify a specific research problem or question that you want to address.
• Analyze existing research: Analyze the existing research related to your research problem. This will help you identify areas that have not been studied, inconsistencies in the findings, or limitations of the previous research.
• Brainstorm potential research ideas : Based on your analysis, brainstorm potential research ideas that address the identified gaps.
• Consult with experts: Consult with experts in your research area to get their opinions on potential research ideas and to identify any additional gaps that you may have missed.
• Refine research questions: Refine your research questions and hypotheses based on the identified gaps and potential research ideas.
• Develop a research proposal: Develop a research proposal that outlines your research questions, objectives, and methods to address the identified research gap.

Types of Research Gap

There are different types of research gaps that can be identified, and each type is associated with a specific situation or problem. Here are the main types of research gaps and their explanations:

Theoretical Gap

This type of research gap refers to a lack of theoretical understanding or knowledge in a particular area. It can occur when there is a discrepancy between existing theories and empirical evidence or when there is no theory that can explain a particular phenomenon. Identifying theoretical gaps can lead to the development of new theories or the refinement of existing ones.

Empirical Gap

An empirical gap occurs when there is a lack of empirical evidence or data in a particular area. It can happen when there is a lack of research on a specific topic or when existing research is inadequate or inconclusive. Identifying empirical gaps can lead to the development of new research studies to collect data or the refinement of existing research methods to improve the quality of data collected.

Methodological Gap

This type of research gap refers to a lack of appropriate research methods or techniques to answer a research question. It can occur when existing methods are inadequate, outdated, or inappropriate for the research question. Identifying methodological gaps can lead to the development of new research methods or the modification of existing ones to better address the research question.

Practical Gap

A practical gap occurs when there is a lack of practical applications or implementation of research findings. It can occur when research findings are not implemented due to financial, political, or social constraints. Identifying practical gaps can lead to the development of strategies for the effective implementation of research findings in practice.

Knowledge Gap

This type of research gap occurs when there is a lack of knowledge or information on a particular topic. It can happen when a new area of research is emerging, or when research is conducted in a different context or population. Identifying knowledge gaps can lead to the development of new research studies or the extension of existing research to fill the gap.

Examples of Research Gap

Here are some examples of research gaps that researchers might identify:

• Theoretical Gap Example : In the field of psychology, there might be a theoretical gap related to the lack of understanding of the relationship between social media use and mental health. Although there is existing research on the topic, there might be a lack of consensus on the mechanisms that link social media use to mental health outcomes.
• Empirical Gap Example : In the field of environmental science, there might be an empirical gap related to the lack of data on the long-term effects of climate change on biodiversity in specific regions. Although there might be some studies on the topic, there might be a lack of data on the long-term effects of climate change on specific species or ecosystems.
• Methodological Gap Example : In the field of education, there might be a methodological gap related to the lack of appropriate research methods to assess the impact of online learning on student outcomes. Although there might be some studies on the topic, existing research methods might not be appropriate to assess the complex relationships between online learning and student outcomes.
• Practical Gap Example: In the field of healthcare, there might be a practical gap related to the lack of effective strategies to implement evidence-based practices in clinical settings. Although there might be existing research on the effectiveness of certain practices, they might not be implemented in practice due to various barriers, such as financial constraints or lack of resources.
• Knowledge Gap Example: In the field of anthropology, there might be a knowledge gap related to the lack of understanding of the cultural practices of indigenous communities in certain regions. Although there might be some research on the topic, there might be a lack of knowledge about specific cultural practices or beliefs that are unique to those communities.

Examples of Research Gap In Literature Review, Thesis, and Research Paper might be:

• Literature review : A literature review on the topic of machine learning and healthcare might identify a research gap in the lack of studies that investigate the use of machine learning for early detection of rare diseases.
• Thesis : A thesis on the topic of cybersecurity might identify a research gap in the lack of studies that investigate the effectiveness of artificial intelligence in detecting and preventing cyber attacks.
• Research paper : A research paper on the topic of natural language processing might identify a research gap in the lack of studies that investigate the use of natural language processing techniques for sentiment analysis in non-English languages.

How to Write Research Gap

By following these steps, you can effectively write about research gaps in your paper and clearly articulate the contribution that your study will make to the existing body of knowledge.

Here are some steps to follow when writing about research gaps in your paper:

• Identify the research question : Before writing about research gaps, you need to identify your research question or problem. This will help you to understand the scope of your research and identify areas where additional research is needed.
• Review the literature: Conduct a thorough review of the literature related to your research question. This will help you to identify the current state of knowledge in the field and the gaps that exist.
• Identify the research gap: Based on your review of the literature, identify the specific research gap that your study will address. This could be a theoretical, empirical, methodological, practical, or knowledge gap.
• Provide evidence: Provide evidence to support your claim that the research gap exists. This could include a summary of the existing literature, a discussion of the limitations of previous studies, or an analysis of the current state of knowledge in the field.
• Explain the importance: Explain why it is important to fill the research gap. This could include a discussion of the potential implications of filling the gap, the significance of the research for the field, or the potential benefits to society.
• State your research objectives: State your research objectives, which should be aligned with the research gap you have identified. This will help you to clearly articulate the purpose of your study and how it will address the research gap.

Importance of Research Gap

The importance of research gaps can be summarized as follows:

• Advancing knowledge: Identifying research gaps is crucial for advancing knowledge in a particular field. By identifying areas where additional research is needed, researchers can fill gaps in the existing body of knowledge and contribute to the development of new theories and practices.
• Guiding research: Research gaps can guide researchers in designing studies that fill those gaps. By identifying research gaps, researchers can develop research questions and objectives that are aligned with the needs of the field and contribute to the development of new knowledge.
• Enhancing research quality: By identifying research gaps, researchers can avoid duplicating previous research and instead focus on developing innovative research that fills gaps in the existing body of knowledge. This can lead to more impactful research and higher-quality research outputs.
• Informing policy and practice: Research gaps can inform policy and practice by highlighting areas where additional research is needed to inform decision-making. By filling research gaps, researchers can provide evidence-based recommendations that have the potential to improve policy and practice in a particular field.

Applications of Research Gap

Here are some potential applications of research gap:

• Informing research priorities: Research gaps can help guide research funding agencies and researchers to prioritize research areas that require more attention and resources.
• Identifying practical implications: Identifying gaps in knowledge can help identify practical applications of research that are still unexplored or underdeveloped.
• Stimulating innovation: Research gaps can encourage innovation and the development of new approaches or methodologies to address unexplored areas.
• Improving policy-making: Research gaps can inform policy-making decisions by highlighting areas where more research is needed to make informed policy decisions.
• Enhancing academic discourse: Research gaps can lead to new and constructive debates and discussions within academic communities, leading to more robust and comprehensive research.

Advantages of Research Gap

Here are some of the advantages of research gap:

• Identifies new research opportunities: Identifying research gaps can help researchers identify areas that require further exploration, which can lead to new research opportunities.
• Improves the quality of research: By identifying gaps in current research, researchers can focus their efforts on addressing unanswered questions, which can improve the overall quality of research.
• Enhances the relevance of research: Research that addresses existing gaps can have significant implications for the development of theories, policies, and practices, and can therefore increase the relevance and impact of research.
• Helps avoid duplication of effort: Identifying existing research can help researchers avoid duplicating efforts, saving time and resources.
• Helps to refine research questions: Research gaps can help researchers refine their research questions, making them more focused and relevant to the needs of the field.
• Promotes collaboration: By identifying areas of research that require further investigation, researchers can collaborate with others to conduct research that addresses these gaps, which can lead to more comprehensive and impactful research outcomes.

Disadvantages of Research Gap

While research gaps can be advantageous, there are also some potential disadvantages that should be considered:

• Difficulty in identifying gaps: Identifying gaps in existing research can be challenging, particularly in fields where there is a large volume of research or where research findings are scattered across different disciplines.
• Lack of funding: Addressing research gaps may require significant resources, and researchers may struggle to secure funding for their work if it is perceived as too risky or uncertain.
• Time-consuming: Conducting research to address gaps can be time-consuming, particularly if the research involves collecting new data or developing new methods.
• Risk of oversimplification: Addressing research gaps may require researchers to simplify complex problems, which can lead to oversimplification and a failure to capture the complexity of the issues.
• Bias : Identifying research gaps can be influenced by researchers’ personal biases or perspectives, which can lead to a skewed understanding of the field.
• Potential for disagreement: Identifying research gaps can be subjective, and different researchers may have different views on what constitutes a gap in the field, leading to disagreements and debate.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Identifying the Research Problem

• First Online: 13 April 2022

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• Yanmei Li 3 &
• Sumei Zhang 4  

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The first step of conducting research is identifying a researchable problem. This chapter explains the procedures to identify the research problem. The procedure of research involves systematically investigating a subject matter to reveal facts or reach new conclusions. Research can be theory driven or problem driven. Most of the studies in urban and regional planning attempt to investigate issues or problems either to: (1) identity and define the problem, and/or (2) probe further to answer research questions after identifying, defining, and operationalizing the problem. This chapter introduces methods, such as factual data mining, back of envelope analysis, quick research, and issues unique to a sub-discipline of planning, to identify the research problem.

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Sharifi, A., & Khavarian-Garmsir, A. Z. (2020). The COVID-19 pandemic: Impacts on cities and major lessons for urban planning, design, and management. Science of the Total Environment, 749 (2020).

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Li, Y., Zhang, S. (2022). Identifying the Research Problem. In: Applied Research Methods in Urban and Regional Planning. Springer, Cham. https://doi.org/10.1007/978-3-030-93574-0_2

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The Research Process 1. Identifying a Research Problem

You begin a research study by identifying a topic to study-typically an issue or problem in education that needs to be resolved. Identifying a research problem consists of specifying an issue to study, developing a justification for studying it, and suggesting the importance of the study for select audiences that will read the report. By specifying a "problem," you limit the subject matter and focus attention on a specific aspect of study. Consider the following "problems," each of which merits research: ◆ Teens are not learning how to connect to others in their communities ◆ Teenage smoking will lead to many premature deaths These needs, issues, or controversies arise out of an educational need expressed by teachers, schools, policy makers, or researchers, and we refer to them as research problems. You will state them in introductory sections of a research report and provide a rationale for their importance. In a formal sense, these problems are part of a larger written section called the "statement of the problem," and this section includes the topic, the problem, a justifi cation for the problem, and the importance of studying it for specific audiences such as teachers, administrators, or researchers. Let's examine Maria's research to see how she will specify her study's research problem. Maria plans to study school violence and weapon possession in schools. She starts with a problem: escalating weapon possession among students in high schools. She needs to justify the problem by providing evidence about the importance of this problem and documenting how her study will provide new insight into the problem. In her research, Marie will need to identify and justify the research problem that she is studying. 2. Reviewing the Literature It is important to know who has studied the research problem you plan to examine. You may fear that you will initiate and conduct a study that merely replicates prior research. However, faculty and advisors often fear that you will plan a study that does not build on existing knowledge and does not add to the accumulation of fi ndings on a topic. Because of these concerns, reviewing the literature is an important step in the research process. Reviewing the literature means locating summaries, books, journals, and indexed publications on a topic; selectively choosing which literature to include in your review; and then summarizing the literature in a written report. The skills required for reviewing the literature develop over time and with practice. You can learn how to locate journal articles and books in an academic library, access computerized databases, choose and evaluate the quality of research on your topic, and summarize it in a review. Library resources can be overwhelming, so having a strategy for searching the literature and writing the review is important. Let's examine Maria's approach to reviewing the literature. To inform her committee about the latest literature on school violence and to plan her own research, Maria needs to conduct a literature review. This process will involve becoming familiar with the university library holdings, spending time reviewing resources and making decisions about what literature to use, and writing a formal summary of the literature on school violence. She consults the library catalog at her university and plans to search the computerized databases. In order to review the literature, Maria will need to become familiar with the literature and visit her university library. 3. Specifying a Purpose for Research If your research problem covers a broad topic of concern, you need to focus it so that you can study it. A focused restatement of the problem is the purpose statement. This statement conveys the overall objective or intent of your research. As such, it is the most

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The methodology section or methods section tells you how the author(s) went about doing their research. It should let you know a) what method they used to gather data (survey, interviews, experiments, etc.), why they chose this method, and what the limitations are to this method.

The methodology section should be detailed enough that another researcher could replicate the study described. When you read the methodology or methods section:

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What are they? Peer-reviewed articles, also known as scholarly or refereed articles are papers that describe a research study. 

Why are peer-reviewed articles useful? They report on original research that have been reviewed by other experts before they are accepted for publication, so you can reasonably be assured that they contain valid information. 

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We are often told that scholarly and peer-reviewed sources are the most credible, but, it's sometimes hard to understand why they are credible and why we should trust these sources more than others. This video takes an in depth approach at explaining the peer review process. 

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What Are Library Databases? 

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You can view our most popularly used databases on the Library's Home Page , or view a list of all of our databases organized by subject or alphabetically at  U-M Library Databases .

Popular Multidisciplinary Databases

Many students use ProQuest , JSTOR , and Google Scholar for their initial search needs. These are multi-disciplinary and not subject-specific, and they can supply a very large number of  search results.

Subject-Specific Databases

Some popular subject-specific databases include PsycINFO for psychology and psychiatry related topics and  PubMed for health sciences topics. 

Why Should You Use Library Databases?

Unlike a Google search, the Library Databases will grant you access to high quality credible sources. 

The sources you'll find in library databases include:

• Scholarly journal articles
• Newspaper articles
• Theses & dissertations
• Empirical evidence

Database Filters & Limits Most databases have Filters/Limits. You can use these to narrow down your search to the specific dates, article type, or population that you are researching.

Here is an example of limits in a database, all databases look slightly different but most have these options:

Keywords and Starting a Search

What are Keywords?

• Natural language words that describe your topic 
• Allows for a more flexible search - looks for anywhere the words appear in the record
• Can lead to a broader search, but may yield irrelevant results

Keyword searching  is how we normally start a search. Pull out important words or phrases from your topic to find your keywords.

Tips for Searching with Keywords:

• Example: "climate change"
• Example:  "climate change" AND policy
• Example: comput* will return all words starting with four letters; computing, computer, compute, etc.  
• Example: wom?n will find both woman and women.

What are Subject Headings?

• Pre-defined "controlled vocabulary" that describe what an item is  about 
• Makes for a less flexible search - only the subject fields will be searched
• Targeted search; results are usually more relevant to the topic, but may miss some variations

Subject Terms and/or Headings are pre-defined terms that are used to describe the content of an item. These terms are a controlled vocabulary and function similarly to hashtags on social media. Look carefully at the results from your search. If you find an article that is relevant to the topic you want to write about, take a look at the subject headings. 

Hot Tip: Make a copy of this Google Doc to help you find and develop your topic's keywords.

More Database Recommendations

Need articles for your library research project, but not sure where to start? We recommend these top ten article databases for kicking off your research. If you can't find what you need searching in one of these top ten databases, browse the list of all library databases by subject (academic discipline) or title .

• U-M Library Articles Search This link opens in a new window Use Articles Search to locate scholarly and popular articles, as well as reference works and materials from open access archives.
• ABI/INFORM Global This link opens in a new window Indexes 3,000+ business-related periodicals (with full text for 2,000+), including Wall Street Journal.
• Academic OneFile This link opens in a new window Provides indexing for over 8,000 scholarly journals, industry periodicals, general interest magazines and newspapers.
• Access World News [NewsBank] This link opens in a new window Full text of 600+ U.S. newspapers and 260+ English-language newspapers from other countries worldwide.
• CQ Researcher This link opens in a new window Noted for its in-depth, unbiased coverage of health, social trends, criminal justice, international affairs, education, the environment, technology, and the economy.
• Gale Health and Wellness This link opens in a new window
• Humanities Abstracts (with Full Text) This link opens in a new window Covers 700 periodicals in art, film, journalism, linguistics, music, performing arts, philosophy, religion, history, literature, etc.
• JSTOR This link opens in a new window Full-text access to the archives of 2,600+ journals and 35,000+ books in the arts, humanities, social sciences and sciences.
• ProQuest Research Library This link opens in a new window Indexes over 5,000 journals and magazines, academic and popular, with full text included for over 3,600.
• PsycInfo (APA) This link opens in a new window Premier resource for surveying the literature of psychology and adjunct fields. Covers 1887-present. Produced by the APA.

• Frontiers in Immunology
• Cancer Immunity and Immunotherapy
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The Role of Artificial Intelligence and Machine Learning in Identifying Tumor-Related Immunotherapy Targets

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The rapid advancement of tumor immunotherapy has generated new hope for cancer treatment. However, identifying effective immunotherapy targets remains a significant challenge. Traditional methods often depend on experience and laboratory studies, which are not only time-consuming and labor-intensive, but may also lack specificity. In the highly heterogeneous tumor microenvironment, the diversity of immune targets and their dynamic changes complicate target screening. Furthermore, individual patients' immune responses vary considerably based on genetic, environmental, and tumor characteristics, further exacerbating the difficulty of identifying and validating new targets. Therefore, it is crucial to employ novel technical approaches to enhance the efficiency of target discovery. In this context, the integration of artificial intelligence (AI) and machine learning (ML) offers new promise for identifying immune targets. AI and ML possess robust data processing and pattern recognition capabilities, enabling the extraction of valuable features from complex biological data. By analyzing large-scale genomic, clinical, and immunomic datasets, these technologies have begun to uncover potential immune targets. Additionally, through the application of deep learning models, researchers can predict immune responses, identify tumor antigens, and develop personalized immunotherapy regimens. An increasing number of studies have demonstrated that AI and ML not only enhance the accuracy and efficiency of target screening but also provide substantial support for clinical translation. This research Topic aims to enhance the application of artificial intelligence and machine learning in the identification of tumor immunotherapy targets, thereby providing a more robust scientific foundation for the early diagnosis and treatment of diseases. We welcome submissions that focus on the role of artificial intelligence and machine learning in identifying tumour-related immunotherapy targets. The specific scope includes: 1) Research on immune target screening methods utilizing machine learning; 2) The application of AI in analyzing the tumor microenvironment; 3) Case studies that integrate multi-omics data to identify novel immune targets; 4) The use of deep learning in advancing antigen prediction; 5) Studies investigating the relationship between immune responses and tumor characteristics; 6) AI-driven design of clinical trials and verification of targets; 7) Applications and challenges of machine learning in personalized immunotherapy. Please note that manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by robust and relevant validation (clinical cohort or biological validation in vitro or in vivo) are out of scope for this Research Topic.

Keywords : Artificial Intelligence, Machine Learning, immune cell subpopulations, multi-omics, antigen prediction, Immune-Related Therapeutic Targets

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• Research process
• How to Define a Research Problem | Ideas & Examples

How to Define a Research Problem | Ideas & Examples

Published on 8 November 2022 by Shona McCombes and Tegan George.

A research problem is a specific issue or gap in existing knowledge that you aim to address in your research. You may choose to look for practical problems aimed at contributing to change, or theoretical problems aimed at expanding knowledge.

Some research will do both of these things, but usually the research problem focuses on one or the other. The type of research problem you choose depends on your broad topic of interest and the type of research you think will fit best.

This article helps you identify and refine a research problem. When writing your research proposal or introduction , formulate it as a problem statement and/or research questions .

Table of contents

Why is the research problem important, step 1: identify a broad problem area, step 2: learn more about the problem, frequently asked questions about research problems.

Having an interesting topic isn’t a strong enough basis for academic research. Without a well-defined research problem, you are likely to end up with an unfocused and unmanageable project.

You might end up repeating what other people have already said, trying to say too much, or doing research without a clear purpose and justification. You need a clear problem in order to do research that contributes new and relevant insights.

Whether you’re planning your thesis , starting a research paper , or writing a research proposal , the research problem is the first step towards knowing exactly what you’ll do and why.

Prevent plagiarism, run a free check.

As you read about your topic, look for under-explored aspects or areas of concern, conflict, or controversy. Your goal is to find a gap that your research project can fill.

Practical research problems

If you are doing practical research, you can identify a problem by reading reports, following up on previous research, or talking to people who work in the relevant field or organisation. You might look for:

• Issues with performance or efficiency
• Processes that could be improved
• Areas of concern among practitioners
• Difficulties faced by specific groups of people

Examples of practical research problems

Voter turnout in New England has been decreasing, in contrast to the rest of the country.

The HR department of a local chain of restaurants has a high staff turnover rate.

A non-profit organisation faces a funding gap that means some of its programs will have to be cut.

Theoretical research problems

If you are doing theoretical research, you can identify a research problem by reading existing research, theory, and debates on your topic to find a gap in what is currently known about it. You might look for:

• A phenomenon or context that has not been closely studied
• A contradiction between two or more perspectives
• A situation or relationship that is not well understood
• A troubling question that has yet to be resolved

Examples of theoretical research problems

The effects of long-term Vitamin D deficiency on cardiovascular health are not well understood.

The relationship between gender, race, and income inequality has yet to be closely studied in the context of the millennial gig economy.

Historians of Scottish nationalism disagree about the role of the British Empire in the development of Scotland’s national identity.

Next, you have to find out what is already known about the problem, and pinpoint the exact aspect that your research will address.

Context and background

• Who does the problem affect?
• Is it a newly-discovered problem, or a well-established one?
• What research has already been done?
• What, if any, solutions have been proposed?
• What are the current debates about the problem? What is missing from these debates?

Specificity and relevance

• What particular place, time, and/or group of people will you focus on?
• What aspects will you not be able to tackle?
• What will the consequences be if the problem is not resolved?

Example of a specific research problem

A local non-profit organisation focused on alleviating food insecurity has always fundraised from its existing support base. It lacks understanding of how best to target potential new donors. To be able to continue its work, the organisation requires research into more effective fundraising strategies.

Once you have narrowed down your research problem, the next step is to formulate a problem statement , as well as your research questions or hypotheses .

Once you’ve decided on your research objectives , you need to explain them in your paper, at the end of your problem statement.

Keep your research objectives clear and concise, and use appropriate verbs to accurately convey the work that you will carry out for each one.

I will compare …

The way you present your research problem in your introduction varies depending on the nature of your research paper . A research paper that presents a sustained argument will usually encapsulate this argument in a thesis statement .

A research paper designed to present the results of empirical research tends to present a research question that it seeks to answer. It may also include a hypothesis – a prediction that will be confirmed or disproved by your research.

Research objectives describe what you intend your research project to accomplish.

They summarise the approach and purpose of the project and help to focus your research.

Your objectives should appear in the introduction of your research paper , at the end of your problem statement .

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If you want to cite this source, you can copy and paste the citation or click the ‘Cite this Scribbr article’ button to automatically add the citation to our free Reference Generator.

McCombes, S. & George, T. (2022, November 08). How to Define a Research Problem | Ideas & Examples. Scribbr. Retrieved 26 August 2024, from https://www.scribbr.co.uk/the-research-process/define-research-problem/

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Abstract: This paper presents DeepDelveAI, a comprehensive dataset specifically curated to identify AI-related research papers from a large-scale academic literature database. The dataset was created using an advanced Long Short-Term Memory (LSTM) model trained on a binary classification task to distinguish between AI-related and non-AI-related papers. The model was trained and validated on a vast dataset, achieving high accuracy, precision, recall, and F1-score. The resulting DeepDelveAI dataset comprises over 9.4 million AI-related papers published since Dartmouth Conference, from 1956 to 2024, providing a crucial resource for analyzing trends, thematic developments, and the evolution of AI research across various disciplines.

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• Open access
• Published: 26 August 2024

Identification of mothers with mental health problems is accidental: perceptions of health care providers on availability, access, and support for maternal mental health care for adolescent mothers in Malawi

• Chimwemwe Tembo 1 ,
• Linda Portsmouth 2 &
• Sharyn Burns 2  

BMC Health Services Research volume  24 , Article number:  983 ( 2024 ) Cite this article

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Integration of maternal mental health into primary health care is considered a strategy to improve access to mental health support in low- and middle-income countries (LMICs). Health care workers’ (HCWs) and traditional practitioners’ (traditional healers, herbalists, traditional birth attendants, spiritual healers, prophets, and community health volunteers) perceptions of the availability and management of adolescent mothers’ maternal mental health care were explored in rural Malawi. Recognizing and identifying the barriers associated with access to maternal mental health support is essential to improving the mental health of adolescent mothers.

A descriptive qualitative design (DQ) was used to explore HCWs’ and traditional practitioners’ perceptions of maternal mental health services for adolescent mothers. In-depth interviews were conducted with HCWs ( n  = 6), and three focus group discussions were conducted with 30 community-based traditional practitioners. Participants were purposefully recruited because they provide formal or informal health services to adolescent mothers during the postnatal period at Mitundu Rural Hospital and its catchment area in Lilongwe District, in Malawi. Interviews were analyzed using reflective thematic analysis and inductive thinking.

Thematic analysis found four themes to describe access to maternal mental health care for adolescent mothers. Participant perceptions were themed around health system challenges and how cultural background and beliefs influence access to mental health care and support. The themes were: (1) Inadequate staff development; (2) Limited resources (medication and infrastructure); (3) Limited policy and guidelines implementation; and (4) Cultural background and belief influence on help-seeking. HCWs suggested improving pre-service and in-service training to improve mental health assessment of mothers, while traditional practitioners wanted to increase their awareness of mental health issues.

Participants emphasized that multifaceted factors influenced access to mental health support. These factors affect the assessment, treatment, and support of adolescent mothers and help-seeking by mothers. Therefore, strengthening the healthcare system and empowering providers with the knowledge and skills to recognize at-risk mothers and provide timely support is essential.

Peer Review reports

The burden of poor maternal mental health in adolescent mothers is a public health concern [ 1 ]. Worldwide, about 10% of pregnant women and 13% of those that have given birth, experience some mental disorder [ 2 ]. The prevalence rates of CMDs among perinatal women are two to three times more prevalent in Low to Middle-Income Countries (LMIC) compared to High-Income Countries (HIC) [ 1 , 2 ]. Studies in LMIC reported a prevalence rate of 19.8% after childbirth [ 2 ]. In sub-Saharan Africa (SSA), the prevalence rates of CMDs range from 10 to 39% postnatally [ 1 , 3 ]. In Malawi, the prevalence of depressive disorders during the perinatal period ranges from 21 − 42% [ 4 , 5 ]. A recent study in Malawi found a prevalence of postnatal depression of 43.2% among adolescent mothers [ 6 ]. Motherhood initiated during adolescence can have its own challenges, hence the urgent need for early identification and treatment of mental health problems. Adolescence brings various challenges and vulnerabilities associated with physical, cognitive, and psychological well-being [ 7 , 8 ]. For adolescent mothers, this period can be more challenging and may complicate social roles [ 9 , 10 ]. Considering the broad implications of adolescent motherhood on the well-being of the mother and their child’s development, early identification and effective treatment are essential for preventing the escalation of mental health problems [ 11 ]. Untreated maternal mental health is the largest contributor to the disease burden for women of childbearing age [ 12 ]. Furthermore, adolescent mothers with untreated postnatal mental health problems are more likely to have low birth weight, poor interactions with their babies, neonatal complications that affect breastfeeding, baby care, parenting and babies may develop malnutrition and frequent hospitalisation [ 13 , 14 ].

Further, access to healthcare is critical to the performance of healthcare systems globally [ 15 ]. However, some challenges exist in LMICs for people with specific health conditions regarding access to comprehensive care [ 16 ]. For example, less than half of affected mothers with mental health conditions have access to adequate treatment and healthcare [ 16 ]. Mental health care access refers to the opportunity to have mental health care needs fulfilled by having access to appropriate and culturally secure mental health services and/or when communities can use appropriate mental health services in proportion to their needs [ 15 ]. The disparity between the number of individuals experiencing mental health issues and the number who receive appropriate treatment is referred to as the treatment gap. In many LMICs, this gap is estimated to be between 75% and 80% [ 17 ].

The Government of Malawi is committed to improving health and wellbeing in line with the WHO recommendations and Sustainable Development Goals (SDG) three and five. The Malawian Ministry of Health has developed a mental health policy that aims to provide comprehensive and accessible mental health care services to all citizens of Malawi, including the mental health care needs of special groups [ 18 , 19 , 20 ]. However, the implementation of the policy is limited, particularly in managing maternal mental health [ 18 ]. The challenges to accessing mental health care in SSA countries and other LMICs derive from inadequate mental health support from the health system [ 18 ], economic hardships, a negative societal perception of adolescent motherhood, rural residency, and mothers’ low education levels [ 12 , 18 , 21 , 22 , 23 ]. Additionally, various cultural factors, such as polygamy and traditional practices around gender roles and marriage, impact access to mental health care [ 24 , 25 ]. Furthermore, adolescent mothers in SSA have lower levels of help-seeking behaviours [ 24 ], which has been linked to a perceived lack of confidentiality, negative healthcare worker attitudes, and a lack of services tailored to their unique needs [ 16 ]. For example, research with HIV-positive adolescent mothers aged 15–19 years in Malawi exploring barriers and facilitators of prevention of mother-to-child transmission of HIV found adolescent mothers expressed a preference for peer-led, age-appropriate, non-judgmental maternal health support services that link communities and facilities to pragmatically address barriers of stigma, and health system complexity [ 14 ]. The Malawian study highlighted the need for tailored services that consider the specific needs of adolescent and young mothers.

Access to healthcare is critical in the management of postnatal depression, and the role of health workers in the prevention of maternal mental health cannot be underestimated [ 26 ]. A Malawian study [ 6 ] found that adolescent mothers who interacted with a health worker during the postnatal period were less likely to report depression than their peers who did not experience any health worker contact. Interaction with a health worker may provide an opportunity for mental health screening and subsequent referral and support [ 26 ]. Perinatal screening is considered an important strategy for the early detection of mental health problems across different healthcare settings and within different economic settings [ 21 , 24 , 27 ]. Furthermore, studies from some LMICs found that perinatal women accepted screening for common mental disorders as part of their primary care [ 28 , 29 ]. However, there are challenges in implementing screening in some LMICs due to a lack of knowledge among health workers around screening for mental health issues, staff workload, the lack of clinical guidelines for the screening of pregnant and parenting teens, and limited specialized mental health services [ 18 , 26 , 30 ]. Understanding barriers and facilitators to help-seeking is fundamental for developing contextual interventions, enhancing prevention, improving identification, and prompting appropriate treatment [ 11 ].

In Malawi, the use of traditional healing is widespread [ 31 ], unlike in HIC, where women are more likely to seek help from biomedically trained doctors and midwives [ 32 ]. One Malawian study found that the prevalence of people with mental disorders who seek the services of traditional healers before visiting a hospital was 22.7% [ 33 ]. Furthermore, another Malawian study found the prevalence of herbal medicine use among all women during pregnancy was estimated at 25.7% in 2018 with use of herbal medicine decreasing among older mothers, with younger women being more likely to use herbal medicine [ 31 ]. Another study in Zimbabwe found the use of herbal medicine was more common among women during their first pregnancy or first childbirth [ 34 ]. In the context of Malawi, traditional healers provide an alternative or additional approach to mental health care [ 33 ]. Therefore, they are key providers in the health care system in Malawi and many other SSA countries [ 14 , 32 , 34 , 35 ]. Further, the ethnobotanical research on the traditional use of plants for improving healthcare has been based on knowledge held by traditional practitioners [ 14 , 35 ]. A study in Mali found that traditional practitioners have broad experience and knowledge about the herbal treatment of pregnant ailments [ 35 ]. Understanding mothers’ use of traditional healers can help identify opportunities to address existing access to health services challenges, thereby improving maternal mental health outcomes [ 31 ].

The World Health Organization (WHO) recommends the incorporation of mental health prevention, early intervention, and promotion strategies in maternal and child health services to identify at-risk mothers early, therefore reducing the morbidity and mortality associated with poor mental health [ 36 ]. Community-based health workers are important in supporting people with their health because they are local, trusted by communities, and integrated within the health system [ 37 ]. This study explored the perceptions of healthcare workers (HCWs) and traditional practitioners regarding the access to maternal mental health care by adolescent mothers in rural Malawi.

The public health care system in Malawi adopts a three-tier health care delivery system based on three levels of health care: primary, secondary, and tertiary [ 38 , 39 ]. The healthcare system comprises central hospitals, district hospitals, health centers, community hospitals, clinics, and rural hospitals. Each district hospital serves an average population of 600,000 to 900,000 within a geographical distance of 15 to 20 km. District hospitals manage smaller rural hospitals, health centers and health posts [ 38 ]. There are twenty-eight administrative districts and twenty-six district hospitals in Malawi (The Malawi Government, 2005). District and rural hospitals operate 24 h, 7 days per week. This study was conducted at Mitundu, located about 40 km east of Lilongwe, the capital city of Malawi. Mitundu is a rural area that has a population of 147,823 [ 38 ]. Mitundu Rural Hospital (MRH), the only health facility in the area, was chosen because it serves a relatively higher number of people compared to other facilities within Lilongwe District, with an average of 135 deliveries by adolescent mothers every month. The area has more cases of adolescent marriages compared to urban areas [ 6 ]. The hospital also operates thirteen outreach clinics, which are visited monthly by community health workers. MRH provides free outpatient, maternal and child health, family planning and maternity services. The reproductive health services offered at district hospitals include antenatal care, labor and delivery, postnatal care, family planning, cancer screening, and the management of sexually transmitted infections. The facility has forty-six clinical health workers, with eight working in maternal and child health services. Saint John of God Hospitaller Services, Malawi, supports mental health services through conducting monthly outpatient clinics for people with mental illnesses.

Study design and participants

A qualitative-descriptive design was used to explore the views of HCWs and traditional practitioners’ perceptions of maternal mental health services for adolescent mothers. The HCWs comprised medical practitioners (doctors) and nurses employed in the Maternal and Child Health Department (MCH) at the MRH. Traditional practitioners comprised traditional healers, herbalists, traditional birth attendants, spiritual healers, prophets, and community health volunteers. Community health volunteers are lay community members who liaise with HCWs to assist with health promotion activities in the community.

In-depth interviews were conducted with HCWs to explore their perspectives, experiences and attitudes around their understanding and knowledge of healthcare services and how they are available and accessible. HCWs working in the Maternal and Child Care Department (MCH) were selected as they were in a position to provide a rich insight into appropriate and equitable intervention programs that would meet the needs of postnatal mothers [ 40 ]. In-depth interviews allowed participants to share their understanding in a non-threatening environment [ 40 ]. Interviews enabled the collection of rich and deep contextual data that could reveal underlying reasons behind delivering maternal mental health services, considering the small number of potential participants [ 40 ]. In addition, due to a limited number of HCWs and the need to schedule data collection around work rosters, interviews were deemed the most effective method to collect data from this group.

Traditional practitioners participated in focus group discussions (FGDs), which enabled the discussion of local knowledge and drew on the complex personal experiences, beliefs, perceptions, and attitudes of participants about adolescents’ mental health through moderated interaction [ 41 , 42 ]. FGDs were employed to gain a greater understanding of traditional practitioners’ role in providing mental health care services [ 43 ]. These discussions were used to gather diverse views from multiple participants and allowed for robust discussion [ 42 ]. Our study was reported according to the consolidated criteria for reporting qualitative studies COREQ [ 44 ] (Supplementary file 3).

A purposive sampling method [ 45 , 46 ] was used to recruit HCWs who worked in the maternal and child health departments at MRH. The in-depth interviews included six HCWs: two medical doctors, two community nurses, and two registered nurse midwives. All HCWs employed in the Department of Maternal and Child Health at MRH during the data collection period were invited and consented to participate. These HCWs were purposively invited to participate because they are consistently in contact with perinatal mothers during their provision of maternal and child health services [ 26 ]. Traditional practitioners were purposively invited to participate in FGDs to achieve variation in gender and the type of services they provide. Thirty traditional practitioners participated in three FGDs and were grouped according to their roles to ensure that participant groups were relatively homogenous. The three FGDs were conducted with traditional healers (six males and four females), community volunteers (eight females and two males), and spiritual healers (three females and one male prophet and six female traditional birth attendants who also use spiritual healing).

Recruitment of participants and procedures

This study was approved by the Curtin University Human Research Ethics Committee (HRE2021-0223) and the Malawian Ethics Board National Committee on Research Ethics in the Social Sciences and Humanities (P.05/21/575). HCWs were recruited at MRH in their designated work departments. An appointment was scheduled within the hospital at a convenient place and time for each HCW. HCWs were provided with an English version of the information sheet describing the research and procedures and provided consent prior to participating.

Traditional practitioners were recruited through a community health worker who lived within the Mitundu catchment area. An appointment was scheduled to meet potential participants at a convenient community shelter. All participants received information about the study, which was read in Chichewa by the researcher prior to each FGD, and consent was provided prior to participating.

Data collection

Interview guides were used to guide data collection for individual face-to-face semi-structured interviews and FGDs (supplementary files 1 and 2). The interview guides were tested with two HCWs who were not participating in the study to develop the lines of questioning when probing and ensure any ambiguities were excluded and clarified before initiating data collection. Open questions to elicit free responses were used. Questions focused on understanding mental health challenges faced by adolescent mothers during the postnatal period (Fig. 1 ). The opening questions for HCWs and traditional practitioners explored participants’ understanding of the common mental health problems and disorders that affect adolescent mothers during the postpartum period, with some probing questions to explore further understanding of how common these mental health problems are in the catchment area. Participants were also asked about how they identify and manage adolescent mothers who have mental health problems (supplementary files 1 and 2). The first author conducted all in-depth interviews with HCWs and two of the FGDs. One FGD was facilitated by a research assistant (CN).

Model describing HCW and traditional healers’ perceptions of availability, access and support for adolescent mothers

Data collection took place between September 2021 and March 2022. Individual interviews were carried out by CT, PK, and CN (Malawian mental health practitioners and researchers fluent in Chichewa and English). The FGD discussions were moderated by CT and CN while PK took notes. The interviews and FGDs were conducted face-to-face, recorded on a digital recorder, and transcribed verbatim. After each interview, member validation was conducted to ensure participant perspectives and experiences were accurately represented. Interviews with HCWs were conducted in English. All FGDs were conducted in Chichewa. Interviews lasted an average of 30 min to an hour, and FGDs lasted 45 min to an hour. Field notes and a reflexive diary that included non-verbal communication and observations were recorded to supplement recorded data.

Prior experiences, assumptions, and beliefs can inevitably impact the data collection [ 47 ]. The lead researcher in this study (CT) drew upon her background as someone who experienced adolescent motherhood and is now a mental health nurse in her mid-forties. This experience informed the researcher’s understanding of participants’ perspectives, attitudes, and experiences regarding motherhood. Therefore, the researcher implemented self-reflection and awareness to ensure bracketing. The researcher kept a reflexive diary throughout the data collection process, recording thoughts, emotions, and observations while engaging with participants and gathering data. This served as a resource for analyzing the positionality and potential biases. Additionally, the researcher collaborated with participants to collectively construct shared realities. The construction of reality is a collaborative process between the researcher and the topic under investigation, influenced by the subjective experiences of everyone involved [ 48 ]. However, the researcher minimized biased approaches during data collection by holding a neutral stance and not sharing her experiences and views while prompting and guiding the discussions. The aforementioned statements pertain to epistemological presuppositions regarding acquiring knowledge about reality [ 47 ].

De-identified transcripts were organised using NVivo version 10 [ 49 ] and analysed using thematic analysis [ 50 , 51 ]. The study employed Braun and Clarke [ 51 ] six-phases of reflexive thematic analysis: (1) familiarization with the data; (2) generating initial codes; (3) generating themes; (4) reviewing the themes; (5) final review and defining of themes; and (6) writing the results. During this process, the data was familiarized by reading and re-reading the transcripts and interview notes and noting ideas. Then, using open coding, transcripts were initially coded by (CT) and (MZ) to generate initial codes using an inductive and data-driven approach. CT and MZ coded separately during this process and then discussed the coding. Themes were generated according to the patterns of codes identified, which were grouped and allocated to a theme. The themes were discussed and confirmed by authors SB, CT, and LP to ensure the themes aligned with the coded extracts. Ongoing analysis enabled the refinement of the specifics of each theme and the generation of clear definitions and names of themes and subthemes [ 50 , 52 , 53 ]. The final step was the write-up of the results. Constant comparison by the research team achieved confirmability and dependability. The supervisory team (SB and LP) contributed to the data interpretation and ongoing reviews of the results [ 54 ]. The involvement of a team helped remove potential bias and strengthen the results [ 44 ].

Healthcare providers (HCPs) views regarding the availability, accessibility, and management of maternal mental health of adolescent mothers were explored. Participants ( n  = 36) included six HCWs who participated in in-depth individual interviews and 30 traditional practitioners, including 10 traditional healers, 10 community volunteers, six traditional birth attendants and four spiritual healers who participated in the three FGDs (9 males and 21 females). Eighteen participants were Christians, four were Muslims, and eight belonged to traditional religions. Ten participants had never been to school.

Overview of themes and conceptual model

Four main themes emerged to help understand the perceptions of healthcare workers (HCWs) and traditional practitioners regarding the access and availability of mental health services for adolescent mothers in rural Malawi. The themes of inadequate staff development , limited resources , limited policy , and guidelines implementation pertain to health systems. The theme C ultural background and beliefs influencing seeking help describes cultural norms.

Inadequate staff development

The theme of inadequate staff development has four subthemes: health providers’ skills and knowledge , standard mental health screening tools , qualified mental health professionals , and health worker workforce.

Health provider’s skills and knowledge

All healthcare providers acknowledged encountering many adolescent mothers during their daily activities. HCWs reported focusing on physical examinations, nutrition assessments, nutrition counselling sessions and other health education sessions for pregnant mothers in clinics and at the community level. However, they did not address mental health. However, HCWs perceived themselves to be strategically positioned to provide initial mental health assessments and support to mothers. Some HCWs acknowledged their hesitancy to include mental health assessments as they felt they lacked the skills to identify symptoms of mental health problems and to provide appropriate mental health support. Furthermore, they expressed a need for regular professional development, for example:

Some of health workers have the skills but… most of us do not have the skills to conduct a mental health assessment…. An in-service or reorientation would be good. Of course , we had a training during our clinical placement but…. psychiatric or mental health is difficult , we have forgotten (HCW1) .

Similarly, traditional practitioners also expressed concerns about their limited awareness about mental health and perceived deficiencies in counselling skills. Community volunteers and traditional birth attendants do not routinely include mental health care. Many community volunteers had received prior training in conducting home visits to pregnant women, offering nutrition education, and performing basic physical assessments, which they believed positioned them well to support mothers in crisis before directing them to clinics. While traditional practitioners discussed their need for basic counselling skills, they also recognized the need for experienced counsellors they could refer adolescent mothers to. Other traditional practitioners, such as traditional birth attendants and herbalists, also felt they would benefit from mental health awareness and basic counselling skills.

The major reason for us who live and work in the community…. We do not have the capacity or basic skills for counselling or communicating with someone about their mental health. We do not have the knowledge for counseling. We need counsellors…. To be honest we don’t teach about mental health but about nutrition only because we don’t have the required skills or knowledge in the mental health field. (Community volunteer FDG1)

If there was an opportunity for us to learn how to manage mental health and teach about mental health , (it would) be good …. so that we can help adolescent mothers live without stress. We will be incredibly grateful also because we will add more knowledge to what we already teach mothers . ( Community volunteer FDG1).

Standard mental health screening tools

Most HCWs were willing to screen women for possible common mental health problems. However, they attributed the lack of culturally approved screening instruments as a challenge to screening. HCWs felt it important to have a standard screening tool for common disorders incorporated into their routine assessment guides. They reported that most adolescent mothers with common mental health issues requiring help go unrecognized, especially when they look happy or do not show any visible signs of sadness. One health worker summarized this sentiment, suggesting the identification of mothers with mental health problems is mostly “accidental’ due to the lack of formal screening and assessment.

Most of the time we prioritize those who come here as a family to seek help because we encourage family involvement or partner involvement. So , if someone comes alone , we explore further to identify the reason she has come alone. That is when we identify the issues. We can say identification is accidental  (HCW3) .

Qualified mental health professionals

Most participants acknowledged the importance of specialized mental health professionals who offer tailored and comprehensive assessments and psychological support that incorporate mothers’ specific psychosocial needs. For example,

S ome mothers needed counselling services and most of them would need psychosocial counselling and psychosocial counselling (which) would range from 1 week to up to 6 months and (this) needs qualified psychosocial counsellors (HCW 2).

Participants reported that at the time of the study, the hospital had only one mental health nurse working in the labor ward who was responsible for managing clients with severe mental illnesses. To address the issue of limited staff, some HCWs suggested a need for integration of mental health services into primary health care. It was suggested that this could be achieved by engaging non-mental health professionals to support mothers and implement early intervention. This would enable support to be provided to mothers immediately, which was especially important for young mothers, many of whom travel long distances, often on foot, to get to the clinic.

Another thing , is if we can have enough mental health personnel …for example , we only have 1 psychiatric nurse , the one who deals with all mental health issues… So , it will be ideal…if we have … a psychiatric nurse or anyone who looks into all those mental health conditions in the department like for example …. here at antenatal have one-person , general wards should have one and the other departments as well. That would help rather than just referring them to one person… It may happen that the person on that particular day is absent he is engaged with other issues so it means these people (adolescent with mental health issues) will not be assisted. And then telling them (adolescents) you should come another day will look like a burden to them. Looking at the distance they walk from home to here. I think that can be a problem. So…If we can have more mental health experts here (HCW 2) .

Health worker workforce

HCWs acknowledged the government of Malawi’s commitment to strengthen human resources for health including accelerating training and recruiting health professionals to support all positions required in the health sector. However, some HCWs also expressed concerns over the limited number of staff employed at the facility. Lack of staff was an issue, with the clinic treating around fifty mothers daily with only two nurses per shift, which tended to result in staff prioritizing physical health issues. Some HCWs and community volunteers suggested that community volunteers and community health workers can assist with screening mothers for mental health issues. Community volunteers concurred this would be feasible if they received appropriate training regarding screening procedures and mental health problems.

Given the workload at the clinic , little time is available to screen for mental disorders and hence they go unrecognized…they should be assisted (but) it is only the psychiatric nurse that decides the kind of medication. So , most of us will just look at the condition and we do not help much. We only focus on anemia , malaria , and pregnancy. Furthermore , community workers can assist with screening.  (HCW 5).

Only if there was that opportunity for us (community volunteer) to learn how to teach about mental health and support mothers so that they could live without stress. We will be incredibly grateful because we will add more knowledge to what we already teach. ….and assist them properly (Community volunteerFGD1) .

Yes , we can use community workers or can find volunteers in the community who can identify people with mental issues and record their names and bring them to the hospital or provide mental health support (HCW 3).

Limited resources

Resource availability was cited as a facilitator for effectively delivering appropriate mental health services. Besides limited human resources, HCWs expressed concerns about the availability of other key resources to deliver the services. This theme has two subthemes: medication availability , lack of appropriate infrastructure. and competing priorities .

Medication availability

HCWs reported that all health services provided at the facility are free of charge. Hence, mothers do not pay for consultations and medication received at MRH. The faith-based organization St. John of God Hospitaller Services also partially supports mental health services with a free monthly mental health mobile clinic that provides medications for those with severe mental illnesses who attend the clinic on their clinic day. However, MRH provides perinatal and other outpatient services daily. Therefore, it was challenging for MRH to support mothers who required treatments on non-clinic days because MRH frequently experienced shortages of essential medications used to treat common mental disorders such as depression. HCWs attributed these shortages to limited government financing for medication and that mental health is not considered a priority by the authorities. Additionally, some HCWs also highlighted that medications safe for pregnant and lactating mothers were often not available, leaving some mothers untreated unless they could afford to pay for medication from the pharmacy.

Sometimes we have capacity , but we do not have resources. For example…. having safer antidepressants , we rarely have them …. we have the patients , but we are failing to put them on safe anti-depression medications… we could ask the family to buy , from pharmacies or private clinics… The situation is worse with mental health. No medication at all and we prioritize other medication (HCW 6) .

Lack of appropriate infrastructure

Some health workers expressed concern that the current hospital infrastructure does not allow for privacy, making some interventions difficult to implement. Rooms were difficult to access for private counselling sessions. The available open public spaces did not allow confidential discussions and did not have the capacity for partners to attend and accompany their spouses for labor, delivery, and clinic checkups. The need for privacy for mothers who had lost a baby was also emphasized by one participant who expressed concern that these mothers remained on the ward with other mothers and their babies.

Our hospital physical environment will not allow them (spouses/partners) to come…. postnatally …. they can’t be assisted well if they come with partners ……at least if the facility had rooms to provide privacy (HCW2).

We should have a separate room to deal with or to treat the mothers and give counselling because most of them would need psychosocial counselling and psychosocial counselling that would range from 1 week to up to 6 months and (this) needs privacy. (HCW3).

Particularly those that have lost their babies we need… a separate room for them because if we put them together with the mothers that have babies that brings in more mental disturbance…being traumatized (HCW6) .

Competing priorities

HCWs also expressed concerns over competing priorities with limited funding from the Malawi government and a lack of other non-government organizations and stakeholders supporting mental health services. Participants described how some health conditions receive special donor funding through specific projects. Some of these projects include funding of medication for communicable diseases such as malaria, sexually transmitted infections, and HIV/AIDS. However, there are currently no similar projects that fund mental health medications. This affects the availability of safe treatment options since government funding is insufficient to procure pregnancy-safe antidepressants. Further, during the COVID-19 pandemic, the situation worsened as funding and interventions shifted. For example, “We noticed that there is a lack of resources , particularly drugs because now the focus is on COVID-19 prevention supplies; this has affected the supply of other medications , including medication used during emergencies such as adrenaline” (HCW6”). Another health worker who was involved in providing mental health services stated:

We have patients who have chronic diseases such as epilepsy and mental illnesses , these have been affected more compared to patients that come for malaria or TB treatment Because malaria and TB have specific donors that supply medication but for epilepsy and mental health , we don’t have any medications (HCW3) .

Limited policy and guidelines implementation

Policy and guidelines were highlighted as facilitators to improved mental health care for women. Nurses and doctors acknowledged the availability of policies and guidelines regarding antenatal and postnatal care. However, the HCWs discussed the gap between these policies and their implementation. HCWs attributed gaps in implementation to issues such as fragmented care and inadequate financing for mental health services, insufficient workforce, unclear practical guidelines specific to maternal mental health care and a lack of staff orientation to new guidelines.

While the Ministry of Health had recently reviewed the antenatal guidelines and incorporated maternal mental health assessment, not all HCWs in this study were aware of these changes. Those who were aware reported that many staff were unfamiliar with recent guidelines. Some participants suggested the guidelines are not explicit, and HCWs require orientation to familiarize themselves with the changes. Furthermore, participants indicated that current antenatal policy does not clearly stipulate the mental health screening of postnatal mothers. HCWs suggested mental health screening should be mandatory.

Yes , the policies and guidelines might be there…so many people (nurses and clinicians) are not even aware of what is in the policies and to use them (policies)…Even the new anti-natal guidelines if you ask some nurses , they just know they are there but still practicing old ways where we only assess for physical problems like anemia , gestation age , and malaria (HCW1).

If you may ask me about motivational interviewing , and screening , I don’t know what it entails (HCW2).

I am personally not familiar with the changes; these were not disseminated to us. Orientation would help and for postnatal women we only assess for physical problems up to six weeks postnatal checkup. Probably screening should be mandatory (HCW 3) .

Cultural background and beliefs influence on help seeking

Adolescent mothers’ cultural backgrounds and beliefs impacted access to services. Broader community influence and traditional healer’s influence were sub-themes of this theme.

Broader community influence and beliefs

Traditional practitioners had different perceptions of how they described mental health problems. Mental health disorders were perceived to be the result of witchcraft or “someone just being silly” or “stupid”, with some participants in the traditional practitioners FGDs suggesting these issues do not warrant hospital treatment. The following quotes from herbalists and a spiritual healer support these sentiments:

Mental health conditions are because of stupidity mmm …Some people say it’s stupidity …but sometimes it’s indeed witchcraft (Herbalist FDG3).

You don’t think straight when you have mental issues. If such things happen , some say it is witchcraft , some say it is madness , and others say it’s Satanism. People talk a lot about these things (Spiritual healer FDG2).

……. aah! I think maybe we don’t know that this depression is a condition that can be treated if they can seek help… Only if we know that this is a disease can people go and seek medical help , but the problem is that people don’t know that this is a disease (Herbalist FDGs3).

Traditional practitioners discussed informal support provided within the community rather than the hospital. The discussion with community volunteers highlighted differing approaches. For example, a community volunteer shared an example of an adolescent mother who attempted suicide, refused to breastfeed and abandoned her baby. The mother was taken to the police as laws were broken, instead of being taken to the hospital for mental health support. Some community volunteers agreed with this, for example: When someone has dumped a baby because the mother is not thinking well … , hmm we take the mother to the police station so that the mother is punished” (Community volunteer FDG1). However, other participants focused on the safety of the child and the mother in this situation, for example: “It is because they fear for the life of that child. So , to protect their lives (the children) , they first go to the police station because if the child dies in their hands , they (the mothers) may be in trouble. We do not only want to get help for the baby but also save the life of the mother who dumped it. When you get to the police station , they tell you to go to the hospital” (Community volunteer FDG1).

Traditional healers influence

Traditional practitioners discussed providing mental health support within rural communities and the importance of traditional social support systems in the context of accessing mental health care. HCWs and traditional practitioners felt mothers seek help from spiritual healers, traditional healers or the health care system based on their perception of their health issue. Therefore, some community members consider traditional healing services the first point of contact for support.

Traditional practitioners reported that some adolescents with symptoms of mental health problems visit traditional practitioners for ‘ breaking of spells’ , a spell being cast by ancestor’s spirits upon the person for wrongdoing with mental health problems as a form of punishment. One traditional healer commented: “Some of the mental health disorders come when the adolescent’s parents or ancestors did not follow some rituals , and therefore , they are spiritually tied like a chain…. and this is like a covenant…… and therefore it runs in the families , and these can only be healed by breaking the chain…. another one echoed this sentiment: “They are spells from their ancestors , they can only be healed through exhortation” (Traditional healer FGD3) . A spiritual healer brought a different dimension to dealing with mental issues. For example, one spiritual healer recounted an incident whereby a girl visited the spiritual healer with issues, and the healer felt the girl’s mental health issues were because she was “thinking too much”: “I had a certain girl at home who was 7 months pregnant. She was always worried when she came to me , she never opened up. I do not have a clinic , but I practice spiritual healing. She came to me and said you should test me…so I asked her what I should check on. She said just check me. When I consulted the spirits , they told me that the girl has no problems in her life , but she thinks a lot because of her wrongdoing so she should stop that. I told her that when she stopped thinking a lot , her health would improve (Spiritual healer FGD2). Similarly, another spiritual healer discussed encouraging mothers to talk, pray and make peace with others to alleviate mental health problems:

When someone with worries comes to me , we encourage each other by talking with them through prayers. Then we advise the person on how to behave where she is staying with her neighbours…If some people were not talking to her , she should be the first to open up by starting with greeting them. When they do that , they come back here to give a testimony…God has helped in resolving the disputes! And most mothers say that …. I thank God and praise him for what He has done because I never thought I would ever be happy again , but your prayers and my prayers have worked. God has answered the prayers (Spiritual healer FGD2) .

In addition, traditional practitioners across all three groups perceived that sometimes, HCWs’ attitude encourages mothers to opt to seek help from traditional healers and other community-based informal providers for their mental health problems rather than HCWs. Traditional practitioners reported that the reception people receive when they visit the hospital is not always positive. For example, in FGD3 with traditional healers, one traditional healer, a traditional birth attendant, stated “ Health workers are the biggest problem , so let us be open here. Instead of welcoming and assisting us based on our feelings , you treat us badly… (Traditional birth attendant FGD3). Another Herbalist stated sometimes you (health workers) take too long to assist someone…instead of assessing someone to know how they are , you are busy chatting or sliding your smartphones (Herbalist FGD3). Similarly, a spiritual healer in FGD2 stated when adolescents come to us (spiritual healers) , we pray for them , sit down with them , and hold their hands. However , in hospitals , the care is left to cleaners , who sometimes send them back even without seeing a professional health worke r (S piritual healer FGD2) . Given these experiences some traditional practitioners discussed the need to provide better and more compassionate care than hospitals. For example:

Even though you (health workers) do not allow women to deliver at traditional caregivers… more women around this hospital prefer to go there because they are treated well. The treatment we get from the traditional caregivers and here at the hospital is very different because of the behaviour of the people who work at the hospitals (Traditional birth attendant FGD2 ).

If you put the nurses and the traditional caregivers here and compare them , you will see that we manage to help people deliver babies properly in the villages. We treat people very well but at the hospital they are very cruel, they shout at pregnant women (Traditional birth attendant FGD2 ).

Notably, all participants from the FGDs and in-depth interviews discussed the need to collaborate with each other. Traditional practitioners felt that traditional healers and birth attendants should refer clients to the hospital. In addition, all traditional practitioners, including community volunteers, wanted more mental health training to enhance their confidence to identify and refer clients with potential mental health problems to the hospital. Participants discussed that while mental health support can be provided by different groups, such as the church, community volunteers, traditional birth attendants, and other people within the community, it was important that mothers experiencing mental health problems were referred to the hospital. HCWs emphasized that proper sensitization and awareness of traditional practitioners and the community around mental health issues is very important due to traditional practitioners’ limited knowledge and skills about maternal mental health. There was a general agreement that task sharing with collaboration is more important than working in isolation. Participants felt utilizing current community structures (community health workers, community health volunteers, and village health committees) would assist in extending support to more mothers. For example:

The traditional healers and government health workers should work together so that we should encourage the pregnant girls with such conditions (mental health problems) to go to the hospital. So that when they give birth to their baby they can go back to school , and this will ensure a better future for those young people and if we see that the girl needs counselling , we should take them to the hospital. We should work together because we are all helping people (Herbalist FGD3) .

I hope the best lesson is that we should work together , we are all helping people including girls. Sometimes we are ignorant of some things , do not neglect us, give us trainings so that we refer clients to each other when we meet somethings that we cannot manage. (Traditional Birth Attendant FGD2)

This is the first study to explore access to maternal mental health of adolescent mothers in Malawi. Access to mental health care services by adolescent mothers remains a challenge in most LMICs [ 55 , 56 ], and the reasons are multifaceted. In this Malawian study, HCW’s competence in mental health assessment, lack of a culturally appropriate screening tool, limited resources, and cultural and community influences were the perceived factors that impacted access to maternal mental health. Studies conducted in Uganda, Liberia and Nepal around barriers to accessing mental health support for people with mental health problems reported similar findings [ 57 , 58 ]. In South Africa, the reasons that contributed to poor access to maternal mental health were attributed to systemic health issues such as structural stigma, for example, not implementing appropriate mental health policies, cultural background of mothers, particularly beliefs about the causes of mental health disorders, and health workers competence [ 11 , 59 ]. Comprehensive access to mental health care requires a multifaceted and holistic approach, highlighting the need to improve mental health literacy and skills among HCWs and traditional practitioners and to address systemic barriers.

While HCWs in this study acknowledged the importance of screening as an essential intervention for early identification and treatment, screening of mothers for mental health problems was challenging. This finding is similar to studies conducted in Kenya and Ghana where health workers also reported challenges in providing screening services due to a lack of training around the conduct of maternal mental health assessments and the lack of a formal process to screen women for postnatal depression [ 26 , 56 , 60 ]. In Malawi, limited competencies among HCWs may be attributed to inadequacies within the current health workers’ pre-service training curriculum. These findings call for a review of the current Malawian nursing and medical curriculum to incorporate modules focusing on screening for common mental disorders in perinatal women. In addition, in-service training for health workers around the implementation of maternal mental health screening tools is essential to improve health workers’ confidence in the provision of comprehensive screening and management.

The findings of this study highlight that insufficient numbers of mental health professionals resulted in fewer opportunities for ongoing support, and long waiting times for mothers to access mental health support. Some studies suggest task shifting to be a strategy to increase access [ 26 ]. This involves psychological therapies being provided by non- trained health workers [ 61 ] or where tasks are shifted from professionals to community volunteers with fewer qualifications [ 62 , 63 ], thereby increasing reach [ 60 , 64 ]. For example, a literature review focusing on the implementation of task sharing in LMICs, where there are limited health workers, has found improved access to mental health support [ 65 ]. In Malawi, community health workers, informal health care providers, and community health volunteers are embedded within the community setting. These existing personnel and the current organizational structure may provide opportunities for task sharing [ 60 ]. For example, in Malawi, community links with the primary care facility via a team of health surveillance assistants (HSAs), community health workers (CHWs) and traditional healers is possible. HSAs are community-level cadres who receive six weeks of initial training and supervise community volunteers. HSAs and community volunteers provide health promotion and preventive health care through door-to-door visitations and outreach clinics and are supervised by community nurses and public health officers. Each HSA is responsible for a population of 1500, and each village has a volunteer [ 66 ]. In this study, HCWs and traditional practitioners suggested a task-sharing approach to provide effective assistance. However, they felt that orientation and training would be necessary considering the complexity of maternal mental health problems and some of the different belief systems and ways of working between HCWs and traditional practitioners. It was evident in this study that traditional practitioners play an important role in the health care of young mothers in Malawi, with many providing examples of support which could be enhanced by training. In addition, policy makers should consider deploying mental health workers in maternal health departments to provide support to adolescent mothers.

Limited resources in terms of infrastructure and competing priorities were also discussed as barriers to the availability of mental health services. These factors affect the type of support available to adolescent mothers. For example, adequate and appropriate infrastructure provides privacy for therapeutic communication and counselling [ 55 ]. Lack of infrastructure creates difficulties for both service providers and the consumers of mental health services to render and access appropriate services [ 55 ]. Similarly, participants in this study felt that improving the current infrastructure may create a conducive environment that may support adolescent mothers.

Participants in this study highlighted the importance of mental health policy. They felt policies and guidelines on maternal mental health screening in Malawi were not explicit and not well implemented. A lack of policy implementation may contribute to inequality in resource allocation, leading to the diversion of attention and resources, which may result in poor funding of services tailored for maternal mental health. Some authors attribute this to structural stigma within the health system, which affects funding and resource allocation [ 24 , 65 , 67 , 68 ]. Therefore, research on effective and efficient mental health interventions would inform policymakers on evidence-based, cost-effective interventions that are appropriate for perinatal women. For example, adopting task sharing using existing community structures and traditional health workers, including community volunteers, could be trialed. Furthermore, policy reviews and enforcement around the implementation of policy may provide support for funding and hence result in improvements in maternal mental health service delivery [ 69 ]. The inclusion of screening guidelines in policies would emphasize the need for mental health screening into the postnatal period and facilitate financing for its implementation.

There is ongoing debate on the integration of spirituality or religiosity into the management of people experiencing mental health problems. However, evidence from programs in HIC has found that integrating religious elements into therapy is beneficial for some patients [ 70 ]. In the Sub-Saharan African context, [ 56 , 71 ] and consistent with the findings of this study, traditional practitioners highlighted the benefits of spirituality. Participants in this study did, however, discuss differing beliefs that impacted care. HCWs discussed their biopsychosocial explanation of mental disorders, while some traditional practitioners discussed their belief that bad spirits or being cursed causes mental disorders. These differing beliefs may cause mistrust between HCWs and traditional practitioners. In our study, spiritual healing was reported to assist adolescent mothers in considering life as sacred and meaningful, and as such, was an essential part of the recovery process, with spiritual healers providing alternative coping methods that are essential for healing. Our study also found adolescent mothers who were experiencing mental health difficulties were more likely to be prayerful and hence receptive to intervention from traditional practitioners [ 6 ]. These findings highlight the importance of collaborating and supporting religious leaders and other traditional practitioners.

Strengths and limitations

This study was conducted in a rural setting in Malawi in one hospital catchment area. While findings are unique to this setting, they may be of interest to other regions of Malawi and other SSA countries. The perceptions of HCWs and traditional practitioners provide a unique contribution to the understanding of access and availability of mental health support for adolescent mothers. Despite being conducted during the COVID-19 pandemic, 30 traditional practitioners were recruited. All six HCWs at the MCH at MRH consented to participate in the study.

Conclusion and recommendations

Access to mental health care support for adolescent mothers in Malawi appears to be impacted by inadequate staff development, limited resources, limited policy and guidelines implementation, and cultural background and beliefs influences on help-seeking. Enhancing mental health literacy among HCWs and traditional practitioners is important to improve their understanding of mental health issues. Training of health workers should include mandatory screening for common mental disorders for pregnant and postnatal adolescents using standard, locally validated screening tools to ensure that mental health problems are detected early. Furthermore, training in empathetic communication skills to improve communication would be essential.

Health facilities should co-develop and implement coordinated interventions with community stakeholders to strengthen community engagement initiatives between HCWs and traditional practitioners with the aim of improving support for adolescent mothers.

Advocacy is required to encourage the Government of Malawi to increase funding for mental health services. Funding is needed to access medications, enhance infrastructure and support policy implementation. Critically staffing increase, especially for mental health nurses, is essential.

Lastly, future research should evaluate the efficacy and effectiveness of interventions that promote help-seeking, enhance prevention, early detection, and timely treatment, utilizing HCWs and traditional practitioners as referral points. For example, research on providing interventions through task sharing would be beneficial.

Availability of data and materials

Data are hosted by the Curtin University survey office through the Human Research Ethics Committee. Researchers who meet the criteria for access to confidential data can request it through the Chairperson Ethics Committee, and the data will be made available.

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Acknowledgements

The authors acknowledge the support of the head of the School of Population Health, Curtin University for scholarship support, the Lilongwe District Health Officer, and his team for accepting us to conduct the study and the Clinic in charge for the coordination. I would also like to acknowledge the support of Margret Zgambo, Precious Kachale, Dr Saulos Gondwe, and Charles Ndawala for your support during data collection.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The author secured a Research Training Stipend Scholarship for doctoral studies. From Curtin University.

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CT came up with the idea for the study, while SB and LP, who served as supervisors, gave it a critical assessment, and enlarged it. CT, SB, and LP conceptualized the study. Data curation was done by CT, L P, and SB. Supervision and formal analysis of data were done by all authors. All authors reviewed the manuscript.

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The corresponding author (CT) is a mental health nurse with an interest in the mental health promotion of women and a Malawi representative for the African Alliance for Maternal Mental Health. She works with St John of God Malawi as a community mental health coordinator and is a PhD student at Curtin University in Australia and is supervised by Professor Sharyn Burns (PhD, MPH, BEd) and Dr Linda Portsmouth (PhD, MHlthComm, BAppSc).

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Correspondence to Chimwemwe Tembo .

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Tembo, C., Portsmouth, L. & Burns, S. Identification of mothers with mental health problems is accidental: perceptions of health care providers on availability, access, and support for maternal mental health care for adolescent mothers in Malawi. BMC Health Serv Res 24 , 983 (2024). https://doi.org/10.1186/s12913-024-11469-z

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Published : 26 August 2024

DOI : https://doi.org/10.1186/s12913-024-11469-z

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Eating Disorder Treatment and Recovery

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Warning signs of an eating disorder

Worried about someone speak out, how to talk to someone about their eating disorder, encouraging a person to get help, treatments for eating disorders, dealing with eating disorders in the home.

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Helping Someone with an Eating Disorder

Are you worried that someone you know has anorexia, bulimia, or another eating disorder? These tips can help you support your child, family member, or friend.

Understanding your loved one’s eating disorder

Eating disorders involve extreme disturbances in eating behaviors—following rigid diets, bingeing on food in secret, throwing up after meals, obsessively counting calories. It’s not easy to watch someone you care about damage their health—especially when the solution appears, at least on the outside, to be simple. But eating disorders are more complicated than just unhealthy dietary habits. At their core, they’re attempts to deal with emotional issues and involve distorted, self-critical attitudes about weight, food, and body image. It’s these negative thoughts and feelings that fuel the damaging behaviors.

People with eating disorders use food to deal with uncomfortable or painful emotions. Restricting food is used to feel in control. Overeating temporarily soothes sadness, anger, or loneliness. Purging is used to combat feelings of helplessness and self-loathing. Over time, people with an eating disorder lose the ability to see themselves objectively and obsessions over food and weight come to dominate everything else in their lives. Their road to recovery begins by identifying the underlying issues that drive their eating disorder and finding healthier ways to cope with emotional pain.

While you can’t force a person with an eating disorder to change, you can offer your support and encourage treatment. And that can make a huge difference to your loved one’s recovery.

Speak to a Licensed Therapist

BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.

Types of eating disorders

The most common eating disorders are:

Anorexia. People with anorexia starve themselves out of an intense fear of becoming fat. Despite being underweight or even emaciated, they never believe they’re thin enough. In addition to restricting calories, people with anorexia may also control their weight with exercise, diet pills, or purging.

Bulimia. Bulimia involves a destructive cycle of bingeing and purging. Following an episode of out-of-control binge eating, people with bulimia take drastic steps to purge themselves of the extra calories. In order to avoid weight gain they vomit, exercise to excess, fast, or take laxatives.

Binge Eating Disorder. People with binge eating disorder compulsively overeat, rapidly consuming thousands of calories in a short period of time. Despite feelings of guilt and shame over these secret binges, they feel unable to control their behavior or stop eating even when uncomfortably full.

Myths and Facts about Eating Disorders

You have to be underweight to have an eating disorder.

People with eating disorders come in all shapes and sizes. Many individuals with eating disorders are of average weight or are overweight.

Only teenage girls and young women are affected by eating disorders.

While eating disorders are most common in young women in their teens and early twenties, they are found in men and women of all ages—from children to older adults.

People with eating disorders are vain.

It’s not vanity that drives people with eating disorders to follow extreme diets and obsess over their bodies, but rather an attempt to deal with uncomfortable feelings.

Eating disorders aren’t really that dangerous.

Eating disorders are serious conditions that cause both physical and emotional damage. All eating disorders can lead to irreversible and even life-threatening health problems, such as heart disease, bone loss, stunted growth, infertility, and kidney damage.

Many people worry about their weight, what they eat, and how they look. This is especially true for teenagers and young adults, who face extra pressure to fit in and look attractive at a time when their bodies are changing. As a result, it can be challenging to tell the difference between an eating disorder and normal self-consciousness, weight concerns, or dieting. Further complicating matters, people with an eating disorder will often go to great lengths to hide the problem. However, there are warning signs you can watch for. And as eating disorders progress, the red flags become easier to spot.

Restricting food or dieting

• Making excuses to avoid meals or situations involving food (e.g. they had a big meal earlier, aren’t hungry, or have an upset stomach)
• Eating only tiny portions or specific low-calorie foods, and often banning entire categories of food such as carbs and dietary fat
• Obsessively counting calories, reading food labels, and weighing portions
• Developing restrictive food rituals such as eating foods in certain orders, rearranging food on a plate, excessive cutting or chewing.
• Taking diet pills, prescription stimulants like Adderall or Ritalin, or even illegal drugs such as amphetamines (speed, crystal, etc.)
• Unexplained disappearance of large amounts of food in short periods of time
• Lots of empty food packages and wrappers, often hidden at the bottom of the trash
• Hoarding and hiding stashes of high-calorie foods such as junk food and sweets
• Secrecy and isolation; may eat normally around others, only to binge late at night or in a private spot where they won’t be discovered or disturbed
• Disappearing right after a meal or making frequent trips to the bathroom
• Showering, bathing, or running water after eating to hide the sound of purging
• Using excessive amounts of mouthwash, breath mints, or perfume to disguise the smell of vomiting
• Taking laxatives, diuretics, or enemas
• Periods of fasting or compulsive, intense exercising, especially after eating
• Frequent complaints of sore throat, upset stomach, diarrhea, or constipation
• Discolored teeth

Distorted body image and altered appearance

• Extreme preoccupation with body or weight (e.g. constant weigh-ins, spending lots of time in front of the mirror inspecting and criticizing their body )
• Significant weight loss, rapid weight gain, or constantly fluctuating weight
• Frequent comments about feeling fat or overweight, or about a fear of gaining weight
• Wearing baggy clothes or multiple layers in an attempt to hide weight

If you notice the warning signs of an eating disorder in a friend or family member, it’s important to speak up. You may be afraid that you’re mistaken, or that you’ll say the wrong thing, or you might alienate the person. However, it’s important that you don’t let these worries stop you from voicing your concerns.

People with eating disorders are often afraid to ask for help. Some are struggling just as much as you are to find a way to start a conversation about their problem, while others have such low self-esteem they simply don’t feel that they deserve any help. Whatever the case, eating disorders will only get worse without treatment, and the physical and emotional damage can be severe. The sooner you start to help, the better their chances of recovery. While you can’t force someone with an eating disorder to get better, having supportive relationships is vital to their recovery. Your love and encouragement can make all the difference.

The decision to make a change is rarely an easy one for someone with an eating disorder. If the eating disorder has left them malnourished, it can distort the way they think—about their body, the world around them, even your motivations for trying to help. Bombarding them with dire warnings about the health consequences of their eating disorder or trying to bully them into eating normally probably won’t work. Eating disorders often fill an important role in the person’s life—a way to cope with unpleasant emotions—so the allure can be strong. Since you may be met with defensiveness or denial, you’ll need to tread carefully when broaching the subject.

Pick a good time. Choose a time when you can speak to the person in private without distractions or constraints. You don’t want to have to stop in the middle of the conversation because of other obligations! It’s also important to have the conversation at a time of emotional calm. Don’t try to have this conversation right after a blow up.

Explain why you’re concerned. Be careful to avoid lecturing or criticizing, as this will only make your loved one defensive. Instead, refer to specific situations and behaviors you’ve noticed, and why they worry you. Your goal at this point is not to offer solutions, but to express your concerns about the person’s health, how you much you love them, and your desire to help.

Be prepared for denial and resistance. There’s a good chance your loved one may deny having an eating disorder or become angry and defensive. If this happens, try to remain calm, focused, and respectful. Remember that this conversation likely feels very threatening to someone with an eating disorder. Don’t take it personally.

Ask if the person has reasons for wanting to change. Even if your loved one lacks the desire to change for themselves, they may want to change for other reasons: to please someone they love, to return to school or work, for example. All that really matters is that they are willing to seek help.

Be patient and supportive. Don’t give up if the person shuts you down at first. It may take some time before they’re willing to open up and admit to having a problem. The important thing is opening up the lines of communication. If they are willing to talk, listen without judgment, no matter how out of touch they may sound. Make it clear that you care, that you believe in them, and that you’ll be there in whatever way they need, whenever they’re ready.

What not to do

Avoid ultimatums . Unless you’re dealing with an underage child, you can’t force someone into treatment. The decision to change must come from them. Ultimatums merely add pressure and promote more secrecy and denial.

Avoid commenting on appearance or weight. People with eating disorders are already overly focused on their bodies. Even assurances that they’re not fat play into their preoccupation with being thin. Instead, steer the conversation to their feelings. Why are they afraid of being fat? What do they think they’ll achieve by being thin?

Avoid shaming and blaming. Steer clear of accusatory “you” statements like, “You just need to eat!” Or, “You’re hurting yourself for no reason.” Use “I” statements instead. For example: “I find it hard to watch you wasting away.” Or, “I’m scared when I hear you throwing up.”

Avoid giving simple solutions.  For example, “All you have to do is accept yourself.” Eating disorders are complex problems. If it were that easy, your loved one wouldn’t be suffering.

Aside from offering support, the most important thing you can do for a person with an eating disorder is to encourage treatment. The longer an eating disorder remains undiagnosed and untreated, the harder it is on the body and the more difficult it is to overcome, so urge your loved one to see a doctor right away.

A doctor can assess your loved one’s symptoms, provide an accurate diagnosis, and screen for any medical problems that might be involved. The doctor can also determine whether there are any co-existing conditions that require treatment, such as depression , substance abuse, or an anxiety disorder .

If your friend or family member is hesitant to see a doctor, ask them to get a physical just to put your worries to rest. It may help if you offer to make the appointment or go along on the first visit.

The right treatment approach for each person depends on their specific symptoms, issues, and strengths, as well as the severity of the disorder. To be most effective, treatment for an eating disorder must address both the physical and psychological aspects of the problem. The goal is to treat any medical or nutritional needs, promote a healthy relationship with food, and teach constructive ways to cope with unpleasant emotions and life’s challenges.

A team approach is often best. Those who may be involved in treatment include medical doctors, mental health professionals, and nutritionists. The participation and support of family members also makes a big difference in the success of eating disorder treatment.

Medical treatment. The first priority is to address and stabilize any serious health issues. Hospitalization or residential treatment may be necessary if your loved one is dangerously malnourished, suffering from medical complications, severely depressed or suicidal, or resistant to treatment. Outpatient treatment is an option when the patient is not in immediate medical danger.

Nutritional counseling. Dietitians or nutritionists can help your loved one design balanced meal plans, set dietary goals, and reach or maintain a healthy weight. Counseling may also involve education about proper nutrition.

Therapy. Therapy plays a crucial role in eating disorder treatment. Its goals are to identify the negative thoughts and feelings that are behind the disordered eating behaviors, and to replace them with healthier and less distorted attitudes. Another important goal is to teach the person how to deal with difficult emotions, relationship problems, and stress in a productive, rather than a self-destructive way.

Common types of therapy for eating disorders

Individual therapy. Explores both the eating disorder symptoms and the underlying emotional and interpersonal issues that fuel them. The focus is on increasing self-awareness, challenging dysfunctional beliefs, and improving self-esteem and sense of control.

Family therapy. Examines the family dynamics that may contribute to an eating disorder or interfere with recovery. Often includes some therapy sessions without the patient—a particularly important element when the person with the eating disorder denies having a problem.

Group therapy. Allows people with eating disorders to talk with each other in a supervised setting. Helps to reduce the isolation many people with eating disorders feel. Group members support each other through recovery and share their experiences and advice.

As a parent, there are many things you can do to support your child’s eating disorder recovery—even if they are still resisting treatment.

Set a positive example. You have more influence than you think. Instead of dieting, eat nutritious, balanced meals . Be mindful about how you talk about your body and your eating. Avoid self-critical remarks or negative comments about others’ appearance. Instead, focus on the qualities on the inside that really make a person attractive.

Make mealtimes fun. Try to eat together as a family as often as possible. Even if your child isn’t willing to eat the food you’ve prepared, encourage them to join you at the table. Use this time together to enjoy each other’s company, rather than talking about problems. Meals are also a good opportunity to show your child that food is something to be enjoyed rather than feared.

Avoid power struggles over food. Attempts to force your child to eat will only cause conflict and bad feelings and likely lead to more secrecy and lying. That doesn’t mean you can’t set limits or hold your child accountable for their behavior. But don’t act like the food police, constantly monitoring your child’s behavior.

Encourage eating with natural consequences. While you can’t force healthy eating behaviors, you can encourage them by making the natural consequences of not eating unappealing. For example, if your child won’t eat, they can’t go to dance class or drive the car because, in their weakened state, it wouldn’t be safe. Emphasize that this isn’t a punishment, but simply a natural medical consequence.

Do whatever you can to promote self-esteem  in your child, with intellectual, athletic, and social endeavors. Give boys and girls the same opportunities and encouragement. A well-rounded sense of self and solid self-esteem are perhaps the best antidotes to disordered eating.

Don’t blame yourself.  Parents often feel they must take on responsibility for the eating disorder, which is something they truly have no control over. Once you can accept that the eating disorder is not anyone’s fault, you can be freed to take action that is honest and not clouded by what you “should” or “could” have done.

Supporting a loved one’s recovery

Recovering from an eating disorder takes time. There are no quick fixes or miracle cures, so it’s important to have patience and compassion. Don’t put unnecessary pressure on your loved one by setting unrealistic goals or demanding progress on your own timetable. Provide hope and encouragement, praise each small step forward, and stay positive through struggles and setbacks.

Learn about eating disorders. The more you know, the better equipped you’ll be to help your loved one, avoid pitfalls, and cope with challenges.

Listen without judgment. Show that you care by asking about your loved one’s feelings and concerns—and then truly listening. Resist the urge to advise or criticize. Simply let your friend or family member know that they’re being heard. Even if you don’t understand what they’re going through, it’s important to validate your loved one’s feelings.

Be mindful of triggers. Avoid discussions about food, weight, eating or making negative statements about your own body. But don’t be afraid to eat normally in front of someone with an eating disorder. It can help set an example of a healthy relationship with food.

Take care of yourself. Don’t become so preoccupied with your loved one’s eating disorder that you neglect your own needs. Make sure you have your own support, so you can provide it in turn. Whether that support comes from a trusted friend, a support group, or your own therapist, it’s important to have an outlet to talk about your feelings and emotionally recharge. It’s also important to schedule time into your day for relaxing and doing things you enjoy.

Helplines and support

National Eating Disorders Association  or call 1-800-931-2237 (National Eating Disorders Association)

Beat Eating Disorders  or call 0345 643 1414 (Helpfinder)

Butterfly Foundation for Eating Disorders  or call 1800 33 4673 (National Eating Disorders Collaboration)

Service Provider Directory  or call 1-866-633-4220 (NEDIC)

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• Help for Friends & Family - Tips on how to approach a person with an eating disorder, what to say, and how to take care of yourself. (National Eating Disorder Information Centre)
• Treatment - Tips on eating disorder treatment. (National Eating Disorders Association)
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• Open access
• Published: 26 August 2024

The impact of surge capacity enhancement training for nursing managers on hospital disaster preparedness and response: an action research study

• Alireza Shafiei 1 ,
• Narges Arsalani 2 ,
• Mehdi Beyrami Jam 3 &
• Hamid Reza Khankeh   ORCID: orcid.org/0000-0002-9532-5646 4  

BMC Emergency Medicine volume  24 , Article number:  153 ( 2024 ) Cite this article

Metrics details

Introduction

Hospitals as the main providers of healthcare services play an essential role in the management of disasters and emergencies. Nurses are one of the important and influential elements in increasing the surge capacity of hospitals. Accordingly, the present study aimed to assess the effect of surge capacity enhancement training for nursing managers on hospital disaster preparedness and response.

All nursing managers employed at Motahari Hospital in Tehran took part in this interventional pre- and post-test action research study. Ultimately, a total of 20 nursing managers were chosen through a census method and underwent training in hospital capacity fluctuations. The Iranian version of the “Hospital Emergency Response Checklist” was used to measure hospital disaster preparedness and response before and after the intervention.

The overall hospital disaster preparedness and response score was 184 (medium level) before the intervention and 216 (high level) after the intervention. The intervention was effective in improving the dimensions of hospital disaster preparedness, including “command and control”, “triage”, “human resources”, “communication”, “surge capacity”, “logistics and supply”, “safety and security”, and “recovery”, but had not much impact on the “continuity of essential services” component.

The research demonstrated that enhancing the disaster preparedness of hospitals can be achieved by training nursing managers using an action research approach. Encouraging their active participation in identifying deficiencies, problems, and weaknesses related to surge capacity, and promoting the adoption and implementation of suitable strategies, can enhance overall hospital disaster preparedness.

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Hospitals, as the main providers of healthcare services, play an essential role in managing and reducing the suffering of injured people in emergencies and disasters [ 26 ]. Most of the definitive, life-saving and emergency care for injured people are carried out in hospitals. Therefore, the preparedness of hospitals is essential in moderating and decreasing the negative health consequences of disasters [ 29] . From an international perspective, the Sendai Framework for Disaster Risk Reduction 2015–2030 and World Health Organization (WHO), highlights the need for disaster preparedness and risk reduction measures in hospitals [ 30 , 31 ]. Based on WHO, the preparedness and well-trained hospital personnel is the main factor in minimizing the casualties and damages resulting from disasters. Therefore, assessing and improving hospitals’ capacity and preparedness for disasters is a crucial first step toward effective disaster response and achieving the objectives outlined in the Sendai Framework 2015–2030 [ 30 , 32 ].

In Iran, efforts to enhance hospitals’ disaster preparedness began in the winter of 2009 with the creation of the National Hospital Disaster Preparedness Plan (NHDPP) by the Health Research Center on Disasters at the University of Social Welfare and Rehabilitation Sciences. This initiative, serving as a national guideline, received backing from the Secretariat of the Disaster Health Working Group in the Ministry of Health and was communicated to all hospitals across the country [ 1 ]. Furthermore, in the third phase of Iran’s hospital accreditation program, criteria for disaster risk management were added in the form of seven standards and thirty-seven measurements, directly addressing the hospital’s preparedness and response to emergencies and disasters [ 2 ].

To effectively address disasters, a hospital needs a thorough preparedness strategy, necessary tools, equipment, sufficient space, skilled staff, and, in essence, enough surge capacity [ 33 ]. Surge capacity refers to the ability to acquire additional resources during a disaster or emergency. It is the ability to provide quickly the usual functions beyond the increased demand for experienced staff, medical care, and social health services. Surge capacity has three core components including staff, stuff, and structures [ 3 ].

Nurses are one of the major groups of healthcare providers in hospitals(staff) [ 4 ]. They have the most contact with patients and provide the most care [ 5 ]. Along with other disaster management teams, they also play crucial roles in planning, education and training, response, and recovery for hospital disaster preparedness [ 6 , 7 ].

Experiences have shown that training and exercises before the occurrence of disasters can significantly increase the ability of people to face critical situations such as natural disasters [ 4 , 6 ]. Therefore, providing effective disaster training for nurses has a crucial role in increasing hospital preparedness and capacity for response to disasters. Previous studies have demonstrated inadequate training for nurses on preparedness and response to emergencies and disasters [ 2 , 4 , 5 , 6 ]. Moreover, despite numerous investigations assessing the preparedness of Iranian hospitals for disasters [ 8 , 9 , 10 ], to the best of our knowledge, only a limited number of interventional studies have explored the impact of disaster training for nurses on enhancing hospital disaster preparedness in Iran. Hence, recognizing the crucial contributions of nurses to the development of hospital capacity, this research aimed to examine the effects of training of surge capacity enhancement for the nursing managers on the emergency and disaster preparedness of Motahari Hospital in Iran.

Study design and settings

The current investigation utilized a pretest-posttest interventional design, conducted at Shahid Motahari Burn Hospital, affiliated with Iran University of Medical Sciences in Tehran, Iran. This hospital is the first and only main and specialized center providing medical services to burn patients in the center of the country and plays an essential role in the management of the injured during disasters and emergencies, especially fires.

Population and sampling

Aligned with the study’s goals, we employed a census sampling method to select all nursing managers at Shahid Motahari Hospital in Tehran. The eligibility criteria encompassed individuals within the nursing profession, such as nursing managers, supervisors, and head nurses, who held a minimum of a bachelor’s degree and possessed a minimum of one year of managerial experience. Those who expressed unwillingness to participate in the study were excluded.

The data was collected using the Persian version of the Hospital Emergency Response Checklist developed by Khankeh et al. (2013) [ 34 ]. The checklist was used to estimate the current state of preparedness of hospitals and healthcare centers. The original version of this tool was formulated by the World Health Organization [ 35 ]. The checklist measures 9 key components including command and control (7 items), triage (10 items), human resources (15 items), communication (9 items), surge capacity (13 items), logistics and supply management (10 items), safety and security (10 items), continuity of essential services (8 items) and post-disaster recovery (8 items). The reliability and validity of the Persian version of the tool have been confirmed by Karimian et al. (2013) [ 14 ]. They confirmed the validity of the tool (CVI = 0.86) and its reliability with Cronbach’s alpha of 0.83. The items in the checklist are rated on a 3-point scale (1 = due for review, 2 = in progress, and 3 = completed).

Moreover, the hospital surge capacity guideline was used to examine the current situation, weaknesses, problems, and target actions and develop a hospital surge capacity training program. This guidance was formulated by the Health in Emergency and Disaster Research Center at the University of Social Welfare and Rehabilitation Sciences and approved and disseminated by the Iranian Ministry of Health [ 34 ].

Intervention

This intervention study adopted a participatory action research approach as the participants were involved in problem identification and intervention to improve the process. Research in action is a type of study used by people to change unfavorable situations into relatively favorable situations and finally improve procedures in their workplace [ 11 ]. Action research is a type of study that attempts to learn and understand purposeful interventions meant to bring about desired changes in the organizational environment [ 12 ]. Action research simultaneously promotes problem-solving and expands scientific knowledge, as well as strengthens the skills of research participants [ 13 ].

In general, in action research, participants are involved in all stages of the research, from identifying the problem and collecting the data to planning, implementation, and evaluation. The engagement of participants in all stages of the research will encourage their participation in the research procedure and make them interested in the research topic [ 7 ].

This study adopted Streubert Speziale and Carpenter’s five-step action research method [ 7 ]. These steps include (1) defining the problem (explaining the current situation), (2) collecting, analyzing, and interpreting data, (3) planning, (4) implementing, and (5) evaluating. In this research, nurses actively engaged in elucidating the issue, gathering and analyzing data related to hospital surge capacity, devising and executing capacity-enhancing strategies based on their training, and assessing these measures to enhance hospital disaster preparedness and response.

To collect the data, the required permits were obtained from the hospital managers and officials. Besides, some instructions about the research procedure and data gathering were provided in a briefing session for the participants. The researcher and the participants made the required arrangements and plans for conducting the training intervention. In the next step, the items on the instruments (the Hospital Emergency Response Checklist) were completed by the participants(pre-test). When completing the checklist, the officials and managers of the hospital were also interviewed to better identify the problems and challenges related to the surge capacity. After that, topics and concepts related to increasing surge capacity and hospital disaster preparedness were taught to the participants during a two-day workshop, and they did round table exercises. Following the National Hospital Emergency Preparedness and Response Instructions [ 1 ], the content of the workshop included hospital risk and hazard assessment, incident command system, early warning system, response plan, and enhancing hospital capacity in response to emergencies and disasters with emphasis on solving problems and weaknesses identified in the pre-intervention stage. After completing the training workshop, the participants were given a six-month opportunity to carry out interventions and transfer the training to other staff and nurses. During this period, the participants and other members of the disaster risk management committee attended meetings held every two weeks. In these meetings, the necessary actions for the next two weeks were set, and the officials to manage each action were specified. In addition, in each meeting, the extent to which the goals of the previous meeting were achieved and the reasons for not fulfilling them were discussed. Finally, the items in the Hospital Emergency Response Checklist were completed for the second time (post-test) and the collected data was analyzed.

Ethical considerations

To comply with ethical protocols, this research project was approved with the code of ethics of the Ethics Committee of the University of Rehabilitation Sciences and Social Health. Moreover, informed consent was obtained from all the participants. The participants completed the checklists anonymously and, they were assured that their participation was voluntary and had no impact on their evaluation procedure.

The participants in this study were 20 nursing managers and supervisors at Motahari Burn Hospital in Iran. The study participants had an average age of 38 years (30 to 52 years old) and an average work experience of 16 years (4 to 25 years). Most of the participants were female (15 persons), married (18 persons), had a bachelor’s degree (12 persons), and had served in managerial positions (9 persons). Table No. 1 Shows other demographic characteristics of the participants. The surge capacity enhancement strategies that were recognized and put into practice by the participants throughout the study(6 months) included: 1- Executing a memorandum with retired personnel and reactivating them when necessary, Executing a memorandum with the Iran University of Medical Sciences to hire students if needed, drafting instructions for requesting staff from the relevant authorities such as the Emergency Operations Center (EOC) of the Ministry of Health, in the realm of enhancing “staff” capacity. 2- Preparing and reserving medications and essential equipment for a minimum duration of 72 h, signing a memorandum with other hospitals and nearby health centers to provide equipment in emergencies, and also creating more water storage volume to be used in emergencies and disasters, in the realm of enhancing “stuff” capacity. 3- Identifying suitable non-clinical and clinical spaces in the Motahhari Hospital to place beds and admit patients during disasters and emergencies, concluding an agreement with a school near the hospital to provide physical space for the hospital, creating a new rehabilitation department in the hospital, enlarging the space of the emergency department in the realm of increasing “space” capacity. And, 4- developing plans and instructions necessary to manage the risk of emergencies and disasters, doing training and practice in the hospital, in the realm of enhancing “system” capacity. The data showed that hospital disaster preparedness was at an average level (184) before the intervention and reached the optimal level (216) after the intervention. Also, the results also demonstrated that, except for “continuity of essential services”, the intervention improved the hospital’s disaster preparedness score across all dimensions. Most notably, the intervention enhanced “surge capacity” by 10 units and “staff” by 6 units. For detailed information on the intervention’s effects on hospital preparedness dimensions, please refer to Table No. 2 .

This study aimed to examine how providing action research training to nursing managers enhances surge capacity and contributes to improving hospital disaster preparedness. Many hospitals may face numerous challenges due to inadequate preparedness in the face of disasters and the increased demand for healthcare services [ 36 , 37 ]. The results of this study indicated that implementing the surge capacity enhancement intervention for nursing managers and officials led to a 32-unit improvement in disaster preparedness at Motahari Hospital. This improvement was expected because surge capacity is one of the most important components of hospital disaster preparedness and response.

Regarding the impact of the intervention on enhancing hospital disaster preparedness, various studies have been conducted in Iran, each employing distinct approaches to bolster preparedness.

In a study conducted by Karimiyan et al. (2013), it was found that hospital preparedness training aligned with the national plan significantly enhanced the hospital’s preparedness to address emergencies and disasters [ 14 ]. Delshad et al. (2015) showed early warning system training improved the preparedness of Motahari Hospital in emergencies and disasters [ 15 ]. Also, Salawati et al. (2014) in another study, examined the effect of teaching and applying non-structural hospital safety principles for nurses on the preparedness of medical departments of several private and public hospitals in Tehran during disasters [ 16 ]. The findings indicated that the safety score of two non-structural and functional parts of the hospital safety index increased after the intervention. The authors concluded that teaching and applying non-structural safety principles to nurses improves hospital safety and preparedness [ 16 ].

Like numerous other hospitals in Iran [ 17 , 18 , 19 ], Motahari Hospital’s disaster preparedness status was assessed as moderate before the intervention. Nevertheless, some studies have indicated inadequacies in the preparedness level of the examined hospital. For example, both the investigation conducted by Hekmatkhah et al. [ 20 ] and that of Ojaghi et al. [ 21 ] revealed insufficient preparedness in the hospitals under examination.

The current study demonstrated that enhancing the hospital’s response capacity and hospital’s disaster preparedness across various components can be achieved through capacity-building training for nursing managers through action research. The greatest effect of the intervention in this study was on “surge capacity” and the “human resource” dimension(staff). This outcome can be primarily attributed to instructing the hospital surge capacity-building principles for participants in the training workshop. Additionally, due to steps were taken to augment capacity in terms of “human resources”, “medication, and equipment”. Two studies conducted in Iran have identified a shortage of human resources and equipment as a primary factor contributing to the limited preparedness of hospitals in dealing with disasters [ 22 , 23 ]. In this research, the re-employment of retired employees and the use of university students were among the most important strategies that were adopted to increase the hospital capacity and preparedness in the human resource dimension. Similarly, Dowlati et al. (2021) reported that the preparation of a list of employers from other hospitals and medical centers, including clinics and health students, is one of the most important strategies to increase the capacity of hospital staff to respond to chemical, biological, and nuclear hazards and disasters [ 38 ].

The results of this study show that the intervention improved the hospital preparedness scores in the “triage” and “command and control” dimensions. In this context, the educational intervention on triage by Rahmati and colleagues enhances the preparedness of the emergency department, as highlighted in their study [ 24 ]. Also, Delshad et al. conducted a study where actions such as designating an external location for triage and formulating a strategy for the postponement of elective surgeries contributed to an improvement in the hospital preparedness score [ 15 ].

The results of this study emphasize that enhancing hospital preparedness can be achieved through conducting a needs assessment, recognizing gaps within the organization as identified by study participants, and effectively communicating and raising awareness among hospital managers. In this context, Karimian et al. (2013) underscored the importance of providing additional training for officials, managers, and hospital staff concerning emergency preparedness and response in hospitals [ 14 ].

The data in the present study indicated the intervention had a smaller impact on the components of “continuity of essential services”, “logistics and supply”, and “safety and security” compared to other components of hospital preparedness. Perhaps one of the main reasons was the restricted timeframe of the study and limited financial resources to carry out capacity-building and preparedness measures in these dimensions. As stated earlier, measures to increase the surge capacity and improve preparedness were formulated and followed up during the meetings of the emergency and disaster risk committees. Since these meetings were held every two weeks, the 6-month timeframe of the study did not leave an opportunity to carry out measures to improve the mentioned components. Furthermore, the limited financial resources can be considered one of the main reasons for not carrying out the actions planned by the committee. The findings of the “logistics” and “essential services” are consistent with the findings of the study by Ingrassia et al. (2016). This study showed that hospital preparedness in these dimensions was poor [ 25 ]. The findings concerning the " logistics and supply” as well as the “countiniuty of essential services “dimensions in this research align with the outcomes observed in Ingrassia et al.‘s (2016) study, highlighting the inadequate preparedness of the hospital in these aspects [ 25 ].

Limitations

The study was constrained by a limited duration of 6 months and insufficient financial resources, restricting the ability to implement further measures to enhance hospital preparedness. Future investigations could overcome these limitations by extending the study period to at least one year and ensuring adequate financial resources. Furthermore, as this study solely assessed the impact of the intervention on the disaster preparedness level of a single hospital, statistical analysis could not be conducted due to the absence of mean and standard deviation data. The alterations were solely presented descriptively.

This study examined the effect of surge capacity training using an action research plan on disaster preparedness and response at Shahid Motahari Hospital in Tehran. The results showed that surge capacity enhancement training for nursing managers and officials increased their sensitivity to the importance of hospital emergency preparedness and response. Furthermore, their proactive involvement in recognizing capacities, deficiencies, problems, and weaknesses with appropriate tools and taking measures to address them can improve hospital emergency preparedness and response. The findings indicated that senior managers within the hospital can instigate changes through the provision of financial backing and the implementation of mandatory protocols.

Data availability

The datasets that were used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to express their acknowledgments to the staff at the Department of Postgraduate Studies in the University of Social Welfare and Rehabilitation Sciences and appreciate the sincere cooperation of hospital managers, officials, and staff of Shahid Motahhari Hospital for their contributions to conducting this research project.

This study was conducted as part of a master’s thesis at the University of Social Welfare and Rehabilitation Sciences.

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ASH, HKH design of the study, MB, ASH and NA collect and analysed the data and ASH, MB, HKH preparation of the manuscript.

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Shafiei, A., Arsalani, N., Beyrami Jam, M. et al. The impact of surge capacity enhancement training for nursing managers on hospital disaster preparedness and response: an action research study. BMC Emerg Med 24 , 153 (2024). https://doi.org/10.1186/s12873-024-00930-1

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DOI : https://doi.org/10.1186/s12873-024-00930-1

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