3 INTRODUCCION
3.2 Anemia en el cáncer colorrectal
3.2.3 Tratamiento de la anemia perioperatoria en el cáncer colorrectal
One of the major discussions within philosophy centres on the debate surrounding epistemological and ontological issues (Blunden, 2009). Scientific research is strongly based on epistemological assumptions which assert evidence of knowing and moreover a coherent structure of epistemological, ontological, axiological and methodological reasoning which can direct research (Cresswell, 1998). Research philosophies reflect underlying assumptions in relation to the nature of reality and validity in knowledge which in turn influence the research design from initial phases to conclusion (Easterby-Smith et al., 2012). Consequently reflection on differing philosophies is important to understanding and ensuring the adoption of an approach congruent with achieving the research goals (Blaikie, 2000). Saunders et al., (2009) argue for a practical approach to the selection of a research philosophy in asserting that the highest priority should be the research question. Blaikie (2000) further underlines the significance of aligning research approach and design with the research problem to avoid incoherence within the study.
Three main philosophical perspectives have been considered reflecting differing ontological and epistemological views influencing the underlying approach to this research. Blaikie (1993) suggests that in social sciences research ontology involves claims on what exists, its nature and characteristics, what units it is constituted of and how these interact. Ontological perspectives are generally divided between two different positions asserting either that reality is concrete and external and exists independently of human perception, or that reality is subjective and exists only in human consciousness (Saunders et al., 2009). Selection of an
Page | 77 appropriate research approach further involves epistemological assumptions on the most appropriate ways of inquiring into the nature of reality (Easterby-Smith et al., 2012) and is informed by and depends on the ontological position adopted (Hatch and Cunliffe, 2006).
According to Eriksson and Kovalainen (2008) epistemology involves questions regarding what constitutes valid knowledge and its sources and limits and further assert that perspectives on these issues impinge on the research methods selected. A fundamental epistemological issue is whether the social world can be studied utilising the same principles, methods and philosophical approach as the natural sciences (Bryman and Bell, 2007).
One of the principle research philosophies, positivism, links to the ontological belief in the concrete and external nature of reality which accordingly can be measured in an objective manner unrelated to context (Bryman and Bell, 2007). This provides the basis for the formulation of laws and generalisable conclusions (Remenyi et al., 1998) which in turn offers an appropriate scientific foundation for the generation of a broadly applicable model of IT systems risk awareness. Positivist research can further support the investigation of causal factors in IT risk management practices and their observable outcomes such as risk awareness in a quantifiable manner which can be numerically analysed (Remenyi et al., 1998).
Positivistic research has the advantage of being able to provide wide coverage of a range of situations, nevertheless positivistic methods can be inflexible and artificial and may fail to provide a deeper understanding of the processes related to IT risk awareness and management or the significance and meaning which the actors involved in risk management attach to actions (Saunders et al., 2009). This suggests that positivistic approaches may not be fully suited to exploring the deeper significance and influence of the factors involved in the understanding, usage and level of risk awareness and impact on the quality and success of risk management.
The contrasting position of interpretivism emphasises humans as social actors (Bryman and Bell, 2007) and contends that reality is socially constructed, multiple, and only properly understood in the context from which it emerges (Wimmer, 2012). Therefore it is perceived as important for the researcher to understand the interpretation and meaning which actors attach to social phenomena and the contextual factors which determine and influence these meanings, which is viewed as possible mainly through qualitative research methods (Saunders et al., 2009). Such an approach can potentially provide a more in-depth, insightful and richer understanding of the specific social situation of IT system risk awareness within
Page | 78 the sample police force (Easterby-Smith et al., 2012). However the significant focus on context and socially constructed meaning potentially limits wider generalisability of the research findings (Saunders et al., 2009).
Therefore consideration of both positivism and interpretivism suggests potential methodological constraints for the achievement of the research objectives. Another perspective is realism which incorporates elements of both philosophies in accepting the positivist argument that phenomena and events exist independent of human thought and experience, while asserting that knowledge of them is created through social conditioning (Saunders et al., 2009). Hatch and Cunliffe (2006) argue that realism focuses on explaining phenomena in the social world through understanding the social structures from which they have emerged and how these may empower or constrain social actors, in addition to how these can be critiqued and changed. Realism further posits examination and understanding at multiple levels and different angles in order to contribute to knowledge (Chia, 2002).
Nevertheless realists assert the importance of a scientific approach to the development of knowledge which implies that social phenomena can be studied empirically using quantitative methods. In contrast to positivism, however, realism focuses more on explanation and understanding than prediction (Blaikie, 1993). This provides the basis for a research approach combining the flexibility of interpretivist theories to examine social phenomena while grounded in the empirical approach which characterises positivism.
On balance, consideration of the three research perspectives has led to the adoption of a realist view as the most suitable for answering the research questions. A significant advantage of adopting a realist perspective is the endorsement of a mixed methods approach to research which can be selected in accordance with the type and goals of the project (Zachariadis et al., 2010). Given the multi-layered and multi-dimensional nature of this research the value of utilising mixed methods lies in the ability of the different methods to mutually inform each other to reveal relationships between context-specific practices and changes that are happening at another level of analysis (Kaplan and Duchon, 1988). This means that the research questions can be linked in multi-level analysis and the findings may be systematically cross-referenced. Zachariadis et al., (2010) claim that mixed methods research provides strong cases for basing proposals for change at practice or policy levels.
Page | 79 4.3 Research Strategy
A mixed method case study based strategy combining quantitative and qualitative methods has been adopted. A case study has been defined by Yin (1994) as: “an empirical enquiry that investigates contemporary phenomena within its real life context especially when the boundaries between phenomenon and context are not clearly evident.”(p.13). The case study method utilising a range of research techniques has been used to study risk management. This approach facilitates the collection of data on a research situation from a small number of organisations using multiple data sources. The case study approach helps to generate empirical and in-depth qualitative data depending on the methods employed (Yin, 1994) and is widely employed in management research studies (Gummesson, 2000). Case studies are
“of particular value in situations with a relatively underdeveloped theoretic base or where complex observational tasks are involved and it is necessary to capture the complexity or dynamism of the context or organisational setting” (Harrison and Leitch, 2000). This is particularly justified given the subjectivity surrounding risk awareness identified in the literature. In research cases where an in-depth analysis is necessary, the case study approach is highly recommended as they answer the questions of ‘how’ and ‘why’ or when it is difficult to differentiate the organisational context from the research phenomena (Yin, 1993).
Given complexity of the organisational context in relation to the research topic a case study strategy offers the opportunity to gain a holistic view of risk awareness multiple methods focused on specific objectives (Eisenhardt, 1991; Gummesson, 2000; Yin, 1994).
This strategy is significantly informed by Creswell and PlanoClark (2007) who explain that mixed methods research can be viewed as both a methodological approach and a method in itself. From a methodological perspective mixed methods research is underpinned by philosophical assumptions which influence the means and methods used to collect and analyse data and the combination of qualitative and quantitative approaches. When considered as a method the principal assumption is that utilising a blend of both quantitative and qualitative approaches contributes more enhanced understanding of research problems than can be obtained from a single approach alone (Creswell and PlanoClark, 2007).
A mixed methods research is associated with a number of advantages over traditional research structures. Principally the opportunity to compensate for weaknesses in any one specific approach is afforded (Jick, 1979). For example quantitative research is more
Page | 80 removed from participants and is limited in terms of providing understanding of contextual factors. These limitations can often be mitigated in the increased interaction with research participants characteristic of qualitative research which enables a more in-depth understanding (Creswell and Plano-Clark, 2007). In contrast qualitative research can engender greater risk of bias in the degree of subjective interpretation required which is balanced by a broader use of participants in quantitative research. Therefore in supporting the combination of a range of methods, philosophical assumptions and theories mixed methods research is able to provide a more holistic and complete understanding (Creswell and Plano-Clark, 2007).
In particular, the choice of method is influenced by the data required to best address the research objectives which in this study utilises both quantitative and qualitative methods.
Quantitative research methods have been used extensively in risk management research to facilitate standardised and measurable data which lend themselves to empirical conclusions (Saunders et al., 2009). The emphasis on scientifically-derived objective data offers the potential to make inferences on the collective understanding and practice of risk management within the UAE based on the sample population (Easterby-Smith et al., 2012). Quantitative research is concerned for example with the percentage of employees or managers who indicate a high level of risk awareness. Despite the acknowledged authoritativeness and legitimacy of quantitative methods it can therefore run the risk of overlooking critical knowledge and understanding. Quantitative methods are limited in providing sufficient insight through numerical representation of the complexities involved given the psychological, behavioural, social and cultural dimensions identified in the literature in relation to risk awareness.
This factor underpins the rationale for adopting a qualitative approach. In contrast qualitative research aims to capture the subjective understandings of reality from the perspective of the participants (Easterby-Smith et al., 2012). This allows for gaining greater comprehension of the perceptions of participants in relation to IT system risk awareness and its influence on risk management effectiveness. Qualitative data is non-standardised data based on words and meaning and are often richer and able to offer a more rounded view of a social phenomenon (Saunders et al., 2009). Easterby-Smith et al., (2012) explain that qualitative research enables a more informed and detailed view of perceptions, attitudes, feelings and motivations for behaviour which is highly relevant for this research in terms of gaining deeper insight into
Page | 81 risk awareness and resulting conduct. A qualitative approach focuses on individual cases and the human perspective and understanding embedded within those cases and questions the why and how of factors in relation to risk awareness. This approach allows for the intricacies of the social aspects of organisational contexts in relation to risk awareness to be clarified and understood by means of a more in-depth and comprehensive investigation.