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• How to Write a Discussion Section | Tips & Examples

How to Write a Discussion Section | Tips & Examples

Published on August 21, 2022 by Shona McCombes . Revised on July 18, 2023.

The discussion section is where you delve into the meaning, importance, and relevance of your results .

It should focus on explaining and evaluating what you found, showing how it relates to your literature review and paper or dissertation topic , and making an argument in support of your overall conclusion. It should not be a second results section.

There are different ways to write this section, but you can focus your writing around these key elements:

• Summary : A brief recap of your key results
• Interpretations: What do your results mean?
• Implications: Why do your results matter?
• Limitations: What can’t your results tell us?
• Recommendations: Avenues for further studies or analyses

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Table of contents

What not to include in your discussion section, step 1: summarize your key findings, step 2: give your interpretations, step 3: discuss the implications, step 4: acknowledge the limitations, step 5: share your recommendations, discussion section example, other interesting articles, frequently asked questions about discussion sections.

There are a few common mistakes to avoid when writing the discussion section of your paper.

• Don’t introduce new results: You should only discuss the data that you have already reported in your results section .
• Don’t make inflated claims: Avoid overinterpretation and speculation that isn’t directly supported by your data.
• Don’t undermine your research: The discussion of limitations should aim to strengthen your credibility, not emphasize weaknesses or failures.

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Start this section by reiterating your research problem and concisely summarizing your major findings. To speed up the process you can use a summarizer to quickly get an overview of all important findings. Don’t just repeat all the data you have already reported—aim for a clear statement of the overall result that directly answers your main research question . This should be no more than one paragraph.

Many students struggle with the differences between a discussion section and a results section . The crux of the matter is that your results sections should present your results, and your discussion section should subjectively evaluate them. Try not to blend elements of these two sections, in order to keep your paper sharp.

• The results indicate that…
• The study demonstrates a correlation between…
• This analysis supports the theory that…
• The data suggest that…

The meaning of your results may seem obvious to you, but it’s important to spell out their significance for your reader, showing exactly how they answer your research question.

The form of your interpretations will depend on the type of research, but some typical approaches to interpreting the data include:

• Identifying correlations , patterns, and relationships among the data
• Discussing whether the results met your expectations or supported your hypotheses
• Contextualizing your findings within previous research and theory
• Explaining unexpected results and evaluating their significance
• Considering possible alternative explanations and making an argument for your position

You can organize your discussion around key themes, hypotheses, or research questions, following the same structure as your results section. Alternatively, you can also begin by highlighting the most significant or unexpected results.

• In line with the hypothesis…
• Contrary to the hypothesized association…
• The results contradict the claims of Smith (2022) that…
• The results might suggest that x . However, based on the findings of similar studies, a more plausible explanation is y .

As well as giving your own interpretations, make sure to relate your results back to the scholarly work that you surveyed in the literature review . The discussion should show how your findings fit with existing knowledge, what new insights they contribute, and what consequences they have for theory or practice.

Ask yourself these questions:

• Do your results support or challenge existing theories? If they support existing theories, what new information do they contribute? If they challenge existing theories, why do you think that is?
• Are there any practical implications?

Your overall aim is to show the reader exactly what your research has contributed, and why they should care.

• These results build on existing evidence of…
• The results do not fit with the theory that…
• The experiment provides a new insight into the relationship between…
• These results should be taken into account when considering how to…
• The data contribute a clearer understanding of…
• While previous research has focused on  x , these results demonstrate that y .

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Even the best research has its limitations. Acknowledging these is important to demonstrate your credibility. Limitations aren’t about listing your errors, but about providing an accurate picture of what can and cannot be concluded from your study.

Limitations might be due to your overall research design, specific methodological choices , or unanticipated obstacles that emerged during your research process.

Here are a few common possibilities:

• If your sample size was small or limited to a specific group of people, explain how generalizability is limited.
• If you encountered problems when gathering or analyzing data, explain how these influenced the results.
• If there are potential confounding variables that you were unable to control, acknowledge the effect these may have had.

After noting the limitations, you can reiterate why the results are nonetheless valid for the purpose of answering your research question.

• The generalizability of the results is limited by…
• The reliability of these data is impacted by…
• Due to the lack of data on x , the results cannot confirm…
• The methodological choices were constrained by…
• It is beyond the scope of this study to…

Based on the discussion of your results, you can make recommendations for practical implementation or further research. Sometimes, the recommendations are saved for the conclusion .

Suggestions for further research can lead directly from the limitations. Don’t just state that more studies should be done—give concrete ideas for how future work can build on areas that your own research was unable to address.

• Further research is needed to establish…
• Future studies should take into account…
• Avenues for future research include…

If you want to know more about AI for academic writing, AI tools, or research bias, make sure to check out some of our other articles with explanations and examples or go directly to our tools!

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In the discussion , you explore the meaning and relevance of your research results , explaining how they fit with existing research and theory. Discuss:

• Your  interpretations : what do the results tell us?
• The  implications : why do the results matter?
• The  limitation s : what can’t the results tell us?

The results chapter or section simply and objectively reports what you found, without speculating on why you found these results. The discussion interprets the meaning of the results, puts them in context, and explains why they matter.

In qualitative research , results and discussion are sometimes combined. But in quantitative research , it’s considered important to separate the objective results from your interpretation of them.

In a thesis or dissertation, the discussion is an in-depth exploration of the results, going into detail about the meaning of your findings and citing relevant sources to put them in context.

The conclusion is more shorter and more general: it concisely answers your main research question and makes recommendations based on your overall findings.

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The purpose of the discussion section is to interpret and describe the significance of your findings in relation to what was already known about the research problem being investigated and to explain any new understanding or insights that emerged as a result of your research. The discussion will always connect to the introduction by way of the research questions or hypotheses you posed and the literature you reviewed, but the discussion does not simply repeat or rearrange the first parts of your paper; the discussion clearly explains how your study advanced the reader's understanding of the research problem from where you left them at the end of your review of prior research.

Annesley, Thomas M. “The Discussion Section: Your Closing Argument.” Clinical Chemistry 56 (November 2010): 1671-1674; Peacock, Matthew. “Communicative Moves in the Discussion Section of Research Articles.” System 30 (December 2002): 479-497.

Importance of a Good Discussion

The discussion section is often considered the most important part of your research paper because it:

• Most effectively demonstrates your ability as a researcher to think critically about an issue, to develop creative solutions to problems based upon a logical synthesis of the findings, and to formulate a deeper, more profound understanding of the research problem under investigation;
• Presents the underlying meaning of your research, notes possible implications in other areas of study, and explores possible improvements that can be made in order to further develop the concerns of your research;
• Highlights the importance of your study and how it can contribute to understanding the research problem within the field of study;
• Presents how the findings from your study revealed and helped fill gaps in the literature that had not been previously exposed or adequately described; and,
• Engages the reader in thinking critically about issues based on an evidence-based interpretation of findings; it is not governed strictly by objective reporting of information.

Annesley Thomas M. “The Discussion Section: Your Closing Argument.” Clinical Chemistry 56 (November 2010): 1671-1674; Bitchener, John and Helen Basturkmen. “Perceptions of the Difficulties of Postgraduate L2 Thesis Students Writing the Discussion Section.” Journal of English for Academic Purposes 5 (January 2006): 4-18; Kretchmer, Paul. Fourteen Steps to Writing an Effective Discussion Section. San Francisco Edit, 2003-2008.

Structure and Writing Style

I.  General Rules

These are the general rules you should adopt when composing your discussion of the results :

• Do not be verbose or repetitive; be concise and make your points clearly
• Avoid the use of jargon or undefined technical language
• Follow a logical stream of thought; in general, interpret and discuss the significance of your findings in the same sequence you described them in your results section [a notable exception is to begin by highlighting an unexpected result or a finding that can grab the reader's attention]
• Use the present verb tense, especially for established facts; however, refer to specific works or prior studies in the past tense
• If needed, use subheadings to help organize your discussion or to categorize your interpretations into themes

II.  The Content

The content of the discussion section of your paper most often includes :

• Explanation of results : Comment on whether or not the results were expected for each set of findings; go into greater depth to explain findings that were unexpected or especially profound. If appropriate, note any unusual or unanticipated patterns or trends that emerged from your results and explain their meaning in relation to the research problem.
• References to previous research : Either compare your results with the findings from other studies or use the studies to support a claim. This can include re-visiting key sources already cited in your literature review section, or, save them to cite later in the discussion section if they are more important to compare with your results instead of being a part of the general literature review of prior research used to provide context and background information. Note that you can make this decision to highlight specific studies after you have begun writing the discussion section.
• Deduction : A claim for how the results can be applied more generally. For example, describing lessons learned, proposing recommendations that can help improve a situation, or highlighting best practices.
• Hypothesis : A more general claim or possible conclusion arising from the results [which may be proved or disproved in subsequent research]. This can be framed as new research questions that emerged as a consequence of your analysis.

III.  Organization and Structure

Keep the following sequential points in mind as you organize and write the discussion section of your paper:

• Think of your discussion as an inverted pyramid. Organize the discussion from the general to the specific, linking your findings to the literature, then to theory, then to practice [if appropriate].
• Use the same key terms, narrative style, and verb tense [present] that you used when describing the research problem in your introduction.
• Begin by briefly re-stating the research problem you were investigating and answer all of the research questions underpinning the problem that you posed in the introduction.
• Describe the patterns, principles, and relationships shown by each major findings and place them in proper perspective. The sequence of this information is important; first state the answer, then the relevant results, then cite the work of others. If appropriate, refer the reader to a figure or table to help enhance the interpretation of the data [either within the text or as an appendix].
• Regardless of where it's mentioned, a good discussion section includes analysis of any unexpected findings. This part of the discussion should begin with a description of the unanticipated finding, followed by a brief interpretation as to why you believe it appeared and, if necessary, its possible significance in relation to the overall study. If more than one unexpected finding emerged during the study, describe each of them in the order they appeared as you gathered or analyzed the data. As noted, the exception to discussing findings in the same order you described them in the results section would be to begin by highlighting the implications of a particularly unexpected or significant finding that emerged from the study, followed by a discussion of the remaining findings.
• Before concluding the discussion, identify potential limitations and weaknesses if you do not plan to do so in the conclusion of the paper. Comment on their relative importance in relation to your overall interpretation of the results and, if necessary, note how they may affect the validity of your findings. Avoid using an apologetic tone; however, be honest and self-critical [e.g., in retrospect, had you included a particular question in a survey instrument, additional data could have been revealed].
• The discussion section should end with a concise summary of the principal implications of the findings regardless of their significance. Give a brief explanation about why you believe the findings and conclusions of your study are important and how they support broader knowledge or understanding of the research problem. This can be followed by any recommendations for further research. However, do not offer recommendations which could have been easily addressed within the study. This would demonstrate to the reader that you have inadequately examined and interpreted the data.

IV.  Overall Objectives

The objectives of your discussion section should include the following: I.  Reiterate the Research Problem/State the Major Findings

Briefly reiterate the research problem or problems you are investigating and the methods you used to investigate them, then move quickly to describe the major findings of the study. You should write a direct, declarative, and succinct proclamation of the study results, usually in one paragraph.

II.  Explain the Meaning of the Findings and Why They are Important

No one has thought as long and hard about your study as you have. Systematically explain the underlying meaning of your findings and state why you believe they are significant. After reading the discussion section, you want the reader to think critically about the results and why they are important. You don’t want to force the reader to go through the paper multiple times to figure out what it all means. If applicable, begin this part of the section by repeating what you consider to be your most significant or unanticipated finding first, then systematically review each finding. Otherwise, follow the general order you reported the findings presented in the results section.

III.  Relate the Findings to Similar Studies

No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your results to those found in other studies, particularly if questions raised from prior studies served as the motivation for your research. This is important because comparing and contrasting the findings of other studies helps to support the overall importance of your results and it highlights how and in what ways your study differs from other research about the topic. Note that any significant or unanticipated finding is often because there was no prior research to indicate the finding could occur. If there is prior research to indicate this, you need to explain why it was significant or unanticipated. IV.  Consider Alternative Explanations of the Findings

It is important to remember that the purpose of research in the social sciences is to discover and not to prove . When writing the discussion section, you should carefully consider all possible explanations for the study results, rather than just those that fit your hypothesis or prior assumptions and biases. This is especially important when describing the discovery of significant or unanticipated findings.

V.  Acknowledge the Study’s Limitations

It is far better for you to identify and acknowledge your study’s limitations than to have them pointed out by your professor! Note any unanswered questions or issues your study could not address and describe the generalizability of your results to other situations. If a limitation is applicable to the method chosen to gather information, then describe in detail the problems you encountered and why. VI.  Make Suggestions for Further Research

You may choose to conclude the discussion section by making suggestions for further research [as opposed to offering suggestions in the conclusion of your paper]. Although your study can offer important insights about the research problem, this is where you can address other questions related to the problem that remain unanswered or highlight hidden issues that were revealed as a result of conducting your research. You should frame your suggestions by linking the need for further research to the limitations of your study [e.g., in future studies, the survey instrument should include more questions that ask..."] or linking to critical issues revealed from the data that were not considered initially in your research.

NOTE: Besides the literature review section, the preponderance of references to sources is usually found in the discussion section . A few historical references may be helpful for perspective, but most of the references should be relatively recent and included to aid in the interpretation of your results, to support the significance of a finding, and/or to place a finding within a particular context. If a study that you cited does not support your findings, don't ignore it--clearly explain why your research findings differ from theirs.

V.  Problems to Avoid

• Do not waste time restating your results . Should you need to remind the reader of a finding to be discussed, use "bridge sentences" that relate the result to the interpretation. An example would be: “In the case of determining available housing to single women with children in rural areas of Texas, the findings suggest that access to good schools is important...," then move on to further explaining this finding and its implications.
• As noted, recommendations for further research can be included in either the discussion or conclusion of your paper, but do not repeat your recommendations in the both sections. Think about the overall narrative flow of your paper to determine where best to locate this information. However, if your findings raise a lot of new questions or issues, consider including suggestions for further research in the discussion section.
• Do not introduce new results in the discussion section. Be wary of mistaking the reiteration of a specific finding for an interpretation because it may confuse the reader. The description of findings [results section] and the interpretation of their significance [discussion section] should be distinct parts of your paper. If you choose to combine the results section and the discussion section into a single narrative, you must be clear in how you report the information discovered and your own interpretation of each finding. This approach is not recommended if you lack experience writing college-level research papers.
• Use of the first person pronoun is generally acceptable. Using first person singular pronouns can help emphasize a point or illustrate a contrasting finding. However, keep in mind that too much use of the first person can actually distract the reader from the main points [i.e., I know you're telling me this--just tell me!].

Analyzing vs. Summarizing. Department of English Writing Guide. George Mason University; Discussion. The Structure, Format, Content, and Style of a Journal-Style Scientific Paper. Department of Biology. Bates College; Hess, Dean R. "How to Write an Effective Discussion." Respiratory Care 49 (October 2004); Kretchmer, Paul. Fourteen Steps to Writing to Writing an Effective Discussion Section. San Francisco Edit, 2003-2008; The Lab Report. University College Writing Centre. University of Toronto; Sauaia, A. et al. "The Anatomy of an Article: The Discussion Section: "How Does the Article I Read Today Change What I Will Recommend to my Patients Tomorrow?” The Journal of Trauma and Acute Care Surgery 74 (June 2013): 1599-1602; Research Limitations & Future Research . Lund Research Ltd., 2012; Summary: Using it Wisely. The Writing Center. University of North Carolina; Schafer, Mickey S. Writing the Discussion. Writing in Psychology course syllabus. University of Florida; Yellin, Linda L. A Sociology Writer's Guide . Boston, MA: Allyn and Bacon, 2009.

Writing Tip

Don’t Over-Interpret the Results!

Interpretation is a subjective exercise. As such, you should always approach the selection and interpretation of your findings introspectively and to think critically about the possibility of judgmental biases unintentionally entering into discussions about the significance of your work. With this in mind, be careful that you do not read more into the findings than can be supported by the evidence you have gathered. Remember that the data are the data: nothing more, nothing less.

MacCoun, Robert J. "Biases in the Interpretation and Use of Research Results." Annual Review of Psychology 49 (February 1998): 259-287; Ward, Paulet al, editors. The Oxford Handbook of Expertise . Oxford, UK: Oxford University Press, 2018.

Another Writing Tip

Don't Write Two Results Sections!

One of the most common mistakes that you can make when discussing the results of your study is to present a superficial interpretation of the findings that more or less re-states the results section of your paper. Obviously, you must refer to your results when discussing them, but focus on the interpretation of those results and their significance in relation to the research problem, not the data itself.

Azar, Beth. "Discussing Your Findings."  American Psychological Association gradPSYCH Magazine (January 2006).

Yet Another Writing Tip

Avoid Unwarranted Speculation!

The discussion section should remain focused on the findings of your study. For example, if the purpose of your research was to measure the impact of foreign aid on increasing access to education among disadvantaged children in Bangladesh, it would not be appropriate to speculate about how your findings might apply to populations in other countries without drawing from existing studies to support your claim or if analysis of other countries was not a part of your original research design. If you feel compelled to speculate, do so in the form of describing possible implications or explaining possible impacts. Be certain that you clearly identify your comments as speculation or as a suggestion for where further research is needed. Sometimes your professor will encourage you to expand your discussion of the results in this way, while others don’t care what your opinion is beyond your effort to interpret the data in relation to the research problem.

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Guide to Writing the Results and Discussion Sections of a Scientific Article

A quality research paper has both the qualities of in-depth research and good writing ( Bordage, 2001 ). In addition, a research paper must be clear, concise, and effective when presenting the information in an organized structure with a logical manner ( Sandercock, 2013 ).

In this article, we will take a closer look at the results and discussion section. Composing each of these carefully with sufficient data and well-constructed arguments can help improve your paper overall.

The results section of your research paper contains a description about the main findings of your research, whereas the discussion section interprets the results for readers and provides the significance of the findings. The discussion should not repeat the results.

Let’s dive in a little deeper about how to properly, and clearly organize each part.

How to Organize the Results Section

Since your results follow your methods, you’ll want to provide information about what you discovered from the methods you used, such as your research data. In other words, what were the outcomes of the methods you used?

You may also include information about the measurement of your data, variables, treatments, and statistical analyses.

To start, organize your research data based on how important those are in relation to your research questions. This section should focus on showing major results that support or reject your research hypothesis. Include your least important data as supplemental materials when submitting to the journal.

The next step is to prioritize your research data based on importance – focusing heavily on the information that directly relates to your research questions using the subheadings.

The organization of the subheadings for the results section usually mirrors the methods section. It should follow a logical and chronological order.

Subheading organization

Subheadings within your results section are primarily going to detail major findings within each important experiment. And the first paragraph of your results section should be dedicated to your main findings (findings that answer your overall research question and lead to your conclusion) (Hofmann, 2013).

In the book “Writing in the Biological Sciences,” author Angelika Hofmann recommends you structure your results subsection paragraphs as follows:

• Experimental purpose
• Interpretation

Each subheading may contain a combination of ( Bahadoran, 2019 ; Hofmann, 2013, pg. 62-63):

• Text: to explain about the research data
• Figures: to display the research data and to show trends or relationships, for examples using graphs or gel pictures.
• Tables: to represent a large data and exact value

Decide on the best way to present your data — in the form of text, figures or tables (Hofmann, 2013).

Data or Results?

Sometimes we get confused about how to differentiate between data and results . Data are information (facts or numbers) that you collected from your research ( Bahadoran, 2019 ).

Whereas, results are the texts presenting the meaning of your research data ( Bahadoran, 2019 ).

One mistake that some authors often make is to use text to direct the reader to find a specific table or figure without further explanation. This can confuse readers when they interpret data completely different from what the authors had in mind. So, you should briefly explain your data to make your information clear for the readers.

Common Elements in Figures and Tables

Figures and tables present information about your research data visually. The use of these visual elements is necessary so readers can summarize, compare, and interpret large data at a glance. You can use graphs or figures to compare groups or patterns. Whereas, tables are ideal to present large quantities of data and exact values.

Several components are needed to create your figures and tables. These elements are important to sort your data based on groups (or treatments). It will be easier for the readers to see the similarities and differences among the groups.

When presenting your research data in the form of figures and tables, organize your data based on the steps of the research leading you into a conclusion.

Common elements of the figures (Bahadoran, 2019):

• Figure number
• Figure title
• Figure legend (for example a brief title, experimental/statistical information, or definition of symbols).

Tables in the result section may contain several elements (Bahadoran, 2019):

• Table number
• Table title
• Row headings (for example groups)
• Column headings
• Row subheadings (for example categories or groups)
• Column subheadings (for example categories or variables)
• Footnotes (for example statistical analyses)

Tips to Write the Results Section

• Direct the reader to the research data and explain the meaning of the data.
• Avoid using a repetitive sentence structure to explain a new set of data.
• Write and highlight important findings in your results.
• Use the same order as the subheadings of the methods section.
• Match the results with the research questions from the introduction. Your results should answer your research questions.
• Be sure to mention the figures and tables in the body of your text.
• Make sure there is no mismatch between the table number or the figure number in text and in figure/tables.
• Only present data that support the significance of your study. You can provide additional data in tables and figures as supplementary material.

How to Organize the Discussion Section

It’s not enough to use figures and tables in your results section to convince your readers about the importance of your findings. You need to support your results section by providing more explanation in the discussion section about what you found.

In the discussion section, based on your findings, you defend the answers to your research questions and create arguments to support your conclusions.

Below is a list of questions to guide you when organizing the structure of your discussion section ( Viera et al ., 2018 ):

• What experiments did you conduct and what were the results?
• What do the results mean?
• What were the important results from your study?
• How did the results answer your research questions?
• Did your results support your hypothesis or reject your hypothesis?
• What are the variables or factors that might affect your results?
• What were the strengths and limitations of your study?
• What other published works support your findings?
• What other published works contradict your findings?
• What possible factors might cause your findings different from other findings?
• What is the significance of your research?
• What are new research questions to explore based on your findings?

Organizing the Discussion Section

The structure of the discussion section may be different from one paper to another, but it commonly has a beginning, middle-, and end- to the section.

One way to organize the structure of the discussion section is by dividing it into three parts (Ghasemi, 2019):

• The beginning: The first sentence of the first paragraph should state the importance and the new findings of your research. The first paragraph may also include answers to your research questions mentioned in your introduction section.
• The middle: The middle should contain the interpretations of the results to defend your answers, the strength of the study, the limitations of the study, and an update literature review that validates your findings.
• The end: The end concludes the study and the significance of your research.

Another possible way to organize the discussion section was proposed by Michael Docherty in British Medical Journal: is by using this structure ( Docherty, 1999 ):

• Discussion of important findings
• Comparison of your results with other published works
• Include the strengths and limitations of the study
• Conclusion and possible implications of your study, including the significance of your study – address why and how is it meaningful
• Future research questions based on your findings

Finally, a last option is structuring your discussion this way (Hofmann, 2013, pg. 104):

• First Paragraph: Provide an interpretation based on your key findings. Then support your interpretation with evidence.
• Secondary results
• Limitations
• Unexpected findings
• Comparisons to previous publications
• Last Paragraph: The last paragraph should provide a summarization (conclusion) along with detailing the significance, implications and potential next steps.

Remember, at the heart of the discussion section is presenting an interpretation of your major findings.

Tips to Write the Discussion Section

• Highlight the significance of your findings
• Mention how the study will fill a gap in knowledge.
• Indicate the implication of your research.
• Avoid generalizing, misinterpreting your results, drawing a conclusion with no supportive findings from your results.

Aggarwal, R., & Sahni, P. (2018). The Results Section. In Reporting and Publishing Research in the Biomedical Sciences (pp. 21-38): Springer.

Bahadoran, Z., Mirmiran, P., Zadeh-Vakili, A., Hosseinpanah, F., & Ghasemi, A. (2019). The principles of biomedical scientific writing: Results. International journal of endocrinology and metabolism, 17(2).

Bordage, G. (2001). Reasons reviewers reject and accept manuscripts: the strengths and weaknesses in medical education reports. Academic medicine, 76(9), 889-896.

Cals, J. W., & Kotz, D. (2013). Effective writing and publishing scientific papers, part VI: discussion. Journal of clinical epidemiology, 66(10), 1064.

Docherty, M., & Smith, R. (1999). The case for structuring the discussion of scientific papers: Much the same as that for structuring abstracts. In: British Medical Journal Publishing Group.

Faber, J. (2017). Writing scientific manuscripts: most common mistakes. Dental press journal of orthodontics, 22(5), 113-117.

Fletcher, R. H., & Fletcher, S. W. (2018). The discussion section. In Reporting and Publishing Research in the Biomedical Sciences (pp. 39-48): Springer.

Ghasemi, A., Bahadoran, Z., Mirmiran, P., Hosseinpanah, F., Shiva, N., & Zadeh-Vakili, A. (2019). The Principles of Biomedical Scientific Writing: Discussion. International journal of endocrinology and metabolism, 17(3).

Hofmann, A. H. (2013). Writing in the biological sciences: a comprehensive resource for scientific communication . New York: Oxford University Press.

Kotz, D., & Cals, J. W. (2013). Effective writing and publishing scientific papers, part V: results. Journal of clinical epidemiology, 66(9), 945.

Mack, C. (2014). How to Write a Good Scientific Paper: Structure and Organization. Journal of Micro/ Nanolithography, MEMS, and MOEMS, 13. doi:10.1117/1.JMM.13.4.040101

Moore, A. (2016). What's in a Discussion section? Exploiting 2‐dimensionality in the online world…. Bioessays, 38(12), 1185-1185.

Peat, J., Elliott, E., Baur, L., & Keena, V. (2013). Scientific writing: easy when you know how: John Wiley & Sons.

Sandercock, P. M. L. (2012). How to write and publish a scientific article. Canadian Society of Forensic Science Journal, 45(1), 1-5.

Teo, E. K. (2016). Effective Medical Writing: The Write Way to Get Published. Singapore Medical Journal, 57(9), 523-523. doi:10.11622/smedj.2016156

Van Way III, C. W. (2007). Writing a scientific paper. Nutrition in Clinical Practice, 22(6), 636-640.

Vieira, R. F., Lima, R. C. d., & Mizubuti, E. S. G. (2019). How to write the discussion section of a scientific article. Acta Scientiarum. Agronomy, 41.

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How to write a discussion section?

Writing manuscripts to describe study outcomes, although not easy, is the main task of an academician. The aim of the present review is to outline the main aspects of writing the discussion section of a manuscript. Additionally, we address various issues regarding manuscripts in general. It is advisable to work on a manuscript regularly to avoid losing familiarity with the article. On principle, simple, clear and effective language should be used throughout the text. In addition, a pre-peer review process is recommended to obtain feedback on the manuscript. The discussion section can be written in 3 parts: an introductory paragraph, intermediate paragraphs and a conclusion paragraph. For intermediate paragraphs, a “divide and conquer” approach, meaning a full paragraph describing each of the study endpoints, can be used. In conclusion, academic writing is similar to other skills, and practice makes perfect.

Introduction

Sharing knowledge produced during academic life is achieved through writing manuscripts. However writing manuscripts is a challenging endeavour in that we physicians have a heavy workload, and English which is common language used for the dissemination of scientific knowledge is not our mother tongue.

The objective of this review is to summarize the method of writing ‘Discussion’ section which is the most important, but probably at the same time the most unlikable part of a manuscript, and demonstrate the easy ways we applied in our practice, and finally share the frequently made relevant mistakes. During this procedure, inevitably some issues which concerns general concept of manuscript writing process are dealt with. Therefore in this review we will deal with topics related to the general aspects of manuscript writing process, and specifically issues concerning only the ‘Discussion’ section.

A) Approaches to general aspects of manuscript writing process:

1. what should be the strategy of sparing time for manuscript writing be.

Two different approaches can be formulated on this issue? One of them is to allocate at least 30 minutes a day for writing a manuscript which amounts to 3.5 hours a week. This period of time is adequate for completion of a manuscript within a few weeks which can be generally considered as a long time interval. Fundamental advantage of this approach is to gain a habit of making academic researches if one complies with the designated time schedule, and to keep the manuscript writing motivation at persistently high levels. Another approach concerning this issue is to accomplish manuscript writing process within a week. With the latter approach, the target is rapidly attained. However longer time periods spent in order to concentrate on the subject matter can be boring, and lead to loss of motivation. Daily working requirements unrelated to the manuscript writing might intervene, and prolong manuscript writing process. Alienation periods can cause loss of time because of need for recurrent literature reviews. The most optimal approach to manuscript writing process is daily writing strategy where higher levels of motivation are persistently maintained.

Especially before writing the manuscript, the most important step at the start is to construct a draft, and completion of the manuscript on a theoretical basis. Therefore, during construction of a draft, attention distracting environment should be avoided, and this step should be completed within 1–2 hours. On the other hand, manuscript writing process should begin before the completion of the study (even the during project stage). The justification of this approach is to see the missing aspects of the study and the manuscript writing methodology, and try to solve the relevant problems before completion of the study. Generally, after completion of the study, it is very difficult to solve the problems which might be discerned during the writing process. Herein, at least drafts of the ‘Introduction’, and ‘Material and Methods’ can be written, and even tables containing numerical data can be constructed. These tables can be written down in the ‘Results’ section. [ 1 ]

2. How should the manuscript be written?

The most important principle to be remembered on this issue is to obey the criteria of simplicity, clarity, and effectiveness. [ 2 ] Herein, do not forget that, the objective should be to share our findings with the readers in an easily comprehensible format. Our approach on this subject is to write all structured parts of the manuscript at the same time, and start writing the manuscript while reading the first literature. Thus newly arisen connotations, and self-brain gyms will be promptly written down. However during this process your outcomes should be revealed fully, and roughly the message of the manuscript which be delivered. Thus with this so-called ‘hunter’s approach’ the target can be achieved directly, and rapidly. Another approach is ‘collectioner’s approach. [ 3 ] In this approach, firstly, potential data, and literature studies are gathered, read, and then selected ones are used. Since this approach suits with surgical point of view, probably ‘hunter’s approach’ serves our purposes more appropriately. However, in parallel with academic development, our novice colleague ‘manuscripters’ can prefer ‘collectioner’s approach.’

On the other hand, we think that research team consisting of different age groups has some advantages. Indeed young colleagues have the enthusiasm, and energy required for the conduction of the study, while middle-aged researchers have the knowledge to manage the research, and manuscript writing. Experienced researchers make guiding contributions to the manuscript. However working together in harmony requires assignment of a chief researcher, and periodically organizing advancement meetings. Besides, talents, skills, and experiences of the researchers in different fields (ie. research methods, contact with patients, preparation of a project, fund-raising, statistical analysis etc.) will determine task sharing, and make a favourable contribution to the perfection of the manuscript. Achievement of the shared duties within a predetermined time frame will sustain the motivation of the researchers, and prevent wearing out of updated data.

According to our point of view, ‘Abstract’ section of the manuscript should be written after completion of the manuscript. The reason for this is that during writing process of the main text, the significant study outcomes might become insignificant or vice versa. However, generally, before onset of the writing process of the manuscript, its abstract might be already presented in various congresses. During writing process, this abstract might be a useful guide which prevents deviation from the main objective of the manuscript.

On the other hand references should be promptly put in place while writing the manuscript, Sorting, and placement of the references should not be left to the last moment. Indeed, it might be very difficult to remember relevant references to be placed in the ‘Discussion’ section. For the placement of references use of software programs detailed in other sections is a rational approach.

3. Which target journal should be selected?

In essence, the methodology to be followed in writing the ‘Discussion’ section is directly related to the selection of the target journal. Indeed, in compliance with the writing rules of the target journal, limitations made on the number of words after onset of the writing process, effects mostly the ‘Discussion’ section. Proper matching of the manuscript with the appropriate journal requires clear, and complete comprehension of the available data from scientific point of view. Previously, similar articles might have been published, however innovative messages, and new perspectives on the relevant subject will facilitate acceptance of the article for publication. Nowadays, articles questioning available information, rather than confirmatory ones attract attention. However during this process, classical information should not be questioned except for special circumstances. For example manuscripts which lead to the conclusions as “laparoscopic surgery is more painful than open surgery” or “laparoscopic surgery can be performed without prior training” will not be accepted or they will be returned by the editor of the target journal to the authors with the request of critical review. Besides the target journal to be selected should be ready to accept articles with similar concept. In fact editors of the journal will not reserve the limited space in their journal for articles yielding similar conclusions.

The title of the manuscript is as important as the structured sections * of the manuscript. The title can be the most striking or the newest outcome among results obtained.

Before writing down the manuscript, determination of 2–3 titles increases the motivation of the authors towards the manuscript. During writing process of the manuscript one of these can be selected based on the intensity of the discussion. However the suitability of the title to the agenda of the target journal should be investigated beforehand. For example an article bearing the title “Use of barbed sutures in laparoscopic partial nephrectomy shortens warm ischemia time” should not be sent to “Original Investigations and Seminars in Urologic Oncology” Indeed the topic of the manuscript is out of the agenda of this journal.

4. Do we have to get a pre-peer review about the written manuscript?

Before submission of the manuscript to the target journal the opinions of internal, and external referees should be taken. [ 1 ] Internal referees can be considered in 2 categories as “General internal referees” and “expert internal referees” General internal referees (ie. our colleagues from other medical disciplines) are not directly concerned with your subject matter but as mentioned above they critically review the manuscript as for simplicity, clarity, and effectiveness of its writing style. Expert internal reviewers have a profound knowledge about the subject, and they can provide guidance about the writing process of the manuscript (ie. our senior colleagues more experienced than us). External referees are our colleagues who did not contribute to data collection of our study in any way, but we can request their opinions about the subject matter of the manuscript. Since they are unrelated both to the author(s), and subject matter of the manuscript, these referees can review our manuscript more objectively. Before sending the manuscript to internal, and external referees, we should contact with them, and ask them if they have time to review our manuscript. We should also give information about our subject matter. Otherwise pre-peer review process can delay publication of the manuscript, and decrease motivation of the authors. In conclusion, whoever the preferred referee will be, these internal, and external referees should respond the following questions objectively. 1) Does the manuscript contribute to the literature?; 2) Does it persuasive? 3) Is it suitable for the publication in the selected journal? 4) Has a simple, clear, and effective language been used throughout the manuscript? In line with the opinions of the referees, the manuscript can be critically reviewed, and perfected. [ 1 ]**

Following receival of the opinions of internal, and external referees, one should concentrate priorly on indicated problems, and their solutions. Comments coming from the reviewers should be criticized, but a defensive attitude should not be assumed during this evaluation process. During this “incubation” period where the comments of the internal, and external referees are awaited, literature should be reviewed once more. Indeed during this time interval a new article which you should consider in the ‘Discussion’ section can be cited in the literature.

5. What are the common mistakes made related to the writing process of a manuscript?

Probably the most important mistakes made related to the writing process of a manuscript include lack of a clear message of the manuscript , inclusion of more than one main idea in the same text or provision of numerous unrelated results at the same time so as to reinforce the assertions of the manuscript. This approach can be termed roughly as “loss of the focus of the study” In conclusion, the author(s) should ask themselves the following question at every stage of the writing process:. “What is the objective of the study? If you always get clear-cut answers whenever you ask this question, then the study is proceeding towards the right direction. Besides application of a template which contains the intended clear-cut messages to be followed will contribute to the communication of net messages.

One of the important mistakes is refraining from critical review of the manuscript as a whole after completion of the writing process. Therefore, the authors should go over the manuscript for at least three times after finalization of the manuscript based on joint decision. The first control should concentrate on the evaluation of the appropriateness of the logic of the manuscript, and its organization, and whether desired messages have been delivered or not. Secondly, syutax, and grammar of the manuscript should be controlled. It is appropriate to review the manuscript for the third time 1 or 2 weeks after completion of its writing process. Thus, evaluation of the “cooled” manuscript will be made from a more objective perspective, and assessment process of its integrity will be facilitated.

Other erroneous issues consist of superfluousness of the manuscript with unnecessary repetitions, undue, and recurrent references to the problems adressed in the manuscript or their solution methods, overcriticizing or overpraising other studies, and use of a pompous literary language overlooking the main objective of sharing information. [ 4 ]

B) Approaches to the writing process of the ‘Discussion’ section:

1. how should the main points of ‘discussion’ section be constructed.

Generally the length of the ‘Discussion ‘ section should not exceed the sum of other sections (ıntroduction, material and methods, and results), and it should be completed within 6–7 paragraphs.. Each paragraph should not contain more than 200 words, and hence words should be counted repeteadly. The ‘Discussion’ section can be generally divided into 3 separate paragraphs as. 1) Introductory paragraph, 2) Intermediate paragraphs, 3) Concluding paragraph.

The introductory paragraph contains the main idea of performing the study in question. Without repeating ‘Introduction’ section of the manuscript, the problem to be addressed, and its updateness are analysed. The introductory paragraph starts with an undebatable sentence, and proceeds with a part addressing the following questions as 1) On what issue we have to concentrate, discuss or elaborate? 2) What solutions can be recommended to solve this problem? 3) What will be the new, different, and innovative issue? 4) How will our study contribute to the solution of this problem An introductory paragraph in this format is helpful to accomodate reader to the rest of the Discussion section. However summarizing the basic findings of the experimental studies in the first paragraph is generally recommended by the editors of the journal. [ 5 ]

In the last paragraph of the Discussion section “strong points” of the study should be mentioned using “constrained”, and “not too strongly assertive” statements. Indicating limitations of the study will reflect objectivity of the authors, and provide answers to the questions which will be directed by the reviewers of the journal. On the other hand in the last paragraph, future directions or potential clinical applications may be emphasized.

2. How should the intermediate paragraphs of the Discussion section be formulated?

The reader passes through a test of boredom while reading paragraphs of the Discussion section apart from the introductory, and the last paragraphs. Herein your findings rather than those of the other researchers are discussed. The previous studies can be an explanation or reinforcement of your findings. Each paragraph should contain opinions in favour or against the topic discussed, critical evaluations, and learning points.

Our management approach for intermediate paragraphs is “divide and conquer” tactics. Accordingly, the findings of the study are determined in order of their importance, and a paragraph is constructed for each finding ( Figure 1 ). Each paragraph begins with an “indisputable” introductory sentence about the topic to be discussed. This sentence basically can be the answer to the question “What have we found?” Then a sentence associated with the subject matter to be discussed is written. Subsequently, in the light of the current literature this finding is discussed, new ideas on this subject are revealed, and the paragraph ends with a concluding remark.

Divide and Conquer tactics

In this paragraph, main topic should be emphasized without going into much detail. Its place, and importance among other studies should be indicated. However during this procedure studies should be presented in a logical sequence (ie. from past to present, from a few to many cases), and aspects of the study contradictory to other studies should be underlined. Results without any supportive evidence or equivocal results should not be written. Besides numerical values presented in the Results section should not be repeated unless required.

Besides, asking the following questions, and searching their answers in the same paragraph will facilitate writing process of the paragraph. [ 1 ] 1) Can the discussed result be false or inadequate? 2) Why is it false? (inadequate blinding, protocol contamination, lost to follow-up, lower statistical power of the study etc.), 3) What meaning does this outcome convey?

3. What are the common mistakes made in writing the Discussion section?:

Probably the most important mistake made while writing the Discussion section is the need for mentioning all literature references. One point to remember is that we are not writing a review article, and only the results related to this paragraph should be discussed. Meanwhile, each word of the paragraphs should be counted, and placed carefully. Each word whose removal will not change the meaning should be taken out from the text.” Writing a saga with “word salads” *** is one of the reasons for prompt rejection. Indeed, if the reviewer thinks that it is difficult to correct the Discussion section, he/she use her/ his vote in the direction of rejection to save time (Uniform requirements for manuscripts: International Comittee of Medical Journal Editors [ http://www.icmje.org/urm_full.pdf ])

The other important mistake is to give too much references, and irrelevancy between the references, and the section with these cited references. [ 3 ] While referring these studies, (excl. introductory sentences linking indisputable sentences or paragraphs) original articles should be cited. Abstracts should not be referred, and review articles should not be cited unless required very much.

4. What points should be paid attention about writing rules, and grammar?

As is the case with the whole article, text of the Discussion section should be written with a simple language, as if we are talking with our colleague. [ 2 ] Each sentence should indicate a single point, and it should not exceed 25–30 words. The priorly mentioned information which linked the previous sentence should be placed at the beginning of the sentence, while the new information should be located at the end of the sentence. During construction of the sentences, avoid unnecessary words, and active voice rather than passive voice should be used.**** Since conventionally passive voice is used in the scientific manuscripts written in the Turkish language, the above statement contradicts our writing habits. However, one should not refrain from beginning the sentences with the word “we”. Indeed, editors of the journal recommend use of active voice so as to increase the intelligibility of the manuscript.

In conclusion, the major point to remember is that the manuscript should be written complying with principles of simplicity, clarity, and effectiveness. In the light of these principles, as is the case in our daily practice, all components of the manuscript (IMRAD) can be written concurrently. In the ‘Discussion’ section ‘divide and conquer’ tactics remarkably facilitates writing process of the discussion. On the other hand, relevant or irrelevant feedbacks received from our colleagues can contribute to the perfection of the manuscript. Do not forget that none of the manuscripts is perfect, and one should not refrain from writing because of language problems, and related lack of experience.

Instead of structured sections of a manuscript (IMRAD): Introduction, Material and Methods, Results, and Discussion

Instead of in the Istanbul University Faculty of Medicine posters to be submitted in congresses are time to time discussed in Wednesday meetings, and opinions of the internal referees are obtained about the weak, and strong points of the study

Instead of a writing style which uses words or sentences with a weak logical meaning that do not lead the reader to any conclusion

Instead of “white color”; “proven”; nstead of “history”; “to”. should be used instead of “white in color”, “definitely proven”, “past history”, and “in order to”, respectively ( ref. 2 )

Instead of “No instances of either postoperative death or major complications occurred during the early post-operative period” use “There were no deaths or major complications occurred during the early post-operative period.

Instead of “Measurements were performed to evaluate the levels of CEA in the serum” use “We measured serum CEA levels”

• Translation

How to write the analysis and discussion chapters in qualitative (SSAH) research

By charlesworth author services.

• Charlesworth Author Services
• 11 November, 2021

While it is more common for Science, Technology, Engineering and Mathematics (STEM) researchers to write separate, distinct chapters for their data/ results and analysis/ discussion , the same sections can feel less clearly defined for a researcher in Social Sciences, Arts and Humanities (SSAH). This article will look specifically at some useful approaches to writing the analysis and discussion chapters in qualitative/SSAH research.

Note : Most of the differences in approaches to research, writing, analysis and discussion come down, ultimately, to differences in epistemology – how we approach, create and work with knowledge in our respective fields. However, this is a vast topic that deserves a separate discussion.

Look for emerging themes and patterns

The ‘results’ of qualitative research can sometimes be harder to pinpoint than in quantitative research. You’re not dealing with definitive numbers and results in the same way as, say, a scientist conducting experiments that produce measurable data. Instead, most qualitative researchers explore prominent, interesting themes and patterns emerging from their data – that could comprise interviews, textual material or participant observation, for example. 

You may find that your data presents a huge number of themes, issues and topics, all of which you might find equally significant and interesting. In fact, you might find yourself overwhelmed by the many directions that your research could take, depending on which themes you choose to study in further depth. You may even discover issues and patterns that you had not expected , that may necessitate having to change or expand the research focus you initially started off with.

It is crucial at this point not to panic. Instead, try to enjoy the many possibilities that your data is offering you. It can be useful to remind yourself at each stage of exactly what you are trying to find out through this research.

What exactly do you want to know? What knowledge do you want to generate and share within your field?

Then, spend some time reflecting upon each of the themes that seem most interesting and significant, and consider whether they are immediately relevant to your main, overarching research objectives and goals.

Suggestion: Don’t worry too much about structure and flow at the early stages of writing your discussion . It would be a more valuable use of your time to fully explore the themes and issues arising from your data first, while also reading widely alongside your writing (more on this below). As you work more intimately with the data and develop your ideas, the overarching narrative and connections between those ideas will begin to emerge. Trust that you’ll be able to draw those links and craft the structure organically as you write.

Let your data guide you

A key characteristic of qualitative research is that the researchers allow their data to ‘speak’ and guide their research and their writing. Instead of insisting too strongly upon the prominence of specific themes and issues and imposing their opinions and beliefs upon the data, a good qualitative researcher ‘listens’ to what the data has to tell them.

Again, you might find yourself having to address unexpected issues or your data may reveal things that seem completely contradictory to the ideas and theories you have worked with so far. Although this might seem worrying, discovering these unexpected new elements can actually make your research much richer and more interesting. 

Suggestion: Allow yourself to follow those leads and ask new questions as you work through your data. These new directions could help you to answer your research questions in more depth and with greater complexity; or they could even open up other avenues for further study, either in this or future research.

Work closely with the literature

As you analyse and discuss the prominent themes, arguments and findings arising from your data, it is very helpful to maintain a regular and consistent reading practice alongside your writing. Return to the literature that you’ve already been reading so far or begin to check out new texts, studies and theories that might be more appropriate for working with any new ideas and themes arising from your data.

Reading and incorporating relevant literature into your writing as you work through your analysis and discussion will help you to consistently contextualise your research within the larger body of knowledge. It will be easier to stay focused on what you are trying to say through your research if you can simultaneously show what has already been said on the subject and how your research and data supports, challenges or extends those debates. By drawing from existing literature , you are setting up a dialogue between your research and prior work, and highlighting what this research has to add to the conversation.

Suggestion : Although it might sometimes feel tedious to have to blend others’ writing in with yours, this is ultimately the best way to showcase the specialness of your own data, findings and research . Remember that it is more difficult to highlight the significance and relevance of your original work without first showing how that work fits into or responds to existing studies. 

In conclusion

The discussion chapters form the heart of your thesis and this is where your unique contribution comes to the forefront. This is where your data takes centre-stage and where you get to showcase your original arguments, perspectives and knowledge. To do this effectively needs you to explore the original themes and issues arising from and within the data, while simultaneously contextualising these findings within the larger, existing body of knowledge of your specialising field. By striking this balance, you prove the two most important qualities of excellent qualitative research : keen awareness of your field and a firm understanding of your place in it.

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The five steps to writing a qualitative research discussion guide

Learn how to create an effective discussion guide for qualitative research by following these five steps.

Creating a qualitative research discussion guide

Editor’s note: Joanna Jones is the CEO and founder of InterQ and co-founder of InterQ Learning Labs. This is an edited version of an article that originally appeared under the title “ How to write a discussion guide for qualitative research .”

In qualitative research, the discussion guide is the fundamental document that outlines the questions that the interviewer asks a participant or group of participants. This article focuses on discussion guides that are used in interview-based research, not on platforms (for example, mobile ethnography platforms, bulletin boards or online diaries). Although, keep in mind that the best platform research ends with an in-depth interview or group discussion, so a discussion guide will come after the first phase.

Discussion guides are fundamental to good interviewing. Moderators often have various techniques with how they use guides (some digest the key questions they need to know and skip around, others follow the question outline closely), but most moderators will agree that setting up your questions first is the key to a good interview.

Before diving into the key components every discussion guide has, let me first say that discussion guides are not a script. They’re a guide – and the key to being a good moderator is to know how to let participants go on tangents and when to guide people back to the core questions. Rarely, though, are guides read through verbatim.

Step 1: Know the goal and the essential question

There is a lot of pre-work that must happen before writing a discussion guide. This includes understanding the core goals of the research, defining the outputs and aligning the stakeholders. Our process for this stage is to conduct workshops with stakeholders, but everyone has their own methods.

This initial stage is where the researcher will define what I like to call “the essential question.” In other words, if you could only learn one thing from the research, what would it be?

Additionally, you’ll want to clearly label and record the various hypotheses that are being tested. Once you know this – and the team is aligned – you’ll be able to choose the methodology, define the participant criteria and, once everyone has signed off, start on the guide. (Keep in mind this is a general description of qualitative projects and details will differ depending on the specific project goals.)

Step 2: The introduction

When a moderator begins a research discussion, the introduction is critical. This is the part where the moderator builds rapport with the participant and sets the scene. 

What to include in this stage:

• The purpose of the study and the length of the interview (be sure to keep the client name out if the study is being done blindly).
• Confidentiality details: If it’s being recorded, how it will be used and what information will be shared with whom.
• The length of the study.
• Ground rules (this is mostly used in focus groups or co-creation groups): Not trying to build consensus, letting everyone speak, participants can discuss ideas with each other as well as the moderator.

Once the key expectations are covered, it’s then good to add in a sort of icebreaker or non-study related question to get the group members or the individual participant to relax. For example, you can ask people what their dream car is or where they most want to travel. I typically try to tie the ice-breaker question to the study theme.

Step 3: Ask general questions about the topic

Discussion guides can be seen as an upside down triangle: Start general at the top and get narrower as you go along.

The next goal is to set the scene by asking general questions about the topic. This phase helps build empathy and slowly invites the participant(s) into the topic. A key component here is that you want the participants to define and name their perceptions of the category before you name it. This is a great opportunity to add in projective techniques. A favorite one that I typically do at this stage – if I’m leading groups – is an association exercise. I’ll write down a few words related to the topic on a board and have everyone write down all the associations they have with the category on sticky notes. They first write it down individually, so as not to bias each other – and then we collect the stickies and discuss as a group. This brings everyone in and sets the tone. It also gives the moderator context and helps them be grounded in the category knowledge or opinions.

Step 4: Ask specific questions and conduct activities

Once participants have defined the category and the researcher has set the scene, the discussion guide then moves into the next section: the specifics. If the study is a user test, this is where the moderator has the participant move through the product design. If it’s a focus group, the researcher will start to hone-in on the essential question that was defined at the outset of the study. This is where moderator training is so crucial. Good moderators know how to probe, guide and ask non-leading questions – while still capturing how people think, feel and do. Projective techniques and exercises are also commonly used in this phase. 

Step 5: Close the interview

As the interview winds down, this is where the researcher has a chance to share the brand name to test perceptions. If it’s a completely blind study, this last phase of the discussion guide is to close the loop. For example, how would the participant rate the concepts? Where would the participant expect to purchase the product? What type of media outlets does the participant pay attention to (to test brand placement)? How is the decision-making done at an organization (to understand the buying process)? The closing section is crucial as it allows the moderator to capture more direct responses without leading the participant, since the categories and initial perceptions/ideas were captured organically – with the participant defining the terms – in the very beginning of the interview.

Discussion guides are important

To close, expect to spend five to eight hours developing your discussion guide. How the questions are set up, the order of the questions and, super important – the exercises included in the interview – require creativity and thought to put together.

Once the guide is together, practice and know it well – this will help you skip around if the participant brings up topics before you get to them. When appropriate, be able to skip around as well as probe on ideas that are the most pertinent to the study’s objectives.

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How to Write a Discussion Guide for Qualitative Research

• January 18, 2023

Article Summary:  Discussion guides are the “script” used by qualitative researchers when conducting interviews. Though they shouldn’t be read like a script (questions asked verbatim), they are fundamental when conducting interviews. Understanding the structure of the guide and how to frame the questions is key to a good guide.

In  qualitative research,  the discussion guide is the fundamental document that outlines the questions that the interviewer asks a participant or group of participants.

In this post, I’m going to focus on discussion guides that are used in interview-based research, and not on platforms (for example, mobile ethnography platforms, bulletin boards, or online diaries). Although, keep in mind that the best platform-research  ends  with an  in-depth interview or group discussion , so a discussion guide will come after the first phase.

Discussion guides are fundamental to good interviewing. Moderators often have various techniques with how they use guides (some digest the key questions they need to know and skip around, others follow the question outline closely), but most moderators will agree that setting up your questions first is the key to a good interview.

Before I get started and dive into the key components every discussion guide has, let me first say that discussion guides are  not a  script. They’re a guide – and the key to being a good moderator is to know how to let participants go on tangents and when to guide people back to the core questions. Rarely, though, are guides read through verbatim.

Step 1 to writing a good discussion guide: First, know the goal of the research and the essential question

There is a lot of pre-work that has to happen before a discussion guide ever gets written. This includes understanding the core goals of the research, defining the outputs, and aligning the stakeholders. Our process for this stage is to conduct workshops on Miro with stakeholders, but everyone has their own methods.

This initial stage is where the researcher will define what I like to call “the essential question.”

In other words, if you could only learn one thing from the research, what would it be?

Additionally, you’ll want to clearly label and record the various hypotheses that are being tested. Once you know this – and the team is aligned – you’ll be able to choose the methodology, define the participant criteria, and, once everyone has signed off, start on the guide. (Keep in mind this is a general description of qualitative projects, but of course the details will differ depending on the specific project goals.)

Step 2 to writing a good discussion guide: The introduction

When a moderator begins a research discussion, the introduction is critical. This is the part where the moderator builds rapport with the participant and sets the scene. Be sure to include the following in this stage:

–          Purpose of the study and length of the interview (be sure to keep the client name out if the study is being done blindly)

–          Confidentiality details: If it’s being recorded, how it will be used, and what information will be shared with whom

–          Length of the study

–          Ground rules (this is mostly used in  focus groups or co-creation groups) : Not trying to build consensus, letting everyone speak, participants can discuss ideas with each other as well as the moderator

Once the key expectations are covered, it’s then good to add in a sort of ice-breaker or non-study related question to get the group members or the individual participant to relax. For example, you can ask people what their dream car is or where they most want to travel. I typically try to tie the ice-breaker question to the study theme.

Step 3 to writing a good discussion guide: General questions about the topic

Discussion guides can be seen as an upside-down triangle: Start general at the top (broad at top) and get narrower as you go along.

In this second section, the next goal is to set the scene: Ask general questions about the topic and participant(s). This phase helps build empathy and also slowly invites the participant(s) into the topic. A key component here is that you want the participants to define and name their perceptions of the category before you name it. This is a great opportunity to add in  projective techniques . One favorite one that I typically do at this stage – if I’m leading groups – is to do an association exercise. I’ll write down a few words related to the topic on a board and have everyone write down all the associations they have with the category on sticky notes. They first write it down individually, so as not to bias each other – and then we collect the stickies and discuss as a group. This brings everyone in and sets the tone. Importantly, it also gives the moderator context and helps the moderator to be grounded in the category knowledge or opinions.

Step 4 to writing a good discussion guide: Specific questions and activities

Once the participants have defined the category and the researcher has “set the scene,” the discussion guide then moves into the next section: the specifics. If the study is a user test, this is where the moderator has the participant move through the product design. If it’s a focus group, the researcher will start to hone-in on the Essential Question that was defined at the outset of the study. This is where moderator training is so crucial: Good moderators know how to probe, guide, and ask non-leading questions – while still capturing how people think, feel, and do. Projective techniques and exercises are also commonly used in this phase.

Step 5 to writing a good discussion guide: Closing the interview

As the interview winds down, this is where the researcher has a chance to share the brand name (if the study is blind in the beginning but not 100% blind) to test perceptions. If it’s a completely blind study, this last phase of the discussion guide is to close-the-loop. For example, how would the participant rate the concepts? Where would the participant expect to purchase the product? What type of media outlets does the participant pay attention to (to test brand placement)? Or how is the decision-making done at an organization (to understand the buying process). The closing section is crucial as it allows the moderator to then capture more direct responses without leading the participant, since the categories and initial perceptions/ideas were captured organically – with the participant defining the terms – in the very beginning of the interview.

The discussion guide is crucial: Spend time on this step!

To close up, expect to spend 5-8 hours developing your discussion guide. How the questions are set up, the order of the questions, and, super important – the exercises included in the interview – require creativity and thought to put together.

Once the guide is together, practice and know it well – this will help you skip around if the participant brings up topics before you get to them. When appropriate, be able to skip around as well as probe on ideas that are the most pertinent to the study’s objectives.

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• How to Write a Discussion Section | Tips & Examples

How to Write a Discussion Section | Tips & Examples

Published on 21 August 2022 by Shona McCombes . Revised on 25 October 2022.

The discussion section is where you delve into the meaning, importance, and relevance of your results .

It should focus on explaining and evaluating what you found, showing how it relates to your literature review , and making an argument in support of your overall conclusion . It should not be a second results section .

There are different ways to write this section, but you can focus your writing around these key elements:

• Summary: A brief recap of your key results
• Interpretations: What do your results mean?
• Implications: Why do your results matter?
• Limitations: What can’t your results tell us?
• Recommendations: Avenues for further studies or analyses

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Table of contents

What not to include in your discussion section, step 1: summarise your key findings, step 2: give your interpretations, step 3: discuss the implications, step 4: acknowledge the limitations, step 5: share your recommendations, discussion section example.

There are a few common mistakes to avoid when writing the discussion section of your paper.

• Don’t introduce new results: You should only discuss the data that you have already reported in your results section .
• Don’t make inflated claims: Avoid overinterpretation and speculation that isn’t directly supported by your data.
• Don’t undermine your research: The discussion of limitations should aim to strengthen your credibility, not emphasise weaknesses or failures.

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Start this section by reiterating your research problem  and concisely summarising your major findings. Don’t just repeat all the data you have already reported – aim for a clear statement of the overall result that directly answers your main  research question . This should be no more than one paragraph.

Many students struggle with the differences between a discussion section and a results section . The crux of the matter is that your results sections should present your results, and your discussion section should subjectively evaluate them. Try not to blend elements of these two sections, in order to keep your paper sharp.

• The results indicate that …
• The study demonstrates a correlation between …
• This analysis supports the theory that …
• The data suggest  that …

The meaning of your results may seem obvious to you, but it’s important to spell out their significance for your reader, showing exactly how they answer your research question.

The form of your interpretations will depend on the type of research, but some typical approaches to interpreting the data include:

• Identifying correlations , patterns, and relationships among the data
• Discussing whether the results met your expectations or supported your hypotheses
• Contextualising your findings within previous research and theory
• Explaining unexpected results and evaluating their significance
• Considering possible alternative explanations and making an argument for your position

You can organise your discussion around key themes, hypotheses, or research questions, following the same structure as your results section. Alternatively, you can also begin by highlighting the most significant or unexpected results.

• In line with the hypothesis …
• Contrary to the hypothesised association …
• The results contradict the claims of Smith (2007) that …
• The results might suggest that x . However, based on the findings of similar studies, a more plausible explanation is x .

As well as giving your own interpretations, make sure to relate your results back to the scholarly work that you surveyed in the literature review . The discussion should show how your findings fit with existing knowledge, what new insights they contribute, and what consequences they have for theory or practice.

Ask yourself these questions:

• Do your results support or challenge existing theories? If they support existing theories, what new information do they contribute? If they challenge existing theories, why do you think that is?
• Are there any practical implications?

Your overall aim is to show the reader exactly what your research has contributed, and why they should care.

• These results build on existing evidence of …
• The results do not fit with the theory that …
• The experiment provides a new insight into the relationship between …
• These results should be taken into account when considering how to …
• The data contribute a clearer understanding of …
• While previous research has focused on  x , these results demonstrate that y .

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Even the best research has its limitations. Acknowledging these is important to demonstrate your credibility. Limitations aren’t about listing your errors, but about providing an accurate picture of what can and cannot be concluded from your study.

Limitations might be due to your overall research design, specific methodological choices , or unanticipated obstacles that emerged during your research process.

Here are a few common possibilities:

• If your sample size was small or limited to a specific group of people, explain how generalisability is limited.
• If you encountered problems when gathering or analysing data, explain how these influenced the results.
• If there are potential confounding variables that you were unable to control, acknowledge the effect these may have had.

After noting the limitations, you can reiterate why the results are nonetheless valid for the purpose of answering your research question.

• The generalisability of the results is limited by …
• The reliability of these data is impacted by …
• Due to the lack of data on x , the results cannot confirm …
• The methodological choices were constrained by …
• It is beyond the scope of this study to …

Based on the discussion of your results, you can make recommendations for practical implementation or further research. Sometimes, the recommendations are saved for the conclusion .

Suggestions for further research can lead directly from the limitations. Don’t just state that more studies should be done – give concrete ideas for how future work can build on areas that your own research was unable to address.

• Further research is needed to establish …
• Future studies should take into account …
• Avenues for future research include …

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How To Write The Discussion Chapter

A Simple Explainer With Examples + Free Template

By: Jenna Crossley (PhD) | Reviewed By: Dr. Eunice Rautenbach | August 2021

If you’re reading this, chances are you’ve reached the discussion chapter of your thesis or dissertation and are looking for a bit of guidance. Well, you’ve come to the right place ! In this post, we’ll unpack and demystify the typical discussion chapter in straightforward, easy to understand language, with loads of examples .

Overview: The Discussion Chapter

• What  the discussion chapter is
• What to include in your discussion
• How to write up your discussion
• A few tips and tricks to help you along the way
• Free discussion template

What (exactly) is the discussion chapter?

The discussion chapter is where you interpret and explain your results within your thesis or dissertation. This contrasts with the results chapter, where you merely present and describe the analysis findings (whether qualitative or quantitative ). In the discussion chapter, you elaborate on and evaluate your research findings, and discuss the significance and implications of your results .

In this chapter, you’ll situate your research findings in terms of your research questions or hypotheses and tie them back to previous studies and literature (which you would have covered in your literature review chapter). You’ll also have a look at how relevant and/or significant your findings are to your field of research, and you’ll argue for the conclusions that you draw from your analysis. Simply put, the discussion chapter is there for you to interact with and explain your research findings in a thorough and coherent manner.

What should I include in the discussion chapter?

First things first: in some studies, the results and discussion chapter are combined into one chapter .  This depends on the type of study you conducted (i.e., the nature of the study and methodology adopted), as well as the standards set by the university.  So, check in with your university regarding their norms and expectations before getting started. In this post, we’ll treat the two chapters as separate, as this is most common.

Basically, your discussion chapter should analyse , explore the meaning and identify the importance of the data you presented in your results chapter. In the discussion chapter, you’ll give your results some form of meaning by evaluating and interpreting them. This will help answer your research questions, achieve your research aims and support your overall conclusion (s). Therefore, you discussion chapter should focus on findings that are directly connected to your research aims and questions. Don’t waste precious time and word count on findings that are not central to the purpose of your research project.

As this chapter is a reflection of your results chapter, it’s vital that you don’t report any new findings . In other words, you can’t present claims here if you didn’t present the relevant data in the results chapter first.  So, make sure that for every discussion point you raise in this chapter, you’ve covered the respective data analysis in the results chapter. If you haven’t, you’ll need to go back and adjust your results chapter accordingly.

If you’re struggling to get started, try writing down a bullet point list everything you found in your results chapter. From this, you can make a list of everything you need to cover in your discussion chapter. Also, make sure you revisit your research questions or hypotheses and incorporate the relevant discussion to address these.  This will also help you to see how you can structure your chapter logically.

Need a helping hand?

How to write the discussion chapter

Now that you’ve got a clear idea of what the discussion chapter is and what it needs to include, let’s look at how you can go about structuring this critically important chapter. Broadly speaking, there are six core components that need to be included, and these can be treated as steps in the chapter writing process.

Step 1: Restate your research problem and research questions

The first step in writing up your discussion chapter is to remind your reader of your research problem , as well as your research aim(s) and research questions . If you have hypotheses, you can also briefly mention these. This “reminder” is very important because, after reading dozens of pages, the reader may have forgotten the original point of your research or been swayed in another direction. It’s also likely that some readers skip straight to your discussion chapter from the introduction chapter , so make sure that your research aims and research questions are clear.

Step 2: Summarise your key findings

Next, you’ll want to summarise your key findings from your results chapter. This may look different for qualitative and quantitative research , where qualitative research may report on themes and relationships, whereas quantitative research may touch on correlations and causal relationships. Regardless of the methodology, in this section you need to highlight the overall key findings in relation to your research questions.

Typically, this section only requires one or two paragraphs , depending on how many research questions you have. Aim to be concise here, as you will unpack these findings in more detail later in the chapter. For now, a few lines that directly address your research questions are all that you need.

Some examples of the kind of language you’d use here include:

• The data suggest that…
• The data support/oppose the theory that…
• The analysis identifies…

These are purely examples. What you present here will be completely dependent on your original research questions, so make sure that you are led by them .

Step 3: Interpret your results

Once you’ve restated your research problem and research question(s) and briefly presented your key findings, you can unpack your findings by interpreting your results. Remember: only include what you reported in your results section – don’t introduce new information.

From a structural perspective, it can be a wise approach to follow a similar structure in this chapter as you did in your results chapter. This would help improve readability and make it easier for your reader to follow your arguments. For example, if you structured you results discussion by qualitative themes, it may make sense to do the same here.

Alternatively, you may structure this chapter by research questions, or based on an overarching theoretical framework that your study revolved around. Every study is different, so you’ll need to assess what structure works best for you.

When interpreting your results, you’ll want to assess how your findings compare to those of the existing research (from your literature review chapter). Even if your findings contrast with the existing research, you need to include these in your discussion. In fact, those contrasts are often the most interesting findings . In this case, you’d want to think about why you didn’t find what you were expecting in your data and what the significance of this contrast is.

Here are a few questions to help guide your discussion:

• How do your results relate with those of previous studies ?
• If you get results that differ from those of previous studies, why may this be the case?
• What do your results contribute to your field of research?
• What other explanations could there be for your findings?

When interpreting your findings, be careful not to draw conclusions that aren’t substantiated . Every claim you make needs to be backed up with evidence or findings from the data (and that data needs to be presented in the previous chapter – results). This can look different for different studies; qualitative data may require quotes as evidence, whereas quantitative data would use statistical methods and tests. Whatever the case, every claim you make needs to be strongly backed up.

Step 4: Acknowledge the limitations of your study

The fourth step in writing up your discussion chapter is to acknowledge the limitations of the study. These limitations can cover any part of your study , from the scope or theoretical basis to the analysis method(s) or sample. For example, you may find that you collected data from a very small sample with unique characteristics, which would mean that you are unable to generalise your results to the broader population.

For some students, discussing the limitations of their work can feel a little bit self-defeating . This is a misconception, as a core indicator of high-quality research is its ability to accurately identify its weaknesses. In other words, accurately stating the limitations of your work is a strength, not a weakness . All that said, be careful not to undermine your own research. Tell the reader what limitations exist and what improvements could be made, but also remind them of the value of your study despite its limitations.

Step 5: Make recommendations for implementation and future research

Now that you’ve unpacked your findings and acknowledge the limitations thereof, the next thing you’ll need to do is reflect on your study in terms of two factors:

• The practical application of your findings
• Suggestions for future research

The first thing to discuss is how your findings can be used in the real world – in other words, what contribution can they make to the field or industry? Where are these contributions applicable, how and why? For example, if your research is on communication in health settings, in what ways can your findings be applied to the context of a hospital or medical clinic? Make sure that you spell this out for your reader in practical terms, but also be realistic and make sure that any applications are feasible.

The next discussion point is the opportunity for future research . In other words, how can other studies build on what you’ve found and also improve the findings by overcoming some of the limitations in your study (which you discussed a little earlier). In doing this, you’ll want to investigate whether your results fit in with findings of previous research, and if not, why this may be the case. For example, are there any factors that you didn’t consider in your study? What future research can be done to remedy this? When you write up your suggestions, make sure that you don’t just say that more research is needed on the topic, also comment on how the research can build on your study.

Step 6: Provide a concluding summary

Finally, you’ve reached your final stretch. In this section, you’ll want to provide a brief recap of the key findings – in other words, the findings that directly address your research questions . Basically, your conclusion should tell the reader what your study has found, and what they need to take away from reading your report.

When writing up your concluding summary, bear in mind that some readers may skip straight to this section from the beginning of the chapter.  So, make sure that this section flows well from and has a strong connection to the opening section of the chapter.

Tips and tricks for an A-grade discussion chapter

Now that you know what the discussion chapter is , what to include and exclude , and how to structure it , here are some tips and suggestions to help you craft a quality discussion chapter.

• When you write up your discussion chapter, make sure that you keep it consistent with your introduction chapter , as some readers will skip from the introduction chapter directly to the discussion chapter. Your discussion should use the same tense as your introduction, and it should also make use of the same key terms.
• Don’t make assumptions about your readers. As a writer, you have hands-on experience with the data and so it can be easy to present it in an over-simplified manner. Make sure that you spell out your findings and interpretations for the intelligent layman.
• Have a look at other theses and dissertations from your institution, especially the discussion sections. This will help you to understand the standards and conventions of your university, and you’ll also get a good idea of how others have structured their discussion chapters. You can also check out our chapter template .
• Avoid using absolute terms such as “These results prove that…”, rather make use of terms such as “suggest” or “indicate”, where you could say, “These results suggest that…” or “These results indicate…”. It is highly unlikely that a dissertation or thesis will scientifically prove something (due to a variety of resource constraints), so be humble in your language.
• Use well-structured and consistently formatted headings to ensure that your reader can easily navigate between sections, and so that your chapter flows logically and coherently.

If you have any questions or thoughts regarding this post, feel free to leave a comment below. Also, if you’re looking for one-on-one help with your discussion chapter (or thesis in general), consider booking a free consultation with one of our highly experienced Grad Coaches to discuss how we can help you.

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37 Comments

Thank you this is helpful!

This is very helpful to me… Thanks a lot for sharing this with us 😊

This has been very helpful indeed. Thank you.

This is actually really helpful, I just stumbled upon it. Very happy that I found it, thank you.

Me too! I was kinda lost on how to approach my discussion chapter. How helpful! Thanks a lot!

This is really good and explicit. Thanks

Thank you, this blog has been such a help.

Thank you. This is very helpful.

Dear sir/madame

Thanks a lot for this helpful blog. Really, it supported me in writing my discussion chapter while I was totally unaware about its structure and method of writing.

With regards

Syed Firoz Ahmad PhD, Research Scholar

I agree so much. This blog was god sent. It assisted me so much while I was totally clueless about the context and the know-how. Now I am fully aware of what I am to do and how I am to do it.

Thanks! This is helpful!

thanks alot for this informative website

Dear Sir/Madam,

Truly, your article was much benefited when i structured my discussion chapter.

Thank you very much!!!

This is helpful for me in writing my research discussion component. I have to copy this text on Microsoft word cause of my weakness that I cannot be able to read the text on screen a long time. So many thanks for this articles.

This was helpful

Thanks Jenna, well explained.

Thank you! This is super helpful.

Thanks very much. I have appreciated the six steps on writing the Discussion chapter which are (i) Restating the research problem and questions (ii) Summarising the key findings (iii) Interpreting the results linked to relating to previous results in positive and negative ways; explaining whay different or same and contribution to field of research and expalnation of findings (iv) Acknowledgeing limitations (v) Recommendations for implementation and future resaerch and finally (vi) Providing a conscluding summary

My two questions are: 1. On step 1 and 2 can it be the overall or you restate and sumamrise on each findings based on the reaerch question? 2. On 4 and 5 do you do the acknowlledgement , recommendations on each research finding or overall. This is not clear from your expalanattion.

Please respond.

This post is very useful. I’m wondering whether practical implications must be introduced in the Discussion section or in the Conclusion section?

Sigh, I never knew a 20 min video could have literally save my life like this. I found this at the right time!!!! Everything I need to know in one video thanks a mil ! OMGG and that 6 step!!!!!! was the cherry on top the cake!!!!!!!!!

Thanks alot.., I have gained much

This piece is very helpful on how to go about my discussion section. I can always recommend GradCoach research guides for colleagues.

Many thanks for this resource. It has been very helpful to me. I was finding it hard to even write the first sentence. Much appreciated.

Thanks so much. Very helpful to know what is included in the discussion section

this was a very helpful and useful information

This is very helpful. Very very helpful. Thanks for sharing this online!

it is very helpfull article, and i will recommend it to my fellow students. Thank you.

Superlative! More grease to your elbows.

Powerful, thank you for sharing.

Wow! Just wow! God bless the day I stumbled upon you guys’ YouTube videos! It’s been truly life changing and anxiety about my report that is due in less than a month has subsided significantly!

Simplified explanation. Well done.

The presentation is enlightening. Thank you very much.

Thanks for the support and guidance

This has been a great help to me and thank you do much

I second that “it is highly unlikely that a dissertation or thesis will scientifically prove something”; although, could you enlighten us on that comment and elaborate more please?

Sure, no problem.

Scientific proof is generally considered a very strong assertion that something is definitively and universally true. In most scientific disciplines, especially within the realms of natural and social sciences, absolute proof is very rare. Instead, researchers aim to provide evidence that supports or rejects hypotheses. This evidence increases or decreases the likelihood that a particular theory is correct, but it rarely proves something in the absolute sense.

Dissertations and theses, as substantial as they are, typically focus on exploring a specific question or problem within a larger field of study. They contribute to a broader conversation and body of knowledge. The aim is often to provide detailed insight, extend understanding, and suggest directions for further research rather than to offer definitive proof. These academic works are part of a cumulative process of knowledge building where each piece of research connects with others to gradually enhance our understanding of complex phenomena.

Furthermore, the rigorous nature of scientific inquiry involves continuous testing, validation, and potential refutation of ideas. What might be considered a “proof” at one point can later be challenged by new evidence or alternative interpretations. Therefore, the language of “proof” is cautiously used in academic circles to maintain scientific integrity and humility.

This was very helpful, thank you!

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General Research Paper Guidelines: Discussion

Discussion section.

The overall purpose of a research paper’s discussion section is to evaluate and interpret results, while explaining both the implications and limitations of your findings. Per APA (2020) guidelines, this section requires you to “examine, interpret, and qualify the results and draw inferences and conclusions from them” (p. 89). Discussion sections also require you to detail any new insights, think through areas for future research, highlight the work that still needs to be done to further your topic, and provide a clear conclusion to your research paper. In a good discussion section, you should do the following:

• Clearly connect the discussion of your results to your introduction, including your central argument, thesis, or problem statement.
• Provide readers with a critical thinking through of your results, answering the “so what?” question about each of your findings. In other words, why is this finding important?
• Detail how your research findings might address critical gaps or problems in your field
• Compare your results to similar studies’ findings
• Provide the possibility of alternative interpretations, as your goal as a researcher is to “discover” and “examine” and not to “prove” or “disprove.” Instead of trying to fit your results into your hypothesis, critically engage with alternative interpretations to your results.

For more specific details on your Discussion section, be sure to review Sections 3.8 (pp. 89-90) and 3.16 (pp. 103-104) of your 7 th edition APA manual

*Box content adapted from:

University of Southern California (n.d.). Organizing your social sciences research paper: 8 the discussion . https://libguides.usc.edu/writingguide/discussion

Limitations

Limitations of generalizability or utility of findings, often over which the researcher has no control, should be detailed in your Discussion section. Including limitations for your reader allows you to demonstrate you have thought critically about your given topic, understood relevant literature addressing your topic, and chosen the methodology most appropriate for your research. It also allows you an opportunity to suggest avenues for future research on your topic. An effective limitations section will include the following:

• Detail (a) sources of potential bias, (b) possible imprecision of measures, (c) other limitations or weaknesses of the study, including any methodological or researcher limitations.
• Sample size: In quantitative research, if a sample size is too small, it is more difficult to generalize results.
• Lack of available/reliable data : In some cases, data might not be available or reliable, which will ultimately affect the overall scope of your research. Use this as an opportunity to explain areas for future study.
• Lack of prior research on your study topic: In some cases, you might find that there is very little or no similar research on your study topic, which hinders the credibility and scope of your own research. If this is the case, use this limitation as an opportunity to call for future research. However, make sure you have done a thorough search of the available literature before making this claim.
• Flaws in measurement of data: Hindsight is 20/20, and you might realize after you have completed your research that the data tool you used actually limited the scope or results of your study in some way. Again, acknowledge the weakness and use it as an opportunity to highlight areas for future study.
• Limits of self-reported data: In your research, you are assuming that any participants will be honest and forthcoming with responses or information they provide to you. Simply acknowledging this assumption as a possible limitation is important in your research.
• Access: Most research requires that you have access to people, documents, organizations, etc.. However, for various reasons, access is sometimes limited or denied altogether. If this is the case, you will want to acknowledge access as a limitation to your research.
• Time: Choosing a research focus that is narrow enough in scope to finish in a given time period is important. If such limitations of time prevent you from certain forms of research, access, or study designs, acknowledging this time restraint is important. Acknowledging such limitations is important, as they can point other researchers to areas that require future study.
• Potential Bias: All researchers have some biases, so when reading and revising your draft, pay special attention to the possibilities for bias in your own work. Such bias could be in the form you organized people, places, participants, or events. They might also exist in the method you selected or the interpretation of your results. Acknowledging such bias is an important part of the research process.
• Language Fluency: On occasion, researchers or research participants might have language fluency issues, which could potentially hinder results or how effectively you interpret results. If this is an issue in your research, make sure to acknowledge it in your limitations section.

University of Southern California (n.d.). Organizing your social sciences research paper: Limitations of the study . https://libguides.usc.edu/writingguide/limitations

In many research papers, the conclusion, like the limitations section, is folded into the larger discussion section. If you are unsure whether to include the conclusion as part of your discussion or as a separate section, be sure to defer to the assignment instructions or ask your instructor.

The conclusion is important, as it is specifically designed to highlight your research’s larger importance outside of the specific results of your study. Your conclusion section allows you to reiterate the main findings of your study, highlight their importance, and point out areas for future research. Based on the scope of your paper, your conclusion could be anywhere from one to three paragraphs long. An effective conclusion section should include the following:

• Describe the possibilities for continued research on your topic, including what might be improved, adapted, or added to ensure useful and informed future research.
• Provide a detailed account of the importance of your findings
• Reiterate why your problem is important, detail how your interpretation of results impacts the subfield of study, and what larger issues both within and outside of your field might be affected from such results

University of Southern California (n.d.). Organizing your social sciences research paper: 9. the conclusion . https://libguides.usc.edu/writingguide/conclusion

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How to Write an Effective Discussion in a Research Paper; a Guide to Writing the Discussion Section of a Research Article

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The discussion section of a research paper is where the author analyzes and explains the importance of the study's results. It presents the conclusions drawn from the study, compares them to previous research, and addresses any potential limitations or weaknesses. The discussion section should also suggest areas for future research.

Everything is not that complicated if you know where to find the required information. We’ll tell you everything there is to know about writing your discussion. Our easy guide covers all important bits, including research questions and your research results. Do you know how all enumerated events are connected? Well, you will after reading this guide we’ve prepared for you!

What Is in the Discussion Section of a Research Paper

The discussion section of a research paper can be viewed as something similar to the conclusion of your paper. But not literal, of course. It’s an ultimate section where you can talk about the findings of your study. Think about these questions when writing:

• Did you answer all of the promised research questions?
• Did you mention why your work matters?
• What are your findings, and why should anyone even care?
• Does your study have a literature review?

So, answer your questions, provide proof, and don’t forget about your promises from the introduction. 

How to Write a Discussion Section in 5 Steps

How to write the discussion section of a research paper is something everyone googles eventually. It's just life. But why not make everything easier? In brief, this section we’re talking about must include all following parts:

• Answers for research questions
• Literature review
• Results of the work
• Limitations of one’s study
• Overall conclusion

Indeed, all those parts may confuse anyone. So by looking at our guide, you'll save yourself some hassle.  P.S. All our steps are easy and explained in detail! But if you are looking for the most efficient solution, consider using professional help. Leave your “ write my research paper for me ” order at StudyCrumb and get a customized study tailored to your requirements.

Step 1. Start Strong: Discussion Section of a Research Paper

First and foremost, how to start the discussion section of a research paper? Here’s what you should definitely consider before settling down to start writing:

• All essays or papers must begin strong. All readers will not wait for any writer to get to the point. We advise summarizing the paper's main findings.
• Moreover, you should relate both discussion and literature review to what you have discovered. Mentioning that would be a plus too.
• Make sure that an introduction or start per se is clear and concise. Word count might be needed for school. But any paper should be understandable and not too diluted.

Step 2. Answer the Questions in Your Discussion Section of a Research Paper

Writing the discussion section of a research paper also involves mentioning your questions. Remember that in your introduction, you have promised your readers to answer certain questions. Well, now it’s a perfect time to finally give the awaited answer. You need to explain all possible correlations between your findings, research questions, and literature proposed. You already had hypotheses. So were they correct, or maybe you want to propose certain corrections? Section’s main goal is to avoid open ends. It’s not a story or a fairytale with an intriguing ending. If you have several questions, you must answer them. As simple as that.

Step 3. Relate Your Results in a Discussion Section

Writing a discussion section of a research paper also requires any writer to explain their results. You will undoubtedly include an impactful literature review. However, your readers should not just try and struggle with understanding what are some specific relationships behind previous studies and your results.  Your results should sound something like: “This guy in their paper discovered that apples are green. Nevertheless, I have proven via experimentation and research that apples are actually red.” Please, don’t take these results directly. It’s just an initial hypothesis. But what you should definitely remember is any practical implications of your study. Why does it matter and how can anyone use it? That’s the most crucial question.

Step 4. Describe the Limitations in Your Discussion Section

Discussion section of a research paper isn’t limitless. What does that mean? Essentially, it means that you also have to discuss any limitations of your study. Maybe you had some methodological inconsistencies. Possibly, there are no particular theories or not enough information for you to be entirely confident in one’s conclusions.  You might say that an available source of literature you have studied does not focus on one’s issue. That’s why one’s main limitation is theoretical. However, keep in mind that your limitations must possess a certain degree of relevancy. You can just say that you haven’t found enough books. Your information must be truthful to research.

Step 5. Conclude Your Discussion Section With Recommendations

Your last step when you write a discussion section in a paper is its conclusion, like in any other academic work. Writer’s conclusion must be as strong as their starting point of the overall work. Check out our brief list of things to know about the conclusion in research paper :

• It must present its scientific relevance and importance of your work.
• It should include different implications of your research.
• It should not, however, discuss anything new or things that you have not mentioned before.
• Leave no open questions and carefully complete the work without them.

Discussion Section of a Research Paper Example

All the best example discussion sections of a research paper will be written according to our brief guide. Don’t forget that you need to state your findings and underline the importance of your work. An undoubtedly big part of one’s discussion will definitely be answering and explaining the research questions. In other words, you’ll already have all the knowledge you have so carefully gathered. Our last step for you is to recollect and wrap up your paper. But we’re sure you’ll succeed!

How to Write a Discussion Section: Final Thoughts

Today we have covered how to write a discussion section. That was quite a brief journey, wasn’t it? Just to remind you to focus on these things:

• Importance of your study.
• Summary of the information you have gathered.
• Main findings and conclusions.
• Answers to all research questions without an open end.
• Correlation between literature review and your results.

But, wait, this guide is not the only thing we can do. Looking for how to write an abstract for a research paper  for example? We have such a blog and much more on our platform.

Our academic writing service is just a click away. We are proud to say that our writers are professionals in their fields. Buy a research paper and our experts can provide prompt solutions without compromising the quality.

Discussion Section of a Research Paper: Frequently Asked Questions

1. how long should the discussion section of a research paper be.

Our discussion section of a research paper should not be longer than other sections. So try to keep it short but as informative as possible. It usually contains around 6-7 paragraphs in length. It is enough to briefly summarize all the important data and not to drag it.

2. What's the difference between the discussion and the results?

The difference between discussion and results is very simple and easy to understand. The results only report your main findings. You stated what you have found and how you have done that. In contrast, one’s discussion mentions your findings and explains how they relate to other literature, research questions, and one’s hypothesis. Therefore, it is not only a report but an efficient as well as proper explanation.

3. What's the difference between a discussion and a conclusion?

The difference between discussion and conclusion is also quite easy. Conclusion is a brief summary of all the findings and results. Still, our favorite discussion section interprets and explains your main results. It is an important but more lengthy and wordy part. Besides, it uses extra literature for references.

4. What is the purpose of the discussion section?

The primary purpose of a discussion section is to interpret and describe all your interesting findings. Therefore, you should state what you have learned, whether your hypothesis was correct and how your results can be explained using other sources. If this section is clear to readers, our congratulations as you have succeeded.

Joe Eckel is an expert on Dissertations writing. He makes sure that each student gets precious insights on composing A-grade academic writing.

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Framing Collective Moral Responsibility for Climate Change: A Longitudinal Frame Analysis of Energy Company Climate Reporting

• Original Paper
• Open access
• Published: 26 August 2024

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• Melanie Feeney 1 ,
• Jarrod Ormiston 2 ,
• Wim Gijselaers 1 ,
• Pim Martens 3 &
• Therese Grohnert 1  

Responding to climate change and avoiding irreversible climate tipping points requires radical and drastic action by 2030. This urgency raises serious questions for energy companies, one of the world’s largest emitters of greenhouse gases (GHGs), in terms of how they frame, and reframe, their response to climate change. Despite the majority of energy companies releasing ambitious statements declaring net zero carbon ambitions, this ‘talk’ has not been matched with sufficient urgency or substantive climate action. To unpack the disconnect between talk and action, this paper draws on the literature on framing, organisational hypocrisy, and collective moral responsibility. We conduct a longitudinal qualitative content analysis of the framing of climate change used by the ten largest European investor-owned energy companies and the actions they have taken to shift their business practices. Our findings reveal three main categories of energy companies: (i) deflecting, (ii) stagnating, and (iii) evolving. We show key differences in the relationship between framing and action over time for each category, revealing how deflecting companies have larger and persistent gaps between green talk and concrete action and how stagnating companies are delaying action despite increased green talk, while evolving companies exhibit a closer link between talk and action that tends to be realised over time. Our analysis reveals how competing approaches to framing collective moral responsibility help understand the trajectories of talk and action across the different categories of energy companies. This research makes several contributions to the literature on organisational hypocrisy and collective moral responsibility in the context of climate change. Our analysis highlights the complex relationship between collective moral responsibility, organisational hypocrisy and climate action, revealing how different collective framings—diffuse, teleological, or agential—can both enable and offset substantive climate action. The study also enriches our understanding of the performative nature of collective moral responsibility by examining its temporal dimensions and showing how an agential, backward-looking focus is associated with more meaningful climate action.

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Introduction

The energy sector remains one of the world’s largest emitters of greenhouse gases (GHGs), with electricity and heat production responsible for almost half of the world’s GHGs in 2014 (Ritchie & Roser, 2019 ; United Nations, 2019 ). In 2020, two of the world’s largest energy providers, Royal Dutch Shell and British Petroleum (BP), released statements declaring their net zero carbon ambitions by 2050 (Shell Ambrose, 2020 ; Global, 2020 ). However, recent studies suggest that responding to climate change and avoiding irreversible climate tipping points requires drastic action by 2030, not 2050 (Liu et al., 2019 ; Steffen et al., 2015a , 2015b ). Acknowledging this urgency, the European Union recently committed to fighting climate change through higher renewable energy targets by 2030, aiming to source 42.5% of its energy from renewable sources such as wind and solar (Reuters, 2023 ).

This increased urgency raises challenging questions for energy companies in terms of how they frame, and reframe, their response to climate change (Campbell et al., 2019 ; Cornelissen & Werner, 2014 ), and whether this framing can be matched by the radical transformation needed in their business models and actions. To understand this transformation, this paper explores how energy companies are framing their responses to climate change and their actions to shift their business practices. In doing so, we engage with the growing field of scholarship exploring the role of framing in justifying climate change responses and legitimising sustainability strategies (Hahn & Lulfs, 2014 ; Metze, 2018 ; Nyberg & Wright, 2006 ; Nyberg et al., 2018 ; Wright & Nyberg, 2017 ).

Despite the increase in talk about sustainable action and engagement with frames to discuss responses to climate change, we as a society are trending towards overstepping multiple environmental limits and planetary boundaries (O’Neill et al., 2018 ; Steffen et al., 2015a , 2015b ). This dissonance is matched in corporate sustainability reporting, where the expansion of sustainability talk has not been matched with sufficient sustainability action (Cho et al., 2015 ; Higgins et al., 2020 ; Milne & Gray, 2013 ). Understanding this disconnect between talk and action is crucial in ensuring the energy sector moves beyond discursive strategies to seek legitimacy, towards genuine climate action that will contribute to a just transition (Banerjee, 2012 ; Christensen et al., 2021 ). To unpack this potential disconnection between frames, decisions and action, we draw on the literature on organisational hypocrisy and collective moral responsibility.

Organisational hypocrisy aims to explain the discrepancies between the talk and actions of companies (Brunsson, 2002 ; Wagner et al., 2009 ). In recent years, there has been a growing body of literature that explores hypocrisy in corporate sustainability reporting by comparing symbolic approaches (talk) with substantive approaches (action) (Hyatt & Berente, 2017 ; Rodrigue et al., 2013 ; Schons & Steinmeier, 2016 ). Through a critical lens, the hypocritical gap between symbolic talk and substantive action can be viewed as a duplicitous attempt to conceal unsustainable practices or hide a lack of substantive action (Cho & Patton, 2007 ; Milne & Gray, 2013 ; Hyatt & Berente, 2017 ; Snelson-Powell et al., 2020 ). Alternatively, this hypocrisy may be viewed as inevitable as organisations attempt to juggle competing stakeholders' demands (Brunsson, 1986 , 1993 ; Higgins et al., 2020 ), and may be a signal for future substantive action (Clarkson, et al., 2008 ; Clune & O’Dwyer, 2020 ; Malsch, 2013 ).

To better understand the nature of organisational hypocrisy in energy company responses to climate change, we examine the role of collective moral responsibility in shaping the disconnect between talk and action. Moral responsibility refers to the blameworthiness or praiseworthiness for a particular situation (Bovens, 1998 ). We engage collectivist perspectives of moral responsibility, arguing that organisations may have a collective responsibility to respond to, or bring about, a particular state of affairs (Mellema, 1997 , 2003 ; Soares, 2003 ; Tamminga & Hindriks, 2020 ). In unpacking the role of collective moral responsibility in shaping climate action, we zoom in on the temporal nature of moral responsibility, differentiating between both backward-looking (reactive) and forward-looking (prospective) responsibility (Gilbert, 2006a , 2006b ; Sanbhu, 2012 ; Van de Poel, 2011 ). Backward-looking moral responsibility involves taking on blame for immoral past actions, while forward-looking moral responsibility refers to a sense of obligation to avoid future immoral actions (Sanbhu, 2012 ). We also draw on the work of Collins ( 2019 ) that explores a more nuanced understanding of the ‘collective’, differentiating between diffuse collectives that are loosely described groups of agents such as ‘society’, ‘the private sector’, teleological collectives that are responsive towards each other and act towards commons goals such as ‘the energy sector’, and agential collectives that have well-defined collective-level decision-making procedure such as a specific company, partnership or alliance.

To shed light on the disconnects between talk and action and the role of collective moral responsibility, we conduct a qualitative content analysis of the framing used by Europe’s ten largest investor-owned energy companies over a ten-year period. We review 111 sustainability reports from these energy companies between 2010 and 2019 to understand the evolution of their framing of climate change and the actions they have taken over time. The analysis is guided by the following overarching research questions: “How have energy companies framed their responses to climate change over time?”, “How does their framing relate to climate action?”, and “What is the relationships between different framings of collective moral responsibility and the nature of climate change talk and action?”.

Our analysis of framing and action over time reveals three main categories of energy companies: (i) deflecting, (ii) stagnating, (iii) evolving. Deflecting companies continue to engage in unsustainable business-as-usual practices despite offering some green rhetoric. Stagnating companies are making some progress but seem to be stalling and delaying more radical action despite increased sustainability talk. Evolving companies appear to be progressing towards a more sustainable future and questioning and rethinking their business models. We noticed key differences in the relationship between action and framing over time for each category, with evolving companies having a closer link between talk and action that tends to be realised over time, and deflecting companies having more significant and persistent gaps between green talk and concrete action.

The findings show how competing approaches to framing the nature of collective moral responsibility help to understand the trajectories of talk and action across the different categories of energy companies. As suggested by the data from our study of ten energy companies, deflecting firms seem to evoke a diffuse collective of society, deferring responsibility to other actors, including government and civil society and framing their own moral responsibility in a more forward-looking, prospective way. The companies we classified as stagnating seem to shift from a diffuse collective before framing their role as part of a broader teleological collective of the energy sector, yet remain somewhat vague in terms of their own responsibility for climate action. The companies we classified as evolving, seem to frame their role as an agential collective and acknowledge their own moral responsibility for causing or contributing to climate change. This backward-looking perspective on their moral responsibility appears to be shaping substantive action in the present.

By engaging with theories of collective moral responsibility, our paper contributes to the literature on business ethics and climate change in several ways. We contribute to the literature on business ethics, moral responsibility, and organisational hypocrisy by providing a nuanced understanding of the performative nature of collective moral responsibility (Soares, 2003 ; Tamminga & Hindriks, 2020 ). In doing so, we highlight the diverse ways in which conceptions of the collective as diffuse, teleological, or agential (Collins, 2019 ) are associated with different types of climate talk and action and different levels of organisational hypocrisy. Specifically, we show that agential collectives with a backward-looking sense of responsibility are more likely to engage in substantive action, while diffuse and teleological collectives tend to focus on symbolic talk. We contribute to the broader literature on framing (Cornelissen & Werner, 2014 ) and organisational hypocrisy (Brunsson, 2002 ) by unpacking the relationship between organisational framing of collective moral responsibility and the nature of organisational hypocrisy. We show how agential notions of the collective and backward-looking responsibility are associated with more substantive climate action. This insight extends prior research by highlighting the dynamic interplay between framing, moral responsibility and climate action. We also contribute to a temporal understanding of collective moral responsibility and organisational hypocrisy by adopting a temporal lens that reveals how the understanding of the collective and the direction of responsibility shift over time and how this relates to action and inaction on climate change (Brunson, 1986 , 1993 , 2002 ; Cho et al., 2015 ). Our longitudinal analysis shows the ways in which these shifts are critical for substantive action. Finally, we contribute to practice by highlighting the shifts in collective moral responsibility associated with energy companies becoming more sustainable and authentically engaging in climate action.

Theoretical Background

Frames and sustainability.

Corporate responses to climate change, particularly within the energy sector, require drastic changes to a company’s strategy, operations, and often even their identity (Boons et al., 2013 ; Frandsen & Johansen, 2011 ). Transitioning from a company that has operated as a leader in energy production sourced from fossil fuels to a company that prioritises a carbon–neutral energy mix is a complicated process (Mori, 2021 ). This shift requires companies to rethink what technologies they invest in, the speed at which they make these changes, and how to ensure their workforce is on-board and prepared for the change (Garavan & McGuire, 2010 ; Nisar et al., 2013 ). All of these require managers to make tough choices between long-term and short-term value (Slawinski & Bansal, 2015 ). This transformation requires companies to frame and reframe how they understand their role in terms of climate action. We thereby engage with literature on framing (Cornelissen & Werner, 2014 ) to explore how energy companies engage in meaning-making with regard to climate change and how this relates to their climate change responses and actions.

The construct of frame or framing was first introduced in the 1930s within the social sciences and has since gained popularity in a wide range of research traditions (Cornelissen & Werner, 2014 ), including cognitive psychology and behavioural economics (e.g., Kahneman et al., 1986 ), sociology and social movements (e.g., Fligstein & McAdam, 2011 ), political science (e.g., Barth & Bijsmans, 2018 ), and organisation and management studies (e.g., Gioia & Chittipeddi, 1991 ). According to Goffman ( 1974 ), no action or behaviour can be initiated without some form of framing, that is, making sense of what is going on. Frames are constructed based on past experiences and act as a point of reference for sense-making (Kahneman, 1984 ). Rather than viewing a frame as an isolated or static structure, framing is understood as an interactional and ongoing process of constructing meaning (Dewulf et al., 2009 ). Frames are, therefore, constantly updated and adjusted based on new experiences or information (Dewulf et al., 2009 ; Kahneman, 1984 ). In fact, Nyberg et al. ( 2016 ) argue that any theory of framing must contain time, which underpins our temporal analysis of energy company framing of climate change over a ten-year period.

Framing has been applied in research on cognition, sense-making and decision-making processes (Benner & Tripsas, 2012 ; Walsh, 1995 ; Weick, 1995 ), and in research on organised groups and organisations (Cornelissen & Werner, 2014 ). How an organisation frames its environment and where it sits within that environment is referred to as strategic framing (Gilbert, 2006a , 2006b , Kaplan, 2008 ). A strategic frame refers to “a set of cause-effect understandings about industry boundaries, competitive rules, and strategy-environment relationships available to a group of related firms in an industry” (Nadkarni & Narayanan, 2007 , p.689). Strategic frames, and subsequent decision-making processes, can therefore be influenced by a variety of actors, e.g., shareholders and other stakeholders, or external forces e.g., changing markets, industry trends or changing societal beliefs and values (Battilana et al., 2009 ; Gilbert, 2006a , 2006b ).

Traditionally the greatest forces of influence over corporate sustainability strategies have come from government legislation and regulation and changing market and industry trends (Boons et al., 2013 ; Brønn & Vidaver-Cohen, 2009 ; Christensen et al., 2021 ). Whilst these regulatory and market conditions still greatly influence corporate sustainability strategies, we are now also seeing increased pressure from social actors on companies to act ethically and responsibly (Banerjee, 2008 ; O’Brien et al., 2018 ; Porter & Kramer, 2011 ). As a result, the variety of stakeholder expectations that energy companies must consider, and the regulatory and market environments that they operate in, have become increasingly complex (Banerjee, 2008 ). With this growing complexity has come an increased interest from scholars in corporate sustainability framing and responses (Hahn et al., 2014 ).

Framing and sustainability responses in the energy sector have been a growing area of academic interest in recent years (Schlichting, 2013 , Hahn et al., 2014 ). Studies have sought to understand the frames adopted in political conversations around specific energy technologies like fracking (Metze, 2018 ; Nyberg et al., 2020 ), or the framing of intertemporal tensions in oil companies’ climate change responses (Slawninski & Bansal, 2015 ). These studies have found that how an organisation frames climate change has implications for the types of responses they enact in the short and long-term (Nyberg et al., 2020 ; Slawinski & Bansal, 2015 ). These studies further demonstrate the importance of unpacking energy company framing of climate change to understand current and future action and inaction.

Several theoretical and empirical articles that have contributed to our understanding of energy company framing of sustainability and climate change in recent years (Wright & Nyberg, 2017 , Hahn et al., 2014 , Shlichting, 2013 ). In 2013, Schlichting published an article that looked at the ways different industry actors (including energy sector actors) had framed climate change from 1990 to 2010, their reasoning for adopting each frame, and their strategies for communicating frames. The study revealed dominant frames at three moments of time across the two decades, starting with ‘scientific uncertainty’ from 1990 to the mid-1990s when industry actors questioned the science around climate change. From 1997 to the early 2000s, companies used ‘socioeconomic consequences' frames, where industry actors acknowledged the potential risks of climate change but drew attention to the costs to the company and consumers if they were to act in accordance with the Kyoto Protocol (that was passed in 1997). Finally, from the 2000s to 2010, companies adopted ‘industrial leadership’ frames, where industry actors acknowledged their role in climate change and saw technology as offering a win–win solution to remaining competitive while also responding to the threat of climate change. Whilst Schlichting ( 2013 ) contributes to our understanding of energy company framing of climate change, the article does not consider the specific actions or inactions that are related to each frame.

In a similar study, Wright and Nyberg ( 2017 ) looked at framing as one element of corporate responses to climate change from 2005 to 2015 and concluded that the dominant framing across all companies (including one oil and gas company) for climate change was ‘business case’ framing. Wright and Nyberg ( 2017 ) describe business case framing of climate change as when companies conformed to short-term market conditions and observed that over time, companies would regress toward traditional business concerns, i.e., profit maximisation. The authors offer some examples of how energy company framing aligns with actions in response to climate change, i.e., investment in renewable energy projects and greater attention given to potential regulatory changes, however, due to the diversity of companies included in the study, these examples are limited.

Finally, Hahn et al. ( 2014 ) identify the business case as a dominant frame in their review study of managers’ responses to sustainability. However, the authors positioned business case frames on a continuum with ‘paradoxical’ frames on the opposing end. Paradoxical frames capture a more developed understanding and appreciation for the tensions between social, environmental, and economic aspects of sustainability by managers and are more aligned with more radical, albeit slow, responses to sustainability issues (Hanh et al., 2014 ). Given that the Hahn et al. ( 2014 ) article is a review paper, the focus is largely theoretical and does not specifically observe the relationship between frames and actions.

Our study builds on previous research by focusing specifically on energy companies and attempting to understand the relationship between frames and actions. Previous research has paid limited attention to the relationship between climate change frames and actions adopted by energy companies (for example, Schlichting, 2013 , Hahn et al., 2014 ). Understanding the relationship between frames and action is important, as while frames are often viewed as causal mechanisms for shaping decisions and action, broader research on sustainability reporting highlights the pervasive disconnects between sustainability talk and action (Cho et al., 2015 , Higgins et al., 2020 , Hyatt & Berente, 2017 , Rodrigue et al., 2013 , Schons & Steinmeier, 2016 ). Our paper thereby aims to build on previous research by taking a more critical and nuanced stance in reviewing frames and sustainability reports that question the links between frames and action. In the following section, we introduce the literature on organisational hypocrisy (Brunsson, 2002 ; Wagner et al., 2009 ) to help unpack the potential for disconnects between symbolic talk and substantive action.

Symbolic Talk, Substantive Action, and Organisational Hypocrisy

Research on sustainability reporting suggests a persistent gap between talk and action in how corporations are responding to sustainability challenges (Cho et al., 2015 ; Higgins et al., 2020 ). Fassin and Buelens ( 2011 ) highlight this dissonance between sustainability rhetoric and actual business practices noting that the “idealism of corporate communication contrasts sharply with the reality of day-to-day business life” (pp. 586–587). To better understand the disconnect between sustainability talk and action in energy company responses to climate change, we engage with the literature on organisational hypocrisy. Organisational hypocrisy refers to the disconnect between talk and action (Brunsson, 2002 ; Wagner et al., 2009 ), as evidenced by “the distance between assertions and performance” (Fassin & Buelens, 2011 , p. 587). This literature on organisational hypocrisy is underpinned by early work in institutional theory that explores how organisations engage in myth and ceremony as they decouple talk from action in order to gain legitimacy (Bromley & Powell, 2012 ; Crilly et al., 2012 ; Meyer & Rowan, 1977 , Oliver, 1991 ). This research has tended to look at how talk is decoupled from action at particular moments in time, with insufficient exploration of the relationship between talk and action over time (Reinecke & Lawrence, 2023 ).

Significant literature on corporate sustainability and corporate social responsibility has explored organisational hypocrisy by comparing symbolic approaches (green talk) with substantive approaches (green action) (Hyatt & Berente, 2017 ; Rodrigue et al., 2013 ; Schons & Steinmeier, 2016 ). Substantive approaches involve meaningful ‘actions’ that shift practices to prioritise improved environmental performance (Hyatt & Berente, 2017 ; Sharma & Vredenburg, 1998 ). Ashforth and Gibbs ( 1990 ) define substantive approaches as those that involve “real, material changes in organizational goals, structures, and processes or socially institutionalized practices.” (p. 178). Substantive approaches thereby require tangible, observable shifts in organisational activities and resource use (Schons & Steinmeier, 2016 ).

Symbolic approaches refer to ‘talk’ that creates an appearance of commitment to sustainability without necessarily shifting organisational practices (Donia & Sirsly, 2016 ; Hyatt & Berente, 2017 ). Companies often engage in symbolic talk to enhance their reputation or to increase their legitimacy in the eyes of certain stakeholders (Ashforth & Gibbs, 1990 ; Elsbach & Sutton, 1992 ). Symbolic approaches can be viewed as ceremonial conformity to the demands of influential stakeholders without the actual changes to activities (Meyer & Rowan, 1977 ; Oliver, 1991 ). The goal of engaging in purely symbolic talk is often to deflect or conceal relatively poor environmental performance (Cho et al., 2010 ).

There are significant debates about the linkages between symbolic talk and substantive action and the implications of organisational hypocrisy for sustainability action over time (Rodrigue et al., 2013 ). From a critical perspective, the hypocritical gap between talk and action is viewed as an attempt to conceal continued poor environmental performance, recast unsustainable practices in a more positive light, or obscure a lack of substantive action (Cho & Patton, 2007 ; Milne & Gray, 2013 ; Hyatt & Berente, 2017 ). Some studies adopt a more positive lens on the disconnect between talk and action, suggesting that symbolic talk in the form of extensive environmental disclosures can be a signal for future substantive action on environmental issues (Clarkson, et al., 2008 ; Clune & O’Dwyer, 2020 ; Malsch, 2013 ). This stream of research suggests the potential for hypocrisy to play an aspirational role, as discrepancies between talk and action may serve to stimulate improvements in sustainability performance over time, even when companies do not meet their aspirations (Christensen et al., 2013 ).

Research on organisational hypocrisy also reveals competing perspectives on the nature of intentionality and duplicity associated with the disconnect between talk and action. Organisational hypocrisy is often used to describe situations in which companies have intentionally presented themselves in a way that does not reflect the underlying reality (Higgins et al., 2020 ; Laufer, 2003 ). This form of hypocrisy is viewed as duplicitous, where the intention is to deceive certain parties (Snelson-Powell et al., 2020 ). This duplicitous form of hypocrisy is echoed in the literature on greenwashing and other forms of unethical management practices (Delmas & Burbano, 2011 ; Laufer, 2003 ; Lyon & Montgomery, 2015 ). An alternative perspective views organisational hypocrisy as an inadvertent and inevitable response for organisations attempting to juggle competing demands and expectations in their broader environment (Higgins et al., 2020 ). Through this lens, organisations might construct conflicting ideologies and hypocritical talk and decisions in order to garner support and legitimacy in the face of incompatible demands (Brunsson, 1986 ) In this sense, organisations might engage in hypocrisy in an attempt to isolate competing stakeholder ideas and pressures from action, resulting in actions that are difficult to justify being compensated by talk in the opposite direction (Brunsson, 1993 ).

To unpack the evolution of talk and action over time, we draw on Dyllick and Muff’s ( 2016 ) article that introduces a typology of business sustainability actions and responses. The article provides examples of common sustainability-related strategies, the actions that support these strategies, and four levels of business sustainability, i.e., business-as-usual, sustainability 1.0, sustainability 2.0, and sustainability 3.0. We detail how the Dyllick and Muff ( 2016 ) framework was used as a starting point for analysing the frames and actions of energy company sustainability reports in the methods section.

To better understand the nature of, and reasons for, organisational hypocrisy in energy company responses to climate change, we now turn to the literature on collective moral responsibility as a lens to explore disconnects between talk and action.

Collective Moral Responsibility

To understand the relationship between climate change talk and action over time, we engage with the literature on collective moral responsibility. Moral responsibility refers to the blameworthiness or praiseworthiness for a certain state of affairs (Bovens, 1998 ). For moral responsibility (blame or praise) to be ascribed to an agent, they need to have autonomy, intentionality, and contextual knowledge, and there needs to be a direct or direct causal connection between the agent and the outcome (Constantinescu & Kaptein, 2015 ).

There are multiple philosophical and ethical debates between collectivist and individualist approaches of understanding moral responsibility (Miller & Makela, 2005 ; Soares, 2003 ). In this paper, we align with collectivist approaches to moral responsibility, which argue that a collective may have a responsibility to bring about a certain state of affairs and that while no individual might be individually responsible, they have an obligation as a member of the collective (Mellema, 1997 , 2003 ; Tamminga & Hindriks, 2020 ). This collective view has been adopted by business ethics scholars, who argue that this broader collective perspective on moral responsibility is needed to ensure corporations and organisations take into consideration the needs and interests of society (Soares, 2003 ). Through this lens, responsibility for a situation can be ascribed to the corporation and the individual members or both (Constantinescu & Kaptein, 2015 ). Corporations should thereby be viewed as intentional actors capable of responding to internal and external challenges (Soares, 2003 ).

Moral responsibility can be both backward and forward-looking (Gilbert, 2006a , 2006b ; Sanbhu, 2012 ; Van de Poel, 2011 ). Forward-looking moral responsibility is concerned with obligations to prevent future immoral actions, whereas backward-looking moral responsibility is concerned with the blameworthiness of immoral actions in the past (Sanbhu, 2012 ). Gilbert ( 2006a , 2006b ) describes the related yet distinct nature of backward-looking and forward-looking moral responsibility as follows: “Though we are not morally responsible for what happened, we are morally responsible for ameliorating its effects.” (p.94). Van de Poel ( 2011 ) outlines five normative notions of moral responsibility, three of which are backward-looking (accountability, blameworthiness and liability) and two which are forward-looking (responsibility as virtue and as moral obligation). In this sense, backward-looking responsibility involves seeing oneself as accountable or to blame for past actions. Whereas forward-looking responsibility is associated with future actions involved in seeing “to it that something is the case” rather than taking the blame for actions in the past.

Prior research is often ambiguous about the nature of the collective when exploring moral responsibility, and often uses backward-looking and forward-looking responsibility interchangeably. To provide a more nuanced perspective on the role of collective moral responsibility in shaping responses to climate change in the energy sector, we draw on the work of Collins ( 2019 ) which encourages a more nuanced understanding of the ‘collective’ and the temporal nature of moral responsibility. Collins ( 2019 ) suggests three forms of collective: diffuse, teleological and agential. As explained in the table below, diffuse collectives are loosely described groups of agents such as ‘society’, ‘humanity’, ‘the private sector’, teleological collectives that are responsive towards each other and act towards commons goals such as ‘the fossil fuel lobby’, ‘the energy sector’, and agential collectives that have well-defined collective-level decision-making procedures such as a specific company, partnership or alliance. Collins ( 2019 ) also differentiates between two forms of moral responsibility: backward-looking or reactive and forward-looking or prospective. These perspectives help to understand whether collectives are taking blame or praise for past actions or future obligations. Table 1 provides a description and example of each of these forms of collective and moral responsibility.

Methodology

We conducted a qualitative content analysis of ten European energy companies’ sustainability reports to determine how they are framing their responses to climate change and the related actions they have taken to shift their business practices. Qualitative content analysis is “a research method for the subjective interpretation of the content of text data through the systematic classification process of coding and identifying themes or patterns” (Hsieh and Shannon, 2005 , p. 1278). Qualitative content analysis was chosen as it allows for a more contextual and circumstantial understanding of texts communicated by companies, rather than quantitative approaches that focus on the frequency of the texts or words used (Mayring, 2000 , 2010 ). Qualitative content analysis has been a widely used approach for analysing corporate sustainability reports (see for example, Boiral et al., 2019 ; Boiral, 2016 ; Hahn & Lulfs, 2014 ) and is viewed as an important method in business ethics research to understand talk and action (Cowton, 1998 ; Lock & Seele, 2015 ). In the following section, we detail the case selection, materials, and methods of content analysis that informed our findings.

Case Selection and Material

The sample consisted of sustainability reports (or Corporate social responsibility (CSR) reports or environment reports) from the ten Footnote 1 largest investor-owned European energy companies (see Table  2 ). The ten energy companies were selected based on the S&P Global Platts Top 250 companies based on their “asset worth, revenues, profits and return on invested capital” (S&P Global, 2020 , p. 3). We chose companies specifically within the European Union (at the time of reporting) to ensure the companies shared the same regulatory environment. Consequently, we excluded the Norwegian company Equinor ASA from the case selection. Additionally, we chose to focus on investor-owned energy companies as many of the largest state-owned energy companies did not publicly list their sustainability data and reports. We note that this lack of data on state-owned companies requires further study given their substantial environmental impact. Table 2 lists the ten companies included in the analysis in order of where they ranked in the S&P Global list of energy companies. The table also shows the country in which they are headquartered, and the number of reports included in the analysis.

For each of the ten selected companies, we then checked whether they were listed on relevant sustainability rankings. It was found that three of the selected companies had been listed on the Carbon Majors database, a global list of companies responsible for the largest amounts of carbon and methane emitted into the atmosphere (Climate Accountability Institute, 2017 ): Royal Dutch Shell, Total and BP. Three were listed on the Global Corporate Knights index, an independently organised ranking of companies based on their sustainability performance (Scott, 2020 ): Enel, Iberdrola and Ørsted. The remaining four companies were not listed on either ranking, including E.ON, Eni, OMV and Repsol. This range in sustainability performance across the ten companies ensured a rich and diverse case selection for exploring our research questions.

We collected PDF versions of each company’s publicly accessible sustainability reports from 2010 to 2019. We chose not to include reports from 2020 due to the potential impact of the COVID-19 pandemic on our analysis. In some instances, sustainability reports were not published for the full timeframe of interest. In these cases, company annual reports were analysed for climate change framing and actions. Similarly, several companies published multiple climate-related reports in the same year, for example, Eni published a ‘Decarbonization report’ and ‘Sustainability report’ in 2017. To ensure that an accurate interpretation of the company’s framing of climate change was captured, all available climate-related reports were included in the analysis. This resulted in a total of 111 reports. As the focus of the study was on climate change, a decision was also made to exclude sections of the sustainability reports not relevant to climate change, specifically some elements of the ‘social’ pillar of sustainability, e.g., ‘working with communities’, and ‘diversity’ as these issues were more closely related to employment and workforce matters rather than core operations.

Data Analysis

We applied a combination of Mayring’s ( 2014 ) step models of deductive and inductive approaches to analysing qualitative data. Our analysis has four main stages (i) coding climate talk and action; (ii) comparing talk and action over time (i.e. organisational hypocrisy); (iii) coding framing of collective moral responsibility; (iv) analysing linkages between organisational hypocrisy and collective moral responsibility.

Stage 1 – Coding talk and action

The first stage of analysis involved coding climate change talk and action in each report. A mix of climate talk and action was coded using Atlas.ti qualitative analysis software. We inductively coded talk and action regarding climate change which led to the emergence of the following dominant categories of codes: climate crisis, competitor mindset, external dialogue, governance, innovation and technology, policy and compliance, positioning, reporting, research and development, shared decision-making, strategy, sustainability goals, temporality, tension between actors, values prioritised.

We then separated and categorised talk from action in each report according to the following four categories that were derived from the Dyllick and Muff ( 2016 ) Business Sustainability Typology (BST). We thereby provided an overall rating for both action and framing for each report according to the following levels.

0.0 – Business as usual: : where companies prioritise financial outcomes and value creation for shareholders with limited focus on sustainability actions.

1.0 – Sustainability as risk management and compliance : where companies take some actions toward sustainability in response to pressure from external stakeholders, viewing sustainability actions as a form of risk management or compliance.

2.0 – Sustainability as multiple value creation: where companies begin attending to multiple forms of value creation (social/cultural, environmental, economic value) and develop defined goals and actions to address sustainability issues.

3.0 – Sustainable transformation: where companies aim to utilise their capabilities and expertise for the purpose of addressing pressing societal challenges such as climate change and enact actions to intentionally generate a positive impact on the world.

In some cases, we coded action or framing as between levels and thereby used 1.5 or 2.5 as the rating. Table 3 provides a description of each of those codes and representative quotes of both action and framing for each level of sustainability.

Stage 2 – Comparing talk and action over time (i.e. organisational hypocrisy)

Following our coding of climate talk and action according to the levels derived from the Dyllick and Muff ( 2016 ) typology, we then explored the relationship between talk and action for each company over the ten-year period. Plotting the shifts in climate talk and action over time allowed us to visualise the evolution of sustainable action from each energy company, as well as visualising the gap between talk and action (i.e. organisational hypocrisy). This analysis allowed us to ascertain different categories of energy companies.

Through this temporal analysis, we identified three categories of energy companies. The first category, Shell and BP, has the largest gaps between talk and action, especially at the beginning of the decade, and were the least progressed in terms of their level of sustainability, only reaching the Sustainability 1.0 level. The second category, Total, Eni, Enel, Repsol, OMV, has made some progress towards the Sustainability 2.0 level but at a relatively slow pace, with action remaining about half a step behind action throughout the decade. The third category, Ørsted, EON, Iberdrola, had made the most progress towards the Sustainability 3.0 level, with framing more closely linked to action, and with action eventually matching up to the talk. The figures presented in the findings section visualise the development of climate talk and action over the decade for each of the companies and the combined development for each category.

Stage 3 – Coding framing of collective moral responsibility

In the next phase of analysis, we sought to understand whether overarching approaches to framing climate change were shaping the nature of climate talk and action. Through a process of connecting, merging and subdivision of codes, we unpacked four overarching frames for conceptualising the role of energy companies in addressing climate change: ‘moral responsibility’, business case’, ‘technological’ and ‘disclosure’. We observed that energy companies did not simply adopt one frame but often adopted multiple frames to communicate and motivate their climate change responses. We observed that the ‘moral responsibility’ framing was the most relevant in differentiating between the three different categories. We thereby decided to recode our data to draw out a more nuanced understanding of how energy companies were framing the nature of moral responsibility.

In this phase of the analysis, we deductively coded the reports drawing on Collins’s ( 2019 ) theorisation of collective moral responsibility. We coded each report for three forms of the ‘collective’: diffuse, teleological, and agential. We also coded two forms of ‘moral responsibility’: backward-looking/reactive and forward-looking/prospective. The following table provides a description and representative quotes for each of these forms of collective and moral responsibility (Table  4 ).

Stage 4 – Linkages between organisational hypocrisy and collective moral responsibility

In the final stage of analysis, we explored the linkages between the framing of collective moral responsibility and the nature of talk and action by comparing the framing of the collective and the temporal nature of moral responsibility for each of the three categories. We observed that the first category tended to refer to a more diffuse collective and frame moral responsibility in a forward-looking manner. We named this category ‘Deflecting’ as they appear to shift blame and responsibility towards a diffuse collective of government, industry and broader societal actors which results in a larger gap between climate talk and action.

Alternatively, the third category tended to refer to a more agential collective over time as they began to take on blame for causing or contributing to climate change through a more backward-looking understanding of moral responsibility. We named this category ‘Evolving’ given that both their climate talk and action tended to improve over time as they adopted a more agential responsibility.

In analysing the remaining category, which sat between the deflecting and evolving groups, we noted that they had shifted more towards a teleological collective over time as they began to acknowledge the role of the energy sector in addressing climate change. This category was less specific about their own responsibility compared to the evolving group, and appeared to have stalled somewhat in their climate action over time. We named this category ‘Stagnating’, as a reflection of their slow movement towards more sustainable climate action.

Table 5 provides an overview of the three categories, the links between talk and action for each category, and the nature of collective moral responsibility for each category.

Our analysis of actions and framing over time revealed three main categories of energy companies: (i) Deflecting (ii) Stagnating, (iii) Evolving.

Deflecting companies largely maintain business as usual despite some green talk/rhetoric. These companies focus on staying compliant with regulations and ensuring awareness of changing societal standards and expectations. Deflecting companies are slow to adopt targets for emissions and energy intensity, choosing to focus more on targets for investment.

Stagnating companies seem to be stalling and delaying more radical action. While they tend to set clear emissions and energy intensity targets, progress in meeting these targets is slow. This is largely due to the fact that they focus on the easier wins that come by saving costs and waste through efficiencies. Stagnating companies also tend to invest in new renewable technologies, however, this is often framed as an opportunity to diversify their portfolio rather than radically transform their business models away from fossil fuels.

Evolving companies are progressing towards a more sustainable future and rethinking their business models. Evolving companies category bold emissions and energy intensity targets that they often meet and exceed, this is largely achieved by a combination of efficiency technologies and going beyond investment in renewables to diversify their portfolio and moving their entire business strategy away from fossil fuels.

We noticed meaningful differences in the relationship between action and framing over time for each category, with evolving companies having a closer link between talk and action and deflecting companies having larger gaps between green talk and concrete action.

We also observed competing approaches to framing the nature of collective moral responsibility. Deflecting firms seem to evoke a diffuse collective and frame moral responsibility in a more forward-looking, prospective way. Stagnating companies seem to engage in teleological moral responsibility over time but are somewhat vague. Evolving companies seem to frame their role as an agential collective and acknowledge a backward-looking moral responsibility for climate change.

Deflecting Companies

Deflecting firms like Shell and BP appear to maintain a largely business-as-usual approach to their activities despite increasing green talk and rhetoric. Figure  1 below illustrates how these companies enacted limited shifts in their climate actions over the decade despite increasing rhetoric. The trajectories highlight that these companies had the largest gaps between talk and action, especially earlier in the decade.

The relationship between talk and action for deflecting companies

As shown in the figures, deflecting companies exhibited the largest gaps between climate talk and action and evidenced the least progression in terms of substantive climate action. Deflecting companies tended to prioritise the growth of their existing fossil fuel-reliant business models over climate outcomes. Over the decade, they appear to justify their continued use of fossil fuels by the need to provide reliable energy to a growing global population of consumers. Using notions of ‘security of supply’ and ‘energy for all’ to position themselves as the solution to the growing demand for energy in developing and emerging economies and argue that renewable energies are not reliable or abundant enough to achieve this:

We have an important role to play in finding much needed resources of oil and gas to meet the growing energy demand. (BP, 2013 Report) The Arctic could be essential to meeting growing demand for energy in the future. It holds as much as 30% of the world’s undiscovered natural gas and around 13% of its yet-to-find oil, according to the U.S. Geological Survey. (Shell, 2010 Report) The world needs to produce enough energy to keep economies growing, while reducing the impact of energy use on a planet threatened by climate change. Shell works to help meet rising energy demand in a responsible way. That means operating safely, minimising our impact on the environment and building trust with the communities who are our neighbours (Shell, 2012 Report)

As illustrated in the following quotes, these energy companies will often prefix their climate commitments by first demonstrating the ways in which they will maximise shareholder returns in future energy scenarios, with climate change presented as an opportunity to increase profits or as a threat that must be dealt with to protect future profits. In these reports early in the decade, we see limited accountability or blame taken on by these companies.

BP’s objective is to create value for shareholders by helping to meet the world’s growing energy needs safely and responsibly (BP, 2011 Report) We are taking steps to prepare for the potential physical impacts of climate change on our existing and future operations. Projects implementing our environmental and social practices are required to assess the potential impacts to the project from the changing climate and manage any significant impacts identified. (BP, 2011 Report)

The actions of these deflecting companies highlight their support for a gas-led transition, offering gas as a cleaner fossil fuel to other alternatives like coal and oil. However, energy companies also use advancements in fossil fuel technologies to position other, more polluting, fossil fuels as ‘clean’.

Our approach to helping to tackle global CO2 emissions focuses on four main areas: producing more natural gas, helping to develop carbon capture and storage, producing low-carbon biofuel and working to improve energy efficiency in our operations (Shell, 2011 Report) We believe that, to meet global climate goals, the world should prioritize: Reducing emissions rather than promoting any one fuel as the answer. The world will need all forms of energy for a long time to come, so we need to make all fuels cleaner. (BP, 2017 Report)

Overall, it is clear from the way that these deflecting companies talk throughout the decade that they are not questioning their underlying business model, and not engaging in any forms of reactive or backward-looking responsibility.

We are producing almost as much cleaner-burning natural gas as oil, producing low-carbon biofuel, helping to develop carbon capture and storage (CCS) technologies, and putting in place steps to improve our energy efficiency. (Shell, 2012 report)

The disconnect between talk and action for deflecting companies was evidenced by the dissonance between their framing around meeting the needs of society while showing that their actions were still focused on business-as-usual practices. For example, both Shell and BP spoke of their desire to focus on the needs of society:

In 2017, we announced our ambition to cut the net carbon footprint of the energy products we provide by around half by 2050 in step with society’s drive to align with the goals of the Paris Agreement. (Shell, 2017 report) Today’s challenge is to manage and meet growing demand for secure, affordable energy while addressing climate change and other environmental and social issues. (BP, 2012 report)

Yet, both companies make clear that they will only act where it makes commercial sense. Or note that they continue with business as usual until climate inaction presents a financial risk:

Shell is a willing and able player in this transition. We will play our role where it makes commercial sense, in oil and gas, as well as in low-carbon technologies and renewable energy sources. (Shell, 2017 report) Even under the International Energy Agency’s most ambitious climate policy scenario (the 450 scenario a), oil and gas would still make up 50% of the energy mix in 2030...This is one reason why BP’s portfolio includes oil sands, shale gas, deepwater oil and gas production, biofuels and wind. (BP, 2012 report)

For deflecting companies, the distance between talk and actions is achieved by talking about what they want to do rather than substantiated action:

We want to help the world reach net zero and improve people’s lives and can only do this by being a safe, focused, responsible, well-governed and transparent organization. (BP, 2019 report)

Or by leading reports with ‘cherry-picked’ data that presents an incomplete story of their actions. For example, in the quote below, Shell draws attention to their success in improving energy intensity across their operations, despite the fact that their overall direct emissions increased in the same year. These deflections can be seen as attempts by Shell to avoid blame or accountability for past actions.

In 2014, we continued to improve our energy intensity (the amount of energy consumed for every unit of output). This is the result of work within our operations to improve the reliability of equipment and undertake energy efficiency projects. (Shell, 2014 report)

Our analysis suggests that deflecting companies seem to evoke a diffuse collective and frame moral responsibility in a more forward-looking, prospective way. The following quotes capture their framing of the diffuse collective of ‘businesses, governments and civil society’ and ‘society as a whole’ when discussing who is responsible for climate action:

Tackling climate change remains urgent and requires action by governments, industry and consumers. (Shell, 2010 report) Climate change is a major global challenge—one that will require the efforts of governments, industry and individuals (BP, 2010 report) Governments and civil society must work together to overcome the challenges of climate change and the energy-water-food stresses. We are encouraging this collaboration. (Shell, 2012 report)

These deflecting firms explicitly do not take responsibility as an agential collective, deferring to the broader diffuse notions of collective responsibility:

The scale of the global challenges that the world faces is too great for one company, or one sector, to resolve. (Shell, 2013 report) No one company or sector alone can deliver a low-carbon future. Everyone, from consumers to corporations to governments, needs to take responsibility. (BP, 2017 report)

The focus on the role of the diffuse collective remains at the end of the decade, despite the acknowledgement of the increased urgency:

In 2019, demands for urgent action on climate change grew ever louder. All of society, from consumers, to businesses, to governments, recognised the need to accelerate global efforts to reduce greenhouse gas emissions. (Shell, 2019 report) Of course, the task of tackling climate change is bigger than any single company. Everyone on the planet, from consumers, to businesses, to governments, must play their part in reducing greenhouse gas emissions. Everyone must work together. (Shell, 2019 report) A shared challenge. To meet the Paris goals, we believe the world must take strong action on a range of fronts (BP, 2018 Report)

Overall, we observed deflecting companies’ tendency to talk about the climate action they will take in the future, with a tendency to talk about what they want to do, rather than what they have been doing. Moral responsibility is thereby considered in a forward-looking, prospective sense:

In 2017, we announced our ambition to cut the net carbon footprint of the energy products we provide by around half by 2050 in step with society’s drive to align with the goals of the Paris Agreement. (Shell, 2017 report) We have set out our strategy for the coming decades, integrating our ambition to be a safe, strong, successful business with our aspiration to be a good corporate citizen and part of the solution to climate change. (BP, 2016 report) We want to help the world reach net zero and improve people’s lives and can only do this by being a safe, focused, responsible, well-governed and transparent organization. (BP, 2019 report)

Stagnating Companies

The category of stagnating companies, which in our study was found to be represented by Total, Eni, Enel, Repsol, and OMV, appear to be somewhat stalled in their attempts to enact more radical sustainability action. As shown in Fig.  2 below, despite early aspirations at the beginning of the decade, these stagnating companies were relatively slow in shifting their activities over the decade.

The relationship between talk and action for stagnating companies

While these companies are setting clear emissions and energy intensity targets, their progress toward meeting these targets is relatively slow. This is largely due to the fact that they focus on the easier wins that come by saving costs and waste through efficiencies. For example, the quote below from Total acknowledges the commitments made as part of the Paris Climate Agreement’s goal of remaining within 2 °C of global temperature increase from pre-industrial levels but aims to do this by making oil and gas more efficient rather than shifting their business model away from fossil fuels.

Under the 2 °C scenario, oil and gas will still make up almost 50% of the primary energy mix at that time. So yes, of course, we will still be an oil and gas major, meeting this demand. But our ambition is to put our talent to work to become the leader in responsible oil and gas, while also ramping up renewables. (Total, 2016 report)

Similarly, Eni draws attention to the reductions in GHG emissions they have achieved in their activities since 2010, while maintaining their conventional asset portfolio. Rather than signalling a shift away from a fossil fuel-based business model, they instead focus future reductions on increasing energy efficiencies. Similar to the deflecting companies, these stagnating companies appear to take limited blame or accountability for how their actions might have shaped the current state of the climate.

Our organic growth is based on a conventional asset portfolio. Since 2010, we have reduced our GHG emissions by 28%. In the future, we aim at a further reduction of 43% in our upstream emissions index, by decreasing flaring and fugitive methane emissions and increasing energy efficiency. (Eni, 2015 report)

Stagnating companies also tend to invest in new renewable technologies, however, this is often framed as an opportunity to diversify their portfolio rather than radically transform their business models away from fossil fuels.

Our ambition is summed up by the motto “20% in 20 years.” We want to make low-carbon businesses a genuine and profitable growth driver accounting for around 20% of our portfolio in 20 years’ time. (TOTAL, 2016 report)

The gap between talk and action for stagnating companies is less pronounced than for deflecting companies, but overall it tends to remain about half a step behind. For example, the below quote from Repsol shows that the company has clearly defined targets around reductions in C02 emissions, actions that could be aligned with sustainability 2.0 framing:

At Repsol, we are committed to the fight against climate change, which is reflected in the company’s new Strategic Plan 2016-2020. In this sense, we have set a goal to reduce CO2 emissions by 22% over the 2011- 2020 period when compared to 2010, and currently we have already reduced emissions by more than 15%. (Respol, 2015 report)

Whilst the company states that they are committed to fighting climate change and are on track toward meeting their defined emissions targets, stating they have already reduced 15% of their 22% target, they are also found to be taking actions that contradict these claims in the acquisition of Talisman Energy, a large oil and gas company, that increased their annual emissions by 50%. This provides one example of how their actions are not in line with their framing of climate change:

Direct emissions of CO2 equivalent during 2015 were 21 million tons, 50% greater than the previous year due to the inclusion of the emissions from new assets in exploration and production acquired from Talisman. All other business emissions remain at values comparable to 2014. (Repsol, 2015 report)

Similar disconnects were observed at OMV where the aspiration for reducing their carbon footprint is at odds with their actions focused on exploring new approaches to oil and gas. These future-focused targets highlight how moral responsibility is viewed in a prospective manner.

We have pledged to reduce the carbon emissions of our operations, as well as the carbon footprint of our product portfolio in order to make a significant contribution to climate protection. (OMV, 2019 report) To realize its mission of providing energy for a better life, OMV is committed to exploring the full potential of oil and gas at its best by following a responsible approach in producing, processing, and marketing oil and gas and petrochemical products. (OMV, 2019 report)

In analysing the relationship between talk, action, and framings of collective moral responsibility for stagnating companies, we noticed that they often engage in teleological moral responsibility, where they vaguely express responsibility at an industry or sector level for increasing GHG emissions. Despite adopting a less diffuse lens on the collective compared to deflecting companies, these stagnating companies tend to frame responsibility prospectively, where they focus on their role in the future of contributing to climate change solutions.

The quotes below from Eni illustrate their framing of responsibility to a teleological collective at an industry level. We note that they still situate this responsibility within the context of other large companies rather than fully taking responsibility for the industry’s role in contributing to climate change.

This is particularly significant given that the industry is responsible for 40% of all greenhouse gas emissions by companies listed in the Global 500 Index, which groups together the top 500 companies worldwide by revenue. (Eni, 2012 report) There is no doubt that much of the economic growth the world has seen over the past 100 years has been achieved thanks to the discovery and use of fossil fuels. For that, they deserve to be thanked. However, it is now abundantly clear that we can no longer continue to use fossil fuels. (Eni, 2017 report)

Similarly, Total assigns responsibility to a teleological collective of high-emitting industry actors, that includes power generation, and engages in prospective responsibility by claiming that they are charged with realising the energy transition. Rather than taking responsibility for contributing to climate change, Total instead focuses on the potential implications that climate change could have on their operations in the future:

The sectors most responsible for emissions in the EU (i.e., power generation, industry, transport, buildings and construction, as well as agriculture) are charged with making the transition to a low-carbon economy over the coming decades, and these issues could affect TOTAL’s operations in the future. (Total, 2014, report)

In another example, OMV below takes some vague accountability for the impacts their operations have on the environment and the broad areas where they attempt to minimise these impacts. These vague comments seem to fall short of an agential view on moral responsibility.

Due to the nature of our operations, we have an impact on the environment. We strive to minimize that impact at all times, particularly in the areas of spills, energy efficiency, greenhouse gas (GHG) emissions, water and waste management. (OMV, 2016 report)

Evolving Companies

The category of evolving companies, which in our study was found to be represented by Ørsted, EON, and Iberdrola, are not only investing in renewables to diversify their portfolios but are moving the entire business strategy away from fossil fuels. As illustrated in Fig.  3 , their framing still tends to be ahead of action, with actions eventually catching up.

The relationship between talk and action for evolving companies

Evolving companies often describe climate change as requiring radical transformation of business models and the energy sector and provide examples of how they are challenging, questioning and rethinking their business model on the path to more sustainable action. These actions include technological advancements to decarbonise the economy, reduce C0 2 emissions and combat climate change, for example, battery storage, localisation of the grid and electric vehicles. The following quotes provide evidence of the substantive actions evolving companies are undertaking as they transform their business activities, which demonstrate an underlying appreciation of their role as agents, and sense of accountability for past actions.

By the end of 2019, we had realised an 86% carbon reduction since 2006, and 86% of the energy we generated came from renewable sources. In just ten years, we met the transformation target we defined for 2040… We had installed 9.9GW renewable capacity, enough to power more than 15 million people. We had reduced our coal consumption by 91%, and 96% of the wooden biomass we sourced was certified sustainable biomass. (Ørsted, 2019 Report) Iberdrola has proposed the shut-down of all of its coal plants. – The company’s CO2 emissions are already 70% less than the average for the European electricity sector (Iberdola, 2017)

For these evolving companies, framing tends to eventually align with action. Evolving companies tend to go beyond what is required of them by law and set their own ambitions for achieving climate outcomes that exceed regulatory expectations. For example, in 2009 Ørsted set themselves the goal of transforming their energy mix from 85% fossil fuels and 15% renewables to 85% renewables and 15% fossil fuels by 2040. By setting bold emissions and energy intensity targets that they often meet and exceed, these energy companies provide insights on what transformation towards authentic and substantive climate action might look like.

We want sustainable energy to empower people, businesses and societies to unleash their potential without having to worry about harming the planet or reducing the opportunities for future generations…. We have now defined a new target of phasing out coal completely from our production by 2023, because coal is the type of fossil energy causing the highest amount of CO2 emissions. (Orsed, 2016 report) It has also set a goal of reducing greenhouse gas (GHG) emissions of absolute scope 1, 2 and 3, which has been approved by the Science-Based Target initiative…The company has committed to maintaining its position as one of the leading European companies with the lowest CO2 emissions per kWh produced, and to achieve this by focusing its efforts on reducing the intensity of greenhouse gases, promoting renewable technology and increasing efficiency. (Iberdola, 2019 report)

These evolving companies provide examples of how the gap in talk and action in evolving companies can be seen to be a positive sign of what is to come in terms of future action. For these companies, the aspirational talk in earlier years appears to have provided an authentic signal of more ambitious and meaningful climate actions rather than an attempt to hide poor sustainability performance.

Over time, evolving companies appear to be more focused on an agential view of the collective and their own responsibility for contributing to climate change in the past. Evolving companies draw attention to the ecological and societal stakes that are at risk by continuing down the path of fossil fuel-dependent energy systems and presenting themselves as being part of the transition toward a cleaner and more just energy future. They often frame the energy sector and their own company as being largely responsible for climate change and consider it their moral responsibility or obligation to reduce C0 2 emissions and respond to climate change.

Ørsted provides a great example of how evolving companies shift their framing of collective moral responsibility over time. At the beginning of the decade, Ørsted evokes a more diffuse collective with forward-looking prospective responsibility by speaking about the role of the energy sector in the future energy transition. Over time they shift towards a more agential collective and backward-looking moral responsibility where they take more ownership of both the blame and future solutions to climate change. The following quotes show how, earlier in the decade, Ørsted tended to evoke a more diffuse collective when discussing climate change:

The challenges facing the energy sector are part of a wider challenge concerning how we, as modern societies, use our resources. (Ørsted, 2011 report) the world is facing serious resource and climate challenges…With more people on the planet and a rapidly expanding consumer middle class, global resources and ecosystems are put under strain.(Ørsted, 2011 report)

In these early reports, Ørsted would frame their moral responsibility through a prospective lens:

As an energy company, we have a major responsibility to help steer the world in a more sustainable direction. We must develop and deploy low-carbon technologies that can meet the future energy demand of our customers, enabling people to live their lives and businesses to thrive. (Ørsted, 2014 report)

Towards the end of the decade, as Ørsted became more sustainable, there was a clear shift in the framing of collective moral responsibility towards agential collective and backward-looking responsibility whereby Ørsted acknowledged their contribution to the current situation.

We need to transform the global energy systems from black to green energy at a higher pace than the current trajectory. (Ørsted, 2017 report) At Ørsted, our vision directly addresses the challenge of climate change. We used to be one of the blackest energy companies in Europe. Today, we produce 64% green energy, and our target for 2023 takes us beyond 95%. (Ørsted, 2017 report)

By the end of the decade, the blameworthiness shifts to praiseworthiness as Ørsted begins to take credit in their own transition and leadership position in renewable energies. In this 2019 report, Ørsted has a strong framing on the role of transformational leadership and how they have transformed their entire business model. They also make frequent mention of their ambitious long-term targets that go beyond the expectations of the industry and underpin their view on their moral responsibility to combat climate change.

Over the past decade, we have been on a major decarbonisation journey to transform from one of Europe’s most carbon-intensive energy companies to a global leader in renewable energy. (Ørsted, 2019 report) In 2019, we adopted three new climate targets to guide our continued decarbonisation journey… Our biggest contribution is our actions to help fight climate change. (Ørsted, 2019 report)

Overall, these insights highlight how evolving companies combine an agential collective perspective with backward-looking responsibility to acknowledge their role in contributing to current climate situation, thereby taking ownership of past actions and future solutions.

A Typology of Energy Company Framing and Action in Response to Climate Change

Our findings illustrate how energy companies are framing their responses to climate change and the related actions they have taken to shift their business practices. Table 6 presents a typology of in energy company responses to climate change through the lens organisational hypocrisy and collective moral responsibility. The table summarises the relationship between talk, action and framing of collective moral responsibility, highlighting the implications for climate action.

Discussion and Concluding Comments

Our paper makes multiple contributions to the literature on business ethics and climate change. First, we contribute to the literature on business ethics, moral responsibility, and organisational hypocrisy by providing a nuanced understanding of the performative nature of collective moral responsibility (Soares, 2003 ; Tamminga & Hindriks, 2020 ). The performative nature of collective moral responsibility refers to how organisations’ talk and actions regarding moral obligations shape and are shaped by their sense of the collective and their relationship with broader stakeholders. As highlighted in our finding, this performativity suggest that collective moral responsibility is not static, but rather is actively constructed and reconstructed through organisational actions and discourses. Revealing this performativity highlights the diverse ways in which conceptions of the collective as diffuse, teleological, or agential (Collins, 2019 ) are associated with different types of climate talk and action and different levels of organisational hypocrisy. As highlighted in Table  6 , we show how organisations that frame their role as part of a more diffuse or teleological collective engage in forward-looking moral responsibility, which tends to promote symbolic talk rather than substantive action. For example, deflecting and stagnating companies made less sustainability progress over time and had larger gaps between talk and action than evolving companies. On the contrary, organisations that understand blameworthiness through a more agential collective, as was the case with Ørsted, E.ON and Iberdrola, seem to engage in substantive climate action as they view moral responsibility from a more backward-looking perspective. This more backward-looking perspective can create an obligation to authentically shift business practices. These findings highlight the importance of developing a more nuanced understanding of the ‘collective’ (Collins, 2019 ). Further, we reveal the value of differentiating between backward-looking (reactive) and forward-looking (prospective) moral responsibility (Gilbert, 2006a , 2006b ; Sanbhu, 2012 ; Poel, 2011 ) for understanding the connection between talk and action.

Our findings contribute to the broader literature on framing (Cornelissen & Werner, 2014 ) and organisational hypocrisy (Brunsson, 2002 ) by unpacking the relationship between organisational framing of collective moral responsibility and organisational hypocrisy. We show that organisations that view collective moral responsibility through the lens of diffuse collectives or teleological collectives (e.g., deflecting and stagnating companies) and forward-looking responsibility tend to have larger disconnects between talk and action and are less likely to engage in substantive action. Conversely, we show how companies that view moral responsibility through the lens of an agential collective (e.g., evolving companies) adopt a more backward-looking sense of responsibility that is associated with tighter linkages between talk and action and indicative of more substantive action over time. These insights extend prior research on framing and climate change by unpacking the relationship between frames and action (Campbell et al., 2019 ; Hahn & Lulfs, 2014 ; Metze, 2018 ; Nyberg & Wright, 2006 ; Nyberg et al., 2018 ; Wright & Nyberg, 2017 ) and showing how shifts in ethical frames relate to substantive shifts in action. Previous studies on framing and climate action have shown how specific political and social events can shape responses to climate change (Nyberg et al., 2018 ; Slawinski & Bansal, 2015 ). Our insights build on this work through a longitudinal analysis of how framing evolves over time and how different frames are correlated with different levels of organisational hypocrisy. In doing so we go beyond prior research by revealing the dynamic nature of these frames and their implications for action over time.

Through the use of a longitudinal study, we contribute to a temporal understanding of collective moral responsibility and organisational hypocrisy. By adopting a temporal lens, we reveal how the understanding of the collective and the direction of responsibility might shift over time and how this relates to action and inaction on climate change (Brunson, ; Cho et al., 2015 ). Evidence from the category of evolving companies, represented in this study by Ørsted, E.ON and Iberdrola, suggests that organisations that consider their own role as an agential collective with backward-looking responsibility seem to live up to aspirational talk over time. This finding extends insights that suggest that organisational hypocrisy can be beneficial to sustainability action when framing is eventually realised in future action (Christensen et al., 2013 ). The findings suggest that while these companies initially engaged in symbolic framing to signal their commitments to climate action, over time, they were able to align their actions with their talk and shift from the symbolic to the substantive. This evolution reveals how, in certain circumstances, organisational hypocrisy can lead to meaningful climate action.

Alternatively, the journey of the category of deflecting companies, represented in this study by BP and Shell, provides insights into the situations in which framing offsets action (Brunson, 1986 , 1993 , 2002 ) or creates facades (Cho et al., 2015 ) that draw attention away from poor performance or climate inaction. These findings align with the seminal work on organisational hypocrisy by Brunnson ( 1986 ), who theorised that talk, and subsequent decisions, often substitute for or postpone action, especially when organisations do not consider action important or desirable.

These temporal insights contribute to the broader literature on sustainability that highlights the need to adopt a process lens when understanding climate action and inaction (Mazutis et al., 2021 ; Schultz, 2022 ; Slawinski & Bansal, 2015 ; Slawinski et al., 2017 ) and respond to calls for a deeper understanding of the temporal elements involved in ethical considerations (Hockerts & Searcy, 2023 ). We show that as organisations shift from the notion of a diffuse collective to a more agential collective, they tend to move away from a forward-looking sense of moral responsibility towards a backward-looking sense that is associated with more substantive action. The impact of this shift in collective moral responsibility over time is best illustrated by the journey of Ørsted in radically transforming its business model. By revisiting institutional theory, we might understand these temporal shifts as being shaped by broader regulatory and normative institutional pressures (Bromley & Powell, 2012 ; Meyer & Rowan, 1977 ; Oliver, 1991 ). For example, shifts towards a stricter regulatory environment might expedite the shifts from symbolic talk to substantive action, while increased pressure from investors, community and NGOs and greater demands of transparency are also pushing energy companies towards a deeper sense of moral responsibility and more genuine climate action. Overall, we echo the call from Collins ( 2019 ) to consider the temporal horizon of moral responsibility in shaping climate action.

Building on these theoretical contributions, we see multiple fruitful avenues for future research. While this study explored talk and action over a ten-year period, future studies would benefit by investigating climate action and the framing of collective moral responsibility over longer time horizons through accessing historical data. Taking time seriously in studies of climate action would assist in developing more processual understanding of how green talk translates into action. Future research would also benefit from comparative studies that take a global lens and explore investor-owned energy companies along with publicly owned energy organisations. Increasing the heterogeneity of energy organisations would assist in understanding the influence of cultural and regulatory differences in shaping climate talk and action. Finally, extending research on framing and collective moral responsibility beyond the context of the climate crisis to human rights issues such as modern slavery and forced displacement would assist in unpacking the nature of organisational hypocrisy in social as compared to environmental crises.

Finally, we contribute to practice by highlighting the shifts in collective moral responsibility associated with energy companies becoming more sustainable and authentically engaging in climate action. As highlighted in the final row of Table  6 , the insights on the category of evolving companies, represented in this study by Ørsted, E.ON and Iberdrola, suggest that for symbolic talk to match substantive action, organisations need to actively question and reject current unsustainable practices. Evolving companies highlight how they are challenging, questioning, and rethinking their business model as they go beyond diversifying their portfolios towards moving their entire business strategy away from fossil fuels. Our findings suggest that aspirational talk is not sufficient to generate substantive climate action. We suggest that organisations that genuinely want to engage in climate action need to engage in a more agential view of the collective and reconsider their own responsibility for contributing to climate change in the past. Rather than deflecting and deferring responsibility to diffuse notions of society, government, civil society, and corporations, organisations that hope to genuinely contribute to climate action need to take ownership of both the blame for past action and their obligation to find future solutions.

Data Availability

This research is based on publicly available sustainability reports.

We note that E.ON separated into two companies in 2016 by setting up a separate entity Uniper to manage its fossil fuel assets. In order to gain a full picture of E.ON’s climate change responses we also reviewed Uniper’s sustainability reporting from 2016 to 2019. For consistency, we still refer to ten energy companies throughout the paper.

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Acknowledgements

We thank the Social Issues in Management (SIM) Division Sandbox community for their invaluable feedback on our paper.

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Feeney, M., Ormiston, J., Gijselaers, W. et al. Framing Collective Moral Responsibility for Climate Change: A Longitudinal Frame Analysis of Energy Company Climate Reporting. J Bus Ethics (2024). https://doi.org/10.1007/s10551-024-05801-0

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Solid health care waste management practice in Ethiopia, a convergent mixed method study

• Yeshanew Ayele Tiruneh 1 ,
• L. M. Modiba 2 &
• S. M. Zuma 2  

BMC Health Services Research volume  24 , Article number:  985 ( 2024 ) Cite this article

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Introduction

Healthcare waste is any waste generated by healthcare facilities that is considered potentially hazardous to health. Solid healthcare waste is categorized into infectious and non-infectious wastes. Infectious waste is material suspected of containing pathogens and potentially causing disease. Non-infectious waste includes wastes that have not been in contact with infectious agents, hazardous chemicals, or radioactive substances, similar to household waste, i.e. plastic, papers and leftover foods.

This study aimed to investigate solid healthcare waste management practices and develop guidelines to improve solid healthcare waste management practices in Ethiopia. The setting was all health facilities found in Hossaena town.

A mixed-method study design was used. For the qualitative phase of this study, eight FGDs were conducted from 4 government health facilities, one FGD from each private health facility (which is 37 in number), and forty-five FGDs were conducted. Four FGDs were executed with cleaners; another four were only health care providers because using homogeneous groups promotes discussion. The remaining 37 FGDs in private health facilities were mixed from health professionals and cleaners because of the number of workers in the private facilities. For the quantitative phase, all health facilities and health facility workers who have direct contact with healthcare waste management practice participated in this study. Both qualitative and quantitative study participants were taken from the health facilities found in Hossaena town.

Seventeen (3.1%) health facility workers have hand washing facilities. Three hundred ninety-two (72.6%) of the participants agree on the availability of one or more personal protective equipment (PPE) in the facility ‘‘ the reason for the absence of some of the PPEs, like boots and goggles, and the shortage of disposable gloves owes to cost inflation from time to time and sometimes absent from the market’’ . The observational finding shows that colour-coded waste bins are available in 23 (9.6%) rooms. 90% of the sharp containers were reusable, and 100% of the waste storage bins were plastic buckets that were easily cleanable. In 40 (97.56%) health facilities, infectious wastes were collected daily from the waste generation areas to the final disposal points. Two hundred seventy-one (50.2%) of the respondents were satisfied or agreed that satisfactory procedures are available in case of an accident. Only 220 (40.8%) respondents were vaccinated for the Hepatitis B virus.

Hand washing facilities, personal protective equipment and preventive vaccinations are not readily available for health workers. Solid waste segregation practices are poor and showed that solid waste management practices (SWMP) are below the acceptable level.

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Healthcare waste (HCW) encompasses all types of waste generated while providing health-related services, spanning activities such as diagnosis, immunization, treatment, and research. It constitutes a diverse array of materials, each presenting potential hazards to health and the environment. Within the realm of HCW, one finds secretions and excretions from humans, cultures, and waste containing a stock of infectious agents. Discarded plastic materials contaminated with blood or other bodily fluids, pathological wastes, and discarded medical equipment are classified as healthcare waste. Sharps, including needles, scalpels, and other waste materials generated during any healthcare service provision, are also considered potentially hazardous to health [ 1 ].

Healthcare waste in solid form (HCW) is commonly divided into two primary groups: infectious and non-infectious. The existence of pathogens in concentrations identifies infectious waste or amounts significant enough to induce diseases in vulnerable hosts [ 1 ] If healthcare facility waste is free from any combination with infectious agents, nearly 85% is categorized as non-hazardous waste, exhibiting characteristics similar to conventional solid waste found in households [ 2 ]. World Health Organization (WHO) recommends that appropriate colour-coded waste receptacles be available in all medical and other waste-producing areas [ 3 ].

Solid waste produced in the course of healthcare activities carries a higher potential for infection and injury than any other type of waste. Improper disposal of sharps waste increases the risk of disease transmission among health facility workers and general populations [ 1 ]. Inadequate and inappropriate handling of healthcare waste may have serious public health consequences and a significant environmental impact. The World Health Organization (2014) guidelines also include the following guidance for hand washing and the use of alcohol-based hand rubs: Wash hands before starting work, before entering an operating theatre, before eating, after touching contaminated objects, after using a toilet, and in all cases where hands are visibly soiled [ 4 ].

Among the infectious waste category, sharps waste is the most hazardous waste because of its ability to puncture the skin and cause infection [ 3 ]. Accidents or occurrences, such as near misses, spills, container damage, improper waste segregation, and incidents involving sharps, must be reported promptly to the waste management officer or an assigned representative [ 5 ].

Africa is facing a growing waste management crisis. While the volumes of waste generated in Africa are relatively small compared to developed regions, the mismanagement of waste in Africa already impacts human and environmental health. Infectious waste management has always remained a neglected public health problem in developing countries, resulting in a high burden of environmental pollution affecting the general masses. In Ethiopia, there is no updated separate regulation specific to healthcare waste management in the country to enforce the proper management of solid HCW [ 6 ].

In Ethiopia, like other developing countries, healthcare waste segregation practice was not given attention and did not meet the minimum HCWM standards, and it is still not jumped from paper. Previous study reveals that healthcare waste generation rates are significantly higher than the World Health Organization threshold, which ranges from 29.5–53.12% [ 7 , 8 ]. In Meneilk II Hospital, the proportion of infectious waste was 53.73%, and in the southern and northern parts of Ethiopia, it was 34.3 and 53%, respectively. Generally, this figure shows a value 3 to 4 times greater than the threshold value recommended by the World Health Organization [ 7 ].

Except for sharp wastes, segregation practice was poor, and all solid wastes were collected without respecting the colour-coded waste disposal system [ 9 ]. The median waste generation rate was found to vary from 0.361- 0.669 kg/patient/day, comprising 58.69% non-hazardous and 41.31% hazardous wastes. The amount of waste generated increased as the number of patients flow increased. Public hospitals generated a high proportion of total healthcare waste (59.22%) in comparison with private hospitals (40.48) [ 10 ]. The primary SHCW treatment and disposal mechanism was incineration, open burning, burring into unprotected pits and open dumping on municipal dumping sites as well as in the hospital backyard. Carelessness, negligence of the health workers, patients and cleaners, and poor commitment of the facility leaders were among the major causes of poor HCWM practice in Ethiopia [ 9 ]. This study aimed to investigate solid healthcare waste management practices and develop guidelines to improve solid healthcare waste management practices in Ethiopia.

The setting for this study was all health facilities found in Hossaena town, which is situated 232 kms from the capital city of Ethiopia, Addis Ababa, and 165 kms from the regional municipality of Hawasa. The health facilities found in the town were one university hospital, one private surgical centre, three government health centres, 17 medium clinics, and 19 small clinics were available in the city and; health facility workers who have direct contact with generating and disposal of HCW and those who are responsible as a manager of health facilities found in Hossaena town are the study settings. All health facilities except drug stores and health facility workers who have direct contact with healthcare waste generation participated in this study.

A mixed-method study design was used. For the quantitative part of this study, all healthcare workers who have direct contact with healthcare waste management practice participated in this study, and one focus group discussion from each health facility was used. Both of the study participants were taken from the same population. All health facility workers who have a role in healthcare waste management practice were included in the quantitative part of this study. The qualitative data collection phase used open-ended interviews, focus group discussions, and visual material analysis like posters and written materials. All FGDs were conducted by the principal investigator, one moderator, and one note-taker, and it took 50 to 75 min. 4–6 participants participated in each FGD.

According to Elizabeth (2018: 5), cited by Creswell and Plano (2007: 147), the mixed method is one of the research designs with philosophical assumptions as well as methods of inquiry. As a method, it focuses on collecting, analyzing, and mixing both quantitative and qualitative data in a single study. As a methodology, it involves philosophical assumptions guiding the direction of the collection and analysis and combining qualitative and quantitative approaches in many phases of the research project. The central premise is that using qualitative and quantitative approaches together provides a better understanding of the research problems than either approach alone.

The critical assumption of the concurrent mixed methods approach in this study is that quantitative and qualitative data provide different types of information, often detailed views of participants’ solid waste management practice qualitatively and scores on instruments quantitatively, and together, they yield results that should be the same. In this approach, the researcher collected quantitative and qualitative data almost simultaneously and analyzed them separately to cross-validate or compare whether the findings were similar or different between the qualitative and quantitative information. Concurrent approaches to the data collection process are less time-consuming than other types of mixed methods studies because both data collection processes are conducted on time and at the same visit to the field [ 11 ].

Data collection

The data collection involves collecting both quantitative and qualitative data simultaneously. The quantitative phase of this study assessed three components. Health care waste segregation practice, the availability of waste segregation equipment for HCW segregation, temporary storage facilities, transportation for final disposal, and disposal facilities data were collected using a structured questionnaire and observation of HCW generation. Recycling or re-using practice, waste treatment, the availability of the HCWM committee, and training data were collected.

Qualitative data collection

The qualitative phase of the data collection for this study was employed by using focus group discussions and semi-structured interviews about SHCWMP. Two focus group discussions (FGD) from each health facility were conducted in the government health facilities, one at the administrative level and one at the technical worker level, and one FGD was conducted for all private health facilities because of the number of available health facility workers. Each focus group has 4–6 individuals.

In this study, the qualitative and the quantitative data provide different information, and it is suitable for this study to compare and contrast the findings of the two results to obtain the best understanding of this research problem.

Quantitative data collection

The quantitative data were entered into Epi data version 3.1 to minimize the data entry mistakes and exported to the statistical package for social science SPSS window version 27.0 for analysis. A numeric value was assigned to each response in a database, cleaning the data, recoding, establishing a codebook, and visually inspecting the trends to check whether the data were typically distributed.

Data analysis

Data were analyzed quantitatively by using relevant statistical tools, such as SPSS. Descriptive statistics and the Pearson correlation test were used for the bivariate associations and analysis of variance (ANOVA) to compare the HCW generation rate between private and government health facilities and between clinics, health centres and hospitals in the town. Normality tests were performed to determine whether the sample data were drawn from a normally distributed population.

The Shapiro–Wilk normality tests were used to calculate a test statistic based on the sample data and compare it to critical values. The Shapiro–Wilk test is a statistical test used to assess whether a given sample comes from a normally distributed population. The P value greater than the significance level of 0.05 fails to reject the null hypothesis. It concludes that there is not enough evidence to suggest that the data does not follow the normal distribution. Visual inspection of a histogram, Q-Q plot, and P-P plot (probability-probability plot) was assessed.

Bivariate (correlation) analysis assessed the relationships between independent and dependent variables. Then, multiple linear regression analysis was used to establish the simple correlation matrices between different variables for investigating the strength relationships of the study variables in the analysis. In most variables, percentages and means were used to report the findings with a 95% confidence interval. Open-ended responses and focused group findings were undertaken by quantifying and coding the data to provide a thematic narrative explanation.

Appropriate and scientific care was taken to maintain the data quality before, during, and after data collection by preparing the proper data collection tools, pretesting the data collection tools, providing training for data collectors, and proper data entry practice. Data were cleaned on a daily basis during data collection practice, during data entry, and before analysis of its completeness and consistency.

Data analysis in a concurrent design consists of three phases. First, analyze the quantitative database in terms of statistical results. Second, analyze the qualitative database by coding the data and collapsing the codes into broad themes. Third comes the mixed-method data analysis. This is the analysis that consists of integrating the two databases. This integration consists of merging the results from both the qualitative and the quantitative findings.

Descriptive analysis was conducted to describe and summarise the data obtained from the samples used for this study. Reliability statistics for constructs, means and modes of each item, frequencies and percentage distributions, chi-square test of association, and correlations (Spearman rho) were used to portray the respondents’ responses.

All patient care-providing health facilities were included in this study, and the generation rate of healthcare waste and composition assessed the practice of segregation, collection, transportation, and disposal system was observed quantitatively using adopted and adapted structured questionnaires. To ensure representativeness, various levels of health facilities like hospitals, health centres, medium clinics, small clinics and surgical centres were considered from the town. All levels of health facilities are diagnosing, providing first aid services and treating patients accordingly.

The hospital and surgical centre found in the town provide advanced surgical service, inpatient service and food for the patients that other health facilities do not. The HCW generation rate was proportional to the number of patients who visited the health facilities and the type of service provided. The highest number of patients who visited the health facilities was in NEMMCSH; the service provided was diverse, and the waste generation rate was higher than that of other health facilities. About 272, 18, 15, 17, and 20 average patients visited the health facilities daily in NEMMCSH: government health centres, medium clinics, small clinics, and surgical centres. Paper and cardboard (141.65 kg), leftover food (81.71 kg), and contaminated gloves (42.96 kg) are the leading HCWs generated per day.

A total of 556 individual respondents from sampled health facilities were interviewed to complete the questionnaire. The total number of filled questionnaires was 540 (97.1) from individuals representing these 41 health facilities.

The principal investigator observed the availability of handwashing facilities near SHCW generation sites. 17(3.1%) of health facility workers had hand washing facilities near the health care waste generation and disposal site. Furthermore,10 (3.87%), 2 (2.1%), 2 (2.53%), 2 (2.1%), 1 (6.6%) of health facility workers had the facility of hand washing near the health care waste generation site in Nigist Eleni Mohamed Memorial Comprehensive Specialized Hospital (NEMMCSH), government health centres, medium clinics, small clinics, and surgical centre respectively. This finding was nearly the same as the study findings conducted in Myanmar; the availability of hand washing facilities near the solid health care waste generation was absent in all service areas [ 12 ]. The observational result was convergent with the response of facility workers’ response regarding the availabilities of hand washing facilities near to the solid health care waste generation sites.

The observational result was concurrent with the response of facility workers regarding the availability of hand-washing facilities near the solid health care waste generation sites.

The availability of personal protective equipment (PPE) was checked in this study. Three hundred ninety-two (72.6%) of the respondents agree on the facility’s availability of one or more personal protective equipment (PPE). The availability of PPEs in different levels of health facilities shows 392 (72.6%), 212 (82.2%), 56 (58.9%), 52 (65.8%), 60 (65.2%), 12 (75%) health facility workers in NEMMCSH, government health centres, medium clinics, small clinics, and surgical centres respectively agree to the presence of personal protective equipment in their department. The analysis further shows that the availability of masks for healthcare workers was above the mean in NEMMCSH and surgical centres.

Focus group participants indicated that health facilities did not volunteer to supply Personal protective equipment (PPEs) for the cleaning staff.

“We cannot purchase PPE by ourselves because of the salary paid for the cleaning staff.”

Cost inflation and the high cost of purchasing PPEs like gloves and boots are complained about by all (41) health facility owners.

“the reason for the absence of some of the PPEs like boots, goggles, and shortage of disposable gloves are owing to cost inflation from time to time and sometimes absent from the market is the reason why we do not supply PPE to our workers.”

Using essential personal protective equipment (PPEs) based on the risk (if the risk is a splash of blood or body fluid, use a mask and goggles; if the risk is on foot, use appropriate shoes) is recommended by the World Health Organization [ 13 ]. The mean availability of gloves in health facilities was 343 (63.5% (95% CI: 59.3–67.4). Private health institutions are better at providing gloves for their workers, 67.1%, 72.8%, and 62.5% in medium clinics, small clinics, and surgical centres, respectively, which is above the mean.

Research participants agree that.

‘‘ there is a shortage of gloves to give service in Nigist Eleni Mohamed Memorial Comprehensive Specialized Hospital (NEMMCSH) and government health centres .’’

Masks are the most available personal protective equipment for health facility workers compared to others. 65.4%, 55.6%, and 38% of the staff are available with gloves, plastic aprons and boots, respectively.

The mean availability of masks, heavy-duty gloves, boots, and aprons was 71.1%, 65.4%, 38%, and 44.4% in the study health facilities. Health facility workers were asked about the availability of different personal protective equipment, and 38% of the respondents agreed with the presence of boots in the facility. Still, the qualitative observational findings of this study show that all health facility workers have no shoes or footwear during solid health care waste management practice.

SHCW segregation practice was checked by observing the availability of SHCW collection bins in each patient care room. Only 4 (1.7%) of the room’s SHCW bins are collected segregated (non-infectious wastes segregated in black bins and infectious wastes segregated in yellow bins) based on the World Health Organization standard. Colour-coded waste bins, black for non-infectious and yellow for infectious wastes, were available in 23 (9.6%) rooms. 90% of the sharp containers were reusable, and 100% of the waste storage bins were plastic buckets that were easily cleanable. Only 6.7% of the waste bins were pedal operated and adequately covered, and the rest were fully opened, or a tiny hole was prepared on the container’s cover. All of the healthcare waste disposal bins in each health facility and at all service areas were away from the arm’s reach distance of the waste generation places, and this is contrary to World Health Organization SHCWM guidelines [ 13 ]. The observation result reveals that the reason for the above result was that medication trolleys were not used during medication or while healthcare providers provided any health services to patients.

Most medical wastes are incinerated. Burning solid and regulated medical waste generated by health care creates many problems. Medical waste incinerators emit toxic air pollutants and ash residues that are the primary source of environmental dioxins. Public concerns about incinerator emissions and the creation of federal regulations for medical waste incinerators are causing many healthcare facilities to rethink their choices in medical waste treatment. Health Care Without Harm [ 14 ], states that non-incineration treatment technologies are a growing and developing field. The U.S. National Academy of Science 2000 argued that the emission of pollutants during incineration is a potential risk to human health, and living or working near an incineration facility can have social, economic, and psychological effects [ 15 ].

The incineration of solid healthcare waste technology has been accepted and adopted as an effective method in Ethiopia. Incineration of healthcare waste can produce secondary waste and pollutants if the treatment facilities are not appropriately constructed, designed, and operated. It can be one of the significant sources of toxic substances, such as polychlorinated dibenzo-dioxins/dibenzofurans (PCDD/ PCDF), polyvinyl chloride (PVC), hexachlorobenzenes and polychlorinated biphenyls, and dioxins and furans that are known as hazardous pollutants. These pollutants may have undesirable environmental impacts on human and animal health, such as liver failure and cancer [ 15 , 16 ].

All government health facilities (4 in number) used incineration to dispose of solid waste. 88.4% and 100% of the wastes are incinerated in WUNEMMCSH and government health centres. This finding contradicts the study findings in the United States of America and Malaysia, in which 49–60% and 59–60 were incinerated, respectively, and the rest were treated using other technologies [ 15 , 16 ].

World Health Organization (2014:45) highlighted those critical elements of the appropriate operation of incinerators include effective waste reduction and waste segregation, placing incinerators away from populated areas, satisfactory engineered design, construction following appropriate dimensional plans, proper operation, periodic maintenance, and staff training and management are mandatory.

Solid waste collection times should be fixed and appropriate to the quantity of waste produced in each area of the health care facility. General waste should not be collected simultaneously or in the same trolley as infectious or hazardous wastes. The collection should be done daily for most wastes, with collection timed to match the pattern of waste generation during the day [ 13 ].

SHCW segregation practices were observed for 240 rooms in 41 health facilities that provide health services in the town. In government health centres, medium clinics, small clinics, and surgical centres, SHCW segregation practice was not based on the World Health Organization standard. All types of solid waste were collected in a single container near the generation area, and there were no colour-coded SHCW storage dust bins. Still, in NEMMCSH, in most of the service areas, colour-coded waste bins are available, and the segregation practice was not based on the standard. Only 3 (10%) of the dust bins collected the appropriate wastes according to the World Health Organization standard, and the rest were mixed with infectious and non-infectious SHCW.

Table 1 below shows health facility managers were asked about healthcare waste segregation practices, and 9 (22%) of the facility leaders responded that there is an appropriate solid healthcare waste segregation practice in their health facilities. Still, during observation, only 4 (1.7%) of the rooms in two (4.87%) of the facilities, SHCW bins collected the segregated wastes (non-infectious wastes segregated at the black bin and infectious wastes segregated at yellow bin) based on the world health organization standard. The findings of this study show there is a poor segregation practice, and all kinds of solid wastes are collected together.

In 40 (97.56%) health facilities, infectious wastes were collected daily from the waste generation areas to the final disposal points. During observation in one of the study health facilities, infectious wastes were not collected daily and left for days. Utility gloves, boots, and aprons are not available for cleaning staff to collect and transport solid healthcare wastes in all study health facilities. 29.26% of the facilities’ cleaning staff have a face mask, and 36.5% of the facilities remove waste bins from the service area when 3/4 full, and the rest were not removed or replaced with new ones. There is a separate container only in 2 health facilities for infectious and non-infectious waste segregation practice, and the rest were segregated and collected using single and non-colour coded containers.

At all of the facilities in the study area, SHCW was transported from the service areas to the disposal site were transported manually by carrying the collection container and there is no trolley for transportation. This finding was contrary to the study findings conducted in India, which show segregated waste from the generation site was being transported through the chute to the carts placed at various points on the hospital premises by skilled sanitary workers [ 17 ].

Only 2 out of 41 health facilities have temporary solid waste storage points at the facility. One of the temporary storage places was clean, and the other needed to be properly cleaned and unsightly. Two (100%) of the temporary storage areas are not fenced and have no restriction to an authorized person. Temporary storage areas are available only in two health facilities that are away from the service provision areas.

Observational findings revealed that pre-treatment of SHCW before disposal was not practised at all study health facilities. 95% of the facilities have no water supply for hand washing during and after solid healthcare waste generation, collection, and disposal.

The United States Agency estimated sharp injuries from medical wastes to health professionals and sanitary service personnel for toxic substances and disease registry. Most of the injuries are caused during the recapping of hypodermic needles before disposal into sharps containers [ 13 ]. Nearly half of the respondents, 245 (51.5%), are recapping needles after providing an injection to the patient. Recapping was more practised in NEMMCSH and surgical centres, which is 57.5% and 57.5%, respectively. In government health centres, medium clinics, and surgical centres, the recapping of used needles was practised below the mean, which is 47.9%, 48, and 43.8%, respectively. This finding was reasonable compared to the study findings of Doylo et al. [ 18 ] in western Ethiopia, where 91% of the health workers are recapping needles after injection [ 18 ]. The research finding shows that there is no significant association P-value of 0.82 between the training and recapping of needles after injection.

Focus group participants ’ response for appropriate SHCWMP regarding patients ’ and visitors ’ lack of knowledge on SHCW segregation practice

“The personal responsibilities of patients and visitors on solid HCW disposal should be explained to help appropriate safe waste management practice and maintain good hygiene .” “Providing waste management training and creating awareness are the two aspects of improving SHCW segregation practice.” “Training upgrades and creates awareness on hygiene for all workers.”

Sharp waste collection practices were observed in 240 rooms in the study health facilities, and 9.2% of the rooms used disposable sharp containers.

Sixty per cent (60%), 13.3%, 8.24%, and 15.71% of the sharps containers in NEMMCSH, government health centres, medium clinics, and small clinics, respectively, were using disposable sharps containers; sharps were disposed together with the sharps container, and surgical centre was using reusable sharp collection container. All disposable sharps containers in medium and small clinics used non-puncture-resistant or simple packaging carton boxes. 60% and 13.3% of the disposable sharps containers in NEMMCSH and the government health centre use purposefully manufactured disposable safety boxes.

Needle sticks injury reporting and occurrence

A total of 70 injuries were reported to the health facility manager in the last one year, and 44 of the injuries were reported by health professionals. The rest of the injuries were reported by supportive staff. These injuries were reported from 35 health facilities, and the remaining six health facilities did not report any cases of injury related to work; see Tables 2 and 3 below.

Accidents or incidents, including near misses, spillages, damaged containers, inappropriate segregation, and any incidents involving sharps, should be reported to the waste-management officer. Accidental contamination must be notified using a standard-format document. The cause of the accident or incident should be investigated by the waste-management officer (in case of waste) or another responsible officer, who should also take action to prevent a recurrence [ 13 ]. Two hundred seventy-one (50.2% (CI: 45.7–54.6) of the respondents agree that satisfactory procedures are available in case of an accident, while the remaining 269 (49.8%( CI: 45.4–54.3) of respondents do not agree on the availability of satisfactory procedures in case of an accident, see Table  4 below. The availability of satisfactory procedures in case of an accident is above the mean in medium clinics, which is 60.8%. 132(24.4%) of the staff are pricked by needle stick injury while providing health services. Nearly half of the respondents, 269 (49.8%), who have been exposed to needle stick injury do not get satisfactory procedures after being pricked by a needle, and those who have not been stung by a needle stick injury for the last year. 204 (37.8%) disagree with the presence of satisfactory procedures in the case of a needle stick injury. In NEMMCSH, 30.2% of the research participants were pricked by needle stick injury within one year of period, and 48.8% of those who were stung by needle stick injuries did not agree upon the presence of satisfactory procedures in case of needle stick injuries in the study hospital. 17.9% and 49.5%, 24.1% and 60.8%, 7.6% and 50% of the respondents are pricked by needle sticks, and they disagree on the availability of satisfactory procedures in case of accidents, respectively, in government health centres, medium clinics, small clinics, and surgical centre respectively.

One hundred seventy-seven (32.7% (CI:29.1–37) respondents were exposed to needle stick injury while working in the current health facilities. One hundred three (58.1%) and 26 (32.9%) needle stick injuries were reported from WUNEMMCSH and medium clinics, which is above the mean. One hundred thirty-two(24.7% (95%CI:20.7–28.1) of the respondents are exposed to needle stick injury within one year of the period. Seventy-eight(30.2%), 17 (17.9%), 19 (24.1%), 15 (16.3%), 3 (18.8%) of the staff are injured by needle sticks from NEMMCSH, government health centres, medium clinics, small clinics, and surgical centre staffs respectively within one year of service.

The mean availabilities of satisfactory procedures in case of accidents were 321 (59.4% (CI:55.4–63.7). Out of this, 13.7% of the staff is injured by needle sticks within one year before the survey. Except in NEMMCSH, the mean availabilities of satisfactory procedures were above the mean, which is 50%, 60%, 77.2%, 66.3%, and 81.3% in NEMMCSH, government health centres, medium clinics, small clinics, and surgical centres respectively.

Table 5 below shows that Hepatitis B, COVID-19, and tetanus toxoid vaccinations are the responses of the research participants to an open-ended question on which vaccine they took. The finding shows that 220 (40.8%) of the respondents were vaccinated to prevent themselves from health facility-acquired infection. One hundred fifty-six (70.9%) of the respondents are vaccinated to avoid themselves from Hep B infection. Fifty-nine (26%0.8) of the respondents were vaccinated to protect themselves from two diseases that are Hep B and COVID-19.

Appropriate health care waste management practice was assessed by using 12 questions: availability of colour-coded waste bins, foot-operated dust bins, elbow or foot-operated hand washing basin, personal protective equipment, training, role and responsibility of the worker, the presence of satisfactory procedures in case of an accident, incinerator, vaccination, guideline, onsite treatment, and the availability of poster. The mean of appropriate healthcare waste management practice was 55.58%. The mean of solid health care waste management practice based on the level of health facilities was summed and divided into 12 variables to get each health facility’s level of waste management practice. 64.9%, 45.58%, 49%, 46.9%, and 51.8% are the mean appropriate health care waste management practices in NEMMCSH, government health centres, medium clinics, small clinics, and surgical centres, respectively. In NEMMCSH, the practice of solid healthcare waste management shows above the mean, and the rest was below the mean of solid healthcare waste management practice.

Healthcare waste treatment and disposal practice

Solid waste treatment before disposal was not practised at all study health facilities. There is an incineration practice at all of the study health facilities, and the World Health Organization 2014 recommended three types of incineration practice for solid health care waste management: dual-chamber starved-air incinerators, multiple chamber incinerators, and rotary kilns incinerators. Single-chamber, drum, and brick incinerators do not meet the best available technique requirements of the Stockholm Convention guidelines [ 13 ]. The findings of this study show that none of the incinerators found in the study health facilities meet the minimum standards of solid healthcare waste incineration practice, and they need an air inlet to facilitate combustion. Eleven (26.82%) of the health facilities have an ash pit to dispose of burned SHCW; the majority, 30 (73.17%), dispose of the incinerated ash and burned needles in the municipal waste disposal site. In one out of 11 health facilities with an ash pit, one of the incinerators was built on the ash pit, and the incinerated ashes were disposed of in the ash pit directly. Pre-treatment of SHCW before disposal was not practised at all health facilities; see Table  6 below.

All government health facilities use incineration to dispose of solid waste. 88.4% and 100% of the solid wastes are incinerated in WUNEMMCS Hospital and government health centres, respectively. This finding was not similar to the other studies because other technologies like autoclave microwave and incineration were used for 59–60% of the waste [ 15 ]. Forty-one (100%) of the study facilities were using incinerators, and only 5 (12.19%) of the incinerators were constructed by using brick and more or less promising than others for incinerating the generated solid wastes without considering the emitting gases into the atmosphere and the residue chemicals and minerals in the ashes.

Research participants’ understanding of the environmental friendliness of health care waste management practice was assessed, and the result shows that more than half, 312(57%) of the research participants do not agree on the environmental friendliness of the waste disposal practices in the health facilities. The most disagreement regarding environmental friendliness was observed in NEMMCSH; 100 (38.8%) of the participants only agreed the practice was environmentally friendly of the service. Forty-four (46.3%), 37 (46.8%), 40 (43.5%), and 7 (43.8%) of the participants agree on the environmental friendliness of healthcare waste management practice in government health centres, medium clinics, small clinics, and surgical centres, respectively.

One hundred twenty-five (48.4%) and 39(42.4%) staff are trained in solid health care waste management practice in NEMMCSH and small clinic staff, respectively; this result shows above the mean. Twenty-seven (28.4%), 30 (38%), and 4 (25%) of the staff are trained in health care waste management practice in Government health centres, medium clinics, and surgical centres, respectively. The training has been significantly associated with needle stick injury, and the more trained staff are, the less exposed to needle stick injury. One hundred ninety-six (36.4%) of the participants answered yes to the question about the availability of trainers in the institution. 43.8% of the NEMMCSH staff agreed on the availability of trainers on solid health care waste management, which is above the mean, and 26.3%, 31.6%, 31.5%, and 25% for the government health centres, medium clinics, small clinics, and surgical centre respectively, which is below the mean.

Trained health professionals are more compliant with SHCWM standards, and the self-reported study findings of this study show that 41.7% (95%CI:37.7–46) of the research participants are trained in health care waste management practice. This finding was higher compared to the study findings of Sahiledengle in 2019 in the southeast of Ethiopia, shows 13.0% of healthcare workers received training related to HCWM in the past one year preceding the study period and significantly lower when compared to the study findings in Egypt which is 71% of the study participants were trained on SHCWM [ 8 , 19 , 20 ].

Three out of four government health facility leaders, 17 (45.94%) of private health facility leaders/owners of the clinic and 141 FGD participants complain about the absence of some PPEs like boots and aprons to protect themselves from infectious agents.

‘ ‘Masks, disposable gloves, and changing gowns are a critical shortage at all health facilities.’’

Cleaners in private health facilities are more exposed to infectious agents because of the absence of personal protective equipment. Except for the cleaning staff working in the private surgical centre, all cleaning staff 40 (97.56) of the health facilities complain about the absence of changing gowns and the fact that there are no boots in the facilities.

Cost inflation and the high cost of purchasing PPEs like gloves and boots are complained by all of (41) the health facility owners and the reason for the absence of some of the PPEs like boots, goggles, and shortage of disposable gloves. Sometimes, absence from the market is the reason why we do not supply PPE to our workers.

Thirty-four (82.92%) of the facility leaders are forwarded, and there is a high expense and even unavailability of some of the PPEs, which are the reasons for not providing PPEs for the workers.

‘‘Medical equipment and consumables importers and whole sellers are selective for importing health supplies, and because of a small number of importers in the country and specifically, in the locality, we can’t get materials used for health care waste management practice even disposable gloves. ’’

One of the facility leaders from a private clinic forwarded that before the advent of COVID-19 -19) personal protective equipment was more or less chip-and-get without difficulty. Still, after the advent of the first Japanese COVID-19 patient in Ethiopia, people outside the health facilities collect PPEs like gloves and masks and storing privately in their homes.

‘‘PPEs were getting expensive and unavailable in the market. Incinerator construction materials cost inflation, and the ownership of the facility building are other problems for private health facilities to construct standard incinerators.’’

For all of the focus group discussion participants except in NEMMCSH and two private health facilities, covered and foot-operated dust bins were absent or in a critical shortage compared to the needed ones.

‘‘ Waste bins are open and not colour-coded. The practice attracts flies and other insects. Empty waste bins are replaced without cleaning and disinfecting by using chlorine solution.’’ “HCW containers are not colour-coded, but we are trying to label infectious and non-infectious in Amharic languages.”

Another issue raised during focus group discussions is incineration is not the final disposal method. It needs additional disposal sites, lacks technology, is costly to construct a brick incinerator, lacks knowledge for health facility workers, shortage of man powers /cleaners, absence of environmental health professionals in health centres and all private clinics, and continues exposure to the staff for needle stick injury, foully smell, human scavengers, unsightly, fire hazard, and lack of water supply in the town are the major teams that FGD participants raise and forwarded the above issue as a problem to improve SHCWMP.

Focus group participants, during the discussion, raised issues that could be more comfortable managing SHCWs properly in their institution. Two of the 37 private health facilities are working in their own compound, and the remaining 35 are rented; because of this, they have difficulty constructing incinerators and ash removal pits and are not confident about investing in SHCWM systems. Staff negligence and involuntary abiding by the rules of the facilities were raised by four of the government health facilities, and it was difficult to punish those who violated the healthcare waste management rules because the health facility leaders were not giving appropriate attention to the problem.

Focus group participants forwarded recommendations on which interventions can improve the management of SHCW, and recommendations are summarised as follows:

“PPE should be available in quality and quantity for all health facility workers who have direct contact with SHCW.” “Scientific-based waste management technologies should be availed for health facilities.” “Continuous induction HCW management training should be provided to the workers. Law enforcement should be strengthened.” “Communal HCW management sites should be availed, especially for private health facilities.” “HCWM committee should be strengthened.” “Non-infectious wastes should be collected communally and transported to the municipal SHCW disposal places.” “Leaders should be knowledgeable on the SHCWM system and supervise the practice continuously.” “Patient and client should be oriented daily about HCW segregation practice.” “Regulatory bodies should supervise the health facilities before commencing and periodically between services .”

The above are the themes that FGD participants discussed and forwarded for the future improvements of SHAWMP in the study areas.

Lack of water supply in the town

Other issues raised during FGDs were health facilities’ lack of water supply. World Health Organization (2014: 89) highlights that water supply for the appropriate waste management system should be mandatory at any time in all health service delivery points.

Thirty-nine (95.12%) of the health facilities complain about the absence of water supply to improve HCW management practices and infection prevention and control practices in the facilities.

“We get water once per week, and most of the time, the water is available at night, and if we are not fetching as scheduled, we can’t get water the whole week”.

In this research, only those who have direct contact have participated in this study, and 434 (80.4%) of the respondents agree they have roles and responsibilities for appropriate solid health care waste management practice. The rest, 19.6%, do not agree with their commitment to manage health care wastes properly, even though they are responsible. Health facility workers in NEMMCSH and medium clinics know their responsibilities better than others, and their results show above the mean. 84.5%, 74.5%, 81%, 73.9% and 75% in NEMMCSH, Government health centres, medium clinics, small clinics, and surgical centres, respectively.

Establishing a policy and a legal framework, training personnel, and raising public awareness are essential elements of successful healthcare waste management. A policy can be viewed as a blueprint that drives decision-making at a political level and should mobilize government effort and resources to create the conditions to make changes in healthcare facilities. Three hundred and seventy-four (69.3%) of the respondents agree with the presence of any solid healthcare waste management policy in Ethiopia. The more knowledge above the mean (72.9%) on the presence of the policy is reported from NEMMCSH.

Self-reported level of knowledge on what to do in case of an accident revealed that 438 (81.1% CI: 77.6–84.3%) of the respondents knew what to do in case of an accident. Government health centre staff and medium clinic staff’s knowledge about what to do in case of an accident was above the mean (88.4% and 82.3%), respectively, and the rest were below the mean. The action performed after an occupational accident revealed that 56 (35.7%) of the respondents did nothing after any exposure to an accident. Out of 56 respondents who have done nothing after exposure, 47 (83.92%) of the respondents answered yes to their knowledge about what to do in case of an accident. Out of 157 respondents who have been exposed to occupational accidents, only 59 (37.6%) of the respondents performed the appropriate measures, 18 (11.5%), 9 (5.7%), 26 (16.6%), 6 (3.8%) of the respondents are taking prophylaxis, linked to the incident officer, consult the available doctors near to the department, and test the status of the patient (source of infection) respectively and the rest were not performing the scientific measures, that is only practising one of the following practices washing the affected part, squeezing the affected part to remove blood, cleaning the affected part with alcohol.

Health facility workers’ understanding of solid health care waste management practices was assessed by asking whether the current SHCWM practice needs improvement. Four hundred forty-nine (83.1%) health facility workers are unsatisfied with the current solid waste management practice at the different health facility levels, and they recommend changing it to a scientific one. 82.6%, 87.4%, 89.9%, 75%, and 81.3% of the respondents are uncomfortable or need to improve solid health care waste management practices in NEMMCSH, government health centres, medium clinics, small clinics, and surgical centres, respectively.

Lack of safety box, lack of colour-coded waste bins, lack of training, and no problems are the responses to the question problems encountered in managing SHCWMP. Two Hundred and Fifty (46.92%) and 232 (42.96%) of the respondents recommend the availability of safety boxes and training, respectively.

Four or 9.8% of the facilities have infection prevention and control (IPC) teams in the study health facilities. This finding differed from the study in Pakistan, where thirty per cent (30%) of the study hospitals had HCWM or infection control teams [ 21 ]. This study’s findings were similar to those conducted in Pakistan by Khan et al. [ 21 ], which confirmed that the teams were almost absent at the secondary and primary healthcare levels [ 20 ].

The availability of health care waste management policy report reveals that 69.3% (95% CI: 65.4–73) of the staff are aware of the presence of solid health care waste management policy in the institution. Availability of health care waste management policy was 188 (72.9%), 66 (69.5%), 53 (677.1%), 57 (62%), 10 (62.5%) in NEMMCSH, Government health centres, medium clinics, small clinics, and surgical centre respectively. Healthcare waste management policy availability was above the mean in NEMMCSH and government health centres; see Table  6 below.

Open-ended responses on the SHCWM practice of health facility workers were collected using the prepared interview guide, and the responses were analyzed using thematic analysis. All the answered questions were tallied on the paper and exported to Excel software for thematic analysis.

The study participants recommend.

“appropriate segregation practice at the point of generation” "health facility must avail all the necessary supplies that used for SHCWMP, punishment for those violating the rule of SHCWMP",

“waste management technologies should be included in solid waste management guidelines, and enforcement should be strengthened.”

The availability of written national or adopted/adapted SHCWM policies was observed at all study health facilities. Twenty eight (11.66%) of the rooms have either a poster or a written document of the national policy document. However, all staff working in the observed rooms have yet to see the inside content of the policy. The presence of the policy alone cannot bring change to SHCWMP. This finding shows that the presence of policy in the institution was reasonable compared to the study findings in Menelik II hospital in Addis Ababa, showing that HCWM regulations and any applicable facility-based policy and strategy were not found [ 22 ]. The findings of this study were less compared to the study findings in Pakistan; 41% of the health facilities had the policy document or internal rules for the HCWM [ 21 ].

Focus group participants have forwarded recommendations on which interventions can improve the management of SHCW, and recommendations are summarised as follows.

‘‘Supplies should be available in quality and quantity for all health facility workers with direct contact with SHCW. Scientific-based waste management technologies should be available for health facilities. Continues and induction health care waste management training should be provided to the workers. Law enforcement should be strengthened. Community healthcare waste management sites should be available, especially for private health facilities. HCWM committee should be strengthened. Non-infectious wastes should be collected communally and transported to the municipal SHCW disposal places. Leaders should be knowledgeable about the SHCWM system and supervise the practice continuously. Patients and clients should be oriented daily about health care waste segregation practices. Regulatory bodies should supervise the health facilities before commencing and periodically in between the service are the themes those FGD participants discussed and forward for the future improvements of SHCWMP in the study areas.’’

The availability of PPEs in different levels of health facilities shows 392 (72.6%), 212 (82.2%), 56 (58.9%), 52 (65.8%), 60 (65.2%), 12 (75%) health facility workers in NEMMCSH, government health centres, medium clinics, small clinics, and surgical centres respectively agree to the presence of personal protective equipment in their department. The availability of PPEs in this study was nearly two-fold when compared to the study findings in Myanmar, where 37.6% of the staff have PPEs [ 12 ].

The mean availability of masks, heavy-duty gloves, boots, and aprons was 71.1%, 65.4%, 38%, and 44.4% in the study health facilities. This finding shows masks are less available in the study health facilities compared to other studies. The availability of utility gloves, boots, and plastic aprons is good in this study compared to the study conducted by Banstola, D in Pokhara Sub-Metropolitan City [ 23 ].

The findings of this study show there is a poor segregation practice, and all kinds of solid wastes were collected together. This finding was similar to the study findings conducted in Addis Ababa, Ethiopia, by Debere et al. [ 24 ] and contrary to the study findings conducted in Nepal and India, which shows 50% and 65–75% of the surveyed health facilities were practising proper waste segregation systems at the point of generation without mixing general wastes with hazardous wastes respectively [ 9 , 17 ].

Ninety percent of private health facilities collect and transport SHCW generated in every service area and transport it to the disposal place by the collection container (no separate container to collect and transport the waste to the final disposal site). This finding was similar to the study findings of Debre Markos’s town [ 25 ]. At all of the facilities in the study area, SHCW was transported from the service areas to the disposal site manually by carrying the collection container, and there was no trolley for transportation. This finding was contrary to the study findings conducted in India, which show segregated waste from the generation site was being transported through the chute to the carts placed at various points on the hospital premises by skilled sanitary workers [ 17 ].

Observational findings revealed that pre-treatment of SHCW before disposal was not practised at all study health facilities. This study was contrary to the findings of Pullishery et al. [ 26 ], conducted in Mangalore, India, which depicted pre-treatment of the waste in 46% of the hospitals [ 26 ]. 95% of the facilities have no water supply for handwashing during and after solid healthcare waste generation, collection, and disposal. This finding was contrary to the study findings in Pakistan hospitals, which show all health facilities have an adequate water supply near the health care waste management sites [ 27 ].

Questionnaire data collection tools show that 129 (23.8%) of the staff needle stick injuries have occurred on health facility workers within one year of the period before the data collection. This finding was slightly smaller than the study findings of Deress et al. [ 25 ] in Debre Markos town, North East Ethiopia, where 30.9% of the workers had been exposed to needle stick injury one year prior to the study [ 25 ]. Reported and registered needle stick injuries in health facilities are less reported, and only 70 (54.2%) of the injuries are reported to the health facilities. This finding shows an underestimation of the risk and the problem, which was supported by the study conducted in Menilik II hospitals in Addis Ababa [ 22 ]. 50%, 33.4%, 48%, 52%, and 62.5% of needle stick injuries were not reported in NEMMCSH, Government health centres, medium clinics, small clinics, and surgical centres, respectively, to the health facility manager.

Nearly 1/3 (177 or 32.7%) of the staff are exposed to needle stick injuries. Needle stick injuries in health facilities are less reported, and only 73 (41.24%) of the injuries are reported to the health facilities within 12 months of the data collection. This finding is slightly higher than the study finding of Deress et al. [ 25 ] in Debere Markos, Ethiopia, in which 23.3% of the study participants had encountered needle stick/sharps injuries preceding 12 months of the data collection period [ 25 ].

Seventy-three injuries were reported to the health facility manager in the last one year, 44 of the injuries were reported by health professionals, and the rest were reported by supportive staff. These injuries were reported from 35(85.3%) health facilities; the remaining six have no report. These study findings were better than the findings of Khan et al. [ 21 ], in which one-third of the facilities had a reporting system for an incident, and almost the same percentage of the facilities had post-exposure procedures in both public and private sectors [ 21 ].

Within one year of the study period, 129 (23.88%) needle stick injuries occurred. However, needle stick injuries in health facilities are less reported, and only 70 (39.5%) of the injuries are reported to the health facilities. These findings were reasonable compared to the study findings of the southwest region of Cameroon, in which 50.9% (110/216) of all participants had at least one occupational exposure [ 28 , 29 ]. This result report shows a very high exposure to needle stick injury compared to the study findings in Brazil, which shows 6.1% of the research participants were injured [ 27 ].

The finding shows that 220 (40.8%) of the respondents were vaccinated to prevent themselves from health facility-acquired infection. One Hundred Fifty-six (70.9%) of the respondents are vaccinated in order to avoid themselves from Hep B infection. Fifty-nine (26%0.8) of the respondents were vaccinated to protect themselves from two diseases that are Hep B and COVID-19. This finding was nearly the same as the study findings of Deress et al. [ 7 ],in Ethiopia, 30.7% were vaccinated, and very low compared to the study findings of Qadir et al. [ 30 ] in Pakistan and Saha & Bhattacharjya India which is 66.67% and 66.17% respectively [ 25 , 30 , 31 ].

The incineration of solid healthcare waste technology has been accepted and adopted as an effective method in Ethiopia. These pollutants may have undesirable environmental impacts on human and animal health, such as liver failure and cancer [ 15 , 16 ]. All government health facilities use incineration to dispose of solid waste. 88.4% and 100% of the wastes are incinerated in WUNEMMCSH and government health centres, respectively. This finding contradicts the study findings in the United States of America and Malaysia, which are 49–60% and 59–60 are incinerated, respectively, and the rest are treated using other technologies [ 15 , 16 ].

All study health facilities used a brick or barrel type of incinerator. The incinerators found in the study health facilities need to meet the minimum standards of solid health care waste incineration practice. These findings were similar to the study findings of Nepal and Pakistan [ 32 ]. The health care waste treatment system in health facilities was found to be very unsystematic and unscientific, which cannot guarantee that there is no risk to the environment and public health, as well as safety for personnel involved in health care waste treatment. Most incinerators are not properly operated and maintained, resulting in poor performance.

All government health facilities use incineration to dispose of solid waste. All the generated sharp wastes are incinerated using brick or barrel incinerators, as shown in Fig.  1 above. This finding was consistent with the findings of Veilla and Samwel [ 33 ], who depicted that sharp waste generation is the same as sharps waste incinerated [ 33 ]. All brick incinerators were constructed without appropriate air inlets to facilitate combustion except in NEMMCSH, which is built at a 4-m height. These findings were similar to the findings of Tadese and Kumie at Addis Ababa [ 34 ].

Barrel and brick incinerators used in private clinic

Strengths and limitations

This is a mixed-method study; both qualitative and quantitative study design, data collection and analysis techniques were used to understand the problem better. The setting for this study was one town, which is found in the southern part of the country. It only represents some of the country’s health facilities, and it is difficult to generalize the findings to other hospitals and health centres. Another limitation of this study was that private drug stores and private pharmacies were not incorporated.

Conclusions

In the study, health facilities’ foot-operated solid waste dust bins are not available for healthcare workers and patients to dispose of the generated wastes. Health facility managers in government and private health institutions should pay more attention to the availability of colour-coded dust bins. Most containers are opened, and insects and rodents can access them anytime. Some of them are even closed (not foot-operated), leading to contamination of hands when trying to open them.

Healthcare waste management training is mandatory for appropriate healthcare waste disposal. Healthcare-associated exposure should be appropriately managed, and infection prevention and control training should be provided to all staff working in the health facilities.

Availability of data and materials

The authors declare that data for this work are available upon request to the first author.

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Acknowledgements

The authors are grateful to the health facility leaders and ethical committees of the hospitals for their permission. The authors acknowledge the cooperation of the health facility workers who participated in this study.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Dr. Yeshanew Ayele Tiruneh is a researcher of this study; the principal investigator does all the proposal preparation, methodology, data collection, result and discussion, and manuscript writing. Professor LM Modiba and Dr. SM Zuma are supervisors for this study. They participated in the topic selection and modification to the final manuscript preparation by commenting on and correcting the study. Finally, the three authors read and approved the final version of the manuscript and agreed to submit the manuscript for publication.

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Tiruneh, Y.A., Modiba, L.M. & Zuma, S.M. Solid health care waste management practice in Ethiopia, a convergent mixed method study. BMC Health Serv Res 24 , 985 (2024). https://doi.org/10.1186/s12913-024-11444-8

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Received : 05 March 2023

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DOI : https://doi.org/10.1186/s12913-024-11444-8

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