L1: Pharmacy-based sociological knowledge generation: Social Research Methods

___ is becoming an increasingly important issue for all health care practitioners. This is epitomised by the increasing emphasis placed on ___.

Research

evidence-based medicine

The whole of the [pharmacy] profession should be ___ (i.e. ___) and a proportion should be ___ (i.e. ___)

research-aware

research users

research active

research doers

___ is complex and consequently its study requires specific and appropriate ___.

Social action

methodologies

___ must be rigorous and involves the use of appropriate ___ to address specific research questions.

Social research

methodological tools

In social research: it is frequently necessary to secure prior approval of the research from the appropriate ___

Ethics Committee

In social research: ___ should be allowed for this when planning such research.

sufficient time

These questions which should be asked at the early stage of any research:

• What is the area of study or investigation?

• What type of question or problem is the research aiming to address?

• What research design is most appropriate to this research question?

• What would be the most appropriate method or methods?

• What would be the most relevant research tools?

Four key questions should be addressed when conducting research, according to ___

Shipman (1988)

1. If the investigation were to be carried out again, by different researchers, using the same methods, would the same results be obtained?

2. Does the evidence reflect the reality under investigation?

3. What relevance do the results have beyond the situation investigated?

4. Is there sufficient detail on the way the evidence was produced for credibility of the research to be assessed?

In the ___, The ___ is established as the ‘___’ of empirical, clinical research and is widely used as an experimental tool.

Experimental method

randomised controlled trial (RCT)

gold standard

largely a clinical rather than social research tool.

EXPERIMENTAL METHOD

In the experimental method: ___ are epidemiological studies in which a direct comparison is made between two or more ___, one of which serves as a ___ for the other.

Randomized trials

treatment groups

control

In the experimental method: ___ are randomly allocated into the differing ___, and all groups are followed over time to observe the effect of the different treatments.

Study subjects

treatment groups

In the experimental method: The ___ may either be untreated (___) or undergo a “___” established regimen against which the new regimen will be assessed (___).

control group

Placebo controlled

gold standard

active controlled

Randomized trial study design

___ describes a comprehensive randomization and trial supply management solution that supports standard to complex trial activities including ___ to ___ from ___ to ___. The functions supported by ___ platforms are generally incorporated into the more comprehensive IRT solution.

Interactive Response Technology (IRT)

patient enrollment and randomization

drug supply management and optimization

trial recruitment

close-out

IWRS, IXRS and RTSM

In METHODS OF SOCIAL ANALYSIS: ___ can be classified as being either ___.

Social research methods

qualitative or quantitative

These divergent approaches in methods of social analysis adopt different research tools and are based upon, and informed by, different ___.

theoretical foundations

Both ___ can be used together; they yield different types of data, and the one may well complement the other.

quantitative and qualitative methods

SAMPLING STRATEGIES in QUANTITATIVE METHOD

Simple random sample

Stratified random sample

involves a random selection of a specific number of units drawn from the population investigated which is treated as an undifferentiated whole.

Simple random sample

involves breaking the investigated population into distinct sub-groups or strata, and then randomly selecting a specific number of units from each stratum.

Stratified random sample

SAMPLING STRATEGIES in QUALITATIVE METHOD

Maximum variety sampling

Convenience sampling

Theoretic sampling

purposively selecting individuals by certain criteria relevant to the research in order to solicit as wide a range of experiences as possible.

Maximum variety sampling

selecting individuals who are available in the study context. For example, identifying individuals for inclusion in a study by their attendance at a pharmacy on a particular day.

Convenience sampling

purposively selecting individuals by criteria relevant to the theory being explored.

For example, an investigation into the public’s perception of pharmacy as a retail outlet might be informed by the theoretical construct of the public as health care consumers rather than patients. This sampling might therefore involve selecting individuals considered to explore this theory

Theoretic sampling

the sampling strategies are designed to ensure that the results will be both valid and generalizable (___)

QUANTITATIVE METHOD

probability sampling

use different sampling strategies (___).

QUALITATIVE METHOD

non-probability sampling

The purpose of this is to generate precise measurements of social action, which can be explained by the aggregation of statistical data.

QUANTITATIVE RESEARCH METHODS

Quantitative research aims to: Explain ___ in terms of a ___ relationship, with the ___ as the effect and an ___ the cause – for example, it may be argued that juvenile delinquency is caused by poverty.

social behaviour

cause and effect

social action

underlying governing principle

Quantitative research aims to: Measure ___ by ___ – for example, how often a patient consults a pharmacist (a consultation being defined in a set of criteria, not as defined by either the patient or the pharmacist)

social behaviour

objective criteria

QUANTITATIVE RESEARCH METHODS

Social surveys

Self-completed questionnaire design

Response rates

Survey question form and content

Data processing

___ are a means of collecting information from large samples of the population relatively quickly and efficiently, and allow comparisons to be made between individuals and groups.

Surveys

___ interviews involve a structured dialogue – the questions are pre-formulated in order to elicit specific answers. These answers form the ___. Success in obtaining the required data depends on asking the appropriate questions.

Social survey

social survey data

There are two principal considerations to be borne in mind when designing ___: The question must be clearly intelligible to the respondent. Care should be taken to ensure that all respondents could provide an appropriate answer to the question.

Social surveys

survey questions

The ___ produces ___ for social scientists but may suffer from being ___ in the sense that it cannot always glean the more subtle aspects of human behavior.

survey method

invaluable data

superficial

___ of survey questions is particularly crucial in the design of a ___

Correct phrasing

self-completed questionnaire design

In ___, while the general nature of the questions to be asked will be determined by the ___ of the survey, the actual selection of questions should be generated from ___ of the population to be surveyed.

self-completed questionnaire design

subject

preliminary studies

before planning specific questions it is important to establish the possible scope of the issues to be surveyed.

self-completed questionnaire design

It is crucial that the information sought cannot be readily obtained from other sources, and that it will achieve the survey’s objective.

Self-completed questionnaire design

In ___, once the questions have been compiled the completed questionnaire should be ‘___ (involves administering the questionnaire to a small sample of respondents)’.

Self-completed questionnaire design

piloted

In ___, the returned questionnaires will highlight any inadequacies in the questionnaire’s ___, and may indicate any potential difficulties with analysis of the ___.

Self-completed questionnaire design

content and wording

full survey data

The success of the survey therefore relies on eliciting the cooperation of the respondent in completing and returning the questionnaire.

Response rates

In ___, it is very important to have a strategy for following up ___ (those unable or unwilling to reply) to a ___

Response rates

nonrespondents

postal questionnaire survey

In Response rates:

o At least ___ should be issued to non-respondents.

o Further reminders may be issued to persistent non-respondents but are likely to have a ___ than the first.

o An alternative to the second reminder, if at all feasible, is to contact the nonrespondent by ___.

one reminder

markedly more reduced effect

telephone

Strategies to ensure an acceptable response rate for postal questionnaires

In ___, the timing for any strategy for issuing reminders is equally important – if issued too early, potential respondents may feel ___, but if issued too late this may indicate to the respondent the survey’s ___ (and possibly its ___).

Response rates

pestered

lack of urgency

lack of importance

In ___, essentially, social surveys involve a researcher administering ___ to a number of potential respondents.

Survey question form and content

preformulated questions

In ___, administering a ___ is indeed relatively straightforward, but the amount and quality of information obtained requires considerable preliminary work prior to administrating the survey if useful and usable data is to be obtained.

Survey question form and content

preformulated question

In Survey question form and content, there are several mistakes to avoid in the difficult task of constructing survey questions.

Inappropriate question form

Loaded or leading questions

Two questions in one

Double negative

Complex questions

Abbreviations, jargon or technical language

Conversational

Ambiguous questions

Vagueness and imprecision

Hypothetical questions

Meaningless or inappropriate questions

It is important to choose the appropriate type (closed or open) to elicit the response desired:

‘Do you have opinions on . . .?’ (closed)

‘What are your opinions on . . .?’ (open)

Inappropriate question form

Implicit in these types of question is the desired or expected answer. An example of this question might be:

‘Do you, like most other pharmacists, consider that the Royal Pharmaceutical Society’s “Pharmacy in a New Age” campaign was a success?’

loaded question

A ___ may produce more information than a ___, though it may not necessarily reflect accurately the individual’s true response. For example:

‘Following the Crown Report on supplementary prescribing, do you think the pharmacist should be involved in prescribing medicines for patients?’

leading question

loaded question

In this case, no simple answer is possible. For instance:

‘Does having a pharmacy within the health centre make querying a prescription with the prescriber easier; has this benefited patients?’

‘Do you think aspirin and paracetamol are appropriate treatments for migraine?

Two questions in one

The answer, ‘Yes’ or ‘No’, to such questions may not convey what the respondent actually believed. For instance:

‘Do you consider not contacting the prescriber about a potential drug interaction on a prescription is unprofessional?’

And taking things to extremes:

‘Do you not think that not continuing to take a prescribed 166 Chapter Nine antibiotic, until the course is completed, is an inappropriate response to failure of the medication.’

Double negative

Similarly, these questions may not permit the respondent to reveal their true beliefs. For instance:

‘If doctors are going to be held responsible for their own budgets do you believe that pharmacists, with their knowledge of drug costs, should have a more interactive role with prescribers at the point when a prescription is written, or not.’

Complex questions

Examples:

‘Do you keep PMRs in this pharmacy?’

‘Do you think the introduction of compulsory CPD will enhance the professional standing of pharmacists?’

These may be confusing to the respondents, and consequently the benefits of using this to shorten the length of the question are outweighed by the risks of eliciting a confused or inappropriate response. Similarly, with the question:

‘After inhaling your bronchodilator aerosol do you hold your breath for ten seconds before exhaling?’

Abbreviations, jargon or technical language

Questions such as:

‘How do you find you get on with the general practitioners?’

‘Do you employ a general assistant to help out in the dispensary?’

In these examples ‘get on’ and ‘help out’ are not defined. The answers to these questions will not be comparable because respondents do not have a shared definition.

Conversational

‘How long has the pharmacy been open?’ Though the question is clearly designed to establish the duration in months and years, the question may invite the facetious answer: ‘Since 8.30 this morning, as usual!’

Another commonly encountered type is contained in the question: ‘How long have you worked in this pharmacy? 0–5 years, 5–10 years, 10–20 years, 20 years or more. The question clearly poses a problem for respondents for whom the answer is 5, 10 or 20 years.

Ambiguous questions

It is important from the outset that it is realised that such questions can only elicit attitudes and opinions, not factual information. For instance:

‘Do you think pharmacists should have access to patient medication records held by the prescriber?’

Hypothetical questions

‘Is the Pharmaceutical Journal as good as the Chemist and Druggist?’ The aims and content of the two publications are completely different, and therefore one is not an appropriate alternative to the other

Meaningless or inappropriate questions

In ___, computer programs designed to process survey data have developed rapidly in recent years and those such as the ___ are relatively simple to master and designed specifically to handle social survey data.

Data processing

Statistical Package for the Social Science (SPSS)

In Data processing, ___ of survey data requires each of the responses to the survey to be assigned an ___.

Computer processing

individual code

It is useful to decide, when planning the survey, what statistical tests are necessary to meet the survey’s objectives.

Data processing

In Quantitative Research Methods, according to ___, data must be:

Data Protection Act (Data Privacy Act of 2012 – RA 10173)

1. Fairly and lawfully processed

2. Processed for limited purposes

3. Adequate, relevant and not excessive

4. Accurate

5. Not kept longer than necessary

6. Processed in accordance with the data subject’s rights

7. Secure

8. Not transferred to countries without adequate protection

In ___, ___ are used to establish whether the overall picture presented by the data occurred because of an actual underlying association or relationship within the data, or whether the relationship is merely a ___.

Analysis of quantitative data

Statistical tests

chance phenomenon

In the Analysis of quantitative data, the key to these statistical tests is the ___.

concept of probability

___ in the statistical sense is a measure indicating the likelihood of an event happening – most usually these events in clinical research describe a relationship or association between two or more events.

Probability

Probability is expressed as a ___ – thus when throwing a dice there is a one-in-six chance of a six coming up.

decimal fraction

The ___ the measure of probability, the ___ our recorded data can be attributed to chance alone, i.e. it indicates an actual rather than chance relationship or association.

greater

less likely

___, by way of direct observation and involvement with people under study, aims for a detailed description and understanding of what people really think, how they structure and organise their thoughts, from where they derive their ideas and how they are likely to act in particular circumstances.

Qualitative research

The emphasis is on naturally occurring events rather than on the aggregation of observations of a series of behaviours, views or attitudes.

QUALITATIVE RESEARCH METHODS

The aim of such research is to facilitate an in-depth understanding and an appreciation of the meanings people attach to what they do or believe.

QUALITATIVE RESEARCH METHODS

Qualitative research aims to elicit:

1. What people ‘___’, from where they derive their ___, how they organise and structure their ideas.

2. How people act in their ‘___’ settings.

3. ___ as it occurs. Unlike in the laboratory it is often unrealistic or impossible to create experimental conditions to control for all, if any, of the extraneous variables – for example, it would be virtually impossible to study behaviour at football matches in such a ‘controlled’ way.

really think, ideas and beliefs

natural

Social action

Main research tools of qualitative analyses

Participant observation

Group interviews/discussions

Semi-structured or conversational interviews.

the observer participates in the daily lives of people under study, observing things that happen and listening to what is said, and then makes notes of his or her observation.

Participant observation

in ___, the researcher, with the aid of a list of relevant topics, guides the conversation among a small group of respondents. Often, the researcher will pursue subjects which emerge spontaneously as well as the ___. The interaction between members of the group is an essential component of a ___, which may also be referred to as ___.

Group interviews/discussions

pre-defined topics

methodology

focus groups

Unlike questionnaires, where the questions are predetermined and uniform to allow for the aggregation of responses, the interviewer talks with the respondent informally around the topics relevant to his or her research. With the aid of a list of topics the interviewer pursues subjects as they arise and follows relevant leads. The role of the interviewer is non-directive and yet not wholly passive, because he or she must assess how what is being said relates to the research focus. Interviewing requires a great deal of skill and therefore the interviewer should be trained so that they possess the necessary qualities.

Semi-structured or conversational interviews.

___ is usually small scale and aims at eliciting a richness of detail rather than statistical generalisations.

Qualitative research

Social science has also gained from ‘___ (detailed examination of a single example or case (for instance, a small society, a pharmacy, an organisation, or a health centre))’ research which often, although not exclusively, uses ___

case study

qualitative research methods.

involves fully participating among those being studied. For example, to understand the impact of pharmacy-based methadone supervision on drug misuse the researcher might operate as a counter assistant to obtain observational data. More likely, however, the method may be adapted to involve the researcher passively watching, listening, keeping diaries, or examining records.

Participant observation

One of the most common forms of data collection in social research.

Interviews

These involve eliciting the same information from every respondent. The questions must be designed to ensure that the answers are comparable and classifiable.

Standardised or structured interviews

two types of standardised or structured interviews

Scheduled interviews

Non-schedule interviews

where the wording and sequence of questions are determined in advance and questions are asked in the same way

Scheduled interviews

where the questions may be asked in any order, as is considered appropriate by the interviewer during the interview. In this case the interviewer is told the information required and is allowed to vary the order and nature of questions if appropriate.

Non-schedule interviews

These may take many forms, but the interviewer is not restricted to pre-set questions as there is no attempt to gain the same classifiable categories of information from every respondent. Such an interview may take the form of ___ or merely a ___ to be discussed.

Non-standardised, depth interviews

specific open questions

list of topics

three important characteristics of Non-standardised, depth interviews method

Flexibility

Responsive or interactive

Probing

the interviewer must be able to adapt and respond to the individual and their circumstances.

Flexibility

the interviewer must keep alert to pursue interesting ideas or ‘leads’.

Responsive or interactive

the interviewer must pursue the respondent’s initial reasoning by asking further questions.

Probing

involves the collection and analysis of data. Focused in actual data, which means the analysis and development of theories happens after you have collected the data.

Analysis using grounded theory

a set of ideas that provides an explanation for human society. Theories are selective in terms of their priorities and perspectives and the data they define as significant. As a result they provide a particular and partial view of

Analysis using sociological theory

The majority of pharmacists, rather than carrying out their own research, will increasingly be required to use research evidence to inform their practice. To do so requires a critical evaluation of published work, whether it is original research or in the form of a ___.

MAKING SENSE OF RESEARCH EVIDENCE

systematic review

Practitioners should be equipped to establish the validity and usefulness of the results.

MAKING SENSE OF RESEARCH EVIDENCE

Key questions to ask when evaluating published research

1. Did the study have a clearly focused research question?

2. Were the research methodologies appropriate for the research question?

3. Were the methodologies correctly applied?

4. In review articles, were all the relevant studies included?

5. Are observed differences between groups statistically significant?

6. Were the reported outcomes of the research considered from all relevant perspectives; for instance, if a pharmacy service was evaluated, was the perspective of users, providers and other stakeholders such as general practitioners considered?

7. Are the results generalisable or transferable to the general population?

8. Are the conclusions supported by the results?

The research question determines the ___

research methodology

The validity of the results is determined by the ___ of the ___

robustness

research instrument

All research requires consideration of ___.

reliability, validity and causality