| Course | HS860 Doctoral Project I: Project Proposal |
|---|---|
| Unit | Unit 2 |
| Paper type | Problem statement draft |
| Length | About 1,120 words, 7 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | Doctor of Health Science (DHSc) |
| Updated | October 2026 |
Free sample paper for HS860 Unit 2
One Sentence and the Evidence Beneath It: A Unit 2 Problem Statement Draft for a Lymphedema Surveillance Doctoral Project
[Student Name]
Purdue University Global
HS860: Doctoral Project I: Project Proposal
Unit 2 Problem Statement Draft
[Instructor Name]
[Date]
The cancer center and its figures are composite and shown in brackets as placeholders; no project data have been collected, and the studies and recommendations cited are real.
The Problem Statement
Although a prospective surveillance model for breast cancer-related lymphedema was proposed in 2012 and has since been adopted by many cancer programs, little is known about where and why women at high risk leave surveillance pathways in community cancer centers, so programs cannot target the steps that fail.
The Problem in the Literature
Lymphedema is a frequent consequence of breast cancer treatment. Pooling 72 studies, DiSipio et al. (2013) estimated incidence at about 17 percent overall and 21 percent in prospective cohorts, with women who had their axillary nodes dissected facing roughly four times the incidence seen after sentinel node biopsy alone, and with incidence rising for up to two years after surgery. Lymphedema affects arm function, body image and quality of life, and treatment for established disease is long-term.
Early detection changes the course. When women were measured before surgery and followed, subclinical increases in arm volume, averaging under 100 milliliters at onset, were found about seven months after surgery on average and reversed with a few weeks of compression garments (Stout Gergich et al., 2008). Building on such work, a multidisciplinary group proposed a prospective surveillance model for rehabilitation in breast cancer, with a preoperative baseline and scheduled follow-up measurements, so that impairments such as lymphedema could be identified and treated early (Stout et al., 2012). An expert panel of breast surgeons later recommended preoperative baseline measurement and ongoing surveillance for women at risk (McLaughlin et al., 2017). A randomized trial found that surveillance with bioimpedance spectroscopy reduced progression to lymphedema needing complex decongestive therapy compared with tape measurement (Ridner et al., 2019).
The Problem Locally
At the candidate's center, the pathway was adopted [three] years ago. According to last year's breast program summary, about one in five women undergoing axillary dissection, [22] percent, was measured at baseline; a surveillance referral appeared at discharge for [58] percent; and fewer than a third, [31] percent, came to their first surveillance appointment within four months. These figures are reported in aggregate in the breast program's annual quality summary and are cited here with the program director's permission. They show that the local situation matches the published problem; they do not establish it.
The local numbers do not prove the problem; the literature does. The local numbers show that this center is a place where the problem can be studied.
The Gap in Knowledge
The published literature describes surveillance programs, mostly in academic centers with research staff, and tests measurement methods and treatment. It rarely examines how surveillance pathways perform once adopted in community settings, or at which steps women are lost. The gap is not that staff fail to follow the pathway; it is that no one knows which steps fail, for which women and why. Without that knowledge, a program cannot target its improvement efforts and may spend effort on steps that are working.
Consequences of the Problem
The consequences reach beyond the arm. Women with lymphedema describe heaviness, tightness and reduced range of motion that interfere with work, household tasks and sleep. Clothing and jewelry no longer fit, and the visible swelling can serve as a daily reminder of cancer long after treatment ends. Infection of the affected arm, cellulitis, is a recurring risk and sometimes requires hospital admission. Treatment for established lymphedema typically involves weeks of daily therapy sessions followed by lifelong compression garments, which many insurers cover only in part. Each of these burdens is larger when lymphedema is found late, after the swelling has become fibrotic and harder to reduce. The surveillance model exists precisely to shift diagnosis earlier, which is why its failure in practice matters.
Explanations the Project Must Consider
Several explanations for the gap are plausible, and the project must be designed to tell them apart rather than assume one. The preoperative visit may be too crowded with oncologic decisions to fit a measurement. Measurement equipment or trained staff may not be available where the preoperative visit happens. Referrals may be entered automatically without explanation, so women do not know why they should come. Surveillance appointments may be scheduled at times or places women cannot manage during radiation or chemotherapy. Women may decide that a swelling risk is a lower priority than their cancer treatment. Each explanation points to a different step and a different remedy. A problem statement that named one cause in advance would bias the study toward finding it.
Who Is Affected and How
Women at high risk of lymphedema are affected most directly: those who miss surveillance are more likely to be diagnosed after swelling is visible, when treatment is longer and outcomes poorer. Rehabilitation clinicians are affected because late referrals require more intensive therapy. The center is affected because it has adopted a standard it cannot show it meets.
Significance
Answering where and why women leave the pathway would allow the center, and similar community programs, to target improvements: for example, embedding measurement in the preoperative visit if that step fails, or changing scheduling if follow-up visits are missed. It would also add to the literature a description of surveillance in community practice, where most women with breast cancer are treated.
How the Statement Will Guide the Project
The problem statement fixes three things for the work that follows. It fixes the population: women at high risk because of axillary dissection, not all women with breast cancer. It fixes the unit of analysis: the steps of the pathway, each of which can succeed or fail. And it fixes the kind of answer sought: a description of where and why women leave, not a test of a remedy. Later units will turn these into a purpose statement and research questions, and any question that drifts beyond them will be treated as a sign that the project is growing past what one candidate can finish.
Limits of the Statement
The problem statement relies on published incidence and effectiveness data from settings that may differ from the center's. Local figures are aggregate and unaudited. The statement makes no claim about why women leave the pathway; that is the question the project will answer. Finally, the statement treats the pathway the center adopted as the standard, although the center's version may differ in timing from published models, a difference the literature map will need to note.
References
DiSipio, T., Rye, S., Newman, B., & Hayes, S. (2013). Incidence of unilateral arm lymphoedema after breast cancer: A systematic review and meta-analysis. The Lancet Oncology, 14(6), 500-515. https://doi.org/10.1016/S1470-2045(13)70076-7
McLaughlin, S. A., Staley, A. C., Vicini, F., Thiruchelvam, P., Hutchison, N. A., Mendez, J., MacNeill, F., Rockson, S. G., DeSnyder, S. M., Klimberg, S., Alatriste, M., Boccardo, F., Smith, M. L., & Feldman, S. M. (2017). Considerations for clinicians in the diagnosis, prevention, and treatment of breast cancer-related lymphedema: Recommendations from a multidisciplinary expert ASBrS panel: Part 1: Definitions, assessments, education, and future directions. Annals of Surgical Oncology, 24(10), 2818-2826. https://doi.org/10.1245/s10434-017-5982-4
Ridner, S. H., Dietrich, M. S., Cowher, M. S., Taback, B., McLaughlin, S., Ajkay, N., Boyages, J., Koelmeyer, L., DeSnyder, S. M., Wagner, J., Abramson, V., Moore, A., & Shah, C. (2019). A randomized trial evaluating bioimpedance spectroscopy versus tape measurement for the prevention of lymphedema following treatment for breast cancer: Interim analysis. Annals of Surgical Oncology, 26(10), 3250-3259. https://doi.org/10.1245/s10434-019-07344-5
Stout Gergich, N. L., Pfalzer, L. A., McGarvey, C., Springer, B., Gerber, L. H., & Soballe, P. (2008). Preoperative assessment enables the early diagnosis and successful treatment of lymphedema. Cancer, 112(12), 2809-2819. https://doi.org/10.1002/cncr.23494
Stout, N. L., Binkley, J. M., Schmitz, K. H., Andrews, K., Hayes, S. C., Campbell, K. L., McNeely, M. L., Soballe, P. W., Berger, A. M., Cheville, A. L., Fabian, C., Gerber, L. H., Harris, S. R., Johansson, K., Pusic, A. L., Prosnitz, R. G., & Smith, R. A. (2012). A prospective surveillance model for rehabilitation for women with breast cancer. Cancer, 118(S8), 2191-2200. https://doi.org/10.1002/cncr.27476
The Purdue Global HS860 Unit 2 instructions
The second unit usually asks candidates to draft the problem statement for their doctoral project, often three to five pages around a core statement of one or two sentences. The core statement should name the problem, who experiences it, where and with what consequence, and it should point to a gap in knowledge rather than a failure by staff. Instructors expect the problem to rest on published evidence: incidence or prevalence, guidelines or standards and studies showing what is known and not known. Local data may confirm that the problem exists at the site, but it should be aggregate, cited with permission and clearly secondary. Many prompts also ask candidates to describe consequences for the people affected and to explain how the statement will shape the purpose and questions that follow.
Inside the HS860 Unit 2 example
The draft opens with its one-sentence statement. A literature section reports incidence from a meta-analysis, the cohort showing early volume increases reversed with compression, the surveillance model, expert recommendations for baseline measurement and a measurement trial. A local section reports bracketed aggregate figures and explains, in the highlighted sentence, why they confirm rather than prove the problem. A gap section frames the issue as missing knowledge about which steps fail. Consequences for women, clinicians and the center are described. A section lists rival explanations, from crowded preoperative visits to scheduling during radiation, so the project will not assume one. The draft ends with how the statement guides later units and its own limits.
HS860 Unit 2 rubric: what earns full points
Problem statements at this level are typically scored on the clarity and precision of the core statement, the strength of the supporting literature, the distinction between a practice problem and a knowledge gap, the handling of local data and significance. Precision often weighs most, since every later element of the proposal depends on it. Literature earns credit when it is current, peer reviewed and directly relevant to the population. Graders reward candidates who frame the gap as missing knowledge rather than blaming staff, because the project's purpose must address what is not known. Local data score well when they are aggregate, permitted and kept secondary. Significance points come from naming who benefits from an answer. Clear writing and correct APA style complete the grade.
Common HS860 Unit 2 mistakes, and how to avoid them
The most frequent problem is a statement that blames people, such as staff not following the pathway, which turns a research problem into a performance complaint. Another is relying on local numbers that have not been approved for research use. Some candidates write several sentences of background and call it the problem statement. Others name a cause in advance, which biases the study toward finding it. Leaving out consequences for patients weakens significance. If your problem concerns another gap between a recommended practice and what happens, perhaps fall risk screening or depression follow-up, send the guideline and a description of your setting, and a problem statement can be drafted that rests on the literature.
Get an HS860 Unit 2 example written to your instructions
Problem statements in Unit 2 are only as strong as the evidence from outside the candidate's setting. Send the Unit 2 prompt, the rubric, the concept paper or its feedback, and any template the program uses. National and published sources establish the problem before any local figure appears, free for a first custom sample, 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
More HS860 papers and DHSc samples
- HS860 Unit 1: Lymphedema Surveillance Concept Paper
- HS860 Unit 3: Discussion Board Post
- HS860 Unit 4: Purpose and Question Alignment
- HS860 Unit 5: Preliminary Literature Map
- HS860 Unit 6: Site Access Memo
- HS860 Unit 7: Seminar Reflection
- HS860 Unit 8: Feasibility Appraisal
- HS860 Unit 9: Committee Response Memo
- HS860 Unit 10: Project Proposal Draft
- HS850 Unit 2: Influence Without Authority Review
- HS840 Unit 2: Research Question Critique Paper
- HS830 Unit 2: Pediatric Issue Scan With Four Tests
- HS810 Unit 2: Discussion Board Post
HS860 Unit 2 questions, answered
What is the difference between a practice problem and a gap in the literature?
A practice problem is something going wrong in care, such as low uptake of an effective treatment. A gap in the literature is something researchers have not yet established, such as where in a process patients drop out in a particular type of setting. Doctoral projects usually need both: a real problem and a specific question the existing evidence does not answer.
Can local data be used in a problem statement before approval?
Aggregate figures already published internally are sometimes cited with permission, but data drawn from records for the project generally needs site and ethics approval first. Many candidates describe local figures as estimates, state their source and note that formal access will be requested. Check your program's and your site's rules before citing any internal number.
How long should the problem statement itself be?
The core statement is often a single sentence, or two at most, naming the problem, who experiences it, where and with what consequence. The section around it may run several pages, building the case. If the core statement needs three sentences, it often contains two problems, and a committee will usually ask which one the project addresses.
Where can I find a free HS860 Unit 2 sample paper?
This page holds the complete Unit 2 problem statement draft for a lymphedema surveillance project, with a one-sentence statement supported by published evidence.
Why are local figures shown in brackets?
They are aggregate numbers from a quality summary used as confirmation before approval, and the brackets mark them as placeholders to be replaced with audited counts.