What are the factors that facilitate and/or hinder CWE’s and parents’ disclosure of the child’s epilepsy to others?
What are the consequences of disclosing the child’s epilepsy to others for CWE and parents of CWE and how does this make them feel?
What is the relationship between CWE’s epilepsy disclosure behaviours and their self-reported demographic and clinical characteristics?
What is the relationship between parents’ disclosure behaviours surrounding a child’s epilepsy and parent-reported demographic characteristics and parent-reported demographic and clinical characteristics of the child?
What is the relationship between CWE’s epilepsy disclosure behaviours and their perceived stigmatisation, illness attitudes, self-perception, health-related quality of life (HRQoL), social support, level of epilepsy-related communication with their parents, need for epilepsy-related information and support, and satisfaction with level of epilepsy-related information received during their engagements with HCPs?
What is the relationship between parents’ disclosure behaviours surrounding their child’s epilepsy and their stigma perceptions, responses to their child’s illness, general tendency to disclose distress to others, perceived social support, level of epilepsy-related communication with the child, perceptions regarding the level of disability and activity restrictions experienced by their child due to epilepsy, perceptions regarding the impact of the epilepsy on the child and the family, need for epilepsy-related information and support, and satisfaction with level of epilepsy-related information received during their interactions with HCPs?
What is the relationship between CWE’s epilepsy disclosure behaviours and parents’
epilepsy disclosure behaviours?
What is the relationship between CWE’s epilepsy disclosure behaviours and parent-reported psychosocial and illness attitude variables?
What is the relationship between parents’ epilepsy disclosure behaviours and child-reported psychosocial and illness attitude variables?
3.3 Mixed Methods Research
In the present study, a mixed methods research design is implemented in order to address the research aims and the specific research questions posited. Varying definitions of mixed methods research have been proffered (O’Cathain and Thomas, 2006). However, according to Creswell & Plano Clark (2007), mixed methods research can be defined as a research design (or methodology) that: “focuses on collecting, analysing and mixing both quantitative and qualitative data in a single study or series of studies.” (p. 5)
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Qualitative research involves the collection of open-ended information that is typically analysed by aggregating words or images that display some elements of commonality into categories or themes. In contrast, quantitative research involves the collection of closed-ended information that can be statistically analysed to test hypotheses or to answer research questions (Creswell & Plano Clark, 2007).
Proponents of mixed methods research advocate for the combination of both qualitative and quantitative approaches (i.e. the collection, analysis and integration of qualitative and quantitative data), proposing that such a design facilitates the research problem being more comprehensively addressed than either approach could offer alone.
3.3.1 Pragmatism
Pragmatic epistemology is the philosophical perspective that informs and underpins the mixed methods approach that is employed in the present study. Counter to the incompatibility thesis i.e. the assertion that combining qualitative and quantitative methods is epistemologically problematic (Howe, 1988), under the philosophical paradigm of pragmatism, it is argued that qualitative and quantitative research designs can be mixed (Robson, 2002). Pragmatists maintain that primary importance should be placed on the research question(s) rather than on the method or the paradigm underlying the method (Creswell & Plano Clark, 2007). In fact, pragmatism is not bound to any particular system of philosophy or reality (Cherryholmes, 1992; Murphy & Rorty, 1990). Instead, the basic tenet underpinning the pragmatic philosophy is that the techniques, methods and procedures that best address the needs of the researcher in attending to the research objectives are those that are most appropriate to employ (Robson, 2002). Thus, multiple methods of data collection can be utilised if such an approach is deemed likely to best answer the research question (Robson, 2002).
Tashakkori & Teddlie (2003) highlight that pragmatism has been embraced by many researchers; many view it as the paradigm that offers the best foundation for mixed methods research as it facilitates the simultaneous use of qualitative and quantitative methods (Howe, 1988). Thus, pragmatists are proponents of mixed methods research and advocate for: 1) the combination of methodological approaches; 2) the utilisation of the most practical data collection approach that is available to address the research question(s); and 3) the integration of findings from the multiple data collection approaches adopted (Creswell and Plano Clark, 2007). Johnson & Onwuegebuzie (2004) argue that according to the pragmatic perspective, mixed methods research should involve mixing research approaches in ways that enable the best opportunities to integrate the insights yielded from both qualitative and quantitative research into a workable solution.
A pragmatic approach to research aims to address the anomalies inherent in paradigms suited only to quantitative or qualitative approaches. In terms of the usefulness of a pragmatic
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approach in connecting theory and data, pragmatists argue for abductive reasoning which involves alternating back and forth between using inductive (data-driven) reasoning and deductive (theory-driven) reasoning inherent in qualitative and quantitative approaches to research respectively. Morgan (2007) postulates that such an approach facilitates researchers in first translating observations into theories and then examining those theories through action. In the present study, the researcher engages in such an abductive process, with the inductive results from the qualitative phase informing the deductive objectives of the quantitative phase.
3.3.2 The Advantages and Disadvantages of Mixed Methods Research
There a number of advantages to using mixed methods research. Adopting a mixed methods approach allows the researcher to capitalise on the strengths and offset the weaknesses of both quantitative and qualitative research (Creswell & Plano Clark 2007; Doyle, Brady & Byrne, 2009; Johnson & Onwuegbuzie, 2004). Quantitative research is frequently criticised for not taking into account the subjective voice of the participants (Creswell & Plano Clark, 2007;
Cherryholmes, 1992). Many would also argue that quantitative research fails to convey information regarding the contextual factors surrounding people’s opinions (Doyle et al., 2009;
Johnson & Unwuegbuzie, 2004). In contrast, qualitative research comes under criticism due to the fact that analysis of the data is subject to interpretation by the researcher and thus is open to bias (Doyle et al., 2009; Johnson & Onwuegbuzie, 2004). Additionally, due to its time-consuming nature, qualitative research generally involves the utilisation of small sample sizes.
This limits the generalisability of findings (Johnson & Onwuegbuzie, 2004). Proponents of mixed methods research suggest that such weaknesses inherent in using either of the approaches alone can be compensated for by using both approaches in combination (Creswell
& Plano Clark, 2007; Doyle et al., 2009; Johnson & Unwuegbuzie, 2004). Furthermore, addressing a research question via two methodological approaches can offer a more complete answer than could addressing the research question using one approach alone by ensuring that a more holistic representation of experiences or associations is attained (Barbour, 1999; Doyle et al., 2009; Farquhar, Ewing & Booth, 2011; Tashakkorri & Teddlie, 2003).
Other advantages of mixed methods research include the following: it can facilitate the researcher in addressing research questions that cannot be answered by qualitative or quantitative approaches alone (Creswell & Plano Clark., 2007); it encourages multi-disciplinary collaboration (O’Cathain, Murphy & Nicholl, 2008); it is ideal in exploring topics where there is a dearth of empirical evidence (O’Cathain & Thomas, 2006); and it is a practical approach which facilitates the researcher in using any and all methods necessary to address the research problem under investigation (Johnson & Onwuegbuzie, 2004). Furthermore, evidence can be strengthened through convergence and corroboration of findings across the various phases of the study, enhancing the generalisability and transferability of the findings (Johnson
& Onwuegbuzie, 2004).
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The challenges of using mixed methods research are that it is a time-consuming and resource intensive process. This is particularly salient when the mixed methods research design involves the conduct of sequential studies with distinct phases (Ivankova, Creswell & Stick, 2006).
Additionally, mixed methods research is a complex process and requires the researcher to be familiar with both qualitative and quantitative data collection whereas generally most investigators are only trained in one form of inquiry (Doyle et al., 2009). Finally, conflicting findings across methods can be difficult to contend with and many researchers fail to consider the integrative element (Creswell & Plano Clark, 2007). With adequate planning, resources and training, the challenges associated with mixed methods research can be overcome.