Health research is one of the largest and most diverse fields of social science research. At one extreme, a significant strand of research has provided basic social science insights into such topics as the nature of the body, the experience of illness and the role of medicine in society. Much of this work has adopted qualitative methodologies, developing concepts such as awareness contexts, lay epidemiology and biographical disruption and providing rich descriptions of the everyday realities of health, illness and health care. At the other extreme, another strand of research has developed as an applied discipline, making a range of contributions to health policy and health promotion and to the evaluation of health and social care services for people with established health problems. Quantitatively focused methodologies have played a significant role, with the Randomised Controlled Trial (RCT) still regarded as the gold standard for evaluating the effectiveness of interventions. Even here, however, the value of qualitative research has been recognised, whether as a component of a feasibility or pilot study prior to the main trial or as a contemporaneous process evaluation to inform future implementation of trial results or to specify mechanisms in complex interventions.
While the methodologies of health research have been enriched by the work of the key theorists in the field such as Foucault, more grounded methodological research has turned attention to a range of more practical concerns. These are the focus of the papers in this virtual special issue. In selecting them I have tried to reflect the diversity of disciplines, study designs and traditions within this field of research, as well as the variety of issues that are raised across the stages of research.
The first three papers are concerned with qualitatively focused research. Watts (2011) describes the challenges of conducting participant observation in a health care setting, drawing particular attention to research ethics, an important but increasingly bureaucratised consideration in health research. Gilliard and colleagues (2012) outline a technique for bringing together the differing perspectives of their research team (which included service users as well as health service researchers and a nurse) to provide a richer understanding of patients’ experience in relation to the staff who provide care. Bird and colleagues (2013) provide a critical reflection on the lessons learned in the challenging context of conducting multi-disciplinary qualitative health research across four culturally diverse countries in Africa.
The next four papers address questions of importance to quantitatively focused research. Michie and Marteau (1999) illustrate the problem of bias created by low recruitment rates and high attrition rates to prospective surveys, and point to the consequent limitations for informing policy and practice. Buers and colleagues (2014) consider questionnaire design and describe a mixed methods study which demonstrates the value of qualitative interviews for ‘optimising’ survey instruments. Barnes (2009) also demonstrates the value of incorporating a qualitative component in a predominantly quantitative study design, in this case to help understand why the outcomes of a quasi-experimental public health trial were not as expected. Parkinson and colleagues (2007) describe a birth cohort study, a longitudinal study design which enables exploration of how earlier events affect later outcomes but which has its own difficulties, as the authors describe.
In the last paper Harden and Thomas (2005) set out a method for conducting systematic reviews which can incorporate studies which use diverse research methods. Given the wealth of methods used in health research, such an approach is particularly valuable.
‘Mixed methods’ has been a recurrent theme in the papers included in this virtual special issue and this methodology is likely to become more common in the future, encouraged perhaps by the requirement of many funders for Patient and Public Involvement (PPI) at all stages of research. A risk to be wary of here, however, is the substitution of PPI for good qualitative research. A further trend in applied health research has been the expectation that specified guidelines (http://www.equator-network.org/) are used in reporting both literature reviews and research findings. Whether this aids greater quality and transparency of research or results in a stultifying standardisation of research presentation remains to be seen.
Professor Mary Boulton, PhD
Faculty of Health & Life Sciences, Oxford Brookes University
All included articles are free to read, download and share online until the end of December 2016. Simply click on the link(s) of your choice below to begin reading.
International Journal of Social Research Methodology
- Jacqueline H. Watts
Producing different analytical narratives, coproducing integrated analytical narrative: a qualitative study of UK detained mental health patient experience involving service user researchers
- Steve Gillard, Rohan Borschmann, Kati Turner, Norman Goodrich-Purnell, Kathleen Lovell & Mary Chambers
Cross-national qualitative research: the development and application of an analytic framework in the Mental Health and Poverty Project
- Philippa Bird, Victoria Campbell-Hall, Ritsuko Kakuma & the MHaPP Research Programme Consortium
- Susan Michie & Theresa Marteau
- Corine Buers, Mattanja Triemstra, Evelien Bloemendal, Nicolien C. Zwijnenberg, Michelle Hendriks & Diana M.J. Delnoij
- Brendon R. Barnes
- Kathryn Parkinson, Charlotte Wright & Robert Drewett
- Angela Harden & James Thomas