Philosophical Paradigm

A philosophical paradigm, the researcher’s worldview, underpins any study. The paradigm plays a critical role, guiding the way in which the researcher conceives the research objectives and approaches the research process; contributing to the research outcomes, and

78

(to some degree) even determining the nature of results. According to Denzin and Lincoln (2000, p. 19) a paradigm is a combination of (a) the researcher’s ontological perspective (what is the nature of reality?), (b) their epistemological views (what is the nature of the relationship between the inquirer and knowledge?), and (c) their methodological premises (how does one gain knowledge of the world?). Crotty (1998) describes four elements of the research process: epistemology, theoretical perspective, methodology and methods. Each element informs the other to create the overall research paradigm.

Creswell (2014) on the other hand prefers the term ‘worldview’ to describe a researcher’s overall philosophical orientation, as does the researcher of this study. The term

‘worldview’ simply defines the researcher’s general orientation and beliefs about the world and nature of the research that they hold. The researcher’s ‘worldview’ will often

determine the research approach they predominantly embrace. Fundamentally, the researcher of this study holds that humans are complex, holistic (physical, mental, emotional and spiritual) beings living in and influenced by a socially and culturally constructed world. To understand human behaviour and phenomena requires a holistic and integrative perspective, that is, a perspective that considers the whole person as being interconnected, and not separate, to the world around them. Therefore the underlying worldview of this study is social constructionism and the theoretical perspective interpretative.

Constructionism is defined by Crotty (1998) as a worldview where meaning is not

discovered but constructed, where “there is no objective truth waiting for us to discover”,

but that “truth, or meaning, comes into existence in and out of our engagement with the

realities in our world”, and argues that “different people construct meaning in different

ways” (p. 8-9) to the same phenomenon. Social constructionism on the other hand

considers that all meaningful reality is socially constructed as people engage with others in the world they are interpreting (Crotty, 2003), meaning, people view the world through the lens of their own cultural and social perspective. The use of the word social in social constructionism emphasises the social mode of meaning generation (Crotty, 1998). Social constructionists view knowledge as socially constructed through language and interaction (Tracy, 2013). Interpretivismis based on the view that that there is no universal truth. Any understanding must therefore arise from interpretations that are created from within the

79

researcher’s frame of reference. Interpretivism views reality as being an essentially

subjective social product that is constructed and interpreted by humans, according to their beliefs and value systems (Crotty, 1998; Esterberg, 2002; Grant & Giddings, 2002).

3.2.1 Theoretical perspective of the study

The theoretical perspective adopted for this research was interpretive. Grant and Giddings (2002, p. 16) describe the interpretive approach as a paradigm that involves “listening to

people” and attempts to “understand what it is to be human and what meanings people attach to events of their lives”. Interpretivists assume that reality is constructed via the

meanings people give through their experiences and “individuals are actively involved in making sense of the world they are experiencing” (Schembri & Sandberg, 2002, p. 195). An interpretive approach was considered appropriate because the CAM phenomenon is multifaceted and can be viewed differently by different people according to their experiences, knowledge, beliefs, values and social context. To understand the CAM

phenomenon from a CAM consumer’s perspective the study focused on the ‘lived

experience’ (Thompson et al., 1990; Schembri & Sandberg, 2011) of CAM consumers and explored how CAM consumers constructed meaning about health and wellbeing by focusing on what they value from their CAM health care.

Holbrook and O’Shaughnessy (1988) have argued the need for an interpretive perspective

in consumer research for many years, recognising “the need for interpretation in our attempt to explicate the meanings embedded in consumer behaviour” (p. 400). Schembri

and Sandberg (2011) acknowledge there has been an increasing acceptance of the interpretive research approach within the marketing field over the past 30 years. Consumer researchers, such as Schembri and Sandberg (2002; 2011), Thompson (1996, 1997), Thompson, Locander and Pollio (1989, 1990), Thompson and Troester (2002), and Arnould and Thompson (2005) not only advocate the use of the interpretive approach in

consumer research but espouse the importance of research that focuses on the consumer’s ‘lived experience’. Schembri and Sandberg (2011, p. 168) explain

our lived experience of the world enables us to make sense of ourselves, other and the things we encounter every day. Hence, within the interpretive research tradition, the human world is never a world in itself but always an experienced world.

80

The researcher’s view is that ‘reality’ is a moment in time and our interpretation of the world is based on our personal experiences, beliefs and values. She argues that to truly gain insight into human (consumer) behaviour requires not only a deep understanding of personal experiences in a socially and culturally constructed world, but must also acknowledge the individual as a complex holistic being. Understanding consumer value and the CAM phenomenon she contends required a holistic interpretative approach. This research has captured ‘moments’ in the CAM consumer’s ‘lived experience’ that has given the researcher an understanding into how CAM consumers perceive and create value from CAM health services providing insights into the CAM phenomenon and its place in modern health care.

3.2.2 The qualitative research approach

The methodological dimension of the research paradigm identifies the researcher’s

philosophy about how knowledge of the world is gained and governs our choice and use of methods (Crotty, 1998). Other authors, including Creswell (2003) view methodology as a philosophical approach, rather than as a dimension of the paradigm. Qualitative methods have traditionally been positioned as sitting in opposition to quantitative methods as a

philosophical approach, but the situation today is “less qualitative versus quantitative and

more how research practices lie on a continuum between the two” (Cresswell, 2003, p. 4),

and depends on the researcher’s world view. Interpretive approaches have become equated

with a qualitative research approach to data collection, analysis and interpretation (Esterberg, 2002; Grant & Giddings, 2002; Spiggle, 1994).

Qualitative research primarily aims to understand a human or a social problem in its natural context and generalises to theory. As opposed to a quantitative approach which typically uses measurements and statistics to test and validate theory, and to ascertain whether it can be generalised to a population. Van Maanen (1983, p. 9) argues that qualitative research

is at best an umbrella term covering an array of interpretive techniques which seek to describe, decode, translate, and otherwise come to terms with the meaning, not the frequency of certain more or less naturally occurring phenomena in the social world.

81

The aim of qualitative research is to build a rich, holistic picture, and a deep understanding of a phenomenon within a particular context (Miles & Huberman, 1994). Denzin and

Lincoln (2000) describe qualitative research as a “situated activity” that places the

researcher “in the world”. The qualitative researcher is seen as employing various interpretative practices to help “make the world visible” (Denzin & Lincoln, 2000, p.3). This involves making sense of the phenomena being studied in terms of the meanings that people in the relevant natural settings bring to them. A qualitative approach typically involves the collection and analysis of a range of empirical materials (such as case studies, personal experiences, interviews, artefacts, texts, and interactions) that describe “moments

and meanings in people’s lives” (Denzin & Lincoln, 2000, p. 3).

3.2.3 Qualitative approach in consumer research

Denzin (2001) argues that critical qualitative inquiry in consumer research is imperative to

understanding today’s consumer and consumption behaviour. Historically, consumer

research has been dominated by positivistic quantitative methods which still continue

today despite a “revolt” against this dominant paradigm in the 1990’s (see Reid & Brown,

1996; Hirschman, 1989; Brown, 1995, Hirschman & Holbrook, 1992; Brown, 1995). However, the transformations in qualitative research made in this period have remained

and scepticism towards qualitative inquiry as ‘soft’ research has diminished (Denzin, 2001; Goulding, 2005). A new respect for qualitative research has emerged as more researchers recognise the contributions it has made to consumer and marketing theory, management implications and policy (Bellenger, Bernhardt, & Goldstucker, 2011).

3.2.4 Rationale for use of qualitative approach in this study

This research adopted a qualitative approach as it was considered an appropriate design to investigate the research problem of what and how CAM consumers perceive and co-create value and to understand further the CAM phenomenon. Of particular importance to this study, qualitative methods have been advocated as the best strategy for exploring a new

area, such as CAM, to understand people’s “lived experience” and generate conceptual

frameworks (Miles and Huberman, 1994). Qualitative methods are also inherently flexible, and can be varied in the course of the study, according to the nature of emerging findings

82

(Spiggle, 1994). This is beneficial when little is known about the phenomenon being investigated (Miles and Huberman, 1994).