Purposive sampling is a process where the participants are chosen for their knowledge and ability to articulate this information. Theoretical sampling is a process most commonly used in grounded theory research such as this study where participant’s quantities are not pre-determined at the beginning of the study. The researcher will carry on interviewing until “saturation point” is reached where no new data is forthcoming (Whittaker, 2010).
Whilst a qualitative approach was used for this research a mixed method approach could have been applied in order to give a more rounded approach to the study. Beginning with an attitude survey would have highlighted positive and negative opinions which could have been followed up with focus groups and interviews organised to include participants with a range of different opinions.
The qualitative research approach adopted by the study was a participatory user involvement one. The study states that it was unable to use a collaborative approach as the palliative care organisations were not available. However a user controlled approach could have been used giving rise to less criticism with regards to it being tokenistic which can be directed at user involvement approaches. Using an action research approach which involves the researcher and participants becoming equal stakeholders lends itself to a more anti-discriminatory and anti-oppressive approach to research (Whittaker, A, 2010), and would have been another option for this study. The power perceived by a participants involved in a research project can be detrimental especially if this is reinforced by those conducting the research with them taking control of the process (Strier, 2006). What sets action research apart from other forms of research approaches are the key elements of change and participation of those who are fundamentally affected by the issue being researched (Alston and Bowles, 2003). Referring this back to the study being discussed both these elements were identified and could have informed another approach to this research.
The research study used focus groups and interviews to gather data. Focus Groups can be an economical and fast way to gain information. However, it can also be counter- productive in that some people may not feel they can speak out if they are not in consensus with the group thinking (Alston and Bowles, 2003). This could be especially relevant with regards this study if one person in the group had a negative experience with their social worker whilst everyone else was reporting positive experiences on their interaction with their social worker. The study states that most people however opted for one to one interviews which would allow people to express their opinions in private.
Although the study states that interviews were transcribed it does not state what form the questions took. However as the study adopted a grounded theory approach, questions would have been informed by previous interviews and themes that had been identified. The study does state that interview schedules were piloted with service users and this coupled with the use of a grounded theory approach suggests that a semi-structured approach to interview questions was used. This would create some flexibility within the interview whilst still maintaining sufficient structure to enable data analysis (Whittaker, 2010). One to one interviews used in the study would allow the interviewer to use their communication skills both verbal and non-verbal to assist the participants to feel comfortable, open and explore their feelings regarding the questions. This does however mean that is could be possible for the interviewer to lead a person or pressure them. The interviewer needs to be aware of any power or political implications that may influence the process (Alston and Bowels, 2003). This could be important especially when dealing with vulnerable people such as the ones taking part in the study as they may feel they need to answer in a certain way as they are dependent on the service they are being questioned about. Researchers should protect the identity of participants involved or if this is not possible as with this study the participants were picked by the social workers then confidentiality should be provided (Neuman, 2006).
The study adopted a grounded theory approach to data collection and analyses. Grounded theory was developed by Strauss and Glaser in 1967 and is now one of the most widely used qualitative research methods in social work research (Oliver, 2012) Its emphasis is on the inductive construction of categories through a process of constant comparison of themes and analytic concepts(Shaw and Gould ). The researcher analyses the data via comparison and cross checking as it comes in and then codes it. Using a process called theoretical sampling they use the emerging themes to shape further data collection (Alston and Bowles, 2003). In the study themes were further examined to identify concepts and links. These links and concepts were then cross checked between the different types of service users within the study i.e. Their age, sex ethnicity, type of illness/bereavement etc. to see if there were any differences between themes identified within these groups. This further constant comparative analysis adds to the validity of the research as it highlights other issues such as culture or gender differences.
Whilst Grounded theory is set within the qualitative interpretivist paradigm of research it has a distinctive positive perspective ingrained into it due to its constant comparative process and cross checking of data. This enables an audit trail of the emerging theory to be seen which adds to the validity of the process (Charmaz, 2010). Critics of qualitative research suggest that it is subjective, unreliable, difficult to replicate, amounts to a generalisation ,has a lack of transparency and does not have the scientific credibility of quantitative research (Della-Porta and Keating, 2008) Denzim et al (cited in Barusch, Gringeri and George,2011) criticized the parallel concepts and expectation that to gain validity and credibility qualitative research has to mirror the criteria set out for quantitative research stating that research paradigms of qualitative research are based on relativism and fundamentally at odds with the concept of achieving a criteria to gain “truth”. This led to an emerging criterion for qualitative research based on a relational quality incorporating the stance of the researcher, a reciprocal relationship between the researcher and the researched, power influences and reflexivity (Barusch, Gringeri and George, 2011). Looking at this criteria criticism could be aimed at the study which used a user-participatory approach when a collaborative approach would have allowed for a more reciprocal equal relationship with the researchers.
Guba (cited in Shenton, 2004) proposed four criteria that should be observed by qualitative researchers to gain trustworthiness in their work. They are credibility, transferability, dependability and confirmability. These criteria are used within the Litva and Jacoby Tool for Appraising Qualitative Research (Litva and Jacoby, 2007). According to this tool for research to gain credibility it needs to have included member checking, negative case analyses, constant comparative analyses and triangulation.
During the study researchers checked the information they had analysed with a steering group to ensure that their interpretations matched up with their actual experiences. This process is called member checking. They maintained an awareness of possible “grateful patient syndrome” and counter balanced this by asking questions that might encourage a negative response ensuring negative case analysis. Using a grounded theory approach ensured that they used a constant comparative analyses. Triangulation is a process used to ensure validity of findings in research and is achieved by the use of a variety of methods, data collection and sometimes researchers (Alston and Bowles, 2003). The study only used two methods of data collection, interviews and focus groups, when they could have also used observation and feedback forms as well. However, data was cross checked and compared vigorously and interviews were transcribed and analyses checked with steering groups which would ensure that triangulation was achieved.
The focus of the research was to obtain service users’ views on their personal experience with specialist palliative social work. In general the research outcomes showed that service users greatly valued the social work practice they received. In particular two elements were highlighted as central to this care. The relationship they had with their social worker and the qualities and skills they felt the social worker brought to the role. With regards to the relationship they had with their social worker the word friendship was continually mentioned. When broken down this friendship relationship was characterised by reciprocity and a flexible professional relationship. Some service users felt this was a unique relationship and compared this with their negative perception of social workers in other fields of work. These findings are important if social work is to maintain credibility and respect as a profession it needs to be based on evidence based practice (Davis, 2008). To do this evidence from research needs to be used in effective interventions (Davis, 2008). However, it is important to be aware of how that evidence is obtained and for what purpose (Trevithick, 2010). Historically research has been primarily funded by government bodies which has produced important social research that has gone on to inform policy and legislation. However it has been argued that this research has also been used to achieve politically agendas and can therefore not be assumed to have no bias attached to it (Davis, 2008).
The research study shows a collaborative relationship between social workers and service users, a relationship where they are both deemed to be on the same side, working together in alliance against a common problem (Koprowska, 2010). In a smaller scale study relating to social workers and mental health patients, Proctor (2002) found similar findings and stated that social workers providing qualities associated with friendship such as warmth, empathy and a friendly attitude affected the working alliance between them and the service users which in turn achieved more successful outcomes. Both studies are dealing with service users in a health environment and it could be argued that the findings would be difficult to replicate in a statutory environment such as child protection where there may be elements of deception and mistrust from the outset which has to be balanced with the safety of children (Shaw and Gold). However, the GSCC code of conduct states that social care workers must… Strive to establish and maintain the trust and confidence of
service users and carers… (GSCC, 2002). The research study also outlined other studies which had similar outcomes with service users identifying similar skills and qualities which they valued in their social workers.
Once a research study is completed and results verified, planning for maximum impact of the results of the study is just as important as the planning process to conduct the initial research (Wadsworth, 1997). The results of a research study are only valuable if they are broadcast to a wider audience where their impact can be felt. This will involve ethical, political and practical issues. Ethically the researchers are accountable to whoever funded the research along with the people involved and the key stakeholders such as those that will benefit from the findings (Alston and Bowels 2003). Referring this to the research study being discussed, as the findings could have an impact on the broader issues of social work practice it is important that this information is received by policy makers and managers of social work practice.
In conclusion social work research is fundamentally important if the modernisation of services into a truly knowledge evidenced based practice is to be achieved. Timing of research can also be an important factor when looking at the implication to practice. The research study being discussed was conducted at a time when there was a review of social work practice underway. The findings show that reflexivity and a flexible professional relationship between social workers and service users can be an integral part of a successful working relationship which leads to positive outcomes for all involved. The findings are transferable across all sections of social work practice and can inform a mutually collaborative working relationship. The implications to policies are that it reinforces the involvement of service user and user-led approaches and lends itself to an anti-oppressive and anti-discriminatory approach to social work care.
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