An overview of research theory and process

Full text

An overview of research theory
and process
Dean Whitehead
LEARNING OUTCOMES
After reading this chapter, you should be
able to:
• identify the theoretical and
philosophical positions that underpin
different research approaches
• explain the existence of a ‘paradigm
tension’ in research
• note broad commonalities and
differences between qualitative and
quantitative research approaches
• discuss the nature, intention and
framework of the research process and
research design.
KEY TERMS
critical social theory
epistemology
interpretive
ontology
paradigm tension
paradigms
positivism
qualitative
quantitative
research design
research framework
research philosophy
research process
research theory
Chapter 2
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2 • An overview of research theory and process
21
underlying theories that underpin research. e
same could easily be argued in the case of
midwives. Nurse and midwifery researchers often
turn to theory to understand research problems
and guide the subsequent investigation and
inquiry. Wallin (2009) tells us that research
theory is needed to aid understanding of the
range of factors at dierent levels that interact
with and determine the extent to which
interventions result in change. However, the fact
that this is not always the case continues to
hinder the national and international progress of
research in these disciplines. Hutchinson and
Johnston (2004), in their Australasian-based
study, found that one of the main reasons why
nurses fail to use research evidence in practice
is because they do not know or understand the
theoretical constructs. A number of other studies
present similar ndings for both nursing and
midwifery (Edwards et al. 2002; Olade 2003;
Veeramah 2004; French 2005; Roxburgh 2006;
O et al. 2008).
eories are conceptual abstract
interpretations of phenomena and their
relationships. It is recognised that theory guides
practice and that theory, research and practice
are very closely linked together (Cody 2003;
RESEARCH THEORIES,
PHILOSOPHIES AND
PARADIGMS
Essentially, theory and philosophy mean the
same thing. e word theory evolved from
ancient Greek philosophy. In research, sometimes
the terms are separated out but, more often,
they are used interchangeably. Where they are
separated out, generally, theory relates to
quantitative research (measurable observations)
while philosophy relates to qualitative research
(ideas) (see later in this section). For the purpose
of this chapter, however, reference to one term
covers all eventualities. Kitson (2001), in
evaluating the state of nursing research in
Australia and New Zealand, believes that there
is a real need for nurses to understand the
INTRODUCTION
Understanding how research works and what methods and processes it adopts is one of the rst
steps in becoming a knowledgeable research consumer. Research is a systematic and logical
process and exists as a mechanism or tool through which knowledge is generated and tested.
Generating and testing new knowledge is a vital component in the nursing and midwifery
disciplines as a means to examine and evaluate practice. It is expected that initial research
inquiry equips the research individual or group to make those early tentative, and then likely
full-scale, attempts at actually conducting and implementing research in a variety of nursing and
midwifery environments; for example, clinical, administration, teaching/learning and quality
assurance disciplines. Without this initial understanding, the research journey rarely ourishes
and, instead, confusion and frustration quickly set in as the research novice struggles to come
to terms with the ‘language’ and instruction of research. It is recommended here then that the
novice research consumer adopts a step-by-step approach to understanding research and its
dierent approaches. is chapter oers the initial theoretical and philosophical foundations for
understanding research, as well as mapping out the frameworks and processes that originate
from these positions. e intention is to produce a rm foundation from which beginning
consumers of research can proceed in an informed manner.
Tutorial Trigger
How might the absence of knowledge
of the underpinning theories and
philosophies of research affect
nursing and midwifery research?
1
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NURSING AND MIDWIFERY RESEARCH 4E
22
Research paradigms are therefore sets of beliefs
and practices shared by all researchers which
serve to govern inquiry within disciplines
(Weaver & Olson 2006). is research paradigm
world-view shapes a researcher’s approach to a
variety of research-related activities. A paradigm,
therefore, guides the direction of research. Which
paradigm position a researcher adopts depends
on a number of factors, such as profession,
‘tradition’, understanding (knowledge-base),
cultural beliefs and hierarchy. No single theory,
paradigm or framework alone can address all
aspects of nursing and midwifery research nor is
any superior to another. erefore, ‘theoretical
pluralism’ exists where many factors decide
which position the researcher adopts and the
nature of the research undertaken (Graham
2003; Weaver & Olson 2006).
One of the main aims of this chapter is to
introduce the reader to the dierent perspectives
of quantitative and qualitative research. e basic
principles and distinguishing features of both
the qualitative and quantitative paradigms are
explored noting the dierences and similarities
of theoretical and philosophical origins,
terminology and evaluation criteria. e chapters
in Section 2 of this book explore dierent
aspects of these two paradigms in far more depth
than this chapter. Section 2 is purposely divided
separately to cover the paradigms of qualitative
and quantitative methods. In Chapter 14, the
rapidly emerging phenomenon of ‘mixed-
methods research’, which aims to ‘mix and
marry’ the processes of both qualitative and
quantitative research, is reviewed.
In generating knowledge, researchers can use
methods from dierent paradigms. Selection of
the paradigm and the resulting research design
(plan) are dependent on the following starting
points:
• the purpose of the research and the question/s
being asked
• the nature of the issue/s or problem/s being
investigated
• what is likely to oer the ‘best t’ for process
and outcomes
• the knowledge and experience of the researcher
• the need, or not, for generalisability (the
application of research ndings from a smaller
group of research participants to much larger
groups).
Marrs & Lowry 2006; Wu & Volker 2009).
According to Graham (2003), research-based
theory-building is appealing due to its problem-
focused nature and its potential to change and
improve practice. However, before the novice
researcher ‘rushes off’ to perform actual research
in practice or use existing research evidence to
inuence and change practice, it is vital that they
rst understand the theoretical and philosophical
foundations of research and their related
processes. Part of the problem with this is that
exact denitions are dicult to nd as not all
research theorists agree on exactly how research
theories and philosophies present. Added to this,
they do change over time too. ere are ways
around this problem, though. For instance,
Fawcett et al. (2001) insist that, as an
acknowledgment of dierent forms of ‘knowing’,
any form of evidence has to be both interpreted
and critiqued against whether or not theory can
be applied to practice situations and, if so, what
it looks like. Such viewpoints do allow a degree
of exibility and uidity but this should not
amount to ‘making things up as you go along’.
eories should only ever be adopted properly.
To approach research from a theoretically ‘blind’
or ‘forced’ position is both unethical and highly
questionable. Forbes (2009), though, has
identied that often our research is not
conducted in a theoretically complete manner.
Studies in midwifery and nursing may not
always be guided by a theoretical framework:
some studies benet from a theoretical
standpoint and some do not (see Chapter 15).
When researchers use a theoretical framework
they provide justication for doing so. For
example, Ip et al. (2009) evaluated an ecacy-
enhancing educational intervention based on
Bandura’s self-ecacy theory. e researchers
used this framework ‘to explore, explain and
predict healthy behaviour in a variety of health
promoting research’ (p 2125).
It is well accepted that research is divided into
two broad classications or paradigms (although
multiple paradigms exist within these); that of
qualitative and quantitative research. e
philosophical basis of a researcher often stems
from a specic paradigm. A paradigm is a
position or view of understanding the world we
live in (world-view or view-of-the-world) which
covers philosophical assumptions that are shared
by a community of scholars or scientists.
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2 • An overview of research theory and process
23
relationships, and what denes knowledge of
these areas, are vital to such practice (Leddy
2000). Unique experiences or transferable
ndings form the basis of decision-making for
identifying if a qualitative or quantitative (or
both) research method is used. Further
delineation (separating out) is outlined in more
common classications of research paradigms;
these being:
• positivist — reductionist, empirical
• critical — emancipatory
• interpretive — naturalistic.
Positivist approach
e term positivist or ‘positivism’ refers to a
philosophical position which reects the
traditional scientic approach of objective
observation, prediction and testing of causal
relationships (Maggs-Rapport 2001). is
paradigm is representative of quantitative
research approaches. Positivism (or modernism)
is a broad cultural reection of rationality and
known science. e related term ‘determinism’
(reductionism) describes the fact that certain
investigated phenomena do not occur by chance.
Instead, they have predisposing causes that are
known to us. A midwifery example concerning
cognition in pregnancy will help to clarify. From
the point of view of determinism, it accepts that
changes in a person’s physical status causes
changes in the person’s psychological status.
erefore, any change in the cognitive status of
a pregnant woman must have its source in the
physiological change brought about by
pregnancy. ‘Empirical-analytical’ or ‘logical
positivism’ are equivalent terms used to describe
the origins and belief system of the quantitative
research paradigm. Another related concept
of quantitative research is that of ‘deductive
reasoning’. is describes a logical thought
process whereby research hypotheses (see
Chapter 4) are derived from theory, and where
reasoning moves from the general (what is
already known) to the particular (what is being
tested/measured). Chapters 9 through to 13 oer
a detailed account of quantitative research.
Some see that the weakness of the
deterministic (or reductionist) viewpoint is
that it does not take account of a person’s
individuality or subjective human experience
within a cultural or situational framework in
Regardless of approach, research is conducted to
examine and expand current knowledge and
understanding of dierent concepts and
phenomena within a particular philosophical
framework. Research is therefore guided by the
following concepts (and related questions):
• Ontology is the study of existence. It provides
the ‘world-view’ that guides the study (e.g.
‘What is the nature of reality?’; ‘What kind of
being is the human being?’)
• Epistemology is the theoretical study of
knowledge involved in the search for
knowledge and truth. It provides a focus for
the study (e.g. ‘What is the relationship
between the researcher and the area of study?’)
• Methodology provides a framework (process) for
conducting the study (e.g. ‘How do we know
the world, or gain knowledge of it?’) (Parse
2001; Denzin & Lincoln 2005)
Other less commonly used terms may also
present themselves related to theoretical and
philosophical positions in research. is is not a
problem, merely an acknowledgment that no
single chapter of a research text can cover all
theoretical and philosophical eventualities.
Where the reader does come across this, it is
usually the case that some background
investigation will solve the issue. For instance,
parsimony is a relatively common philosophical
research term that refers to a principle concerned
with explaining theory by means of the fewest
number of possible conceptual elements in
favour of simplicity (Cutclie & Harder 2009).
Clearly, philosophical ideas such as those just
described are based on singular values and beliefs
which is why there is always the potential for
contention and dierence. However, internal
consistency and logic are achieved in a study
when the links between the three just-mentioned
concepts are clear (Parse 2001). Diering views
exist regarding these concepts and the ways they
interrelate. is dierence is to be celebrated
because it challenges what we do and why we do
it, and helps us to mould, redene and
manipulate our knowledge base and,
subsequently, guide how we conduct our
practice.
From a health professional perspective, the
study of individuals’ responses to disease,
treatment and recovery is a large part of our role.
Philosophical beliefs about human/environment
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NURSING AND MIDWIFERY RESEARCH 4E
24
healthcare and nursing/midwifery, preventing
them from receiving or delivering comprehensive
care and treatment. In doing so, feminist
research adopts a ‘post-structural’ position by
rst exposing and then changing power
structures that are present within social and
political institutions. It is obviously worthwhile
to investigate issues that expose any form of
marginalisation purely based on issues such as
gender. It should be noted though that, while it
is a useful approach for investigating related
issues in nursing, midwifery and women’s
healthcare generally, feminist research represents
a small body of research work in these disciplines
overall. For instance, in Edin and Högberg’s
(2002) midwifery-based study investigating the
incidence of physical and sexual violence
encountered by pregnant women, their extensive
review of the literature unveiled many survey-
based research studies, but uncovered no feminist
studies. To help overcome issues like this, some
contemporary authors have sought to combine
feminist approaches with newer methods. For
instance, Corbett et al. (2007) put forward the
case for an alliance of feminist-informed
participatory action research (see Chapter 14).
For these types of reasons, this book
acknowledges the place of feminist research here,
but does not include it elsewhere. ose who
wish to know more about feminist theory and
research are directed to the references just cited
for a theoretical perspective, as well as others that
demonstrate actual research examples (i.e. Yam
2000; Arslanian-Engoren 2001; Aranda 2006).
which human beings exist (Pepitone 1981).
is concept, however, is not favoured by all,
especially where supporters of determinism
adhere to strict and rigid principles whereby
‘pure’ positivism is championed. Labels attached
to this paradigm, such as ‘proper’, ‘realist’
‘hard’ and ‘scientic’, compound this critique.
Consequently, the ‘post-positivism’ (or post-
modernism) movement has developed as a less
rigid position that acknowledges the limited
nature of ‘complete or total objectivity’.
Critical approach
Critical approaches generally use qualitative
methods to examine phenomena of interest.
Both critical and interpretive (see next section)
approaches are viewed as post-positivist. ey
developed from researchers wishing to nd
alternatives to counter and balance out the
positivist tradition already described. ese
approaches generally use research methods
operating within a social-change context and,
therefore, often with a post-modern stance that
includes questioning the status quo of social
institutions. Consequently, the researcher adopts
a position that is free from the limitations of
tradition and seeks to minimise the ‘distance’
between the researcher and the study
participants.
Critical approaches usually look to encourage
empowerment and equality for research
participants and to challenge and change social
structures. Action research, for instance, is a
critical inquiry that describes and interprets
social situations and, in doing so, aims to
improve social division/inequality through
participant involvement. It is essentially a
critique of existing social situations, via
collaboration and partnership, in order to
generate social change (Williamson & Prosser
2002). Chapter 14 expands on the critical
processes of action research.
Critical approaches are also referred to as
‘emancipatory’. In nursing, emancipation has
emerged from a longstanding history of social
oppression addressed through critical social theory
and, in particular, through feminist theory and
research (Wittmann-Price 2004; Turris 2005).
According to Arslanian-Engoren (2002), feminist
research aims to explore issues that are known to
cause discrepancies and inequities in women’s
RESEARCH IN BRIEF
Brodie (2002) conducted a study over a 2-year
period using a critical feminist approach with
groups of Australian midwives attending 28
separate professional conferences. She found
that the system of midwifery care (at the time)
was medically dominated, not evidence-based,
restricted women’s choice, and that midwifery
autonomy was not recognised or supported.
She identified a need to reform through
strengthening the organisation and system of
midwifery care while forging strong links with
women and consumer organisations and the
expansion of well-informed and skilful
midwifery leadership.
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2 • An overview of research theory and process
25
cannot be separated from the people and
processes involved. e goal is a deep and
self-reexive engagement with the phenomena
being studied.
Another related concept of qualitative research
is that of ‘inductive reasoning’. is describes a
logical thought process whereby generalisations
are developed from specic observations — and
where reasoning moves from the particular to the
general (the opposite to quantitative research).
Chapters 6 through to 8, which deal primarily
with descriptive exploratory, phenomenology,
grounded theory and ethnography approaches,
further add to the understanding of interpretive
qualitative methods. Table 2.1 oers a simplied
comparison between positivist, critical and
interpretive approaches.
CHOOSING A PARADIGM
e reasons for selecting a qualitative paradigm
position rather than a quantitative one, or vice
versa, are based on the research question and the
purpose of the study. e formulation of the
research problem (research question, problem
statement or hypothesis) is an initial and key
step in the process of research, regardless of the
method used (see Chapter 4). At this stage, the
research consumer examines the consistency
between the research problem and the methods
used to address that problem. Critical appraisal/
evaluation skills are required to eectively review
research studies and judge if the ndings could
be applied to practice or not (see Chapters 3
and 15). Recognition of the dierences of the
characteristics of qualitative research from
quantitative research means that the nurse or
Interpretive approach
Interpretive approaches to research aim to
describe, explore and generate meaning within a
social or practice context. e most common
post-positivist examples of this approach are
phenomenology (hermeneutics), grounded
theory and ethnography (see Chapter 6). ey
are also referred to as occurring within a
naturalistic (or constructivist) paradigm. In
eect, ‘reality’ is not xed and is constructed
according to naturally occurring events and
situations. For the interpretive researcher, then,
reality is a exible position whereby the
phenomenon being investigated exists within
contexts that have many dierent possibilities
and meanings. Meanings are therefore located in
a particular context or situation and time and,
generally, meanings emerge from the study
process. Interpretive methods ensure dialogue
between the researcher and those with whom
they interact in order to collaboratively construct
a meaningful reality. e rationality of this
perspective is that the researcher is not and
TABLE 2.1
A simplified comparison of positivist, critical and interpretive approaches
POSITIVIST CRITICAL INTERPRETIVE
Position Empirico-analytical,
reductionist
Post-positive, post-
modern, post-structural,
emancipatory
Post-positive, post-modern,
naturalistic
Methodology Experimental,
quasi-experimental,
correlational etc
Feminist research,
action research, critical
ethnology etc
Phenomenology, grounded
theory, ethnography,
exploratory/descriptive,
case study, historical, Delphi
Data collection Experiments, closed
surveys and interviews
Open observation or
interviews, focus groups
Open observation or
interviews, focus groups
Researcher position Distant Close Close
Point to ponder
Some disciplines will lend themselves more to
feminist research than others. This would
certainly potentially be the case for midwifery,
although it is relevant to all those who work
with women and on issues of women’s health.
A search of the midwifery-based research
literature, to date, uncovers scant feminist
research examples. The previous ‘Research in
brief’ box is one example.
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NURSING AND MIDWIFERY RESEARCH 4E
26
midwife is better able to interpret the research
report ndings and identify ways they might be
applied. Articles, such as ones written by
Cambell and Roden (2010), oer simplied
detail in explaining the relationships, similarities
and dierences between quantitative and
qualitative research approaches. e origins and
belief systems for the qualitative and quantitative
paradigms are also described and compared in
Table 2.2.
Researchers may sometimes be under the
impression that the dierences between
qualitative and quantitative paradigms are so
wide that one paradigm position is incompatible
with the other (Weaver & Olson 2006). While
not intended, the information in Table 2.2 may
exaggerate the apparent division between them.
It is important, however, to acknowledge their
TABLE 2.2
A comparison of qualitative and quantitative approaches
CONCEPTS QUALITATIVE QUANTITATIVE
Origins Search for meaning; interactive approach Search for truth in an objective,
controlled manner
Beliefs Complex beings who attribute unique
meanings to situations
Biopsychosocial beings with measurable
components
Truth Subjective with multiple realities Objective reality
Basis of knowing Meaning, discovery Cause and effect relationships
Focus Complex and broad Concise and narrow
Level Holistic Reductionist
Reasoning Dialectic, inductive Logistical, deductive
Setting Occurs in uncontrolled naturalistic (social
or human) settings
Investigator seeks experimental control
of the setting
Purpose Develops theory by exploring meaning
and describing relationships
Tests hypotheses, theories by control
and observation
Sample People in the sample are referred to as
participants or, in ethnographic studies,
informants
People in a group are termed the
sample, and are referred to as subjects,
cases or respondents
Researcher
position
An active and interactive participant,
immersed in the setting
Uses measuring instruments or tools
(e.g. questionnaires)
Data elements Written form (words) Numerical form (numbers)
Analyses Interpretive analysis usually undertaken
manually
Statistical analysis using software (e.g.
SAS, SPSS, Minitab, Statview)
Outcomes Are often thematic or conceptual, but not
quantifiable and are expressed in words
Must be measurable and are reported in
numerical terms
Clinical
application
Exploration of unique experiences of
individuals or groups
Findings able to be generalised to
similar groups
obvious ‘connectedness’ and inter-relationships.
Both approaches are complementary, not
competitive. Broadly speaking, both paradigms
are scientic, rigorous and follow very similar
process, design and methodology. Neither
quantitative nor qualitative research can occur
by chance: both are governed by systematic
attention to the method and design of the
research process (explained later in this chapter).
Tutorial Trigger
Before reading on, from what you
currently understand, which do you
believe is the best method to use for
conducting nursing or midwifery research
— qualitative or quantitative? Can you justify
your decision?
2
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2 • An overview of research theory and process
27
the mentioned paradigm tension. e ‘hidden’
suggestion of these hierarchies is that some
methods of research (especially positivist
approaches) are better (or more important)
than others. Evans (2003) oers a more reasoned
interpretation of these hierarchies, in that
dierent research methods are needed to answer
dierent clinical questions. erefore
eectiveness, appropriateness and feasibility of
method are more important indicators than
hierarchy. e Australian Health Advisory
Committee (HAC), as part of the National
Health and Medical Research Council
(NHMRC 2009), has more recently identied
with this type of thinking and, accordingly,
developed levels of evidence and grades for
recommendations for developers of clinical
practice guidelines (www.nhmrc. gov.au/
publications/synopses/cp65syn.htm). Table 2.3
highlights the current proposal for the NHMRC
hierarchies of research evidence, although it is
important to note that they represent a
quantitative hierarchy only.
A ‘paradigm tension’ in research?
A ‘traditional’ paradigm tension has existed
for some time within a number of research
communities. Essentially, in research terms,
the paradigms of qualitative and quantitative
research have been (and often still are) viewed
as being in direct competition with each other.
Conventional/traditional researchers and the
research ‘communities’ they represent have often
started and continued this situation, rather than
any particular fault lying with the paradigms
themselves. Take, for instance, the fact that
medical research is predominantly quantitative in
nature, while nursing and midwifery research
leans heavily towards conducting qualitative
research. is situation has often resulted in
unhelpful, limiting and limited outcomes for
healthcare research and created unnecessary
division between and within these health
professions. Weaver and Olson (2006) suggest
that such a state of aairs within nursing and
midwifery research has, in places, introduced
notable confusion, intolerance and competition.
More recently, this has notably changed with a
more reasoned and practical approach to health-
related research which now often includes
research collaboration between all health
professional disciplines (including nurses,
midwives and doctors). ere is now also a wider
acknowledgment of the equal and important
place of qualitative research, and the recent
contribution of ‘mixed-methods’ research adds to
this (see Chapter 14).
TABLE 2.3
Designations of levels of evidence according to
type of research question
LEVEL INTERVENTION
1 Systematic reviews of level 2 studies
2 Randomised controlled trials (RCTs),
or pseudo RCTs
3a Comparative studies with concurrent
controls
3b Comparative studies without
concurrent controls
4 Case series
(Source: National Health and Medical Research Council
(NHMRC) 2009 NHMRC Levels of Evidence and Grades for
Recommendations for Developers of Guidelines NHMRC,
Australia)
Point to ponder
Medical-based research on women’s health
issues (e.g. childbirth, osteoporosis) is often
criticised for its positivist medicalised
orientation, male dominance perspective, and
its tendency to reduce all health events (such
as childbirth) to a disease state or illness
orientation. Interestingly, some midwifery and
nursing-specific research has been accused of
the same.
e existence of ‘hierarchies of research
evidence’, popularised in the late 1970s in
Canada, has contributed (intentionally or not) to
Point to ponder
Looking at Table 2.3, what would be best
evidence for practice; a poorly constructed
systematic review or a well-constructed case
series study?
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NURSING AND MIDWIFERY RESEARCH 4E
28
Where studies are unique, however, and
are exploring either unknown or previously
unexplored issues, it may be that there is no
theoretical framework to guide the researcher. In
this case, conceptual frameworks identify single
or multiple concepts that are related but remain
untested. ey are still useful as a frame of
reference, but the degree of interpretation
is looser and wider than with theoretical
frameworks. Verication of an untested nursing
theory provides an area from which research
problems can be derived (see the next ‘Research
in brief ’).
Most researchers are now realising the
limitations of championing or rejecting one
research paradigm at the expense of another
(Morgan 2007). It is now accepted by many, as
both naïve and simplistic, to suggest either that
one research approach is better than another,
or that they are so dierent that researchers
can only adopt one or the other. It is also
acknowledged now that, in many instances,
adopting a single research approach or method
might prove inadequate when it comes to
answering research questions/hypotheses. e
key issue really is that the researcher, instead,
chooses the most appropriate method for the
actual task at hand. Dierent research methods
will always produce dierent results. One of the
main tasks, for the critical reviewer of research,
is that they can determine if research studies
have adopted the correct method and design
for the intended purpose or predicted outcomes
(see Chapter 15).
THEORETICAL AND
CONCEPTUAL FRAMEWORKS
Research theory and theoretical and conceptual
frameworks are often used in the language of
researchers to represent similar things, but there
are subtle dierences in meaning (Wu & Volker
2009). Research frameworks provide the
knowledge and theory basis for research studies.
eoretical research frameworks represent known
and tested theories. ere are many ‘tried and
tested’ theories in nursing and midwifery that
researchers can cross-reference against. erefore,
this foundational knowledge serves as a ‘frame
of reference’ from which researchers can either
predict or explain their study outcomes. For
instance, Lee and Holroyd (2009) eectively
used a mixed-methods approach to evaluate
the eect of childbirth education classes. is
two-phase study adopted Donabedian’s model as
a theoretical framework. In phase 1 the women
completed a questionnaire: descriptive statistics
summarised participants’ responses. In phase 2,
six of the original 40 women were purposively
selected for a semi-structured interview. ese
researchers believe that ‘using a mixed-method
design guided by a theoretical framework is
essential when evaluating patient education
activity’ (p 367).
RESEARCH IN BRIEF
Here we can see that, as well as most research
possessing a theoretical basis, research can be
used to generate new theories. Dalton (2003)
extends Kim’s theory of collaborative decision-
making in nursing practice, in constructing and
testing a new theory that moves from Kim’s
dyadic theory towards a triadic theory, by
means of a modified version of Walker and
Avant’s theory-derivation process.
Evidence-based practice tip
While research theory, philosophy, paradigms,
frameworks and concepts can be separately
defined, they are closely related and,
therefore, it is not uncommon to see the
terms used interchangeably. This can cause
confusion about their meaning and how the
different terms relate to research overall. To
avoid such confusion, it is recommended that
the reader becomes familiar with the terms
used so far in this chapter.
RESEARCH PROCESS AND
RESEARCH DESIGN
Research process
If we look at a series of ‘typical’ research studies
overall, regardless of which paradigm is used,
we should note that they all abide by the
same process. By paying attention to this
methodological process, critical research
consumers can appreciate the logical nature of
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2 • An overview of research theory and process
29
or potentially both in the case of mixed-
methods research (see Chapters 6, 9 and 14)
2) ethical consent and approval is sought (see
Chapter 5)
3) a sampling framework and technique i.e. the
rationale for choosing an appropriate
population of research participants, subjects
or elements to study, such as a random sample
of rst-year nursing or midwifery students
(see Chapters 7 and 10)
4) for quantitative research, variables are
operationally dened (see Chapter 11)
5) mostly for quantitative research, measuring
instruments are developed or selected and
evaluated (see Chapter 12)
6) data collection techniques are employed (see
Chapters 7 and 11)
7) the collected data are analysed (see Chapters 8
and 13)
8) results/ndings are evaluated (see Chapter 15).
If we look at published research in academic
journals it should be noted that they also closely
follow this process in disseminating published
research ndings (see Chapter 19). e research
then is usually reported in a certain logical
fashion. Hudson-Barr (2004) notes the way
that nursing and midwifery-related academic
journal articles are presented in this very
systematic way (an interpretation of likely
headings is included in the following list in
parentheses):
1) the identication of a research problem, idea
or issue (introduction)
2) a review of previous research and conceptual
work on the identied topic (literature review/
background)
3) specication of the research question,
statement or hypothesis (aim)
4) a description of how the study was
conducted (design, method or approach — to
include the possible subheadings of sampling,
ethical procedure, data collection and data
analysis)
5) discussion on the results of the research
(results/ndings)
6) the interpretation of the research ndings
(discussion — to potentially include
limitations, recommendations and conclusion/
summary).
research methods and the relevance of certain
guiding forces on the outcomes of research
(Maggs-Rapport 2001). To clarify the forces,
drivers and process of research, this book is
designed to take the reader step-by-step through
a sequential process-driven research journey
— chapter by chapter. e order of the chapters
in this book are mostly designed to follow the
sequence of the ‘research process’. e research
process then typically follows this structure:
1) identifying the clinical problem/issue
2) critically searching and reviewing the
available primary (research-based) and
conceptual (theory-based) literature
3) identifying research ideas, questions,
statements or hypotheses
4) determining ethical issues and procedures
5) identifying and justifying an appropriate
research methodology and method
6) sampling (choosing) appropriate research
populations (participants/elements)
7) collecting research data from participants/
elements
8) analysing collected research data
9) determining and making sense of research
results/ndings
10) disseminating (sharing) research ndings to
wider audiences.
We can note from the research process list that a
number of factors determine the nature and
extent of conducted research which, in turn,
inuence the choice of research method or
approach. Regardless of research approach
though, the process remains constant. is can
also be seen by looking at the decision path for
selecting a research approach as outlined in
Figure 2.1.
Research design
Research design takes a specic portion of the
research process that is more concerned with
the actual conducting of the research. In
essence, it is the ‘doing’ part of research. is is
the part where the researcher plans and designs
specic methods for conducting research; these
being:
1) the specic methodology and method/
methods to be used i.e. qualitative–
phenomenology or quantitative–experimental;
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NURSING AND MIDWIFERY RESEARCH 4E
30
Figure 2.1 Decision path for selecting a research approach
Researcher selects participants who
are experiencing the phenomenon of
interest and collects data until
saturation is reached.
Researcher uses an intensive
approach to collect data.
Researcher conducts interviews and
participant or non-participant
observation in environments where
participants usually spend their time.
Researcher bias is acknowledged and
set aside.
Primarily inductive analysis is used,
leading to a narrative summary which
synthesises participant information,
creating a description of human
experience.
What is the structure of the lived
experience of anger for adolescents?
What is the difference in blood
pressure and heart rate for
adolescents who are angry compared
to those who are not angry?
Humans are complex beings who
attribute unique meaning to their life
situations. They are known by their
personal expressions.
Truth is the subjective expression of
reality as perceived by the participant
and shared with the researcher. Truth
is context-laden.
Humans are biopsychosocial beings,
known by their biological, psychological
and social characteristics.
Truth is objective reality that can be
experienced with the senses and
measured by the researcher.
Researcher selects a representative
(of population) sample and determines
size before collecting data.
Researcher uses an extensive
approach to collect data.
Questionnaires and measurement
devices are, according to a standard
protocol, administered to control for
extraneous (unexpected) variables.
Primarily deductive analysis is used,
generating a numerical summary that
allows the researcher to reject or
accept the null hypothesis.
Researcher
beliefs
If your beliefs are:
or
then you'll ask questions, such as:
or
and select approaches:
or
leading to research activities
or
Example
questions
Approaches
Research
activities
Quantitative/deductive Qualitative/inductive
Point to ponder
The terms research process, design, method, methodology and approach are often used
interchangeably. While there are subtle differences between some of them, generally, they are terms
used to describe the same thing. For instance, methodology usually refers to the philosophical basis
that informs what approach is adopted, while method mainly refers to how actual processes (i.e. data
collection and analysis) are adopted and applied. Ofi et al. (2008), in their study, found that nearly a
quarter of the nurses they surveyed did not have a basic knowledge of research methodological
concepts.
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2 • An overview of research theory and process
31
from this, a good understanding serves as a
springboard to advance the novice towards the
rst steps of the already outlined research
process. Much of the available research literature
routinely use the terminology and concepts
highlighted in this chapter and, to a degree,
expects the reader to already be familiar with this
material. e next chapter is devoted to the
initial, yet vital, research process steps of
critically searching for, retrieving and reviewing
the existing research literature.
SUMMARY
KEY POINTS
• Research originates from, and is underpinned by, a number of theoretical and philosophical
positions. These positions create the ‘world-view’ of the researcher and help determine the
research approach that needs to be adopted.
• The two major paradigms of research are qualitative and quantitative research (although
some now refer to the third paradigm of ‘mixed-methods’ research; see Chapter 14). All
research paradigms have their differences and similarities but, ultimately, which paradigm is
chosen (if not all of them) by researchers should be determined on the basis of which
approach is the most appropriate for the task at hand and most likely to produce the best
possible outcomes for health clients and services.
• Conducted research necessarily is conducted according to established scientific, systematic
and structured processes. These must be fully understood before the research consumer can
start to apply research findings, or actually conduct research in practice.
Learning activities
1. e rst step in becoming a knowledgeable
research consumer involves:
a) understanding how to conduct research
b) understanding the ‘language’ of research
c) understanding how research works, its
underpinning theories and what methods
and processes it adopts
d) understanding how research impacts on
nursing practice.
2. Research is guided by the following
concepts (and related questions):
a) ontology, epistemology and methodology
b) ontology, epistemology and oncology
c) ontology, pedagogy and methodology
d) ontology, pedagogy and dermatology.
3. Further delineation of qualitative and
quantitative research is outlined in a
common classication of research
paradigms. ese being:
a) deductive, inductive and productive
b) positivist, critical and interpretive
c) negativist, uncritical and interpretive
d) positivist, critical and productive.
Understanding how research works and what
methods and processes it adopts is a part of
becoming a knowledgeable research consumer.
Without understanding these early steps of
research, it is unlikely that the beginning
research novice will progress to become a
knowledgeable consumer of research. While
some of the theoretical and philosophical terms
might initially appear somewhat confusing they
need to be understood to grasp the whys and
wherefores of conducting research. Following on
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NURSING AND MIDWIFERY RESEARCH 4E
32
4. e term positivist or ‘positivism’ refers to:
a) philosophical position reecting the
traditional scientic approach of
subjective observation and causal
relationships
b) philosophical position reecting the
traditional scientic approach of
objective observation and nursing
relationships
c) philosophical position reecting the
traditional scientic approach of
objective observation and causal
relationships
d) philosophical position reecting the
traditional scientic approach of
subjective observation and nursing
relationships.
5. Critical and interpretive research paradigms
generally use:
a) qualitative methods to examine
phenomena of interest
b) quantitative methods to examine
phenomena of interest
c) qualitative methods to examine
hypotheses
d) quantitative methods to examine
hypotheses.
6. e most likely cause for ‘paradigm tension’
is:
a) a researcher feeling anxious about
research
b) a representation that one research
paradigm is more superior over another
c) when two dierent paradigms are used in
one study
d) when only one paradigm is used.
7. Research frameworks serve as a frame of
reference from which researchers can either
predict or explain their:
a) study methods
b) study designs
c) study inputs
d) study outcomes.
8. e rst part of the research process
involves:
a) identifying the problem/issue
b) critically searching and reviewing the
available primary (research-based) and
conceptual (theory-based) literature
c) identifying research ideas, questions,
statements or hypotheses
d) all of the above.
9. e last part of the research process involves:
a) analysing collected research data
b) determining research results/ndings
c) disseminating research ndings
d) all of the above.
10. e research design (plan) is dependent
upon the following starting points:
a) the purpose and the question/s being
asked
b) the nature of the issue or problem being
investigated
c) what is likely to oer the ‘best t’ and
potential outcomes
d) all of the above.
Additional resources
Beckstead J W, Beckstead L G 2006 A
multidimensional analysis of the epistemic origins
of nursing theories, models, and frameworks.
International Journal of Nursing Studies 43:113–22
French B 2005 e process of research use in nursing.
Journal of Advanced Nursing 49:125–34
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and is condential until formal publication.

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For further content associated with this chapter visit
http://evolve.elsevier.com/AU/Schneider/research/
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