THE BASICS:

The Role of Theory and & Philosophical

Foundations Guiding Qualitative Research

Week 3
 1. Define key concepts in the philosophy of science.
2. Identify assumptions underlying key philosophical perspectives
in health science.

LEARNIN 3. Identify assumptions underlying the post-positivist, critical, and

interpretive/constructivist views of research
G 4. Identify how philosophical beliefs influence the conduct and

OBJECTI interpretation of research.

5. Describe how a framework guides research.
VES 6. Describe the relationships among theory, research, and practice.
 There are many questions that
arise for health care practitioners
on a day-to-day basis related to
their practice

These questions require health

care professionals to engage in
the knowledge development
process
NATURE OF
KNOWLEDGE
THEORETICAL FOUNDATIONS
vMany tasks done by healthcare providers can be mastered by anyone trained
to perform them

vThe hallmark of healthcare practice is:

- a unique body of knowledge combined with disciplinary theory
 Practice is informed by:

SOURCES Traditions
OF Authority
KNOWLED
Trial & Error
GE FOR
Personal Experience
HEALTHCA
Intuition
RE
Common Sense Reasoning
PROFESSIO
NALS
Question – what is the problem with using
non-research-based knowledge?
WHAT IS THEORY?

Used less restrictively to

An abstract generalization
refer to a broad
that explains how
characterization of a
phenomena are interrelated
phenomenon

Theories consist of two or

All research is framed by
more concepts and a set of
theory, whether explicitly or
propositions that form a
not
logically interrelated system
IMPORTANCE OF THEORY
Whether we are aware of it or not, theoretical
assumptions about:
how the world works
how health care, illness behavior, or
practitioner–patient interaction are organized
 frame the kinds of questions we come to
think of as important (or even legitimate) to
ask.

Help orientate our readers to what we are

contributing to knowledge more generally.
EXAMPLE OF DIFFERENT
THEORIES IN HEALTHCARE
MACRO THEORY
‘Macro’ theory – the broad perspectives on the world that
shape the ways in which we approach questions about
health and health care in health research.

Large-scale, or macro, theory allows questions to be

asked at a higher level of abstraction.

It is important to bear in mind that all research is framed

by our worldviews, or theoretical perspectives, and
these both underpin and shape projects and their
findings.
One set of macro theories relates to how far social structures
determine our behaviour and how far human beings have ‘free
will’ to determine their own life chances and decisions. (e.g., to
explain inequalities in health outcomes in high-income countries):

A theory that put more emphasis on social structures would

focus on material factors: how much people’s income or social
status determined the life chances they had, the access they have
to health care, or to the basic determinants of health.

A theory that put more emphasis on people’s ability to make

their own free choice might focus on the knowledge, attitudes
and individual practices that influence health.

EXAMPLE OF MACRO THEORY

MIDDLE-RANGE THEORY

Middle-range theories link the general, abstract concepts of macro and the
grounded, observable behaviour of people in everyday settings.

Middle-range theories shape what we ask and how we approach questions.

They are often rooted in particular disciplines.

Theory can be the topic of research: some studies are prompted by theoretical
problems, such as the recognition of different theoretical positions, and the
consequences the assumptions built into those positions can have for
knowledge, practice and policy.
MACRO VS MIDDLE-RANGE,
EXAMPLES
Collaborative Activity

In small groups, choose one example of a macro-range theory and one middle range
theory that you use or could apply to your practice in your discipline. You may
search the internet or other resources you have.
THEORIES OF KNOWLEDGE
How do we come to know the world, and have faith in the truth of that knowledge?

This is known as epistemology. As research is

essentially about
producing
There are differing epistemological theories which influence how
researchers generate knowledge: knowledge about
1) Positivism and realism the world that we
2) Interpretative approaches can claim as
3) Phenomenology
4) Social constructionism
valid, some
5) Critical approaches attention to
6) Feminist approaches epistemology is
vital.
 PHILOSOPHY (PRIMER)
Comes from the Greek meaning “philo” = love and “sophia” = to be wise
… in other words … the “love of wisdom”
Is the rational investigation of the truths & principles of being, knowledge, or
conduct

Ancient Greeks organized philosophy into 5 broad categories:

Metaphysics: concerned with the nature of existence in the most
fundamental sense …”to be or not to be” “ontology=what is real” &
includes physical reality & social reality
Epistemology: concerned with the nature of knowledge & how man can
know things
Ethics: concerned with nature of values
Politics: concerned with the behavior of men toward one another in the
social context
Aesthetics: concerned with man’s artistic creations
PHILOSOPHY OF SCIENCE (PRIMER)

Branch of philosophy that explores the elements of

scientific inquiry from a philosophical perspective

Is concerned with the

assumptions, foundations,
methods, & implications of
science

So what does this all mean??

PHILOSOPHY
OF SCIENCE
Ontology: refers to believes about the
nature of that knowledge [NOTE: this is
affected by ones believe about reality]
Epistemology: refers to the ways to gain
knowledge

Why does this even matter?

•Researchers’ ontological &

epistemological positions have important
implications for the way they will see
the world & thus the way they believe
they can come to know that world … in
other words…it will influence the way
they will conduct research
 WORLDVIEW OR PARADIGM
POST-POSITIVIST

The term was coined by Thomas Kuhn (1962)

CONSTRUCTIVI CRITICAL
ST SOCIAL

Comes from the Greek word meaning “pattern”

Essentially a paradigm represents a set of beliefs & practices, shared by communities

of researchers that guide the knowledge development process

In other words … the term paradigm is used a)the ways we can come to know
to describe the pattern of philosophical beliefs
& assumptions about: the nature of knowledge

There are different paradigms used by researchers, including healthcare professionals

FOUR MAIN FUNCTIONS OF
PARADIGMS
•Understanding researchers’ paradigms or philosophical
beliefs are important because … it forms the basis for
critiquing the legitimacy of the claims that are being
made:

1. Provides the framework for identifying central

concepts

2. Provides the assumptions that guide theory

development [makes assumptions explicit]

3. Provides information about how one may come to

learn about the world

4. Underscores beliefs about the nature of the

knowledge gained
HOW RESEARCH QUESTIONS ARE
ANSWERED DEPENDS ON THE
PARADIGM USED TO GUIDE THE
RESEARCH PROCESS

POST-POSITIVIST

CONSTRUCTIV CRITICAL
IST SOCIAL
DISTINGUISHING AMONG
PARADIGMS
In addition to different ontologies & epistemologies,
paradigms different along various dimensions:

Methodology → refers to specific principles, rules, &

procedures that guide the process through which knowledge is
acquired

Aim of Inquiry → refers to the goals or specific objectives of

the research

Context → refers to the personal, social, & political

environment in which a phenomenon of interest occurs (e.g.
setting, cultural understandings & beliefs, etc)

Values → refers to the personal beliefs of the researcher(s)

 ONTOLOGY & COMMON
PARADIGMS
Post Positivism Critical Theory Constructionism
 A philosophical  A philosophical  A philosophical
orientation that supports orientation that suggests orientation that supports
the belief that a reality that reality & our the belief that reality is
exists that can be understanding of it is constructed by
observed, measured, & constructed by people individual perception –
known as fact [also with the most power at a  Thus there is not one
recognized there are particular point in time reality but multiple
limits to what can be  Reality is imperfectly realities based on the
known] understood - over subjective perceptions
 Thus …there is a time, reality is shaped of each individual
reality, based on the by numerous social,
observable laws of political, economical,
nature & cultural forces
 Imperfectly shaped

stories become accepted

reality
 EPISTEMOLOGY & COMMON
PARADIGMS
Post Positivism
 Researcher’s Voice: neutral
observer; although
researchers naturally biased -
objectivity is ultimate goal
 Knowledge gained through
the senses - provides an
imperfect understanding of
the external/material world
 Encourages triangulation
(i.e. multiple methods,
multiple researchers, etc.) &
replication of findings
Critical Theory
 Researcher’s Voice: active
participant
 Research is transaction b/w
researcher & participants
 Perceptions naturally
influence knowledge
generation/creation
 Contextual awareness & its
relation to participants’
understanding of reality is
focus of research
 Objectivity not a desired
goal
 Knowledge gained through
understanding
Constructionism
 Researcher’s Voice: can be
an active participant
 Research is transaction b/w
the researcher & participants
 Perceptions naturally
influence knowledge
generation/creation
 Emphasizes meaning
ascribed to human
experiences
 Context is considered but not
emphasized
 Objectivity is not a desired
goal
 Knowledge gained through
understanding “verstehen”
 METHODOLOGY & COMMON PARADIGMS
Post Positivism
 Primarily quantitative
methods including
experimental &
nonexperimental
approaches
 Research questions &
hypotheses are proposed &
subjected to testing
 Careful accounting &
control of factors that may
influence research findings
 Data usually consists of
numbers & statistical
formulae
Critical Theory
 Can be qualitative or
qualitative methods –
BUT inquiry requires
dialogue (i.e. interviews)
b/w researcher &
participants
 Dialogue brings historical
context behind experiences
of suffering, conflict, &
collective struggles to the
forefront & ↑ participants’
awareness of actions
required to incite change
(transformation)
Constructionism
 Primarily qualitative
methods with a focus on
interpretation of written
texts, art, pictures, &
videos
 Inquiry requires dialogue
(i.e. interviews) b/w
researcher & participants
 Findings bring to the
forefront the various ways
in which people construct
meaning & understanding
 Data usually consists of
words or text
 AIM & COMMON PARADIGMS
Post Positivism
 Explanation; prediction; &
control
 Quantitative methods used to
explore research questions or
test hypotheses that describe
phenomena, test relationships,
assess differences, & attempt
to explain cause & effect
interactions b/w variables
being studied
Critical Theory Constructionism
 Critique, change, &  Understanding
emancipation  Reconstruction of what we
 Reconstruction of what we know to be true
know to be true  Qualitative methods used to
explore personal meanings &
context of an experience,
culture, human patterns &
processes
CONTEXT & COMMON PARADIGMS
Post-Positivism
Physical setting, e.g., hospital or
home
Constructionism &
Critical Theory
Less concrete, experiential,
cultural, social, e.g.,
organizational culture or personal
experience
TRUTH & COMMON PARADIGMS
Post-Positivism Constructionism &
Critical Theory:
Truth is sought in an Truth is sought in a
objective, replicable subjective, individual
manner manner

No absolute truth or
validity; truth is relative &
subjective & based on
perception or some
particular frame of
VALUES & COMMON PARADIGMS
Post-Positivism Constructionism & Critical
Theory

Values: included & add to

Values: remain objective; understanding
excluded
QUESTION

What is a major assumption of the constructivist paradigm world view?

a. Reality is mentally constructed by individuals.
b. The researcher is independent from those researched.
c. Values and biases are held in check.
d. Subjectivity is not desirable.
DIFFERENT PROBLEM FOCUS:
CHEMOTHERAPY RX EXAMPLE
Post-Positivism
•May be interested in the
efficacy of cancer drug
treatment
•Factors that influence
drug effectiveness (e.g.
age, illness, gender, etc)
•Look to replicate
•Drug prepared & given
in the same way &
measure the responses
Critical Theory Constructionism
• May be interested in • May be interested in
what it means to
identifying whether people to have
access to cancer cancer or cancer
drugs varies by drugs
racial/ethnic groups • Gain understanding
& what factors through the eyes of
people using cancer
might explain any drugs
variations • Would consider the
different contexts
• Can use qualitative
or quantitative • Can identify patterns
methods that describe
experiences
 Why [post-positivism] or
[constructionism] would be
the best worldview to
design health research
DEBATE IN THE
LITERATURE
Some believe that there is no right or wrong
Both post-positivism and constructionism paradigms are legitimate
& simply represent different views of the world
Some believe that the two paradigms are incompatible & although
respect the evidence gained from either paradigms, the data is
incompatible and therefore you can not synthesize the types of
evidence
… others strongly dismiss the legitimacy of the opposite camp;
committed to fundamental beliefs of whether “reality” exists
BACK TO WHY THIS IS
IMPORTANT
You have to be aware of where you sit so you can take a stand
about what you believe

Knowing & comprehending these different beliefs & views is

important to understanding & using research findings