Philosophical concepts

There are three words which underpin philosophical concepts; ontology (What is reality?) refers to our assumptions about the nature of things, epistemology (How do you know something?) represent our belief about how one discovers knowledge related to the world, and methodology (How do go about finding out?) presents what we do with the instruments and techniques of research (Guba, 1990).

4.2.1 Ontological perspective

The ontological view is a nature of the reality related to subjective and multiple existences (Creswell, 2007; McNiff & Whitehead, 2006). This research project has adopted an approach with draws on the techniques of evaluating stroke participants who attend sessions using OT-MCS rehabilitation. The ontology can be reflected in the occurrence of participatory rehabilitation by stroke participants who provide evidence of outcomes. The existing value comes from the real context which impacts on the therapeutic activities, which are selected and engaged in by stroke participants

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in order to sustain or improve their functional performance in activities in everyday life.

Consideration of the uniqueness which embraces individuals, societies, geographies and cultural lifestyles of stroke participants underpins the moral context. This approach had been evaluated in the efficacy of the OT-MCS management for stroke rehabilitation. The use of OT-MCS provides real activity engagement for stroke participants who can generate and implement by themselves further application within their homes, workplaces, and social environments. Importantly, this system framework empowers stroke participants who live and learn in different ways as well as cultures. They have their own values and can decide for themselves through the offering of various optional pathways in the rehabilitation programme to improve the quality of life.

4.2.2 Epistemological position

Epistemological position is a relationship between the researcher and those being researched which conveys how knowledge can be explained with reference to existing evidence in the specific context (Creswell, 2007; McNiff & Whitehead, 2006). The implications of the outcomes of intervention suggest the potential of OT- MCS for stroke rehabilitation. Moreover, the evaluation has been considered within the individual context of stroke participants in terms of their performance and value related to their functional ability involving relevant activity skills and functional requirements.

The approach is not only based upon theoretical knowledge, but also on the groundwork of collaboration with stroke clients, family members, and OTs. Knowledge translation emerges from the specific and individual contexts of stroke clients. Therefore, the participants, both stroke clients and OTs, work together in all stages of the rehabilitation process to investigate their appropriate individual practices. The knowledge from collaborative processes can be helpful in the adoption of a variety of therapeutic activities across various regions of Thailand.

4.2.3 Methodological strategy

Methodology is the process for discovering the answer to the research question, which is generated from the groundwork of research design and procedure to fit with the research context (Creswell, 2007; McNiff & Whitehead, 2006). The project

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involves OT practitioners, stroke clients, family members, and stakeholders in participatory action in the use of OT-MCS. The development of therapeutic media was generated by OTs and stroke participants who participated and shared their experiences in diversifying activity items.

Communication and negotiation through collaborative team working and the sharing of information between stroke participants and OT providers produces the capacity to cope with difficult situations and identify an appropriate way to solve a problem. The understanding of nature, culture and way of life of stroke participants should be transformed suitably into the contextual framework of the rehabilitative programme. Maintaining patients’ potential skills and improving their functional performance in daily life will lead to better practice in their home and social environment.

Single method (quantitative or qualitative) studies may not be enough to discover relevant information due to the limitation of a narrow research design which does not fit the nature and context of investigation. Consequently, a single method may not discover answers that are essential to increase knowledge and information (Meekun, 2008). Mixed methods research combines qualitative and quantitative approaches into the inquiry thus helping to answer the question which singular research methods cannot in one paradigm (Jones, 2004a; Johnson & Onwuegbuzie, 2004). In general terms, the combination of both qualitative and quantitative methods in a single or multi-phase research study is called a mixed methodology (Tashakkori & Teddlie, 1998). This mixed methods approach is employed to expand the understanding from one method to another in order to integrate and confirm the findings from different data sources. Hence, the rationale for integrating both quantitative and qualitative data in this study is captured as follow;

- To comprehend clearly the nature of research contexts and problems by blending both numerical data from quantitative methods and textual data of qualitative approach

- To explore participants’ perspective and their engagement in the use of OT- MCS and carry out an evaluation leading to the development of effective therapeutic media and tools for rehabilitation

- To take data from mixed methods to convey the needs of stroke participants using OT-MCS and future development

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Before designing the research, the philological assumptions need to be considered which provide a sound basis for the research including: the research philosophy; research strategy; research method (mixed methods design); sampling strategy and mapping of the complete research process.