SMV LECTURES RESEARCH METHODS FOR HEALTH SCIENCES
Research perspectives, research objective and research questions
Across all disciplines, at all levels, and throughout the world, health care is
becoming more complex. What makes the current challenges complex?
- Globalization: if it’s a global concern it will make the problem more
complex. The world is becoming increasingly more integrated and
interdependent.
- Fuzzy, instead of rigid, boundaries: people have fuzzy boundaries, every
individual is part of different groups. In social context it is hard to set rigid
boundaries.
- Internalized rules drive action: people have internalized rules, we do not
always know why we do what we do.
- Agents within the system change: people learn and develop, we cannot
predict their behavior all the time
- Systems are embedded in other systems and co-evolve.
Many issues will be complex issues because we are working with people. We
need a whole range of research methods, methodologies, theoretical
perspectives and epistemologies to help us understand these complex issues.
Not one scientific discipline is going to solve them.
There is a relationship between epistemology, theoretical perspectives,
methodology and methods. There is a bewildering array of theoretical
perspectives and methodologies, terminology applied is often inconsistent.
Epistemology
Epistemology is the study of knowledge, or the study of what constitutes valid
knowledge. We all have theories of knowledge, starts from very early age.
Epistemology is a big field and is important because:
- Knowledge of research philosophy will help the researcher to recognize
which designs will work for a given set of objectives and which will not.
- It can help to clarify issues of research design (but also
misunderstandings/tensions) especially in interdisciplinary teams while
working on complex problems.
Different kinds of epistemologies:
,Objectivism
Reality exists independently of consciousness – in other words, there is an
objective reality ‘out there’. Research is about discovering this objective truth.
Researchers should strive not to include their own feelings and values.
Connected to theoretical perspective positivism: there is only one reality/truth.
Reality can be measured. Knowledge can be formulated into laws. This view has
been challenged, post-positivism: we can only approximate the truth (RCT’s).
Objectivism and positivism can be connected to the methodology of survey
research and the methods of a questionnaire.
Constructivism
Truth and meaning do not exist in some external world but are created by the
subject’s interactions with the world. Meaning is constructed, not discovered.
Subjects construct their own meaning in different ways, even in relation to the
same phenomenon.
Connected to theoretical perspective interpretivism: multiple contradictory but
equally valid accounts of the world can exist. Knowledge is contextual.
Constructivism and interpretivism can be connected to the methodology of
phenomenological research and the methods of interview and focus group.
Subjectivism
Meaning is imposed by the subject on the object. Subjects do construct meaning,
but do so from within collective unconsciousness, from cultural and religious
beliefs, etc.
Postmodernism can be taken as an example of theoretical perspective linked to
subjectivism. Postmodernism emphasis multiplicity, ambiguity, ambivalence and
fragmentation. Subjectivism and postmodernism can be connected to the
methodology of discourse analysis and the methods of content analysis.
-
More theoretical perspectives:
- Critical inquiry: this critical form of research is a meta-process of
investigation, which questions currently held values and assumptions and
challenges conventional social structures. The critical inquiry perspective
is not content to interpret the world but also seeks to change it. The
assumptions that lie beneath critical inquiry are that: Ideas are mediated
by power relations in society.
- Feminism: feminist epistemologies take the view that what a person knows
is largely determined by their social position.
These can both be connected to the methodology of ethnography and the
methods of observation and interview.
Epistemic injustice: groups of people start to believe that their understanding of
knowledge is less valid. Takes place on a systemic level. Injustice related to
knowledge, such as exclusion, silencing, misrepresentation, undervaluing.
,Objective and research questions
The research process can be seen on the right. If the
research uses literature as a starting point it is
theoretical oriented research. If the research uses
problems and questions of the workplace or community
setting as starting point it is practice oriented research.
Both find a research gap.
How to get to a research topic:
1. Own previous work
2. Experiences from fieldwork
3. Donor informed
4. Patient/patient organization informed
5. Interviewing experts and develop a new
research agenda.
Avoid research disasters by making it too big, too
trivial, by lack of resources, materieals and people, if it
is dependent on the completion of another project, or it
is unethical.
From topic to the objective and research questions:
- What is the broad area of research
- What is known/done about it
- What is not known/done about it
- (Why is this a problem)
- Therefore, the aim of this study is ..... (I am going to make known about it)
= Objective
- Research questions (plus sometimes hypotheses)
With this you can format an introduction.
Formulate research objective:
- Informative: indication of knowledge to be gathered
- Useful: relevant according to parties involved
- Realistic: likelihood of contributing to solving the problem
- Feasible: feasibility with time and resources
- Clear: specify contribution
The research objective is …(a)… by …(b)…
a. External objective: contribution of your research project to solution of the
problem/what results can be expected
b. Internal objective: the way in which this will be done/the insights,
information, knowledge needed (very similar to your research question).
Research questions:
- One or more research questions
- Tight connection between literature/theories and the research questions
- Defining the investigations: discovering, exploring, understanding,
explaining, comparing
- Establish boundaries
- Concise and unambiguous
Research topic > research objective > research questions
, Research priority setting and Research agenda’s
Research priority setting
- Organizations conducting or funding public health research have to select
research priorities while often facing competing demands and scarce
resources
- Therefor a collective activity for deciding which uncertainties are most
worth trying to resolve through research is warranted.
- Uncertainties considered may be problems to be understood or solutions
to be developed or tested; across broad or narrow areas.
Consumers and priority setting procedures often form a challenge: consumers
have little understanding of the priority-setting process, little knowledge of
health R&D priorities and relatively poor formulates priorities of their own. This
may bolster the opinion that consumers have little to contribute to R&D priority-
setting or on the other hand they may be seen as evidence that closer
involvement of consumers with the process could lead to useful inputs of views
and experience.
Challenges with consumers and priority setting procedures:
- Power Imbalance: traditional hierarchies in healthcare &research often
place researchers, clinicians, and policymakers in positions of authority,
while patients may have less influence.
- Heterogeneity of Patient Populations: patients are not a homogenous
group. Different individuals may have conflicting priorities.
- Underrepresentation of Marginalized Groups: minorities & low-income
individuals may be underrepresented
- Lack of Training and Support: make it diffficult to effectively participate in
technical, complex research discussions
- Time and Resource Constraints
Health care efficiency research adresses effiencies issues in health care practice.
Issues come from policy parties to stimulate health care innovation.
1. Early evalutation of promising interventions
2. Evidence for guideline and insurace coverage
Research agenda’s steps to follow:
- Inventory of stakeholders
Health care providers
Patients
Societal partners (e.g. insurance companies)
- Summary of evidence
- Priority setting
- Consensus procedures
Research perspectives, research objective and research questions
Across all disciplines, at all levels, and throughout the world, health care is
becoming more complex. What makes the current challenges complex?
- Globalization: if it’s a global concern it will make the problem more
complex. The world is becoming increasingly more integrated and
interdependent.
- Fuzzy, instead of rigid, boundaries: people have fuzzy boundaries, every
individual is part of different groups. In social context it is hard to set rigid
boundaries.
- Internalized rules drive action: people have internalized rules, we do not
always know why we do what we do.
- Agents within the system change: people learn and develop, we cannot
predict their behavior all the time
- Systems are embedded in other systems and co-evolve.
Many issues will be complex issues because we are working with people. We
need a whole range of research methods, methodologies, theoretical
perspectives and epistemologies to help us understand these complex issues.
Not one scientific discipline is going to solve them.
There is a relationship between epistemology, theoretical perspectives,
methodology and methods. There is a bewildering array of theoretical
perspectives and methodologies, terminology applied is often inconsistent.
Epistemology
Epistemology is the study of knowledge, or the study of what constitutes valid
knowledge. We all have theories of knowledge, starts from very early age.
Epistemology is a big field and is important because:
- Knowledge of research philosophy will help the researcher to recognize
which designs will work for a given set of objectives and which will not.
- It can help to clarify issues of research design (but also
misunderstandings/tensions) especially in interdisciplinary teams while
working on complex problems.
Different kinds of epistemologies:
,Objectivism
Reality exists independently of consciousness – in other words, there is an
objective reality ‘out there’. Research is about discovering this objective truth.
Researchers should strive not to include their own feelings and values.
Connected to theoretical perspective positivism: there is only one reality/truth.
Reality can be measured. Knowledge can be formulated into laws. This view has
been challenged, post-positivism: we can only approximate the truth (RCT’s).
Objectivism and positivism can be connected to the methodology of survey
research and the methods of a questionnaire.
Constructivism
Truth and meaning do not exist in some external world but are created by the
subject’s interactions with the world. Meaning is constructed, not discovered.
Subjects construct their own meaning in different ways, even in relation to the
same phenomenon.
Connected to theoretical perspective interpretivism: multiple contradictory but
equally valid accounts of the world can exist. Knowledge is contextual.
Constructivism and interpretivism can be connected to the methodology of
phenomenological research and the methods of interview and focus group.
Subjectivism
Meaning is imposed by the subject on the object. Subjects do construct meaning,
but do so from within collective unconsciousness, from cultural and religious
beliefs, etc.
Postmodernism can be taken as an example of theoretical perspective linked to
subjectivism. Postmodernism emphasis multiplicity, ambiguity, ambivalence and
fragmentation. Subjectivism and postmodernism can be connected to the
methodology of discourse analysis and the methods of content analysis.
-
More theoretical perspectives:
- Critical inquiry: this critical form of research is a meta-process of
investigation, which questions currently held values and assumptions and
challenges conventional social structures. The critical inquiry perspective
is not content to interpret the world but also seeks to change it. The
assumptions that lie beneath critical inquiry are that: Ideas are mediated
by power relations in society.
- Feminism: feminist epistemologies take the view that what a person knows
is largely determined by their social position.
These can both be connected to the methodology of ethnography and the
methods of observation and interview.
Epistemic injustice: groups of people start to believe that their understanding of
knowledge is less valid. Takes place on a systemic level. Injustice related to
knowledge, such as exclusion, silencing, misrepresentation, undervaluing.
,Objective and research questions
The research process can be seen on the right. If the
research uses literature as a starting point it is
theoretical oriented research. If the research uses
problems and questions of the workplace or community
setting as starting point it is practice oriented research.
Both find a research gap.
How to get to a research topic:
1. Own previous work
2. Experiences from fieldwork
3. Donor informed
4. Patient/patient organization informed
5. Interviewing experts and develop a new
research agenda.
Avoid research disasters by making it too big, too
trivial, by lack of resources, materieals and people, if it
is dependent on the completion of another project, or it
is unethical.
From topic to the objective and research questions:
- What is the broad area of research
- What is known/done about it
- What is not known/done about it
- (Why is this a problem)
- Therefore, the aim of this study is ..... (I am going to make known about it)
= Objective
- Research questions (plus sometimes hypotheses)
With this you can format an introduction.
Formulate research objective:
- Informative: indication of knowledge to be gathered
- Useful: relevant according to parties involved
- Realistic: likelihood of contributing to solving the problem
- Feasible: feasibility with time and resources
- Clear: specify contribution
The research objective is …(a)… by …(b)…
a. External objective: contribution of your research project to solution of the
problem/what results can be expected
b. Internal objective: the way in which this will be done/the insights,
information, knowledge needed (very similar to your research question).
Research questions:
- One or more research questions
- Tight connection between literature/theories and the research questions
- Defining the investigations: discovering, exploring, understanding,
explaining, comparing
- Establish boundaries
- Concise and unambiguous
Research topic > research objective > research questions
, Research priority setting and Research agenda’s
Research priority setting
- Organizations conducting or funding public health research have to select
research priorities while often facing competing demands and scarce
resources
- Therefor a collective activity for deciding which uncertainties are most
worth trying to resolve through research is warranted.
- Uncertainties considered may be problems to be understood or solutions
to be developed or tested; across broad or narrow areas.
Consumers and priority setting procedures often form a challenge: consumers
have little understanding of the priority-setting process, little knowledge of
health R&D priorities and relatively poor formulates priorities of their own. This
may bolster the opinion that consumers have little to contribute to R&D priority-
setting or on the other hand they may be seen as evidence that closer
involvement of consumers with the process could lead to useful inputs of views
and experience.
Challenges with consumers and priority setting procedures:
- Power Imbalance: traditional hierarchies in healthcare &research often
place researchers, clinicians, and policymakers in positions of authority,
while patients may have less influence.
- Heterogeneity of Patient Populations: patients are not a homogenous
group. Different individuals may have conflicting priorities.
- Underrepresentation of Marginalized Groups: minorities & low-income
individuals may be underrepresented
- Lack of Training and Support: make it diffficult to effectively participate in
technical, complex research discussions
- Time and Resource Constraints
Health care efficiency research adresses effiencies issues in health care practice.
Issues come from policy parties to stimulate health care innovation.
1. Early evalutation of promising interventions
2. Evidence for guideline and insurace coverage
Research agenda’s steps to follow:
- Inventory of stakeholders
Health care providers
Patients
Societal partners (e.g. insurance companies)
- Summary of evidence
- Priority setting
- Consensus procedures
