Positivist Position

A detailed discussion of the philosophy of research practice is beyond the scope of this thesis. However given that some of the research undertaken might be thought to fall in part under social science, wherein importance is placed on ‘philosophical position’ taken in a research study, it was thought advisable to identify the philosophical position that was taken. An important point within the various treatises on research is that there are several perspectives from which research could be approached. In view of that, it was thought that at the outset the perspective of the research should be established so that the area of knowledge which has been developed would be clear. As established by Creswell (2003), philosophical ideas remain largely hidden in research but as they influence research they need to be identified. He also pointed out that the beliefs held by an individual as a result of variety of factors like background, experiences or field often influence the nature or direction of the research. For such reasons the author like others has suggested that a researcher should make explicit the larger philosophical ideas they espouse (Bowling, 2002; Saks and Allisop, 2007).

The positivist philosophy is acknowledged as being broad and variable depending on the researcher and research purpose (Bowling, 2002; Saks and Allisop, 2007; Creswell, 2003; Bryman, 2008). It is therefore worth starting off by looking at the fundamental definition of the actual notion of positivism that was first coined by Auguste Comet. This is that the view taken in positivism is mechanistic in that knowledge is concerned with ‘facts’ and the observed world and social laws underpin the development of the human species (Bowling, 2002).

The principle of deductivism is the regular approach to research of the positivist paradigm (Bowling, 2002; Saks and Allisop, 2007; Bryman, 2008; Creswell, 2003).

Page | 44 According to Bryman (2008), the researcher, on the basis of what is known about a particular domain and theoretical considerations in relation to that domain, deduces a hypothesis (or hypotheses) that must then be subjected to empirical scrutiny (Bryman, 2008). Hence, the perspective of the positivism paradigm is that theory and the hypothesis deduced from it come first and drive the process of gathering data.

This study was consistent with the positivist approach. However, as expounded in the work of Bryman (2008), usually associated with quantitative research, when the deductive approach is put into operation, it often does not follow the sequence outlined in its pure form. This current study was predominantly deductive in orientation, in that ‘theory’ was implicit in the literature review on the topic in form of accumulated knowledge brought together from articles and books. As Bryman (2008) had observed, the literature consisted of reports around which the study would be focused and on which data collection and analysis would subsequently be geared in order to illuminate the research issues. Another similar feature of this study was the lack of specification of the hypothesis (a prediction the researcher makes about expected relationships among variables). As a general rule, specification of hypothesis will be found with experimental research (Bryman, 2008; Creswell, 2003, Smith, 2005). In addition the study aims reflected a deterministic perspective where causes probably determine effects or outcomes. This was also apposite to the positivist belief (Saks and Allisop, 2007; Creswell, 2003). However, for the present study it was not set out to establish a causal relationship.

This study had clearly established aims informed by the literature highlighted in Chapter 4 and Chapter 5 respectively. The shortage of published studies regarding the two populations of interest supported the need for the investigation of alternative medicine use among consumers in the health shops and the in- patients in a secondary healthcare within the UK. Thus, the aims of the study were to examine the pattern of use of alternative medicine by the consumers and in- patients. This was followed by obtaining attitudes informed from views and previous studies in the literature. This resulted in the further aim of examining the consumers and in-patients attitudes to alternative medicine from their own

Page | 45 individual perspective. The perspective of adverse outcomes as dealt within the literature was associated with side-effects and potential interaction between alternative medicine and conventional drugs. The final aim of the study was to examine the possible incidence of adverse outcomes of alternative medicine as used by the consumers and in-patients in the two population settings.

In brief, a cross-sectional survey study design was carried out which involved the use of pre-designed questions relating to the study aims in face-to-face structured interviews of a sample of alternative medicine consumers purchasing in health shops and in-patients in a secondary healthcare setting. The inclusion of self-filled questionnaires by staff in health shops in the study is discussed in detail in Chapter 4. Data analysis included statistical analysis i.e. frequency distribution, chi-squared test and with a quantitative content analysis being adopted as necessary.

The sample of the population in this study fitted with the principle of generalisability within the positivistic belief. Generalisability is trying to ensure that data obtained may be reliably extended to the population studied (Saks and Allisopp, 2007). Generalisability sought in the study was also the same as Borg and Gall (1989) had defined. The positivist approach acknowledges variations in human behaviour but requires general patterns that hold across individuals. This assumption of generalisability, as pointed out by Borg and Gall (1989), shows how the positivist philosophy also supports the quantitative type of research.

The methodology used in this study is best described as “quantitative” (Saks and Allisop, 2007; Creswell, 2003; Borg and Gall, 1989; Bryman, 2008) and thereafter inherently carries with it attributes that assign it to the positivist paradigm. As proposed in the various discourses quantifying human behaviour, the assumptions about objectivity, neutrality and generalisability place the methods used squarely within the realms of the positivist paradigm. Saks and Allisop (2007) also explained that while trial designs, in particular randomised control trials, are the most commonly associated designs within the realm of positivism, they agreed that the foci may be different and suggested that there are others like cross- sectional designs which are also based on a positivist assumptive base.

Page | 46 Bryman’s (2008) further observation was also that while the experimental investigation may fit the model of ‘hypothesis-testing’ well, on the other hand it is agreed that survey-based studies are often more exploratory than this view implies. A point is that although concepts have to be measured, the nature of their interconnections is frequently not specified in advance. Consequently the position is that analysis of quantitative data is far more exploratory than is generally appreciated and offers opportunities for the generation of theories. The author further proposed that the common portrayal of quantitative research as exclusively an exercise in testing pre-formulated ideas fails to appreciate the degree to which findings frequently suggest new departures and theoretical contributions. Hence, Bryman (2008) pointed out that unlike an interpretivist stance, quantitative research is only concerned with testing of hypotheses and fails to recognise the creative work that goes into analysis of data and interpretation of findings. Another instance in this study was for example seeking the individual perspective with the use of words ‘open questions’ to examine the consumers’ and in-patients’ attitudes to alternative medicine. Bryman (2008) put forward a valid argument that the proponent of qualitative research essentially claims it is only through qualitative research that the world can be studied through the eyes of the people who are studied. His clarification to this through the Platt (1981) observation was that this contention was rather at odds with the widespread study in attitudes in social surveys based on interviews and questionnaires in quantitative research. To clarify further on the point, Creswell (2003) had pointed out that often the distinction between quantitative and qualitative research is framed in terms of using numbers or closed questions ‘quantitative hypotheses (quantitative) rather than word or open-ended questions (qualitative). However, that the approaches are not as completely discrete as might be perceived. The argument was that quantitative and qualitative approaches should not be viewed as polar opposites or dichotomies; instead, they represent ends on a continuum. A study tends to be more quantitative or qualitative.

Purportedly, according to Bryman (2008), interpretivism is a term that usually denotes an alternative to the positivist orthodoxy. Not surprising then, this paradigm has been contrasted to the positivism paradigm (Saks and Allisop, 2007; Creswell, 2003). Generally, the interpretivism paradigm respects the differences

Page | 47 between people and the objects of natural sciences and therefore requires the social scientists to grasp the subjective meaning of social action (Bryman, 2008). Therefore, the distinction is that the interpretivist researcher is not interested in observing patterns in group behaviour, but rather the focus is on single individuals. The interpretivist researcher will therefore tend to use qualitative methodologies, for example in-depth interview, focus groups or ethnographic observation. They will be likely to involve a research site and observe behaviour of an individual without preparing predetermined questions or conducting an interview in which the individual or groups is allowed to talk openly about a topic, largely without the use of specific questions.

There are several bases for argument regarding views on research practice. Part of the debate for this study had been that the positivist and interpretivist positions or quantitative and qualitative research methodologies that fit within either are different. However that they are not completely so antithetical that they never overlap. According to Bryman (2008) this actually belies practice or reality. As discussed, the purpose of this section was not to debate on the broad philosophical perspectives in research practice. However it was thought that it would be useful to clarify that the current study was more inherent with the positivist views and that an overlap of the approach might exist with the beliefs of other research perspectives.