Research as an Important Way of Knowing
Key terms
Abductive reasoning
Action processes
Confirmable
Deductive reasoning
Epistemology
Experimental-type research
Idiographic
Inductive reasoning
Logical
Naturalistic inquiry
Nomothetic
Thinking processes
Understandable
Useful
A 74-year-old single African-American woman with a fractured hip will be discharged shortly from rehabilitation to her home. She appears reluctant to use the self-care techniques you taught her. You wonder whether rehabilitation has been effective in meeting its specified goals and what her future capabilities will be after she returns home.
You have learned how to use a new tool to assess the environmental barriers encountered by children with intellectual impairments. You wonder whether this instrument is more accurate and useful than previous ones you have tried.
A research article describes a progressive approach to promoting physical fitness for adults with intellectual impairments. You wonder whether you should implement these planning procedures in your own practice and whether they will be effective in meeting their goal in diverse geographic locations.
You need to initiate a new program to prevent low back injury in migrant farmworkers. Existing prevention strategies have not been effective in reducing the incidence of low back injury in this population. You wonder why traditional approaches have failed and how to develop an appropriate knowledge base from which to develop an efficacious program.
You notice in your home care practice that some clients need more visits than others to achieve the same health outcomes. You wonder what factors influence service need. You wonder how to increase health literacy and access to health information for people who cannot see.
You are interested in how the outcomes of Internet counseling for minor depression compares to on-site counseling outcomes.
Why is research necessary?
Health and human service professionals routinely have questions about their daily practice. Many of these questions, such as those just listed, are answered best through systematic investigation, or the research process. It is therefore unfortunate that many practitioners do not engage in research. This phenomenon may be caused in part by unfamiliarity with and misconceptions about the research process.
Research is challenging, exhilarating, and stimulating. As with other professional activities, research can also be time-consuming, tedious, and frustrating. The challenges and frustrations of conducting research occur because it is not a simple activity—particularly health and human service research, in which conducting research in service environments and understanding human behavior are often complex matters. Implementing a research study in the home, community, school, outpatient clinic, or medical facility can be much more challenging than research conducted in a laboratory or a setting that can be controlled by the investigator. Throughout this book, we discuss the specific dilemmas and design implications posed by research that is implemented in the health and human service practice (particularly in Part V, Improving Practice Through Inquiry).
There are many important reasons why you should understand the research process and participate in research activities (Box 1-1).
First, research is a systematic process to obtain scientific knowledge about specific problems encountered in daily life and professional practice.1 Thus it is an important way of finding answers to questions about needed interventions, practice outcomes, and clinical irritations. The fundamental goal of research for health and human services is to develop and advance a body of knowledge to guide professional activity. Research contributes to the development of a scientific body of knowledge in several ways. It generates relevant theory and knowledge about human appearance, experience, and behavior; it develops and tests theories that form the basis of specific practices and treatment approaches; and it examines, validates, or determines the effectiveness of different practices in attaining their intended and sometimes unintended outcomes.2
The second important reason to understand and participate in research is its overall impact on health definitions and theories, health care policy, and service delivery. The knowledge obtained through research is often used directly or indirectly to set standards for population health—to inform legislators and regulatory bodies about issues necessary to develop the most efficacious health and human service policies and service delivery models. Federal regulatory agencies and other fiscal intermediaries base many of their decisions and practice guidelines on empirical evidence or knowledge generated through the research process. Evidence from research has become increasingly used to identify “best” practices, as described in Chapter 24. Consider managed care; its very foundation uses systematic cost measures and specific outcome measures to yield data that then form the basis for policy, practice decisions, and implementation of treatment guidelines. Additionally, research provides the tools by which to compare diverse health definitions and needs, practices, health outcomes, and costs across practice settings. Using systematic, standard approaches allows professionals to make comparisons among different populations and diverse health and human service contexts to determine their level of efficiency and effectiveness.
The third reason to learn about research is to enable you to participate in research activities in your own practice setting. In many health and human service settings, practitioners establish or maintain a database of health information and derive statistical reports on client outcomes. In some settings, particularly in an academic health science center or teaching hospital, you or other members of your agency will participate in research to advance the research goals of the institution. You may have many diverse roles as a member of a research project. You may initially want to participate in the process as a data collector, chart extractor, interviewer, provider of an experimental intervention, or recruiter of participants into a study. These are all excellent, time-limited roles to learn firsthand the art and science of the research process. When you feel more comfortable and gain some experience with the process, you may want to serve as a project coordinator and become responsible for the coordination of the detailed tasks and daily activities of a research endeavor, or you may choose the role of the coinvestigator and assist in the conceptual development, design, implementation, and analytical components of a study. If you really become hooked on research, you may want to be a principal investigator and assume responsibility for initiating and overseeing the scientific integrity of the entire research effort.
The fourth reason to know about research is that it provides the tools by which you can learn about and be responsive to the experiences and needs of the individuals and groups you help in your professional practice.
The fifth reason to learn about and participate in research is to become a critical consumer of the growing body of research literature that is published in professional journals and other venues. Research not only yields a body of knowledge but also provides the evidence and reasoning strategies on which the investigator bases knowledge claims. Thus, research provides the foundation for informed professional decision making and action. By understanding the research enterprise when you read a research study, you will learn specific findings and also how the knowledge was generated and whether it can be applied to various settings, persons or areas of practice. Understanding the thinking and action processes of research will provide you with the necessary skills to determine the adequacy of research outcomes and their implications for daily practice.3 Most important, the knowledge you gain about research findings has the potential to improve your practice and thus improve the health and quality of life of the people you serve (patients, clients, families) and the health of your community.
As you can see, there are many reasons to learn about the research process. Most important, whether conducting a study or just using systematic techniques in your professional activity, the procedures and methodologies used in research can improve how you think and act in your daily practice. They answer two fundamental questions: “How do you know?” and “So what?” “How do you know” is answered by explicating the evidence to support claims and the ways in which the evidence was obtained and interpreted. The “so what” question refers to use of knowledge. Now that you have the knowledge, how can it best be put to use? This text offers a range of methodologies and techniques, including case study, analysis of audio or video recordings, single-case design, observation, and in-depth interviewing. As a health care or human service professional, you can use each to gain better insight into a particularly difficult practice situation or, in general, to advance all aspects of your professional practice. For example, if you are experiencing difficulty effectively interacting with and thus treating a child with a developmental disability, borrowing a technique from research (e.g., recording a session and systematically analyzing verbal and nonverbal interactions frame by frame) may provide important insights to better approach this particular individual.
Consider another example:
Let us assume you have been asked to assess the functional ability of residents who live in a congregate living facility in the community to improve self-care skills. You may want to set up a single-subject design to monitor your program and its effectiveness in attaining its outcome and then share findings with staff and administrators. First, you would take several baseline assessments of the resident’s functioning over several days using a standardized functional measure. Second, you would introduce your strategies to improve self-care. Then you would reassess the residents over several days using the same functional assessment. This simple and easy approach allows you to obtain systematic information about your treatment and its outcome. The point is that many aspects of the research process can be easily incorporated into your daily practice to improve your own as well as professional knowledge about methods to achieve practice outcomes.
One final point should be made regarding the importance of participating in research. As health and human service professionals engage in the research process, they contribute to the development of knowledge and theory and help to identify new practice approaches, validate existing strategies, and improve practice. Through this research activity, health and human service professionals are participating in the advancement and refinement of the research process itself and its application to professional issues and service settings. Health and human service professionals who are involved in research today will make significant contributions to the evolution of research methodologies.4–6
What is research?
Research is not “owned” by any one profession or discipline. It is a systematic set of ways of thinking and acting and has distinct vocabularies that can be learned and used by anyone.
Many definitions of research can be found in texts, ranging from a very broad to a very restrictive understanding of the research endeavor. A very broad definition suggests that research includes any type of investigation that uncovers knowledge. In contrast, a formal and more restrictive definition of research implies that only one type of strategy, such as a quantitative orientation, is valid. Many researchers use the classic (but we believe restricted) definition offered by Kerlinger, who defined scientific research as “systematic, controlled, empirical, and critical investigation of natural phenomena guided by theory and hypotheses about the presumed relations among such phenomena.”7 Whereas a broad definition includes any type of activity as research, a restrictive definition, such as Kerlinger’s viewpoint, implies that the only legitimate approach to scientific inquiry is hypothesis testing.
In contrast, we define research in such a way as to reflect and allow for a wide range of ways of knowing or systematic approaches to knowledge building. As such, our definition of research is as follows:
Research is defined as multiple, systematic strategies to generate knowledge about human behavior, human experience, and human environments in which the thinking and action processes of the researcher are clearly specified so that they are logical, understandable, confirmable, and useful.
Our definition has three important components (Box 1-2). First, we state that research is more than one type of investigative strategy; that is, research is not just hypothesis testing, as suggested by Kerlinger, but rather is represented by a broad range of strategies that are systematically implemented. In contrast to the definition offered by the restrictive view, we recognize the legitimacy and value of many distinct types of investigative strategies. Second, our definition emphasizes that research is composed of thinking processes and specific actions (action processes) that must be clearly delineated and articulated. We believe that the beauty and efficacy of the research process lie in the explication of how and on what basis a knowledge claim is made. Third, we characterize thinking and action processes as logical, understandable, confirmable, and useful to meet the criteria of research. That is, in contrast to the broad inclusive definition of research, our approach clearly distinguishes the boundary between research and other forms of knowing (e.g., through trial and error) by establishing these important criteria. Let us examine the three major components of our definition in greater detail.
