1. Outline different approaches to conducting observations and examine their relative advantages.

2. Discuss the different roles observers may adopt.

3. Examine observation in the context of qualitative and quantitative approaches.

• Who is to make the observations.

• The settings in which the observations are made.

• The use of instrumentation.

Who is to make the observations?

When research involves the observation of people, self-observation becomes feasible and, at times, desirable. As an example, consider the study of pain. Here the patients themselves are uniquely positioned to provide subjective evidence concerning the intensity and location of pain over a period of time. Figure 13.1 shows a typical chart for guiding self-recorded pain observations in chronic pain patients, which is used in both research and clinical assessment.

The self-observations of the patients provide data for understanding how patients’ pain experiences change over time, events correlating with the onset and offset of the pain and also evidence for evaluating the relative effectiveness of pain management strategies. Given that the experience of pain may be expressed in the sufferer’s overt behaviour, we may observe such pain-related behaviours when assessing pain. For instance, in a study involving comparison of pain behaviours of surgical patients with different cultural backgrounds, independent observers recorded pain-related behaviours in patients at agreed time intervals during physiotherapy treatments. Figure 13.2 is based on whether the observers recorded a yes or no for each category for each time interval in which the behaviours were sampled.

There are probable relative advantages and disadvantages to using self-observation or outside observers, as shown in Table 13.1.

Settings in which observation is conducted

Some disciplines, such as astronomy or geography, focus on phenomena which are best studied as they occur, in their natural settings. Other disciplines, such as anatomy or chemistry, are more likely to be studied in a laboratory. In the broad range of health sciences research, phenomena are studied in either laboratory or natural settings, and observational data collection may be appropriate in both of these settings.

The general advantage of laboratory environments is that we can impose a considerable degree of control over extraneous factors that may systematically influence (and perhaps bias) our observations. In addition, equipment for facilitating or recording observations is more readily available. For example, in the 1960s, researchers began a series of studies to examine the physiology of the human sexual response. The controlled laboratory setting and the use of appropriate instrumentation enabled these researchers to observe and accurately record poorly understood aspects of human sexual functioning. This work was thought to be fundamental for developing clinically useful interventions aimed at helping people with sexual dysfunction, although it must be noted that this work has been controversial.

The disadvantage with laboratory settings is that the phenomenon being observed may change when it is being observed in an artificial setting. This is particularly true for human behaviour, where the social contexts are important determinants of the behaviours and experiences. Indeed, the discipline of social psychology is devoted to the study of these effects. In other words, laboratory research sometimes has problematic ecological validity in that the findings discovered in this context may not generalize well to other ‘real world’ contexts such as in the clinic or the community. Table 13.2 summarizes some of the relative advantages and disadvantages of laboratory and natural settings for making observations.

Issues in the use of unaided observation or the use of instrumentation

The accurate observation of a variety of phenomena is possible through the unaided senses; for example, observing aspects of human behaviour or clinical symptoms such as abnormal postures, discoloration of the skin, or abnormalities in patients’ eye movements. Other phenomena may be inaccessible to unaided observation such as, for example, very small objects and events, where we might need to use a microscope for accurate observations. Some events are also extremely complex and occur relatively quickly in relation to the abilities of the observer. An example of this is human locomotion where recording the event using a device such as a video camera greatly enhances the accuracy of the observation such as in a gait analysis laboratory. A key factor in the advancement of science and clinical practice has been the development of sophisticated instrumentation to enable better observation of clinical phenomena.

There are, however, certain disadvantages associated with using instrumentation. These issues are discussed later in this book, when we review instrumentation and measurement. In other words, observation and measurement are closely interrelated (see Ch. 12). We can note here, however, that the use of instruments may distort the event being observed; for example, the preparation of tissue for electron microscopy changes to some extent the internal organelles of a cell being observed. These effects are very well known and documented. It requires considerable expertise to use more complex instruments, and a strong theoretical background to separate the artefacts from useful data and interpret the observations. Human research participants also react to being observed. The more intrusive the observer is with equipment and instruments, the more likely that the participants’ behaviour will change.

The use and relative advantages and disadvantages of recording techniques were discussed in the context of interviewing techniques earlier in the book (see Ch. 12). Table 13.3 represents the relative advantages and disadvantages of using instruments for aiding observations.

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