Research Issues in Health and Social Care

221 Pages·2009·0.79 MB·English

by  David Cowan

Research Issues cover aw 12/2/09 4:49 pm Page 1
This book is aimed at various health and social care practitioners including: nurses,
midwives, doctors, social workers, health promotion and public health practitioners, D Research Issues
health visitors and hospital managers, and in particular, those who are studying a r

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multidisciplinary research course. There appears to be no single book on the topic of
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general research issues that is relevant to all of the above. This lack has resulted in v
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requests from a diverse range of research students for the development of a suitable d
textbook. Thus, the book is intended to complement a multidisciplinary research C in Health and Social Care
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Furthermore, the book should be of general use to anybody studying health and/or
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Routine Blood Results The ECG Workbook The Clinician’s Guide to
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Explained 2/e ISBN: 978-1-905539-14-7 · 2008 Chronic Disease

ISBN: 978-1-905539-38-3 · 2007 Management for Long H
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A cognitive-behavioural approach a
ISBN: 978-1-905539-15-4 · 2008 l
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publications, courses
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www.mkupdate.co.uk
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The Management of Pre-Teen and Teenage
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COPD in Primary and Pregnancy:
Secondary Care A 21st century reality a
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ISBN: 978-1-905539-28-4 · 2007 ISBN: 978-1-905539-11-6 · 2007 e
ISBN: 978 1-905539-20-8
Dr David Cowan
www.mkupdate.co.uk
Published by M&K Update Ltd
M&K research issues prelims 12/2/09 10:44 am Page i
Research Issues
in Health and Social Care
M&K research issues prelims 12/2/09 10:44 am Page ii
Other Health & Social Care books from M&K include:
Routine Blood Results Explained 2/e
ISBN: 978-1-905539-38-3 · 2007
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
M&K research issues prelims 12/2/09 10:44 am Page iii
Research Issues in
Health and Social Care
Dr David Cowan
M&K research issues prelims 12/2/09 10:44 am Page iv
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: [email protected]
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
Tel: [phone] · Fax: [phone]
[email protected]
www.mkupdate.co.uk
Designed and typeset in 11pt Usherwood Book by Mary Blood
Printed in England by Ferguson Print, Keswick.
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Contents
Introduction 1
1 Knowledge and uncertainty 3
2 Evidence-based practice 23
3 Developing a research question 55
4 Quantitative research methods 67
5 Analysis of quantitative data 97
6 Qualitative research methods 113
7 Analysis of qualitative data 137
8 Combining quantitative and qualitative
research approaches 143
9 Critical appraisal 151
10 Research writing 175
11 Research governance and ethics 187
12 Conclusion 201
References 205
Index 211
List of tables
5.1 Comparison of mean averages 100
5.2 Comparison of mode and median 101
5.3 Tests for correlation 101
5.4 Significance table for Spearman’s correlation 102
5.5 Examples of statistical tests for different
types of data 103–104
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M&K research issues pages 12/2/09 10:46 am Page 1
Introduction
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 multidisci-
plinary 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.
The aim is to impart information on research issues to a
diverse range of health and social care practitioners in a way that
is meaningful, drawing on examples and material that has
relevance to practice settings.
In the contemporary climate where emphasis is on multidisci-
plinary working and evidence-based practice in health and social
care, there is indeed a need for a book whose focus is not restricted
to either health care or social care approaches to research. (In fact
very few books on research for social workers exist anyway.) In
particular, subsequent to increasing convergence of various areas
of health care and social care practice, such a book would facilitate
exploitation of the potential for multidisciplinary based research to
inform evidence-based practice. These areas of convergence
include: organisational change, service delivery, leadership, service
user involvement, general care in the community, care of
physically disabled people, care of older people, child protection,
problematic use of drugs and alcohol, sexual abuse, sexual health,
sex education, domestic violence, mental health, medication
management and nutrition management.
In addition, it is intended that this book will ameliorate some
of the problems encountered by research students due to
confusion caused by the ambiguous use of research terminology.
Indeed, in order to address some of the ambiguity in the use of
various research terms, throughout the book there will be a series
of ‘Terminology Boxes’.
1
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Research issues in health and social care
In addition to the above reasons, this book may also be of
interest to anybody who is becoming increasingly perplexed by
the amount of health and social care orientated research
information that we are bombarded with in contemporary society.
This is not just information which is directly pertinent to health
and social care practice, but also that which is ancillary, such as
reports in the media on diets, lifestyle, alcohol consumption,
recreational drug use, health products and statistics on numerous
health and social issues including crime and various health and
fitness regimes. All of these issues are now underpinned to
varying degrees by research, this research being of varying
robustness. In reading this book and understanding various
research issues in greater depth and in acquiring some critical
appraisal skills, it should then be possible to examine the
strengths and weaknesses of different types of research evidence.
Accordingly, this book can be used as an aid to formal study or
can be used as an aid to further understanding health and social
care research issues for reasons of personal interest. In either
case, the book can be read ‘cover to cover’ or more likely, be
‘dipped into’ depending on the specific area or issue of interest.
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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 epistemologi-
cal 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:
(cid:2) What is knowledge?
(cid:2) How is knowledge acquired?
(cid:2) How much can people know?
However, it can be suggested that this discourse is not complete
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