Research Methods in Health : Investigating Health and Health Services

by Bowling, Ann

• ISBN13: 9780335206438
• ISBN10: 0335206433
• Edition: 2nd
• Format: Paperback
• Copyright: 2002-01-01
• Publisher: Open University Press

Summary

Praise for the first edition of Research Methods in Health: "Professor Bowling should be congratulated on her achievement in producing such a substantial overview of the topic." - International Journal for Quality in Health Care "...a brilliantly clear documentation of different philosophies, approaches and methods of research about health and health services. Laid out in an accessible and manageable way, it covers an enormous amount of material without sacrificing thoroughness...I would recommend it to a broad readership." - MIDIRS Midwifery Digest "Professor Ann Bowling is not only a superb and illuminating conference presenter - she also writes exceptional books. This major research textbook is as good as an introduction to the field as you are likely to find." - The International Journal of Social Psychiatry "...an easy to read book with excellent background information on the theory and practice of research. A summary of main points, key terms and recommended reading follows each chapter and there is a useful glossary of terms at the end of the book for quick reference...I particularly liked the checklists when undertaking literature reviews and writing research proposals." - British Journal of Health Care Management This new edition of Ann Bowling's well-known and highly respected text has been thoroughly revised and updated to reflect key methodological developments in health research. It is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services. It describes the concepts and methods used by the main disciplines involved in health research, including: demography, epidemiology, health economics, psychology and sociology. The research methods described cover the assessment of health needs, morbidity and mortality trends and rates, costing health services, sampling for survey research, cross-sectional and longitudinal survey design, experimental methods and techniques of group assignment, questionnaire design, interviewing techniques, coding and analysis of quantitative data, methods and analysis of qualitative observational studies, and types of unstructured interviewing. With new material on topics such as cluster randomization, utility analyses, patients' preferences, and perception of risk, the text is aimed at students and researchers of health and health services. It has also been designed for health professionals and policy makers who have responsibility for applying research findings in practice, and who need to know how to judge the value of that research.

Author Biography

Ann Bowling is a social scientist and is currently Professor of Health Services Research in the Department of Primary Care and Population Sciences at University College London. She directs an active research programme and has both PhD and master's programmes, including the MRes in health services research and policy at UCL. She is also author of Measuring Health, A Review of Quality of Life Measurement Scales and Measuring Disease, A Review of Disease-Specific Quality of Life Measurement Scales, both published by the Open University Press.

Ian Rees Jones is Professor of Sociology of Health and Illness, St George's Hospital Medical School, London. He is also a social scientist with an extensive research background, and teaches on both undergraduate and post-graduate courses.

Table of Contents

Preface	xv
Acknowledgements	xvi
Section I Investigating health services and health: the scope of research	1	(114)
Evaluating health services: multidisciplinary collaboration	5	(12)
Introduction	6	(1)
Health Services research	6	(1)
The assessment of quality	7	(1)
Audit	8	(1)
Medical audit, clinical audit and quality assurance	8	(1)
Evaluation	9	(1)
Structure, process and outcome	10	(1)
Appropriateness and inappropriateness	11	(1)
Outcome	12	(3)
Summary of main points	15	(1)
Key questions	15	(1)
Key terms	16	(1)
Recommended reading	16	(1)
Social research on health: sociological and psychological concepts and approaches	17	(37)
Introduction	18	(1)
Sociological and psychological research on health	18	(1)
Health and illness	19	(1)
The bio-medical model	19	(1)
The social model of health	20	(1)
Lay definitions of health	20	(1)
Lay theories of illness	21	(1)
Variations in medical and lay perspectives	22	(1)
Social factors in illness and responses to illness	23	(1)
Social variations in health: structural inequalities	23	(1)
Psycho-social stress and responses to stress	24	(3)
Stigma, normalisation and adjustment	27	(2)
The Sick Role and illness behaviour	29	(4)
Models of health behaviour	33	(1)
Health lifestyles	33	(1)
Health behaviour	34	(1)
Models of health-related actions	35	(4)
Health-related quality of life	38	(1)
Theoretical influences on measurement	39	(2)
Interactions between health professionals and patients	41	(1)
Communication	41	(1)
Patients' evaluations of health care	42	(9)
Summary of main points	51	(2)
Key questions	53	(1)
Key terms	53	(1)
Recommended reading	53	(1)
Health needs and their assessment: demography and epidemiology	54	(35)
Ian Rees Jones
Introduction	55	(1)
The assessment of health needs	55	(1)
Health needs	55	(1)
The need for health and the need for health care	56	(3)
Methods of assessing health needs	59	(3)
The role of epidemiological and demographic research	62	(1)
Epidemiology	63	(1)
The role of epidemiology	63	(1)
Epidemiological research	64	(2)
Methods of epidemiology	66	(7)
Assessing morbidity, mortality, incidence and prevalence	73	(5)
The role of demography	77	(1)
Demographical methods in relation to assessing need	78	(1)
Rates: births and deaths	79	(1)
The need to standardise	80	(3)
Analyses of survival	83	(3)
Summary of main points	86	(1)
Key questions	87	(1)
Key terms	87	(1)
Recommended reading	88	(1)
Costing health services: health economics	89	(26)
Ian Rees Jones
Introduction	90	(1)
Health economics	90	(2)
Demand, utility and supply	92	(1)
Economic appraisal	93	(1)
Cost minimisation	94	(1)
Cost-effectiveness	94	(1)
Cost-benefit analysis	95	(1)
Marginal cost	96	(1)
Complete costs	96	(1)
Event pathways	97	(1)
Opportunity cost	98	(2)
Discounting	100	(1)
Cost-utility analysis	100	(1)
Cost-utility analysis and economic valuations of health	101	(6)
Costing health services	107	(4)
Study methods used for costings	111	(1)
Summary of main points	112	(1)
Key questions	113	(1)
Key terms	113	(1)
Recommended reading	113	(2)
Section II The philosophy, theory and practice of research	115	(48)
The philosophical framework of measurement	117	(16)
Introduction	118	(1)
The Philosophy of science	118	(1)
Paradigms	119	(1)
Objectivity and value freedom	119	(1)
Deductive and inductive approaches	120	(4)
The survival of hypotheses and paradigm shifts	124	(1)
Theoretical influences on social research methods	125	(1)
Social science and grounded theory	125	(1)
Positivism	126	(2)
Phenomenology	128	(2)
Choice of methods	130	(1)
Summary of main points	131	(1)
Key questions	132	(1)
Key terms	132	(1)
Recommended reading	132	(1)
The principles of research	133	(30)
Introduction	134	(1)
Searching the literature	134	(2)
Literature reviews	136	(1)
Meta-analyses	136	(2)
Rigour	138	(1)
Aims, objectives and hypotheses	138	(1)
Concepts and theories	139	(2)
Research proposals	141	(2)
Research design and research methods	143	(1)
Selection of measurement instruments	144	(1)
Level of data and statistical techniques	144	(3)
Reliability and validity	147	(6)
Threats to reliability and validity	153	(3)
Ethics and ethical committees	156	(3)
Dissemination	159	(1)
Summary of main points	160	(1)
Key questions	161	(1)
Key terms	162	(1)
Recommended reading	162	(1)
Section III Quantitative research: sampling and research methods	163	(92)
Sample size and sampling for quantitative research	165	(28)
Introduction	166	(1)
Calculation of sample size, statistical significance and sampling	166	(1)
The sampling unit	166	(1)
Calculation of sample size and statistical power	167	(2)
Testing hypotheses, statistical significance, the null hypothesis	169	(1)
Type I and type II errors	170	(2)
One-or two-sided hypothesis testing	172	(1)
Statistical, social and clinical significance	173	(1)
Sampling frames	174	(2)
Sampling	176	(1)
Confidence intervals and the normal distribution	177	(5)
External validity of the sample results	182	(1)
Methods of sampling	183	(1)
Random sampling	183	(3)
Non-random sampling: quota sampling	186	(1)
Sampling for qualitative research	187	(1)
Sampling for telephone interviews	188	(1)
Summary of main points	189	(2)
Key questions	191	(1)
Key terms	191	(1)
Notes	191	(1)
Recommended reading	192	(1)
Quantitative research: surveys	193	(22)
Introduction	194	(1)
Survey methods	194	(1)
The survey	194	(1)
Descriptive and analytic surveys	195	(2)
Retrospective (ex post facto), cross-sectional surveys	197	(1)
Prospective, longitudinal surveys	197	(3)
Cross-sectional and longitudinal cohort studies	200	(1)
Triangulated research methods and surveys	201	(1)
Methods of analysing change in longitudinal surveys	202	(1)
Analysing change	202	(7)
Sample attrition and analysing change	209	(3)
Stopping rules and analysis of interim results	212	(1)
Summary of main points	212	(1)
Key questions	213	(1)
Key terms	213	(1)
Recommended reading	214	(1)
Quantitative research: experiments and other analytic methods of investigation	215	(22)
Introduction	216	(1)
The experimental method	216	(3)
Internal and external validity	219	(4)
Reducing bias in participants and the investigating team	223	(1)
Blind experiments	224	(1)
The randomised controlled trial in health care evaluation	225	(3)
Other analytic methods of investigation	228	(3)
Before-after study with non-randomised control group	231	(1)
After-only study with non-randomised control group	231	(1)
Time series studies using different samples (historical controls)	232	(1)
Geographical comparisons	232	(1)
People acting as own controls	233	(1)
Within-person, controlled site study	233	(1)
Threats to the validity of causal inferences in other analytic studies	233	(1)
Summary of main points	234	(1)
Key questions	235	(1)
Key terms	235	(1)
Recommended reading	236	(1)
Sample selection and group assignment methods in experiments and other analytic methods	237	(18)
Introduction	238	(1)
Random sampling	238	(1)
Convenience and purposive sampling	238	(1)
Volunteers	239	(1)
Type of investigation and type of sampling frame	239	(1)
Response rates: experiments and other analytical studies	240	(1)
Ensuring similarity in group characteristics: random allocation	241	(6)
Other allocation methods: cross-over methods	247	(1)
Methods of group design for improving the basic RCT	248	(2)
Common methods of controlling to obtain equivalence in non-randomised studies	250	(2)
Summary of main points	252	(1)
Key questions	253	(1)
Key terms	253	(1)
Recommended reading	253	(2)
Section IV The tools of quantitative research	255	(96)
Data collection methods in quantitative research: questionnaires, interviews and their response rates	257	(16)
Introduction	258	(1)
Structured and semi-structured questionnaires	258	(1)
Postal questionnaires and self-administration	259	(1)
Structured and semi-structured interviews	260	(3)
Non-response	263	(6)
Item non-response	269	(2)
Summary of main points	271	(1)
Key questions	271	(1)
Key terms	272	(1)
Recommended reading	272	(1)
Questionnaire design	273	(37)
Introduction	274	(1)
Planning	274	(1)
Piloting	275	(1)
Questionnaire layout	275	(2)
The covering letter	277	(1)
Question form, order and wording	278	(1)
Rules for form	278	(8)
Scores	286	(1)
Constructing additional items and scales	287	(1)
Attitude measurement scales	288	(6)
Rules for order and wording	294	(6)
Rules for questions by type of topic	300	(6)
Checking the accuracy of responses	306	(1)
Translating an instrument and cultural equivalence	307	(1)
Summary of main points	308	(1)
Key questions	309	(1)
Key terms	309	(1)
Recommended reading	309	(1)
Techniques of survey interviewing	310	(25)
Introduction	311	(1)
Types of interview	311	(1)
The interviewer	311	(2)
Interviewer handbooks	313	(2)
Sampling by interviewers	315	(1)
Interviewer training	316	(1)
Interviewer bias	317	(1)
Persistence in contacting respondents	318	(1)
Approaching respondents	319	(1)
Motivating people to respond	320	(2)
Third parties and distractions	322	(1)
Beginning the interview	323	(1)
Rules for structured interviewing	324	(2)
Interviewing Techniques	326	(4)
The end of the interview	330	(1)
Recording responses	331	(1)
Debriefing	332	(1)
Quality control	332	(1)
Summary of main points	333	(1)
Key questions	333	(1)
Key terms	334	(1)
Recommended reading	334	(1)
Preparation of quantitative data for coding and analysis	335	(16)
Introduction	336	(1)
Coding	336	(2)
Coding transfer sheets	338	(1)
The code book	339	(1)
Numerical values for codes	340	(1)
Coding open questions	341	(2)
Coding closed questions	343	(1)
Checking returned questionnaires	343	(1)
Data entry on to computer	344	(1)
Cleaning the data	345	(1)
Checking for bais in the analyses	346	(1)
Missing values and data checks	346	(1)
Computer packages for the analysis of quantitative data	347	(1)
The analysis	348	(1)
Summary of main points	349	(1)
Key questions	350	(1)
Key terms	350	(1)
Recommended reading	350	(1)
Section V Qualitative and combined research methods, and their analysis	351	(79)
Unstructured and structured observational studies	355	(22)
Introduction	356	(2)
Observation	358	(1)
Participant observation	359	(1)
Gaining access	360	(1)
Hardware: video- and audiotapes	361	(1)
Establishing validity and reliability	362	(2)
Observation and traingulated methods	364	(1)
Structured observations: what to record	364	(2)
Time sampling	366	(1)
Recording observed (non-verbal) body language	366	(1)
Unstructured observations	367	(1)
Combining structured and unstructured recordings	368	(1)
Theoretical analysis of observational data	369	(2)
Categorisation of observational data	371	(2)
Narratives	373	(1)
Audio-observation: conversation sampling	373	(1)
Recording and analysing verbal communication	374	(1)
Summary of main points	375	(1)
Key questions	376	(1)
Key terms	376	(1)
Recommended reading	376	(1)
Unstructured interviewing and focus groups	377	(25)
Introduction	378	(1)
Unstructured interviews	378	(1)
Types of unstructured, in-depth interview	378	(1)
In-depth interviewing: sample selection and size	379	(2)
The process of the interview	381	(1)
Techniques of in-depth interviewing	382	(3)
Analysis and presentation of in-depth interview data	385	(2)
Categorising qualitative data: content analysis	387	(2)
Rules for coding	389	(2)
Computer programs for analysing qualitative data	391	(1)
Narrative format	392	(2)
Focus groups	394	(1)
Focus group interviews	394	(1)
Group composition	395	(1)
Appropriate topics for focus groups	395	(3)
Methods of analysis	398	(1)
Summary of main points	399	(1)
Key questions	400	(1)
Key terms	400	(1)
Recommended reading	401	(1)
Other methods using both qualitative and quantitative approaches: case studies, consensus methods, action research and document research	402	(28)
Introduction	403	(1)
Case studies	403	(1)
The study of single or small series of cases	403	(1)
Examples of case studies	404	(2)
The analysis	406	(1)
Consensus methods	406	(1)
Methods for establishing and developing consensus	406	(1)
Delphi technique	407	(1)
Consensus development panels	407	(1)
Nominal group process	407	(2)
The analysis	409	(1)
Action research and rapid appraisal techniques	410	(1)
Action research	410	(2)
Stages of action research	412	(2)
Rapid appraisal	414	(1)
Document research	415	(1)
Documents as sources of, or for, research	415	(1)
Types of documents	416	(2)
Authenticity, bias, error and interpretation	418	(1)
Types of document research	419	(2)
Analysis of documents	421	(3)
Diary methods	424	(3)
Analysis of diaries	427	(1)
Summary of main points	427	(1)
Key questions	428	(1)
Key terms	429	(1)
Recommended reading	429	(1)
Glossary	430	(9)
References	439	(40)
Index	479