Research and Evidence Based Enquiry - Essay Example

Summary. Social research is simply research conducted by social scientists (primarily within sociology and social psychology), but also within otherdisciplines such as social policy, human geography, political science, social anthropology and education. The frame of reference in these findings is centered on stigma, which is viewed as a superficial labeled kind of identity, that is the fault of the mental health system. This circumvents persons suffering from social disapprobation and reduced life chances as a result of having been given a diagnostic label and an identity as a patient as a result of their contact with psychiatric institutions. Under this research Social scientist study a wide spectrum of issues. This includes, from census data on hundreds of thousands of human beings, through the in-depth analysis of a life of a single important person to monitoring what is happening on a streets today and in the medical institutions, or what was happening few hundreds years ago. Many different methods are employed in order to describe, explore and understand social life. Social methods can generally be subdivided into two broad categories. Quantitative methods are concerned with attempts to quantify social phenomena and collect and analyses numerical data, and focus on the links among a smaller number of attributes across many cases. Qualitative methods, on the other hand, emphasize personal experiences and interpretation over quantification, are more concerned with understanding the meaning of social phenomena and focus on links among a larger number of attributes across relatively few cases. Foundations of social research Social research (and social science in general) is based on logic and empirical observations. Charles C. Ragin writes in his Constructing Social Research book "Social research involved the interaction between ideas and evidence. Ideas help social researchers make sense of evidence, and researchers use evidence to extend, revise and test ideas". Social research thus attempts to create or validate theories through data collection and data analysis, and its goal is exploration, description and explanation. It should never lead or be mistaken with philosophy or belief. Social research aims to find social patterns of regularity in social life and usually deals with social groups (aggregates of individuals), not individuals themselves (although science of psychology is an exception here). Research can also be divided into pure research and applied research. Pure research has no application on real life, whereas applied research attempts to influence the real world. Types of explanations Explanations in social theories can be idiographic or nomothetic. An idiographic approach to an explanation is one where the scientists seek to exhaust the idiosyncratic causes of a particular condition or event, i.e. by trying to provide all possible explanations of a particular case. Nomothetic explanations tend to be more general with scientists trying to identify a few causal factors that impact a wide class of conditions or events. For example, when dealing with the problem of how people choose a job, idiographic explanation would be to list all possible reasons why a given person (or group) chooses a given job, while nomothetic explanation would try to find factors that determine why job applicants in general choose a given job. Relationship between Quantitative and Qualitative Research. An examination of the quantitative and qualitative paradigms will help to identify their strengths and weaknesses and how their divergent approaches can complement each other. In most cases, researchers fall into one of the two camps--either relying exclusively upon "objective" survey questionnaires and statistical analyses and eschewing warm and fuzzy qualitative methods, or using only qualitative methodologies, rejecting the quantitative approach as decontextualizing human behavior. However, social marketing researchers recognize that each approach has positive attributes, and that combining different methods can result in gaining the best of both research worlds. Qualitative methods can be used in order to develop quantitative research tools. For example, focus groups could be used to explore an issue with a small number of people and the data gathered using this method could then be used to develop a quantitative survey questionnaire that could be administered to a far greater number of people allowing results to be generalized. Quantitative research uses methods adopted from the physical sciences that are designed to ensure objectivity, generalizability and reliability. These techniques cover the ways research participants are selected randomly from the study population in an unbiased manner, the standardized questionnaire or intervention they receive and the statistical methods used to test predetermined hypotheses regarding the relationships between specific variables. The researcher is considered external to the actual research, and results are expected to be replicable no matter who conducts the research. Qualitative methods can be used to explore and facilitate the interpretation of relationships between variables. For example researchers may inductively hypothesize that there would be a positive relationship between positive attitudes of sales staff and the amount of sales of a store. However, quantitative, deductive, structured observation of 576 convenience stores could reveal that this was not the case, and in order to understand why the relationship between the variables was negative the researchers may undertake qualitative case studies of four stores including participant observation. Quantitative methods are useful for describing social phenomena, especially on a larger scale. Qualitative methods allow social scientists to provide richer explanations (and descriptions) of social phenomena, frequently on a smaller scale. By using two or more approaches researchers may be able to 'triangulate' their findings and provide a more valid representation of the social world. Finally a combination of different methods are often used within "comparative research", which involves the study of social processes across nation-states, or across different types of society. Qualitative methods used in social marketing include observations, in-depth interviews and focus groups. These methods are designed to help researchers understand the meaning people assign to social phenomena and to elucidate the mental processes underlying behaviors. Hypotheses are generated during data collection and analysis, and measurement tends to be subjective. In the qualitative paradigm, the researcher becomes the instrument of data collection, and results may vary greatly depending upon who conducts the research. Strength and Weakness of Quantitative/Qualitative Research. The strengths of the quantitative paradigm are that its methods produce quantifiable, reliable data that are usually generalizable to some larger population. Quantitative measures are often most appropriate for conducting needs assessments or for evaluations comparing outcomes with baseline data. This paradigm breaks down when the phenomenon under study is difficult to measure or quantify. The greatest weakness of the quantitative approach is that it decontextualizes human behavior in a way that removes the event from its real world setting and ignores the effects of variables that have not been included in the model. The advantage of using qualitative methods is that they generate rich, detailed data that leave the participants' perspectives intact and provide a context for health behavior. The focus upon processes and "reasons why" differs from that of quantitative research, which addresses correlation's between variables. The worst weakness is that data collection and analysis may be labor intensive and time-consuming. However, these methods are not yet totally accepted by the mainstream public health community and qualitative researchers may find their results challenged as invalid by those outside the field of social marketing. Research Model. Integrating Formative Research During the formative research stage, in which the goal is to learn as much as possible about how the target audience thinks and behaves in relation to the issue being addressed, a host of research methods provides many different data "viewpoints" for seeing the big picture. Exploratory research conducted at the beginning of the project reviews previous research involving both quantitative and qualitative data and can include interviews with those who have previously attempted to address the issue. This research will help in the initial development of the project strategy to delineate the parameters of the project, steer the selection of the target audience, specify the potential behaviors to be promoted and identify lessons learned and potential pitfalls. Focus groups conducted for exploration also yield valuable qualitative data regarding the target audience, providing insights into their language, issues and obstacles they identify, and meanings attributed to beliefs and behaviors. Information learned from the initial focus groups can then be used to inform questionnaire construction for a population survey to collect hard numbers for baseline data. The survey will also help to segment the target audience based upon its distribution across the stages of behavior change, as described by the Transtheoretical Model of Behavior Change Prochaska & DiClemente (1983), or other characteristics. In addition, commercial marketing databases, while quantitative in nature, provide highly detailed profiles of target audience segments for message development and channel selection. The messages and materials developed based upon the exploratory research should be protested using both qualitative and quantitative methods so that the results provide depth of understanding as well as generalizability. Focus groups provide a valuable means to pretest messages and materials, for audience members can provide spontaneous reactions and explain their responses. This method, however, can only indicate trends and cannot yield hard quantitative data needed for definitive decision making. If enough focus groups are conducted and participants are considered representative of the target audience, a survey questionnaire may be administered either before or after the focus group to collect numerical data as well. A central-site intercept survey, in which potential audience members are approached in a public area and asked to respond to a quick questionnaire, provides another method of pretesting materials. The fast turnaround nature of this method and high volume of responses makes it ideal for testing draft executions of materials such as print or television ads prior to production and implementation. This method is considered semi-quantitative because respondents are not selected from a random sample, but questions are usually closed-ended and tabulated statistically. Final decisions, such as choosing from among several possible ads, can be made based on the numbers this method yields. Methodology The focus groups revolved around a variety of settings depending on the whereabouts in the catchment area where participants emanate from. Convenient efforts pinpointed times and locations, that were considered reliable for participants. The highlighted settings picked on included offices belonging to health trusts, drop-in centers and mental health charities. Rooms and the atmosphere were deliberately kept informal, refreshments were served, and wide ranging discussion, informal interaction and exploration of issues was encouraged. However group stratums varied in the ration of 1:4 groups exclusively contained users two of which were coordinating roles in the mental charity. Other groups contained predominantly users with a social work assistant and community mental health nurse. Further groups consisted of equal number of users and workers, including a rural mental health coordinator, a community mental health nurse and a support worker. Also groups exclusively contained professionals, including: a group of assertive outreach workers consisting of three occupational therapists and a clinical psychologist. Multidisciplinary team including psychiatrists, community mental health nurses, a psychologist, a support worker and a student, an also groups that take part included multidisciplinary team consisting of social workers and a rural mental health coordinator. Finally, a group of professionals working at a unit offering day center activities and outpatient services to a rural clientele. The implicit presence of professionals and users in the same discussion groups could be argued to reduce candour on the part of the users. Researchers' impression was that, perhaps the professionals involved observed philosophical ethics that were not intimidating. This however, were predominantly nurses and support workers, the users were well able to express criticisms of the way they were treated, despite the presence of workers in the group. Analysis and interpretation Material relating to stigma was categorized in term's problem description, reduction strategy or resistance, which formed the basis for the presentation of the data founded. However, the emerging themes stigma reduction and resistance, emerged from the data in a bottom up manner, similar to that advocated in B. G. Glaser and A. Strauss' 'grounded theory' approach to qualitative material (Glaser & Strauss 1967, Strauss & Corbin 1998). Validity and reliability was further advanced by interdisciplinary triangulation (Denzin & Lincoln 1994), so that researchers' local knowledge, remarks made before and after the formal recordings were made, and convergence between the accounts presented by different participants in different discussions were all taken as further checks on the integrity of the data set. Discussion From Historical Archives on sociological research of mental health. Stigmatization emerges as a faade that is a creation of the conscious society. Community mental healthcare has a superimpose human face, that is a classical formulation imposed upon the so-called patience's by the medical world of Psychiatry. Once they have been labelled, the stigma is something that they have to deal with on their own. This kind of prejudices and exclusionary practices hampers the well being the self that is considered a delicate ritual by many researches findings. However, as the present data tentatively show, the issue of stigma is something that those working in community mental health are concerned with too. Society therefore has viewed the elite world with an inclined thought of axis that vehemently puts blame on professionals as bad guys. This in retrospect calls for a collective need of society to grasp clients' subjective concerns and keep them out of hospital, professionals in rural areas must deal with the issues which prevent clients living a fulfilling and supported life in a community setting. The apparent phenomenal however is that the notion of stigma is an overt creation of both the users' and professional's lexicons. This translates that the same professions and community care have the obligation to water down the misrepresented reality about the mask that demeans and tears apart the social fabric in any given social setup. These 'social representations' Moscovici (1976) of stigma also represent powerful tools not only for making sense of existing experiences, but planning services and even everyday activity so that the disapprobation of the rest of the community is not visited upon the client. Whereas professional bodies concerned with mental health have attempted to educate the public in an attempt to reduce stigma (Britten 1998, Byrne 2000). Authors have also put in concerted efforts, Steele (1996) has written active journals and articles that are aimed at combating stigma. What is however, far less well known is how professionals can help clients with stigma Reducing the stigma attached to mental healthcare on a day-to-day basis. In addition, professions should strategize to implement effective and accessible services that help to maintain client's social relationships and social status rather than compromise the same. Important elements like therapeutic maneuvers as the drugs, cognitive behavioral therapy, anxiety management groups or outpatient facilities should be mandatory. Moreover, there is a serious need to view awareness of the signals that could be leaked about their identity such as hospital postmarks on letters, as a significant tool in enhancing sensitivity. Whereas the present study is too small a basis on which to redesign mental health training, it perhaps might highlight the usefulness of exercises like this so that users and the workforce can express what they feel is needed. Again, the results are small in scale and merely suggestive, but the way professionals construct clients has a good deal in common with the idea of incapable patients which characterized the past two centuries of hospital psychiatry Goodwin (2000). On the other hand, clients are active in detecting possible sources of stigma, such as postmarks on letters, and are sometimes even active in problematizing and confronting others' attitudes. It is apposite to take very seriously the way in which clients do this since it may well be therapeutically advantageous for professionals to build upon clients' resources in this area if they are to survive successfully in rural community settings. This might need to involve further paradigm shifts on the part of the professionals. At the moment, the fact that the mental health practitioners are successful in concealing their identity and their visits to clients may reduce the stigma that can attach to those individual clients, but it does not challenge the stigmatizing attitudes on the part of other community members. In a sense, the bigots have won and those who suffer from mental health problems must remain in the closet. By Profession's waging all this there are hopes that the public may become better informed about mental health and that this will lead to a reduction of prejudices (Barry et al. 2000). Professions are also solicitous in managing stigma, they implicitly attribute a relative passivity to clients, who may become trapped in their homes by other villagers' twitching curtains, whispering and cold-shouldering. Progress on this front may be slow. Perhaps it would be possible for professionals to recognize and build on the resources of clients to challenge and transform their own situation and the attitudes of others, as has been successfully attempted by other groups of clients elsewhere (Herman 1993, Everett 1994, Emerick 1996). It is through enhancement of their role in empowering clients that mental health professionals will make their visits much more. Findings. Results are presented under several sub-headings corresponding to different aspects of the phenomenon of stigma, which were identified by the participants. The problem was identified and defined as a testament to the pervasiveness of social science knowledge in popular discourse that the notions of stigma and labelling - once esoteric ideas of interest only to sociologists - were present in the discussion generated by both worker and user groups. For ease expositions, the present authors deal with the narrative of stigma produced by the clients and workers in a sequence, which moves from initial definitions of the problem. Through to cautionary tales of how it might be inadvertently increased by the mental healthcare workforce, and finally, to strategies for minimization and challenge. Mental health workers were of a major impact in highlighting the problems, which could arise from the insensitive application of mental healthcare practice, was through the telling of cautionary tales. Descriptions of the problem were sometimes embellished by means of narratives concerning staff who had somehow violated the implicit norms of good practice. References: A Bryman. Qualitative researches in health care, N Mays, C Pope (1996) A. F., Dixon, L., Mueser, K. T., et al. (2001). Implementing evidence-based practices in routine mental health service settings. Psychiatric Services. Barlow, D. H., & Hersen, M.(1984). Single case experimental designs: Strategies for studying behavior change (2nd ed.). New York: Pergamon. Britton, B. J., Evans, J. G., & Potter, J. M. (1998). Does the fly matter The CRACKPOT study in evidence based trout fishing. British Medical Journal. Drake, R. E., Goldman, H., Leff, H. S., Lehman, Drummond, M., & Mooney, G. (1981). Economic appraisal in health care: A guide to the methodology of economic appraisal. Hospital & Health Services Review. Evidence For and Against EBP Brief Treatment and Crisis Intervention. Egger, M., Smith, G. D., & O'Rourke, K. (2001). Rationale, potentials, and promise of systematic reviews. Ellis, J., Mulligan, I., Rowe, J., & Sackett, D. L. (1995). Inpatient general medicine is evidence based. Lancet. Fletcher, R. H., Fletcher, S. W., & Wagner, E. H. (1988). Clinical epidemiology: The essentials (2nd ed.). Baltimore: Williams & Wilkins. Gambrill, E. (1999). Evidence-based practice: An alternative to authority-based practice. Families in Society: The Journal of Contemporary Human Services. Gambrill, E. (2001). Social work: An authority based profession. Research on Social Work Practice, 11(2), 166. Gambrill, E. D. (2003). Evidence-based practice: Sea change or the emperor's new clothes Journal of Social Work Education. Garfield, S. L. (1998). Some comments on empirically supported treatment. Journal of Consulting and Clinical Psychology. Geddes, J. R., Game, D., Jenkins, N. E., & Sackett, D. L. (1996). What proportion of primary Psychiatric interventions are based on randomised evidence Quality in Health Care. Gibbs, L. E. (2003). Evidence-based practice for the helping professions: A practical guide with Integrated multimedia. Pacific Grove, CA: Brooks/Cole-Thompson Learning. Gibbs, L., & Gambrill, E. (2002). Evidence-based practice: Counteragruments to objections. Research on Social Work Practice. Grahame-Smith, D. (1995). Evidence based medicine: Socratic dissent. British Medical Journal. Tony Newman et al. Social Research Methods, 2nd edition. Read More