Research Issues in Health and Social Care

David Cowan

Description

This book is aimed at various health and social care practitioners including: nurses, midwives, doctors, social workers, health promotion and public health practitioners, health visitors and hospital managers, and in particular, those who are studying a multidisciplinary research course. There appears to be no single book on the topic of general research issues that is relevant to all of the above. This lack has resulted in requests from a diverse range of research students for the development of a suitable textbook. Thus, the book is intended to complement a multidisciplinary research course or indeed, any other type of research endeavour such as a dissertation. Furthermore, the book should be of general use to anybody studying health and/or social care research at undergraduate or postgraduate level

Sujets

• Sociologie, société et politique

Informations

• Publié par: M&K Publishing
• Date de parution: 10 mars 2009
• Nombre de lectures: 0
• EAN13: 9781907830204
• Langue: English

Extrait

Research Issues in Health and Social Care
Other Health & Social Care books from M&K include:
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Pre-Teen and Teenage Pregnancy: A 21st century reality ISBN: 978-1-905539-11-6 2007
The Management of COPD in Primary and Secondary Care ISBN: 978-1-905539-28-4 2007
The Clinician s Guide to Chronic Disease Management for Long Term Conditions: A cognitive-behavioural approach ISBN: 978-1-905539-15-4 2008
The ECG Workbook ISBN: 978-1-905539-14-7 2008
Identification and Treatment of Alcohol Dependency ISBN: 978-1-905539-16-1 2008
Managing Emotions in Women s Health ISBN: 978-1-905539-07-9 Forthcoming 2009
Living with Dying: Perspectives on death, dying and living with loss ISBN: 978-1-905539-21-5 Forthcoming 2009
Research Issues in Health and Social Care
Dr David Cowan
Research Issues in Health and Social Care David Cowan
ISBN: 978-1-905539-20-8
First published 2009
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London, W1T 4LP. Permissions may be sought directly from M&K Publishing, phone: [phone], fax: [phone] or email: [e-mail]
Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.
British Library Catalogue in Publication Data A catalogue record for this book is available from the British Library
Notice Clinical practice and medical knowledge constantly evolve. Standard safety precautions must be followed, but, as knowledge is broadened by research, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers must check the most current product information provided by the manufacturer of each drug to be administered and verify the dosages and correct administration, as well as contraindications. It is the responsibility of the practitioner, utilising the experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Any brands mentioned in this book are as examples only and are not endorsed by the Publisher. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication.
The Publisher
To contact M&K Publishing write to: M&K Update Ltd The Old Bakery St. John's Street Keswick Cumbria CA12 5AS
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Designed and typeset in 11pt Usherwood Book by Mary Blood Printed in England by Ferguson Print, Keswick.
Contents
Introduction
1 Knowledge and uncertainty
2 Evidence-based practice
3 Developing a research question
4 Quantitative research methods
5 Analysis of quantitative data
6 Qualitative research methods
7 Analysis of qualitative data
8 Combining quantitative and qualitative research approaches
9 Critical appraisal
10 Research writing
11 Research governance and ethics
12 Conclusion
References
Index
List of tables
5.1 Comparison of mean averages
5.2 Comparison of mode and median
5.3 Tests for correlation
5.4 Significance table for Spearman’s correlation
5.5 Examples of statistical tests for different types of data
Chapter 1
Knowledge and uncertainty

Introduction
Research is inextricably connected with knowledge. Indeed, research is often used as a way of creating new knowledge, building upon existing knowledge and closing perceived knowledge gaps. This applies to many disciplines, including those of health and social care. Conversely though, while research may inform knowledge, the opposite is also true – approaches to research are in turn informed and underpinned by different knowledge constructs.
This chapter invites the reader to begin contemplating, exploring and questioning certain assumptions about what constitutes knowledge and how such knowledge is generated, applied and perceived. This can be described as an epistemological process. Epistemology is the theory of knowledge, derived from the Greek words episteme (knowledge or science) and logos (account or explanation) and is concerned with studying the conditions, the limits and validity of what we know, or what we think we know. Much of the debate in the field of epistemology has focused on analysing the nature of knowledge and how it relates to notions such as truth and belief. It also deals with the means of producing knowledge, as well as scepticism about different knowledge claims. Thus, epistemology primarily addresses the following questions:
What is knowledge?
How is knowledge acquired?
How much can people know?
However, it can be suggested that this discourse is not complete without the inclusion of what can be seen as the antithesis of knowledge, namely, uncertainty. Indeed, there are still many uncertainties in health and social care practice which appear to be informed more through intuition or ‘rule of thumb’ rather than by research-generated, evidence-based decision making.
In order to trace and examine the origins of contemporary knowledge construction and philosophical approaches to it, we will begin with a brief journey back through time. In doing so, you will be introduced to some of the philosophers and thinkers, who, throughout recent centuries, have influenced intellectual thought, reasoning, knowledge construction and scientific development.
The Renaissance
The Renaissance
Following the social turmoil caused throughout Europe by the bubonic plague epidemic of the late 14th century, people started to contemplate existential issues differently (Rawcliffe 1995). Faith in a divine saviour and confidence in the effectiveness of medical interventions were severely tested. Illustrative of this, many of those who were perceived to have a ‘direct line’ to the Almighty, namely the clergy, were as helpless in the wake of the ‘Black Death’ as the rest of the population and were struck down with equal regularity and devastation. This was equally true of many of the medical ‘experts’ of the time. Thus, during the 15th century, certain philosophers began to question the perceived ‘fact’ that there was a ‘natural order’ controlling human life which could not be subject to change by mere mortals. Indeed, the 15th century Renaissance is perceived by many as marking the beginning of what can be generally termed the ‘Modern Period’ which culminated in what came to be known as the ‘Age of Reason’ (also known as the Age of Rationalism), the ‘Age of Enlightenment’ and the subsequent emergence of modern societies and modern science.
Depending on what one reads in various publications on the Modern Period and on one’s own perspective, the ‘Age of Enlightenment’ may include the earlier period (the Age of Reason), or can comprise only the period directly after. For the purposes of this commentary, the latter definition applies whereby the Age of Reason and the Age of Enlightenment are seen as separate parts of the Modern Period. Regardless, the new ideas and ways of thinking that emerged during this time replaced the knowledge systems that had prevailed in Britain and Europe for centuries. Thus, ‘divine’ knowledge that was ‘revealed’ via theological sources and knowledge of the supernatural, based on unfounded superstition, was gradually replaced by scientific knowledge, this being manufactured by humans. Furthermore, the Renaissance was characterised by the beginning of reconnection of Western European thinking with the philosophies and teachings of classical antiquity, particularly that of the ancient Greeks. There was renewed interest in mathematics, complemented by the creation of new techniques in architecture and the arts. This was facilitated further by a significant increase in the distribution of information facilitated by the important invention of the printing press.
One of the most significant commentators of the time was the German/Polish (there is dispute over his true nationality (Allgemeine Deutsche Biographie 1912)) astronomer, mathematician and physician Nicolaus Copernicus (1473–1543). In his thesis ‘On the Revolutions of the Celestial Spheres’, Copernicus proposed that the sun rather than the earth was at the centre of the then known universe. His heliocentric (sun-centred) theory is considered to be one of the most important scientific theories in history. It signified the start of the shift away from the theological model of knowledge construction, the beginning of modern astronomy and subsequently, modern science.
Illustrative of the abovementioned reconnection with the ancient Greeks, in support of his theory, Copernicus cited the earlier work of astronomers and philosophers in the 3rd and 4th centuries, namely Aristarchus and Philolaus. However, since Copernicus’ theory contradicted the Old Testament account of the sun’s movement around the earth (Joshua 10:13), it is likely that Copernicus was wary of incurring the wrath of the religious authorities in Rome (Rosen 1995). Thus, Copernicus’ book was published with a preface by a respected Lutheran theologian, stating that the heliocentric theory was a mere mathematical model, which may not actually hold any truth or likelihood (Rosen 1995).
The Age of Reason
The Age of Reason
As mentioned, at the beginning of the 17th century the Renaissance period was succeeded by the ‘Age of Reason’ which, can be seen as the forerunner to the ‘Age of Enlightenment’. It was during the Age of Reason that the idea of intellectual enquiry gained popularity and philosophers began to question further still the concept of the existence of divine eternal facts or ‘truths’ as dissemi