Research and theory for nursing and midwifery: rethinking the nature of evidence.
Background and Rationale: The rise in the principles of evidence-based medicine in the 1990s heralded a re-emerging orthodoxy in research methodologies. The view of the randomised controlled trial (RCT) as a 'gold standard' for evaluation of medical interventions has extended recently to evaluation...
| Publicado en: | Worldviews on Evidence-Based Nursing (Wiley-Blackwell) Vol. 2; no. 2; pp. 75 - 84 |
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| Formato: | case study Journal Article |
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Wiley-Blackwell
2005 2nd Quarter
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106508510&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106508510 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1545102X 0PW jtl: Worldviews on Evidence-Based Nursing (Wiley-Blackwell) issn: 1545102X maglogo: Y pubinfo: dt: 2005 2nd Quarter vid: 2 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106508510 17611621 2009011815 10.1111/j.1741-6787.2005.05003.x NLM17040544 106508510 ppf: 75 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Research and theory for nursing and midwifery: rethinking the nature of evidence. aug: au: McCourt C affil: Reader, Thames Valley University, Westel House, 32 Uxbridge Road, London W5 2BS, UK; Chris.McCourt@tvu.ac.uk sug: subj: Midwifery Professional Practice, Evidence-Based Clinical Trials Episiotomy Labor Support Patient Education Support, Psychosocial Systems Theory ab: Background and Rationale: The rise in the principles of evidence-based medicine in the 1990s heralded a re-emerging orthodoxy in research methodologies. The view of the randomised controlled trial (RCT) as a 'gold standard' for evaluation of medical interventions has extended recently to evaluation of organisational forms and reforms and of change in complex systems--within health care and in other human services. Relatively little attention has been given to the epistemological assumptions underlying such a hierarchy of research evidence.Aims and Methods: Case studies from research in maternity care are used in this article to describe problems and limitations encountered in using RCTs to evaluate some recent policy-driven and consumer-oriented developments. These are discussed in relation to theory of knowledge and the epistemological assumptions, or paradigms, underpinning health services research. The aim in this discussion is not to advocate, or to reject, particular approaches to research but to advocate a more open and critical engagement with questions about the nature of evidence.Findings and Discussion: Experimental approaches are of considerable value in investigating deterministic and probabilistic cause and effect relationships, and in testing often well-established but unevaluated technologies. However, little attention has been paid to contextual and cultural factors in the effects of interventions, in the culturally constructed nature of research questions themselves, or of the data on which much research is based. More complex, and less linear, approaches to methodology are needed to address these issues. A simple hierarchical approach does not represent the complexity of evidence well and should move toward a more cyclical view of knowledge development. pubtype: Academic Journal doctype: case study Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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