Understanding: What is an example of a problem statement in nursing?

October 2, 2025 •

4 min read

According to the American Nurses Association, effective problem identification is the bedrock of patient-centered care. This guide will clarify what is an example of a problem statement in nursing, detailing how it guides research and clinical practice to enhance patient outcomes.

Quick Summary

A nursing problem statement outlines a patient's health issue and its contributing factors, as seen in the PES format, or frames a research question using the PICO structure to guide a study. Examples often include a diagnosis, related cause, and supporting evidence.

Key Points

PES Format: Patient-centered problem statements commonly use the PES (Problem, Etiology, Symptoms) format to guide individual patient care plans.
PICO Format: For nursing research, the PICO (Patient, Intervention, Comparison, Outcome) framework helps structure and define clinical questions for a study.
Not a Medical Diagnosis: A nursing problem statement focuses on the patient's response to their condition, distinguishing it from a physician's medical diagnosis.
Clear and Concise: An effective problem statement is specific, clear, and focused on a single issue to ensure effective interventions.
Supported by Evidence: Patient-focused problem statements are supported by "defining characteristics," or evidence like symptoms and signs, observed by the nurse.
Guides Care and Research: Problem statements are essential tools that guide both immediate patient interventions and the long-term direction of nursing research.

The Foundation of Care: What Is a Problem Statement in Nursing?

In nursing, a problem statement is a concise, clear description of an actual or potential patient health problem that requires nursing intervention. It serves as the foundation for the nursing care plan and directs the care provided. For research, the problem statement defines the core issue that the study will address. Unlike a medical diagnosis, which focuses on the disease, a nursing problem statement addresses the patient's individual response to a health condition.

Examples of Patient-Centered Problem Statements (PES Format)

One of the most common frameworks for formulating patient-centered problem statements is the PES format (Problem, Etiology, Symptoms), based on the NANDA-I (North American Nursing Diagnosis Association-International) classification. Here are a few examples:

Acute Pain related to decreased myocardial flow as evidenced by grimacing, expression of pain, and guarding behavior.
Impaired Physical Mobility related to decreased muscle control as evidenced by the inability to control lower extremities.
Risk for Impaired Tissue Integrity related to the client's refusal to turn.
Ineffective Coping related to inadequate perception of the problem as evidenced by poor eye contact and expressions of helplessness.
Altered Urinary Elimination related to urinary tract infection as evidenced by reported pain and increased frequency.

Examples of Research-Focused Problem Statements (PICO Format)

For nursing research, a problem statement often follows the PICO format (Patient/Population, Intervention, Comparison, Outcome) to guide the investigation into clinical questions. These statements frame a gap in knowledge that a study aims to fill. Here are some examples:

Question: It is unknown if or to what degree the implementation of a patient engagement toolkit would impact glycemic levels in adult patients in a rural clinic.
Intervention Study: In mechanically ventilated ICU patients, does positioning the patient in semi-fowlers result in a lower incidence of nosocomial pneumonia when compared to the supine position?
Process Improvement: Day shift nurses are frustrated with charting due to inefficiencies in searching for patient information. This problem takes time away from direct patient care.

Comparing Different Types of Problem Statements

Understanding the context is key, as problem statements for a care plan differ from those for research. The table below outlines the primary distinctions.


Aspect	Patient Care Problem Statement (PES)	Nursing Research Problem Statement (PICO)
Purpose	To guide a specific patient's immediate care and interventions.	To identify a gap in knowledge or practice that requires investigation.
Focus	An individual patient's response to their medical condition.	A broader question about a population, practice, or intervention.
Components	Problem, Etiology (related to), Signs/Symptoms (as evidenced by).	Population, Intervention, Comparison, Outcome.
Scope	Narrow, focused on one patient's specific issues.	Broad, potentially affecting many patients or the entire healthcare system.
Outcome	Improved patient health, resolved symptoms, or managed risk.	New knowledge, evidence for best practices, or policy changes.

How to Write a Strong Problem Statement

Crafting an effective problem statement is a critical skill for nurses. Follow these steps to develop a robust statement for either a care plan or research project.

Identify the Core Problem: What is the central issue? Is it a symptom, a patient behavior, or an inefficiency in a clinical process? Focus on the problem itself, not the solution. Start by observing and documenting patient symptoms or frustrations with a current process.
Determine the Cause (Etiology): For a patient, what is causing the issue? Is it pain, anxiety, or a physical limitation? For a research project, what is the root cause of the current undesirable state? Use tools like the "5 Whys" to dig deeper past surface-level symptoms.
Gather Evidence (Defining Characteristics): For patient care, what signs and symptoms confirm your assessment? These are the "as evidenced by" (AEB) components. This is crucial for justifying the nursing diagnosis.
Formulate the Statement: Combine the identified elements into a clear, concise statement. For research, this might involve turning the problem into a question using the PICO framework. For care plans, use the PES format.
Refine and Focus: Ensure the statement is specific and focused. A single problem statement should target one issue. If you have multiple problems, write a separate statement for each one and prioritize them based on urgency and impact.

The Importance of a Well-Defined Problem Statement

Without a clear problem statement, nursing care can become reactive and fragmented. It ensures all team members are on the same page regarding the patient's needs and the goals of care. For researchers, it provides a clear roadmap for the study, from methodology to intended outcomes. A strong problem statement ultimately leads to more effective and evidence-based nursing practice.

For more detailed guidance on formulating nursing diagnoses and care plans, consult the resources provided by professional organizations like NANDA International.

Conclusion

Problem statements are an indispensable tool in nursing, whether for individual patient care or large-scale research initiatives. From the specific, patient-focused PES format to the broader, research-guiding PICO question, these statements provide clarity and direction. By mastering the art of crafting effective problem statements, nurses can elevate their practice, improve patient outcomes, and contribute meaningfully to the advancement of healthcare. The ability to precisely articulate a patient's health problem is a hallmark of skilled, evidence-based nursing.

Frequently Asked Questions

A medical diagnosis identifies a specific disease or medical condition, such as diabetes or a stroke. A nursing problem statement, on the other hand, describes the patient's individual response to their health condition, like 'Impaired physical mobility' or 'Anxiety', which guides specific nursing interventions.

Yes, a nursing problem statement can address potential problems. This is known as a "risk nursing diagnosis." An example would be 'Risk for impaired tissue integrity' for a bedridden patient, which allows nurses to proactively plan interventions to prevent the problem from occurring.

The PES format stands for Problem, Etiology, and Symptoms. This structure is used to create clear, three-part nursing diagnostic statements that include the patient's health issue (Problem), the related cause (Etiology), and the signs or symptoms (Symptoms) that provide evidence for the diagnosis.

Including the 'as evidenced by' (AEB) component is critical because it provides objective and subjective evidence to support the nursing diagnosis. This ensures the problem statement is based on observable patient data and not just an assumption, justifying the planned interventions.

The etiology is the contributing factor or cause of the patient's problem. You can identify it by asking yourself 'why' the problem is happening. For instance, if the problem is 'Acute Pain', the etiology might be 'decreased myocardial flow' in a patient experiencing a heart attack.

While PICO (Patient, Intervention, Comparison, Outcome) is an excellent framework for clinical intervention questions, other formats exist for different types of research. For qualitative research, for instance, PEO (Population, Exposure, Outcome) might be more appropriate to explore experiences or perspectives.

An effective nursing problem statement is accurate, concise, and focused. It should clearly identify the patient's problem and its cause based on evidence. It must be specific enough to guide targeted nursing interventions and measurable to evaluate the effectiveness of the care plan.