Realism in Health Research: Tenets, Application and Utility

Paper

Thursday, 20 July 2006

This presentation is part of : Research Theoretical and Methodological Strategies

Alexander M. Clark, PhD, BA, RN and Sue L. Lissel, MA. Faculty of Nursing, University of Alberta, Edmonton, AB, Canada

Learning Objective #1: Understand the principles and tenets of realism as used in health research.
Learning Objective #2: Understand how to apply realist principles in research to improve understanding of key health issues.

Realism is an approach to social theory originating from the social sciences but with recent application in economics, crime prevention and industrial development. However, its usage in health research has been comparatively low. We discuss the realist tradition and its orientation to positivism, constructivism and post-positivism. We then outline the main tenets of realism, these being: a stratified ontology, an approach emphasizing the importance of understanding complexity that invokes the interplay of structure and agency factors, and an explanatory focus on understanding phenomena occurring in dynamic open systems. To illustrate the appropriateness of realist approaches to health research, we finally draw on recent debate in relation to evidence-based health care, chronic disease management and randomized control trial research. Using these areas as exemplars in relation to a series of funded research projects, we will convey the contribution that realist-driven research can make guiding empirical and theoretical work in these areas of research priority.

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