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Chapter 1
Identifying the research aim
LEARNING OUTCOMES
When you have completed this chapter you should be able to:
| 1.1 | Explore why society wants health and social care research |
| 1.2 | Discuss why researchers carry out research |
| 1.3 | Understand what is studied by researchers |
| 1.4 | Understand different aims of research. |
Every research project has an aim, which clearly presents the purpose of the research. A well-written research proposal will make this aim clear to potential sponsors or supervisors of the project. In the same way, a well-written research paper or report will make its aim clear to readers and potential users of the study’s findings. But this overt, openly declared, aim may not be the only one.
In this chapter, we will look at three types of research aims. Firstly, we will consider the aims of health and social care research as a whole, including why health and social care research is carried out at all, and why it is seen as important for practice and worth spending so much money on every year. Secondly, we will consider why individual academics or professionals undertake research projects or, in some cases, devote their entire careers to research. Thirdly, we will discuss the aims that apply to individual research projects, including both the stated (explicit) aims and the unstated (implicit or hidden) aims. We will analyse the impact that unstated aims can have on research design; we will also consider why it is so important to take these hidden aims into account when we evaluate a research report.
| 1.2 | Why does society want health and social care research? |
1.2.1 Reflections from Dr Bruce Lindsay
From what I can remember, I was taught nothing about research when I was a student nurse. I have no recollection of lectures on reading research papers, understanding statistics, or critiquing research designs. My tutors, nurses and doctors alike, made few if any references to research findings during classes and my written assignments were not constrained by the need to include long lists of research papers. During practical classes and placements I was taught the ‘right’ way to perform a procedure, set up a dressings trolley or administer medications. No one ever explained why this was the ‘right’ way, except perhaps by referring to ‘experience’ or ‘custom and practice’. I don’t remember questioning my tutors, even when this approach to my education and to health care produced rather ridiculous practices, such as those described in Key Case 1.1 and Key Case 1.2.
| KEY CASE 1.1 – INJECTION TECHNIQUE | |
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I undertook practice placements in a series of health care settings, including two major general hospitals, which have since been demolished. (Last time I looked, one was a car park and the other a supermarket.)
In Hospital 1, intramuscular injections were given in the patient’s thigh. In Hospital 2, intramuscular injections had to be given in the patient’s buttock. If I had given an injection into a patient’s buttock in Hospital 1, I would have been severely told off. If I had given an injection into a patient’s thigh in Hospital 2, I would also have been severely told off. |
| KEY CASE 1.2 – HERNIA REPAIRS | |
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| In Hospital 1, I worked as a nurse on a male surgical ward in which many of the patients were recovering after having had their inguinal hernias repaired. One of the consultant surgeons insisted that every one of his patients must wear a surgical support for five days after surgery. The other consultant surgeon insisted that his patients must not wear surgical supports under any circumstances. Much of my time was spent either ensuring that I hadn’t inadvertently given a surgical support to one of Surgeon 2’s patients, or checking that all Surgeon 1’s patients were wearing their surgical supports (whether or not they wanted to wear them). Much of the rest of my time was spent trying to explain to patients why some of them had to wear supports and some of them were not allowed to wear supports. |
As a staff nurse, I was never called on to back up my actions with reference to research evidence and my early years as a clinical teacher were also almost totally research-free. This is not to say that no health and social care research was being done. The Royal College of Nursing had commissioned some major research projects in the mid-1970s, for example. But this rarely seemed to have any impact on my work in a series of provincial hospitals. The amount of health and social care research being undertaken started to expand more rapidly in the 1980s and 1990s, but as late as 1998 Margaret Ogier remained pessimistic about its impact on nursing: ‘… it is doubtful that research findings are being widely used to inform everyday practice …’ (Ogier, 1998, p. 5).
1.2.2 Reflections from Dr Vanessa Heaslip
As one of the Project 2000 student nurses whose nurse education was based at a university, during my training (1993–1996) there was beginning to be more emphasis on utilising evidence within our practice. We were introduced to, and learnt to really value, books such as the Royal Marsden Manual of Clinical Nursing Procedures, which presented a variety of clinical procedures. During my training and the early days of my career, I was conscious of the need to provide an evidence-based rationale for my decision making. There were also times when I was driven more by the evidence and subsequently had to adapt my practice to fit both the patient and the clinical context (see Key Case 1.3).
| KEY CASE 1.3 – TYPE OF NEEDLES | |
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| During my training we were taught that we should always use a green needle for intramuscular injections. Yet when I went into community nursing practice I can remember being very confused and upset when I saw nurses using a shorter blue needle to deliver intramuscular injections, which was contrary to what I had been taught. When I discussed this with them, they explained to me that the size of the needle has to reflect the patient and their size. For instance, if the patient in question had a very small frame and build, it was important to use a smaller needle. |
In the above reflections, we have shown the gradual move towards an ‘evidence-based’ approach that has occurred in health and social care practice over the last few decades. This has made it even more crucial for practitioners to understand how to make use of research.
Whether you are already qualified, or still studying to become a health or social care practitioner, you therefore need to develop some skills in reading and critiquing research evidence. Much of our teaching for undergraduate and pre-registration students is about research, or it makes use of research findings. Students are expected to refer to research findings and other evidence in their assignments; and practice assessments require students not only to perform skilfully in practice but also to support their actions by referring to evidence. For all these reasons, today’s health and social care professionals are expected to be ‘research aware’ (Moule & Goodman, 2009, p. 1). This means that you need to be able to:
- Search for and identify evidence
- Have an understanding of research and the research process and use this understanding to read and critically analyse the evidence
- Translate your understanding of what you have read into the professional practice context.
Although research is not the only source of evidence, it is an extremely influential one. Governments, international organisations, professional bodies, charities and individual patients and clients expect care to be evidence-based and expect much of the evidence to come from research. There are many complex reasons behind this move away from accepted custom and practice towards a demand for research evidence, which are beyond the scope of this book. However, we think the most important reasons are that:
- The public no longer trusts health and social care professionals to do what is best and this distrust has been fuelled by very high-profile media reports of cases of poor-quality care
- Professionals are conscious of the risk of being sued and want clear evidence for their practice
- Emerging health and social care professions want to create their own evidence for their profession, to develop and contribute to their profession’s knowledge base
- Governments demand clear evidence before funding expensive new trea...
