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| Mike Saks and Judith Allsop |
Chapter 2 - Competing Paradigms
and Health Research
Alex Broom and Evan Willis
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| Contributor
biography |
| Alex Broom is a Postdoctoral Research
Fellow in Health Sociology at the School of Social Science,
University of Queensland, Australia. His research interests
include the sociology of cancer, information technologies
in healthcare, men’s health, and complementary and
alternative medicines. |
| Evan Willis is Professor of Sociology
in the Faculty of Humanities and Social Sciences at La
Trobe University, Australia. His research interests include
the health care workforce, medical technology assessment,
the new genetics and complementary and alternative health
care. He teaches health sociology, public health and sociological
research methods. |
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| Chapter overview |
| The chapter illustrates the way in
which research methodologies are embedded in particular
political and ideological positions – or paradigms.
It provides a critical overview of research paradigms,
and examines different types of paradigms in health research,
and the implications of using a particular paradigm for
knowledge production. |
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| Suggested
Online Readings |
| McDowell,
I. and MacLean, L. (1998) ‘Blending Qualitative
and Quantitative Study Methods in Health Services Research’,
Health Informatics Journal, 4 (2): 15-22. |
| The paper argues that blending qualitative
and quantitative methods in health services research is
well established. Models include a hierarchical approach,
in which one or other approach dominates, and a partnership
model featuring more equal (albeit differing) roles for
each. The partnership model may involve simultaneous or
sequential application of qualitative and quantitative
methods. Ideally, qualitative and quantitative methods
should use the strengths of one approach to compensate
for limitations in the other. The optimal blend varies
at different stages of the research process, from conceptualizing
the study through data collection and analysis, to interpreting
the results. |
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| McEvoy,
P. and Richards, D. (2006) ‘A Critical Realist Rationale
for Using a Combination of Quantitative and Qualitative
Methods’, Journal of Research in Nursing,
11 (1): 66-78. |
| This paper suggests that combining
of quantitative and qualitative approaches, though widely
advocated, may lead to confusion as complex ontological
and epistemological issues must be resolved. It identifies
three approaches to using mixed methods: a methodological
purist position; a pragmatic view and an anti-conflationist
position underpinned by the philosophy of critical realism
that helps to circumvent the problems associated with
paradigm switching. A case study is provided adopting
a critical realist framework in which a combination of
quantitative and qualitative methods was used gatekeeping
decisions arising at the interface of primary care and
community mental health teams. |
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| Roth,
W.D. and Mehtha, J.D. (2002) ‘The Rashomon Effect:
Combining Positivist and Interpretivist Approaches in
the Analysis of Contested Events’, Sociological
Methods Research, 31 (2): 131-73. |
| Positivist and interpretivist analytical
approaches are frequently believed to be incompatible
as research strategies and ways of understanding the world.
This article argues that versions of positivism and interpretivism
can be combined in the analysis of contested events and
this can lead to additional insights. This is illustrated
using two case studies of lethal school shootings to demonstrate
methodological strategies to manage biases that may lead
to contradictory testimony. From the interpretivist perspective
these offer insight into the cultural understandings of
a community. Just as positivist analysis may be used to
aid interpretivism, an interpretive understanding of a
community may be necessary to develop causal theories
of contested events. |
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| Further Reading |
| Brown, B., Crawford, P. and Hicks,
C. (2003) Evidence-based Research: Dilemmas and Debates
in Health Care. Maidenhead: Open University Press. |
| This book focuses on charting the
philosophical background and debates surrounding the use
of health research methods, including the importance of
paradigms. |
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| Daly, J., MacDonald, I. and Willis,
E. (eds.) (1992) Researching Health Care: Dilemmas,
Designs and Disciplines. London: Routledge. |
| This is an older, but now classic,
reference with relevant contributions by many leading
researchers in the field internationally. |
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| Rice, P. and Ezzy, D. (1999) Qualitative
Research Methods: A Health Focus. Melbourne: Oxford
University Press. |
| This is an excellent introductory
textbook on the use of qualitative methods in researching
health. |
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© Sage Publications Ltd.
