1. INTRODUCTION
Research is defined as “ multiple, systematic strategies to generate knowledge about human behavior, human experience and human environments in which the thought and action process of the researcher are clearly specified so that they are logical, understandable, confirmable and useful ” ( Depoy and Gitlin, 1994, p.5 ). The two major types of research are quantitative and qualitative. In the first part of the assignment, the features of both the types of research are discussed along with its advantages and disadvantages. Features of combined methodologies are also analyzed. In the second part of the assignment, the research done and to be done in evaluating the effectiveness of high intensity exercises in Rheumatoid Arthritis patients is reported along with the gaps in the present research.
2. QUANTITATIVE AND QUALITATIVE RESEARCH
2.1 DEFINITIONS
Quantitative research is defined as, “ a systematic scientific investigation of quantitative properties and phenomena and their relationships” (Wikipedia, not dated).Qualitative research is defined as, “ a research which involves an in depth understanding of human behavior and the reasons that govern human behavior” (Wikipedia, not dated ).
2.2 PHILOSOPHICAL BACKGROUND
An epistemology is defined as, “a way of understanding and explaining how we know what we know” ( Crotty, 1998, p. 3 ). The epistemological view of the world differs which contributes to the two types of research. Quantitative research believes in the existence of a single objective reality. It aims to analyze and interpret aspects of reality. Qualitative research on the other hand, believes that there is no absolute truth and the world is made of different realities which are formed by humans from their own experiences.( Jongbloed, 2000).
2.3 GENERAL FEATURES
The features of quantitative and qualitative research can be contrasted with each other. First, while quantitative research is based on deductive reasoning meaning that an observation is made for the hypothesis which is formulated from an already existing theory, qualitative research is based on inductive reasoning in which the process starts with observation and ends with formation of general rules or theories. (Depoy and Gitlin, 1994). Secondly, specific variables are chosen and their inter-relationships are examined in quantitative research, whereas, qualitative research considers the individual as a whole in relation to a particular social context. (Polgar and Thomas, 2000). Thirdly, quantitative research has a predetermined and structured process which is carried out using two variables, Dependant variable (DV) and Independent Variable (IV). IV is the one which the researcher manipulates and the DV is the variable observed for changes due to the changes in the IV.(Hicks,2004). On the contrary, qualitative research has a flexible design which changes according to the data collected and the situation. Finally, quantitative research analyses the results using statistics while in qualitative research the results are in the form of a narration or description. (Polgar and Thomas, 2000).
2.4 TYPES
The four main types of quantitative research are true experimental design, quasi-experimental design, pre-test design and non experimental design. (Depoy and Gitlin, 1994).
Case studies, historical method, ethnography and grounded theory methodology are the main types of qualitative research. (Schmoll, 1993).
2.5 ADVANTAGES AND DISADVANTAGES
Both quantitative and qualitative researches have their own merits and demerits. The detached stand of the researcher with the subject serves as an advantage for quantitative research, whereas, researcher bias is possible in qualitative research as the researcher is more involved with the subject. Nevertheless, qualitative research is the method of choice when dealing with human feelings as these parameters cannot be expressed as numbers. (Hicks, 2004). Generalization to the whole population is made better with quantitative research rather than qualitative research because of the bigger sample size and randomization involved in quantitative research. The same problem can occur with quantitative research when improper sampling methods are used. Bigger sample sizes are not feasible in qualitative research as it makes the whole process lengthy, time consuming and sometimes too expensive. (Currier, 1990). Moreover, the results obtained from one social setting in qualitative research cannot be applied to another society or to the same group after a certain gap because it not always possible to predict human behavior and views also change with new experiences. The advantage of qualitative research is that it produces an in-depth and comprehensive information which lacks in quantitative research.(Polgar and Thomas,2000). The research being carried out in a natural environment is another merit for qualitative research in contrast to the artificial controlled setting of quantitative research as this may influence human behavior. The same problem may arise with qualitative research when the subjects are aware that they are being observed. These problems are sorted by double blinded procedures in quantitative research and multiple data comparison methods in qualitative research. ( Currier,1990; Polgar and Thomas, 2000; Hicks, 2004).
3. COMBINED METHODOLOGIES
As both the approaches have positives and negatives, attempts are now made by researchers to combine both the quantitative and qualitative research paradigm in a single study to get an optimum balance. Since the same phenomenon is examined through two different methods, the results are more valid than using a single method and a better understanding is also possible. This adds more value and strength to the study. However, this integration can be beneficial only when done systematically. It is not sufficient to just use two different methods but they should be blended with each other in such a manner that there is no domination of a single method. Moreover, consideration should be given to the time factor because qualitative research takes a long time for completion when compared with quantitative research. (Depoy and Gitlin,1994; Bryman,2006).
4. RESEARCH DONE IN THE SPECIFIC CHOSEN AREA
The specific research topic chosen is the effectiveness of a long term high intensity exercises in patients with Rheumatoid Arthritis [RA]. Around 5 – 7 studies have been done in the past ten years to research the above.
4.1 ANALYSIS OF THE METHOD USED
Quantitative research dominated this field and the method of choice was the Randomized Controlled Trial [RCT]. Further, blinded procedures were also carried out in these studies thereby avoiding researcher bias. Though few studies had a small sample size, the others had a big sample size. For example, the study of De Jong et al (2003) had a large sample size of 309 out of which 281 completed the study. The same sample has been used in other studies to examine different aspects of the same exercise program. Moreover, all the studies had more females as subjects since females are affected by RA three times more than men.(Newman et.al,1996) Thus, all the factors required for generalizing the results to the whole population have been covered. Both instruments and questionnaires which are found to be valid and reliable were used as outcome measurements. In addition, the outcome expectations of rheumatologists, patients and physiotherapists for high intensity exercises and conventional exercises have been analyzed using close ended questions by Munneke et al (2004). The same procedure has been used to evaluate the adherence and satisfaction of patients to the high intensity exercise regime by Munneke et al (2003).
4.2 GAPS IN THE RESEARCH
Although most of the aspects of quantitative research has been considered, pure qualitative research with direct interviews and open ended questionnaires have not been done in this field. This is of utmost importance since RA patients face a lot of pain and stiffness.(Newman et al, 1996). Therefore, the personal opinion of RA patients about high intensity exercises should be studied first, before the prescription and evaluation of these exercises and its effects. The important factor to be noted with the quantitative research done is the use of the same sample in different studies. This narrows down the results to a small social group. Moreover, only one study is done to find the effects of these exercises in patients with active RA. The intensity and duration of the exercises are also not similar. In addition, radiological damage due to these exercises have been examined only by X rays, whereas, higher forms of scanning should have been done to prove that these exercises do not cause any radiological damage. The studies have also noted that patients are not able to perform the exercises for the prescribed duration. The reasons for the above can be analyzed using qualitative research.
4.3 FUTURE RESEARCH
The future research regarding the high intensity exercises should concentrate more on the qualitative aspects. More number of good quality quantitative research is also needed to prove that these exercises are beneficial, so that they can be prescribed to RA patients without fear of any undesirable effects. The recommended studies should be carried out with large sample sizes and with different social groups. The research should be able to identify the most suitable intensity and duration of exercise which should be further tested on different groups to verify the results. Combining qualitative research with quantitative can yield better and valid results since the opinion of the patients have a role to play in the exercise program. It can also be useful because RA patients have a lot of psychological problems. ( Newman et al, 1996). Studies considering patients with active RA should be concentrated a little more.
5. CONCLUSION
Quantitative and qualitative researches are the two paradigm of research. They have their own strengths and weaknesses. Features which cannot be covered by one can be done with the other. Hence research combining both methodologies is carried out in the recent days. With regard to the research with high intensity exercise for Rheumatoid Arthritis patients, only limited number of studies has been done. The methods used have been analyzed and recommendations are made for future research in this field.
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REFERENCES
4. De Jong,Z., Munneke,M., Zwinderman,A.H., Kroon,H.M., Jansen,A., Ronday,K.H., Schaardenburg,D.V., Dijkmans,B.A., Van den Ende,C.H.M., Breedveld, F.C., Vlieland,M.V., Hazes, M.W.2003. Is a long-term high-intensity exercise program effective ans safe in patients with rheumatoid arthritis? Results of a randomized controlled trial. Arthritis and Rheumatism, 48(9) September, pp. 2415 – 2424.
9. Munneke,M., De Jong,Z., Zwinderman,A.H., Jansen, A., Ronday, H.K., Peter, W.F.H., Boonman,D.C.G., Van Den Ende, C.H.M., Vlieland,M.V., Hazes, M.W. 2003. Adherence and satisfaction with a long-term intensive dynamic exercise program(RAPIT program). Arthritis and Rheumatism, 49(5) October 15, pp. 665 – 672.
10. Munneke,M., De Jong,Z., Zwinderman,A.H., Ronday, H.K., Van Den Ende, C.H.M., Vlieland,M.V., Hazes, M.W. 2004. High intensity exercise or conventional exercise for patients with rheumatoid arthritis? Outcome expectations of patients, rheumatologists and physiotherapists. Annals of Rheumatic Diseases, 63 July, pp. 804 – 808.
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