This chapter will discuss both the methodological and research approaches employed within the present study. The discussion will begin by considering the research paradigms, and their influence upon both the quantitative and qualitative methodologies used. It also delineates the theoretical paradigms. This will be followed by a justification of the utilisation of the ‘phenomenological’ approach and its place within the research paradigms and methodologies. Finally, the research processes used in the study will be reviewed, focusing on the application of ‘phenomenology’ for data collection. Data analysis and a detailed discussion of the components of the research processes are outlined, which include: research procedures, study design, the sampling plan chosen with ethical considerations. Emphasis was placed on the design of the scales, with the pilot study testing its reliability and validity. The following processes were employed to facilitate mix-method data collection: recruitment of participants, data collection tools, demographic data, rationale and strategies for analysing the data and data protection issues.
Methodology and Design
Research paradigms and philosophy
Research paradigms and philosophies are significant influences upon research methodologies. Indeed, it is important to explore them to select and use the appropriate research design and data collection strategies. Due to Clark, Huddleston-Casas, Churchill, Green and Garrett (2008, p. 1543), “a research paradigm is a perspective based on a set of shared assumptions, values, concepts, and practices”. Furthermore, Clark et al. (2008) defined a paradigm as the function of how the researcher considers the development and nature of knowledge. Additionally, a research paradigm is a combination of two ideas that are related to the nature of the world, as well as to the function of the research (Clark et al., 2008). Willis, Jost and Nilakanta (2007, p. 110) explain that the term ‘research paradigm’ refers to an overall perception regarding the intricacies of the real world. In research, interpretivism and positivism represent the two main opposing paradigms in regards to the real world, which are used by researchers to gather proof for their hypotheses (Clark et al., 2008). In addition, both the qualitative and the quantitative methodological approaches are said to be complimentary (Jack & Raturi, 2006).
The predominant focus of this study is the quantitative and qualitative frameworks, which are both vital for the capture of data on the topic of professional stigma. This dual approach means that perspectives on clinical insight and scientific investigation are covered (Guba & Lincoln, 1994). Due to Bryman (2006), a mixed-method approach involves the combination of quantitative and qualitative data being collected and analysed accordingly. This approach was adopted, as the researcher believes that using the techniques and methods from both approaches would most appropriately facilitate the investigation of my original research aims and objectives. In addition, checks on scientific investigation should always be evaluated in terms of their practicality and validity, because clinical models can be sensitive (Link et al., 2004; Lucas, 2014). “Selecting the correct methodological techniques plays a crucial role in the research, as the methodologies define the type of data collected, which in turn influences the results and the interpretation of the nature of the research problem” (Johnson & Onwuegbuzie, 2004, p. 26).
There are different methods for obtaining data under quantitative and qualitative research. Quantitative research involves an objective formal approach, with numerical data findings, and the most common methods of data collection being questionnaire-based surveys, observation, documentary methods, and experiments (Johnson & Onwuegbuzie, 2004). Notwithstanding, the quantitative and qualitative models are differentiated by separate philosophies, and the findings suggest that the data elicited by the qualitative approach involved more proximity between subject and researcher mediated by observation and interviewing techniques, while the quantitative researchers may have relied on more remote, indirect methods of arriving at data (Morrow, 2007).
In a quantitative approach, quantitative methods involve the collection of impartial measurable data through assessments, polls or questionnaires followed by its numerical or statistical analysis, or the reanalysis of already obtainable data by computational techniques. Quantitative research focuses on gathering statistical data and on examining its pattern across groups of people or other variables, with the goal of exploring the specific phenomena and understanding observed events and trends (Rubin & Babbie, 2016). In quantitative approaches, the positivism paradigm necessarily implies a numerical paradigm (Jack & Raturi, 2006). Positivism is predicated on the notion that societal actors respond to exogenous triggers and motivators, and social phenomena must necessarily be observed and interpreted based on the empirical enquiry by applying the deductive method (Johnson & Onwuegbuzie, 2004). Positivism posits that reality is natural, objective, recordable and capable of being reduced to testable propositions (Johnson & Onwuegbuzie, 2004).
In this perspective, the purpose of an analytical enquiry is to understand events, and their interrelatedness, so that societal law may be discerned and recorded and converted to tools for forecasting future probabilities (Morrow, 2007). Positivism is a whole and indivisible reality, which is apprehended and recorded through the filter of sensory perception (Jack & Raturi, 2006). Through this process, the observations recorded by social scientists were deemed ‘things’, equated to concrete phenomena, which separated the observer from the object the subject of the observation, a technique which facilitates the preservation of impartiality (Johnson & Onwuegbuzie, 2004) Likewise, quantitative researchers apply deductive reasoning to observed phenomena, and through objectivity the researcher can substantiate causality of events commensurate to the theory and produce predictive data related to the research study objectives (Johnson & Onwuegbuzie, 2004).
In a qualitative approach,the interpretivism paradigmnecessarily implies a non-numerical narratives paradigm (Jack & Raturi, 2006). It is in direct opposition to positivism and provides a tool for criticism of positivist ideology (Jack & Raturi, 2006). Exponents of interpretivism, by contrast to positivists, do not adhere to the idea of one reality that is both real and recordable. Instead, interpretivism believes in the existence of multiple realities, which may not only be dissimilar but may change per time and location (McEvoy & Richards, 2003). To identify the goal of research methodology from the interpretive perspective, one must go beyond the interpretive approach by developing “explanations of why things happen in a specific way in phenomena” (Jack & Raturi, 2006, p. 345). This is attributable to the fact that reality is a matter of subjective experience and perception, which is also subjectively interpreted by such a society. As a subjective interpretation, reality is nothing more than how people interpret it. From the perspective of interpretivism, it is human beings who are best placed to interpret their social world, since reality is a mere subjective projection, which colours how such human beings perceive and interpret the social interactions taking place (Jack & Raturi, 2006).
Therefore, interpretivism emphasises that the aim of social studies is not to study supposed inherent laws of society, but rather to understand the frameworks of meanings that members of society use to understand the society in which they live. Qualitative research examines the subject’s experiences of phenomena, and the role of the researcher in a qualitative study highlights the collaborative process of knowledge production within the research field. The qualitative researcher acknowledges their own position as part of the research, eliciting knowledge of lived phenomena through experience and meaning making attributed by their participants. Qualitative researchers seek to negate the limitations of experimenter bias through
reporting the participant’s experience from their individual understanding (Bradley, Curry, & Devers, 2007).
Relationship between paradigms and methodology
The mixed method approach, together with the qualitative and quantitative approaches, is a key research methodology. Andrew and Halcomb (2009) believe “mixed method” is a third major methodological approach, offering something other than entirely quantitative or qualitative practices. Tashakkori and Creswell (2007, p. 303) have stated that mixed methods are “research in which the investigator collects data and integrates the findings and draws inferences using both qualitative and quantitative approaches or methods in a single study of inquiry”. Mixed methods research combines elements of qualitative and quantitative research approaches for the broad purpose of increasing the depth of understanding. The definition of mixed methods, from the first issue of the Journal of Mixed Methods Research, is “research in which the investigator collects and analyzes data, integrates the findings, and draws inferences using both qualitative and quantitative approaches or methods in a single study or program of inquiry” (Tashakkori & Creswell, 2007, p. 303). Mixed method research started in anthropologist and sociologist circles from the 1960s, and in the next two decades, “triangulation” started to be mentioned in methodology discussions (Morse, 1991).
Triangulation refers to the combination of methodologies used in a study of the same phenomenon to reduce the level of inherent bias presented using a single method (Morse, 199; Creswell, 2013). In addition, this allows for both the common elements and the differences to be found, triangulated and theories created thus (Creswell, 2013). Wahabet al. (2012, p. 617) state “that triangulation, under the context of social science, consists of two or more theories or approaches in one research study of a specific phenomenon to help reach the desired construct”. This way, research questions can be addressed, establishing trustworthiness and wider applicability to the research (Wahabet al., 2012).
Another possible benefit of using mixed methods is that the research can gain credibility since the qualitative approach offers detailed reasoning compared to a quantitative study through the depth of meaning to numbers with the use of narrative and dialogue (Mackenzie & Knipe, 2006). It has been mentioned already that 'paradigm' in this paper is used for the philosophical aim or foundational theoretical framework and reason for the researcher to undertake the study at hand. Data collection methods can be used in conjunction, and a researcher most often falls in line, philosophically, with an existing paradigm, which is built
from different aspects, and aim to create unique results (Wiersma, 2000). Due to Mackenzie and Knipe (2006, p. 193), a "researcher's theoretical orientation has implications for every decision made in the research process, including the choice of method”. This philosophical debate "left educational research divided between two competing methods: the empirical scientific tradition, and the naturalistic phenomenological mode" (Mackenzie & Knipe, 2006, p. 205).
In modern times, research methodologies are more complicated from a design aspect and can be more openly involve the necessary methods, with mixed-methods becoming more widely used. The mixed-methods approach allows for numeric as well as text data to be collected, and so the end database includes both quantitative and qualitative findings (Creswell, 2003, p. 20). Symonds and Gorard (2010, p. 121), stated that combined or mixed-methods research are found to be a "key element in the improvement of social science, including education research" (p.7) with research strengthened using a variety of methods. Symonds and Gorard (2010) argues that mixed method research "requires a greater level of skill" (p. 7), "can lead to less waste of potentially useful information" (p. 7), "creates researchers with an increased ability to make appropriate criticisms of all types of research" (p. 7) and often has greater impact, because figures can be very persuasive to policy-makers, while stories can be recalled easily and repeated when trying to illustrate a point (p. 7). Numerous experts, such as Creswell et al. (2003), and Thomas (2003) consider qualitative and quantitative approaches to be mutually beneficial when selecting suitable investigation approaches. Paradigms, which are largely in favour of mixed methods approaches, give an opportunity for the question to establish the data collection and analysis methods used, gathering quantitative as well as qualitative data and integrating the data at various parts of the inquiry (Creswell, 2003; 2013).
Philosophical underpinning for the mixed methods approach
Mixed methods research methodologies are growing in popularity for nursing research aiming to increase understanding of nursing phenomena (Polit & Beck, 2008). In this regard, the quantitative and qualitative paradigms represent different philosophical approaches to, and views on, scientific investigation (Morrow, 2007). “A quantitative study is based on the concepts of manipulation and control of phenomenon and the verification of results, using empirical data gathered through the sense; conversely, qualitative research is concerned with gaining insight and understanding into an individual’s perception of events” (Nieswiadomy et al., 2012, p. 1959).
In logical investigations into the phenomenology, Kafle (2013) points out that, in the context of research, phenomenology describes the study of phenomena: their structure and meanings. Methodologies of a phenomenological nature are especially efficacious in highlighting people’s experiences, sentiments and viewpoints, and thus, bring into question extant normative presumptions and commonly held opinions. They are primarily concerned with how reality is viewed through the prism of experience or how it is altered in consciousness, as the aim of the phenomenological researcher is to provide a vivid rendition of lived experience. Dowling (2004) and Langdridge (2007, p. 4) refer to phenomenology as a branch of philosophy that seeks to concentrate on individuals’ perceptions of the world and what they represent to them; a focus on people's “lived experience".
Describing it as a qualitative method; Langdridge notes that “phenomenology focuses on human consciousness”, as it relates to the meaning and the way meaning is mediated through experience. Even though phenomenology can be defined as the philosophical study of the structures of experience and consciousness, the movement’s thoughts have relevance beyond philosophy and have made a valuable contribution to other academic fields: phenomenological traditions can be found in the disciplines of psychology and psychiatry for example (Cohen, Kahn, & Steeves, 2000). Indeed, within the nursing research field, phenomenology and phenomenological practice are becoming increasingly common (Annells, 1996). Nevertheless, nursing literature is starting to mirror concerns regarding researchers’ use of phenomenological approaches, while simultaneously neglecting the philosophical foundations of phenomenology itself (Cohen et al., 2000). When phenomenological research is augmented with an interpretive element, it may then be employed as a foundation for practical theory, thereby allowing its utilisation in education, substantiation or the questioning of existing activities or policies in the future (Stanley & Wise, 2002).
Throughout this study, the idea that lies at the foundation of Heidegger’s philosophy, which relates to interpretive phenomenology “Hermeneutic phenomenology”, shall be expounded and assessed regarding the methodological understandings they facilitate in the process of being employed for phenomenological research (Heidegger 1992, p. 15-16). Heidegger (1889-1976) has reinvigorated the concept of phenomenology by shifting the emphasis away from consciousness and essence to a new accent on its existential and hermeneutic (interpretive) facets (Kafle, 2013). Moreover, other explanations of hermeneutic philosophy are provided by Zahavi (1996, p. 245), and the emphasis on interpretation is based on the traditional hermeneutic philosophy that unifies understanding by “language-critical thinking”, within
“textual meaning,” “dialogue,” “preunderstanding,” and “tradition”; an approach that determines that any objective experience involves some degree of interpretation. It is significant that the methodological process chosen for development of the nursing field is defendable, and that it is seen to be in line with the philosophical timbre of the research in question, as well as the research aim (Annells, 1996; Dowling, 2004). Martin Heidegger claims that human beings cannot be understood except as existing within the day-to-day physical world in which we are empirically and pragmatically embedded (Heidegger 1988, p. 18). Heidegger refers to this as ‘Dasein’ that is ‘Being-in-the-world’ (Tracy, 2010, p. 837-838; Kafle, 2013). Heidegger’s view makes the key point that the relationship between people and their environment is essentially active; he claims that we are not passive spectators of our surroundings and that the environment is not merely a collection of objects surrounding us; both these elements are defined by their relationship to each other, creating thus a web of functionality (Heidegger 1988; Willis et al., 2007).
Furthermore, Heidegger (1992) argues that the way humans interpret experiences is affected by five key elements, including how we exist as part of a social reality – ‘life world’; the objects that are of value to us and how our ability to self-interpret allows us to realise that we physically exist at specific points in time (Kafle, 2013). When conducting interpretive phenomenological analysis, one begins by examining every transcript and identifying a specific unit of meaning, while maintaining the autonomy or uniqueness of individual experiences. The next step is to identify any correlations between the independent units of meaning that could potentially characterise the experiences of the collective group (Willis et al., 2007, p. 100).
Willis et al. (2007, p. 110) noted, for a preliminary introduction to the method, that it is necessary to identify a few steps. The first step in carrying out a phenomenological research project is through “selecting the phenomenon that will represent the shared experience” (Tracy, 2010, p. 837). Following the process of choosing a suitable phenomenon, the researcher may then proceed to the interview stage, and in this instance, this relates to the professional mental health team. Due to Tracy, the researchers must produce appropriate questions for the group they are interviewing (2010, p. 840). The following actions will ensure that the study progresses: querying, expanding, developing and confronting answers, as these will result in clearer output (Kapungwe et al., 2010). Finally, the data should be collected (Lester, Hannon & Campbell, 2011). Further details appear in the section ‘Phase Two Data Collection’. “The reliability of the research data will relate to the depth and quality of the researchers’ understanding of the participants’ experience” (Lester et al., 2011, p. 1058).
In assessing the data, the researcher must seek to locate the “universal nature of an experience” (Tong, Flemming, McInnes, Oliver, & Craig, 2012, p. 1). Data analysis includes the highlighting of “significant statements, sentences, or quotes that provide an understanding of how the participant experiences the phenomenon” (Tracy, 2010, p. 840). These steps will enable the researcher to achieve “understanding of the participant’s experience” ( Tong et al., 2012, p. 1). It was previously explained how this study utilises a mixed-methodology design approach as it was suggested that the methodological choice should be dependent upon the nature of the real problem (Tracy, 2010). Using the techniques and methods from both approaches would most appropriately facilitate the investigation of my original research aims and objectives (Creswell, 2009).
Additionally, in this study, a mixed-methodology design was used to collect data regarding mental health professional viewpoints, and these were evaluated using thematic analysis of professional stigma. This permitted a more comprehensive and in-depth deliberation and investigation of a certain phenomenon. Self-reports and a focus group discussion “consider human, experience, preferences and tendencies, in which sentiments and views are connected to services, ideas and products that are devised”, (Miles & Humberton, 2002, p. 27). The main role of the researcher within the data collection is, due to Kitzinger (1995), to persuade and motivate participating individuals to be more concerned and become included in the dialogue taking place, thereby motivating them to speak about the subject matter in question. Furthermore, the employment of a focus group within the qualitative approach increases validity, as the concepts and the conversations with participants may be substantiated, verified or disagreed with throughout the discussion stage under the interpretive paradigm (Webb & Kevern, 2001). According to Ricoeur (1991, p. 105) “Hermeneutic phenomenology marked a significant shift away from the ideas expressed by its earlier exponents”. Nelson (2000, p. 150) stated, “Proceeding on the acceptability of innumerable interpretations of the phenomenology, which preclude the reduction of this school of thought seeks to penetrate the subjective experience and establish the real, objective nature of the things as sensed by the individual”. At the core of Hermeneutic phenomenology is the “subjective experiences of individuals and groups”, according to Willis et al. (2007, p. 104), while the term has been enlarged beyond the