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Tratamiento de las metastasis en CCR metastásico 1.Metastasectomía

I.I NTRODUCCIÓN

1.5. Tratamiento

1.5.3. CCR Avanzado o metastásico

1.5.3.2. Tratamiento de las metastasis en CCR metastásico 1.Metastasectomía

The methodology adopted in this thesis was designed to perform research activities involving a model validation as well as exploration and verification of potential factors that influence acceptance of new technology. Specific methods implemented to meet this need were determined based on certain research paradigms and theoretical perspectives (Kuhn 1970, 1996; McMurray 2008). To determine research paradigm and approaches used in this thesis, prior relevant scientific theories were examined and taken into consideration.

The framework shown in Figure 4.1, displaying linkages between methods and their related paradigms as proposed by Healy and Perry (2000), was used in constructing the methodology.

FIGURE 4.1 A REPRESENTATIVE RANGE OF METHODOLOGIES AND THEIR RELATED PARADIGMS

Source: Healy and Perry (2000)

An exploratory literature review, personal interviews, surveys, multivariate analysis and structural equation modelling techniques are the methods used by studies employed under the positivist paradigm. The use of quantitative methods to perform theory and extant model testing authenticated the positivism existence. Besides, the examination of relationships among the constructs in technology acceptance through hypotheses tests

Methodology In-depth interviewing and focus groups

(with an interviewer protocol)

Theory-testing research: emphasis on measurement Paradigm In-depth interviewing and focus groups

(with an interviewer protocol)

Theory-testing research: emphasis on measurement Paradigm

indicated the use of positivism paradigm. Specifically, it was demonstrated by the measurement method of the technology acceptance constructs that follow an assumption requiring the measurement result to be a single apprehensible reality (Healy & Perry 2000). The summary of the paradigm elements proposed by Sobh and Perry (2005) shown in Figure 4.2 supports this proposition. However, reflecting methods adopted in this thesis only to the elements of a paradigm was considered insufficient for philosophically confirm the scientific position taken in this research, and further offered to the technology acceptance theory development. In respond to this, it is important to examine the research activities involved in this thesis by applying postulates recognised in a post-positivist perspective. An initiative to undertake a post-positivist review of the Technology Acceptance Model conducted by Silva (2007) was referred for establishing essential philosophy foundations to meet this purpose.

FIGURE 4.2 FOUR SCIENTIFIC PARADIGMS

Source: Sobh and Perry (2005)

Three prominent philosophical views assembled by Silva (2007) are highlighted in this chapter. They include Popper’s principle of demarcation (1972, 2005), Kuhn’s normal science paradigm (Kuhn 1970, 1996), also known as the disciplinary matrix, and the Lakatosian ‘core and protective belt’ progressive scientific framework (Lakatos 1978).

First, this thesis was viewed from Popper’s perspective (1972, 1995). According to Popper, to be accepted as scientific work, studies in technology acceptance like TRAM or TAM research must be examined to determine whether they can meet the principle of demarcation. This principle separates scientific theory from pseudo-science based on the requirement that a theory has to be falsifiable. To scientifically claim that research findings constitute new knowledge, the methods used to produce them must be designed to maximally falsify the existing theories. Consequently, research studies must not rely solely on the implementation of confirmatory procedures or tecnniques. This avoids the trap of directly drawing conclusions based only on the results of confirmatory testing of the data to fit the existing models.

To address Popper’s standpoint, his demarcation principle was implemented in this thesis.

It was applied by questioning and validating the configuration of TRAM in light of construct interrelationships to perform an act of theory falsification. More specifically, the role of technology readiness (TR) as the main antecedent of TAM, as well as the interdependent relationships among variables, was revisited and retested. The possibility of TR performing a different role in the acceptance model was allowed. It was expected that the results of this thesis would not only confirm the existing TRAM or TAM model, but would also challenge the unproven existing or previous theoretical beliefs while simultaneously revitalising and relating them to the more acceptable and improved theories. This proposition was specifically reflected in two main stages of this research, which are the determination of the situation setting for data collection and the model rectification method. The data collected for validating the proposed model were obtained in an

‘uncontrolled normal situation’, where technology adoption was not normatively or formally directed by an institution, as in a work situation. The data were obtained from ordinary potential consumers who possessed the freedom to choose an adoption option. In taking this approach, Popper’s argument was addressed with confidence because the use of intention as the construct indicating adoption was ensured to be scientifically acceptable.

In a normal situation, like that of the respondents in this study, the logical connection between intention and actual usage action follows a contingent causal relationship, not an analytical relationship. Thus, the requirement for scientifically claiming the findings can be supported by the logical connection argument (as referred to in Silva 2007; Anscombe 1957; Melden 1961; Wittgenstein 1953; Wright 1971; and Silva 2007). This argument requires that a consistent approach be applied to the relationship between factors involved in a causal relationship, whether it is a contingent or a necessary (analytic) connection. The former requires the presence of natural processes, while the latter does not. The choice of a normal situation for this research signified the existence of natural processes, made visible by the hypotheses concerning the influence of the moderator

variables. Theory falsification was also confirmed by the rectification procedure conducted to achieve the model fit. In performing this procedure the reseacher adopted a mental attitude to remain open to any possible new configurations of the model based on the primary data obtained from the field.

Second, Kuhn’s philosophical perspective (Kuhn 1970; 1996) provided sound support for this thesis in confirming its scientific nature. In opposition to other post-positivists who view the progress of science in terms of abstract theory integration, Kuhn suggests an accumulation of concepts instead. His standpoint was known as the normal science conception, promoting the view that scientific knowledge is socially constructed, negotiated and evolving. The concept was operationalised by the use of the paradigm known as the disciplinary matrix. This paradigm enables research within a particular disciplinary field to be conducted using different methods. A paradigm was employed to perform ‘a puzzle-solving activity’, and:

[i]t defines and characterizes the subject matter of a discipline through the institutionalisation of a fundamental model of the domain and associated knowledge-producing practices. (Silva 2007, p. 8)

On this account, a paradigm is constructed using two major constituents. The first is a set of exemplars for problem-solving and achievements, while the second refers to the existence of exemplary theory development. These components are reflected in scientific activity through instruments, techniques, approaches, and specific methods adopted to solve an observed research problem.

The Technology Acceptance Model (Davis, Bagozzi & Warshaw 1989b) and Technology Readiness (Parasuraman, A. 2000), acting as the major components of the conceptual model developed in this thesis, have consistently displayed a good fit and appropriate characteristics to become a solid paradigm. An identification of the information system research paradigm termed ‘TAM’ can be gained from the exceptional analysis of the model performed by Silva (2007). According to his review, three main points characterise TAM as a paradigm. First, TAM has received a tremendous number of citations and has been continously and thoroughly investigated in many ongoing studies. Second, TAM has been adopted as a baseline model in many research studies for further modification and development. Third, as a consequence, TAM has become an enabler for various instruments, methods, techniques and procedures to be applied in many research studies.

These findings on TAM strongly support its role as a paradigm in the present research.

Similar findings were found with regard to technology readiness (TR). This model has

been a focus of many studies, following a similar pattern to the application of TAM. It can therefore be concluded that this thesis involved the use of a paradigm in aiming to meet the research objectives. The fact that this was achieved through implementation of exploratory and confirmatory statistical techniques, structural equation modelling (SEM), as well as other methods, further evidenced that a paradigm was put into operation. SEM, in particular, is the most common method employed to test a theory. As pointed out by Tabachnick and Fidell (2007), researchers are required to acquire prior knowledge and develop hypotheses about potential relationships among research variables to solve an essential issue or problem. In other words, the aim of this thesis is to undertake puzzle-solving activity that confirms the effort to make significant scientific progress, thereby filling the gap in technology acceptance research regarding the absence of moderator variables in previous models.

Third, the prominent concept about the methodology of scientific research programs introduced by Lakatos (1978) is an essential perspective referred to in this research to endorse the positivist paradigm. According to Lakatos, a research program must demonstrate a set of theoretical assumptions committed and defended by their proponents. In Lakatosian terminology, the committed assumptions are ‘core’ (Lakatos 1978; zenker 2006). Proponents thus endorse and defend the credibility of assumptions behind the core, and hence assumptions are maintained as unquestionable. Technically, the core is protected by auxiliary hypotheses developed in research-based programs.

Lakatos referred to the hypotheses as a ‘protective belt’ (Lakatos 1978; zenker 2006). As a result, a theory is preserved and developed based on a stable and credible core in a particular research domain. In practice, the Lakatosian concept was operationalised by a heuristic method, which can follow positive or negative approaches. A positive heuristic approach is employed when the research design keeps the core permanently unquestioned. A negative heuristic involves the modification of hypotheses to protect the core. The mechanism of employing these two forms of heuristics is the essence of scientific progress, demarcating research programs into two categories: as either a progressive or a degenerative research endeavour. This thesis was intended to produce progressive-type research findings by employing a positive heuristic. The existence of TAM and TR constructs in the research model were defended and maintained as the core, demonstrating that theories were presented to establish robust scientific findings. The progressive nature of this research was assured through the auxiliary hypotheses investigating the role of moderator variables in technology acceptance formation and those questioning the construct configuration previously proposed by the existing TRAM model. The puzzle-solving mechanism demanded by Lakatosian methodology was made visible by performing an exploratory literature review to identify possible moderator

variables. It was also supported by the exploration of dimensionality analysis in which exploratory factor analysis was adopted.