Want to know how to write an introduction/background section of a paper? Pay attention to STRUCTURE & evidence-based ARGUMENT in order to DIY (do-it-yourself) your own intro/background for a school paper or research report!
Focus only on the INTRO/BACKGROUND section for now. Check out the STRUCTURE then the EVIDENCE-BASED ARGUMENT of the Intro/Background. This is how you should write your own.
STRUCTURE of INTRO/BACKGROUND in Sørbø et al. (2015):
Where is the Intro/Background section located in the article?
What heading is used for the section?
Where are the research questionslocated in the Intro/Background? (HINT: this is the standard place in all papers & in this case the authors call them “aims.)
ARGUMENTS in INTRO/BACKGROUND in Sørbø et al. (2015):
Look at the first (topic) sentence of each paragraph in INTRO/BACKGROUND & listen to the systematic argument the researchers are making for WHY their study is important.
“Breast feeding has long been acknowledged as the optimal infant nutrition conferring beneficial short-term and long-term health effects for both infants and mothers.1–5 …
Abuse of women is common worldwide, as one in three women during lifetime suffer partner or non-partner abuse.10…Adverse effects [of abuse]… are barriers to breast feeding.*…
Given the overwhelming evidence of the positive effects of breast feeding, knowledge about factors influencing breastfeeding behaviour is essential….
We explored the impact of abuse of women on breastfeeding behaviour in a large prospective population in Norway where the expectations to breast feed are high, and breast feeding is facilitated in the work regulations….” (pp. 1-2)
Now look at the research & other evidence written down AFTER each of above key sentences that SUPPORT each idea.
Notice that the INTRO/BACKGROUND is NOT a series of abstracts of different studies!! Instead evidence is grouped into key arguments for the study: Breast feeding is best, Abuse is common, Abuse creates barriers to breastfeeding, & Therefore, knowing about factors affecting breastfeeding is important). [Note: Of course, if your particular professor or editor asks you to do a series of abstracts, then you must, but do group them in arguments like the topic sentences.]
All this leads naturally, logically to …(drum roll please!)…the research questions/hypotheses, which are the gaps in our knowledge that the research will fill. This sets up the rest of the research article!
Critical Thinking: Your turn! Write your own Intro/Background using
Structure:Placement in article, heading, placement of research question/hypothesis
Argument:Key idea topic sentences (make a list 1st) with supporting research & other evidence (your literature review).
In a couple of recent blog entries I noted what you can and cannot learn from research 1) titles & 2) abstracts. Now, let me introduce you to the next part of research article: Introduction (or sometimes called Background or no title at all!). Introduction immediately follows the abstract.
The introduction/background “[a] outlines the background of the problem or issue being examined, [b] summarizes the existing literature on the subject, and [c] states the research questions, objectives, and possibly hypothesis” (p. 6, Davies & Logan, 2012)
This section follows the abstract. It may or may not have a heading(s) of “Introduction” or “Background” or both. Like the abstract, the Introduction describes the problem in which the researcher is interested & sometimes the specific research question or hypothesis that will be measured.
In the Intro/Background you will get a more full description of why the problem is a priority for research and what is already known about the problem (i.e., literature review).
Key point #1: Articles & research that are reviewed in theIntro/Background should be mostly within the past 5-7 years. Sometimes included are classic works that may be much older OR sometimes no recent research exists. If recent articles aren’t used, this should raise some questions in your mind. You know well that healthcare changes all the time!! If old studies are used the author should explain.
Key point #2: The last sentence or two in theIntro/Background is usually the research question or hypothesis (unless the author awards it its own section). If you need to know the research question/hypothesis right away, you can skip straight to the end of the Intro/background—and there it is!
Don’t be fooled. It’s a lot of work to prepare something to publish, and you want your work to appear in a credible source and be accessible. It’s YOUR reputation!
If you are a student search for literature, it is important to know this also!! You want to use the highest quality evidence you can find for your projects.
My last blog post listed the usual sections of a research report (title, abstract, introduction, methods, results, & discussion/conclusion); and I illustrated the amazing things you can learn from only an article title!
This week? Abstracts. Abstracts are great; abstracts are not enough!
An abstract gives us only enough info to INaccurately apply the study findings to practice.
An abstract typically summarizes all the other sections of the article, such as the question the researcher wanted to answer, how the researcher collected data to answer it, and what that data showed. This is great when you are trying to get the general picture, but you should Never assume that the abstract tells you what you need to know.
Abstracts can misleadyou IF you do not read the rest of the article. They are only a short 100-200 words and so they leave out key information. You may misunderstand study results if you read only the abstract. An abstract’s 33,000 foot level description of a study, cannot reveal the same things that can be revealed in the up-close & personal description of the full article.
So…what is the takeaway? Definitely read the abstractto get thegeneral idea. Then read the full article beginning to end to get the full & beautiful picture of the study. Davies & Logan (2012) encourage us, Don’t give up reading the full article just because some parts of the study may be hard to understand. Just read and get what you can, then re-read the difficult-to-understand parts. Get some help with those PRN.
Critical thinking: What info is missing from the below abstract that you might want to know?
J Nurses Prof Dev. 2016 May-Jun;32(3):130-6. doi: 10.1097/NND.0000000000000227. Partnering to Promote Evidence-Based Practice in a Community Hospital: Implications for Nursing Professional Development Specialists. Highfield ME1, Collier A, Collins M, Crowley M.
ABSTRACT: Nursing professional development specialists working in community hospitals face significant barriers to evidence-based practice that academic medical centers do not. This article describes 7 years of a multifaceted, service academic partnership in a large, urban, community hospital. The partnership has strengthened the nursing professional development role in promoting evidence-based practice across the scope of practice and serves as a model for others.
More info on abstracts & other components of research articles? Check out Davies & Logan (2012) Reading Research published by Elsevier.
Research articles have relatively standardized sections:
• Title
• Abstract (overview of project that is somewhat incomplete)
• Introduction (purpose, problem, & background)
• Methods (sample, setting, measurements collected)
• Results (data analysis from measurements), &
• Discussion/conclusions (what the data analysis tells us about the original purpose & problem)
These may vary a little from article to article.
Let’s look at the TITLE for a minute. A good title is a mini-abstract. A good title will include:
• Key variables (remember a variable is something that varies, such as fatigue or satisfaction)
• Population studied
• Setting of study
• Design of study
For example take this research article title “What patients with abdominal pain expect about pain relief in the Emergency Department” by Yee et al in 2006 in JEN.
• Key thing that varies? Expectations about pain relief
• Population studied? ED patients with abdominal pain
• Setting? May be the ED
• Design? (not included, but those with experience in reading research would guess that it is probably a descriptive study—in other words it just describes the patients’ expectations without any intervention.)
Self-report by participants is one of the most common ways that researchers collect data, yet it is fraught with problems. Some worries for researchers are: “Will participants be honest or will they say what they think I want to hear?” “Will they understand the questions correctly?” “Will those who respond (as opposed to those who don’t respond) have unique ways of thinking so that my respondents do not represent everyone well?” and a BIG worry “Will they even fill out and return the questionnaire?”
One way to solve at least the latter 2 problems is to increase the response rate, and Edwards et al (2009 July 8) reviewed randomized trials to learn how to do just that!!
If you want to improve your questionnaire response rates, check it out! Here is Edwards et al.’s plain language summary as published in Cochrane Database of Systematic Reviews,where you can read the entire report.
Postal and electronic questionnaires are a relatively inexpensive way to collect information from people for research purposes. If people do not reply (so called ‘non-responders’), the research results will tend to be less accurate. This systematic review found several ways to increase response. People can be contacted before they are sent a postal questionnaire. Postal questionnaires can be sent by first class post or recorded delivery, and a stamped-return envelope can be provided. Questionnaires, letters and e-mails can be made more personal, and preferably kept short. Incentives can be offered, for example, a small amount of money with a postal questionnaire. One or more reminders can be sent with a copy of the questionnaire to people who do not reply.
Critical/reflective thinking: Imagine that you were asked to participate in a survey. Which of these strategies do you think would motivate or remind you to respond and why?
There are several ways to classify types of research. One way is qualitative versus quantitative–in other words, WORD vs. NUMBER data, methods, & analysis.
Qualitative research focuses on words (or sometimes images) and their meanings.
Quantitative research focuses on numbers or counting things and statistical analysis that yields probable meaning.
If you watch this short, easy-to-understand youtube clip, you’ll have all the basics that you need to understand these! Enjoy!
In honor of Nurse Week, I offer this tribute to the avant garde research work of Florence Nightingale in the Crimea that saved lives and set a precedent worth following.
Nightingale was a “passionate statistician” knowing that outcome data are convincing when one wants to change the world. She did not merely collect the data, but also documented it in a way that revealed its critical meaning for care.
As noted by John H. Lienhard (1998-2002): “Once you see Nightingale’s graph, the terrible picture is clear. The Russians were a minor enemy. The real enemies were cholera, typhus, and dysentery. Once the military looked at that eloquent graph, the modern army hospital system was inevitable. You and I are shown graphs every day. Some are honest; many are misleading….So you and I could use a Florence Nightingale today, as we drown in more undifferentiated data than anyone could’ve imagined during the Crimean War.” (Source: Leinhard, 1998-2002)
As McDonald (2001) writes in the BMJ free, full-text, Nightingale was “a systemic thinker and a “passionate statistician.” She insisted on improving care by making policy & care decisions based on “the best available government statistics and expertise, and the collection of new material where the existing stock was inadequate.”(p.68)
Moreover, her display of the data brought its message home through visual clarity!
Thus while Nightingale adhered to some well-accepted, but mistaken, scientific theories of the time (e.g., miasma) her work was superb and scientific in the best sense of the word. We could all learn from Florence.
CRITICAL THINKING: What issue in your own practice could be solved by more data? How could you collect that data? If you have data already, how can you display it so that it it meaningful to others and “brings the point home”?
Researchers collect two types of data in their studies
Numbers (called quantitative data)
Words & narratives (called qualitative data)
One source of rich word or narrative (qualitative) data for answering nursing questions is nurses’ stories. Dr. Pat Benner RN, author of Novice to Expert explains two things we can do to help nurses fully tell their stories so we can learn the most from their practice.
Listen well without interrupting
Help nurses ‘unpack’ their stories
Check out this excellent 2:59 video of Dr. Benner’s and revolutionize how you learn about nursing from nursing stories: Preview: The use of Narratives
Critical thinking: For a study using narratives in research see Leboul et al. (2017). Palliative sedation challenging the professional competency of health care providers and staff: A qualitative focus group and personal written narrative study. [full text available thru PubMed at https://www.ncbi.nlm.nih.gov/pubmed/28399846]. 1) Do you think the authors listened and unpacked information from the focus groups & written narratives; 2) Do you think there might be a difference in the way people write narratives and verbally tell narratives? 3) How might that difference if any affect the research findings?
Quasi-experiments are a lot of work, yet don’t have the same scientific powerto show cause and effect, as do randomized controlled trials (RCTs).An RCT would provide better support for any hypothesis that X causes Y. [As a quick review of what quasi-experimental versus RCT studies are, see “Of Mice & Cheese” and/or “Out of Control (Groups).”]
So why do quasi-experimental studies at all? Why not always do RCTs when we are testing cause and effect? Here are 3 reasons:
#1 Sometimes ETHICALLY the researcher canNOT randomly assign subjects to a control and an experimental group. If the researcher wants to compare health outcomes of smokers with non-smokers, the researcher cannot assign some people to smoke and others not to smoke! Why? Because we already know that smoking has significant harmful effects. (Of course, in a dictatorship, by using the police a researcher could assign them to smoke or not smoke, but I don’t think we wanna go there.)
#2 Sometimes PHYSICALLY the researcher canNOT randomly assign subjects to control & experimental groups. If the researcher wants to compare health outcomes of
individuals from different countries, it is physically impossible to assign country of origin.
#3 Sometimes FINANCIALLY the researcher canNOT afford to assign subjects randomly to control & experimental groups. It costs $ & time to get a list of subjects and then assign them to control & experimental groups using random numbers table or drawing names from a hat.
Thus, researchers sometimes are left with little alternative, but to do a quasi-experiment as the next best thing to an RCT, then discuss its limitations in research reports.
Critical Thinking: You read a research study in which a researcher recruits the 1st 100 patients on a surgical ward January-March quarter as a control group. Then the researcher recruits the 2nd 100 patients on that same surgical ward April-June for the experimental group. With the experimental group, the staff uses a new, standardized pain script for better pain communications. Then the pain communication outcomes of each group are compared statistically.
Is this a quasi-experiment or a randomized controlled trial (RCT)?
What factors (variables) might be the same among control & experimental groups in this study?
What factors (variables) might be different between control & experimental groups that might affect study outcomes?
How could you design an ethical & possible RCT that would overcome the problems with this study?
Why might you choose to do the study the same way that this researcher did?
review).
Abstracts can mislead 
encourage us, Don’t give up reading the full article just because some parts of the study may be hard to understand. Just read and get what you can, then re-read the difficult-to-understand parts. Get some help with those PRN.
questions correctly?” “Will those who respond (as opposed to those who don’t respond) have unique ways of thinking so that my respondents do not represent everyone well?” and a BIG worry “Will they even fill out and return the questionnaire?”
Postal and electronic questionnaires are a relatively inexpensive way to collect information from people for research purposes. If people do not reply (so called ‘non-responders’), the research results will tend to be less accurate. This systematic review found several ways to increase response. People can be contacted before they are sent a postal questionnaire. Postal questionnaires can be sent by first class post or recorded delivery, and a stamped-return envelope can be provided. Questionnaires, letters and e-mails can be made more personal, and preferably kept short. Incentives can be offered, for example, a small amount of money with 
a postal questionnaire. One or more reminders can be sent with a copy of the questionnaire to people who do not reply.
“Once you see Nightingale’s graph, the terrible picture is clear. The Russians were a minor enemy. The real enemies were cholera, typhus, and dysentery. Once the military looked at that eloquent graph, the modern army hospital system was inevitable. You and I are shown graphs every day. Some are honest; many are misleading….So you and I could use a Florence Nightingale today, as we drown in more undifferentiated data than anyone could’ve imagined during the Crimean War.” (Source: Leinhard, 1998-2002)
One source of rich word or narrative (qualitative) data for answering nursing questions is nurses’ stories. Dr. Pat Benner RN, author of Novice to Expert explains two things we can do to help nurses fully tell their stories so we can learn the most from their practice.
Quasi-experiments are a lot of work, yet don’t have the same scientific power to show cause and effect, as do randomized controlled trials (RCTs). An RCT would provide better support for any hypothesis that X causes Y. [As a quick review of what quasi-experimental versus RCT studies are, see 
and an experimental group. If the researcher wants to compare health outcomes of smokers with non-smokers, the researcher cannot assign some people to smoke and others not to smoke! Why? Because we already know that smoking has significant harmful effects. (Of course, in a dictatorship, by using the police a researcher could assign them to smoke or not smoke, but I don’t think we wanna go there.)
experimental groups. If the researcher wants to compare health outcomes of
to control & experimental groups. It costs $ & time to get a list of subjects and then assign them to control & experimental groups using random numbers table or drawing names from a hat.