Context: ageing, quality of life, and poi around the world

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Methodology

Chapter overview

The following chapter will describe both the methodology, or “philosophical approaches to discovering knowledge” (Killam, 2013, p. 9), and the methods or specific processes and techniques for collecting and analyzing data utilized in this study. This chapter begins with a discussion of the philosophical assumptions and theories upon which the methodology is based, then provides a detailed description of the methods, protocols, and process of analysis for both the clinical study and follow-up questionnaires. The overarching purpose of this chapter is to provide transparency so that readers can evaluate the soundness of the philosophical assumptions, study protocols, and data collection and analysis methods. Transparency will also enable replication of this study, which is vitally important for determining whether its results are valid and reliable (Barrow, 1991; Creswell, 2003; Kuhn, 1962; Wilson, 1952).

Philosophy and methodology

Philosophy is the study of general and fundamental problems concerning the nature of existence, knowledge, values, reason, and human purpose (Honderich, 1995; Paul, 1967; Teichmann & Evans, 1999). Philosophy is particularly important to methodology because decisions on what phenomena to study and how to study them are guided by philosophical assumptions and/or theories. Though these decisions are often sub-conscious, this section aims to make them transparent.
While there are a number of branches of philosophy and several ways to categorize them, the fields of axiology which is the study of value, ontology which is the nature of reality, and epistemology which is the nature of knowledge, are especially relevant to methodology (Killam, 2013). A discussion of each of these fields and their relationship to the methodology of this thesis follows.

Axiology and methodology

Axiology is the branch of philosophy dealing with values, such as judgments of good and bad, or right and wrong (Findlay, 1970; Hartman, 1967; Rescher, 2005). This study is based on a few value assumptions that are particularly relevant to methodology. One assumption is that physical (Warburton, Nicol, & Bredin, 2006) and cognitive (Gates & Valenzuela, 2010) exercise/training are both beneficial for older adults health and wellbeing. This assumption guided the choice to study the effects of International Poi on ageing. Another assumption is that pure research or generating new knowledge for its own sake, and applied research or generating new knowledge to address specific problems (which can at the most basic level be considered the two types of science), are both desirable and appropriate uses/purposes of research (Shuttleworth, 2008).
These assumptions, coupled with the following research aims, lay the foundation for subsequent methodological decisions. First, as discussed in Chapter 2, there is a paucity of research on poi and health, and even less on International Poi specifically. This thesis seeks to at least partially fill that void. Second, this thesis aims to provide data regarding the efficacy of International Poi for improving health in older adults. The number of adults over 60 years old is growing at an unprecedented rate, and there is a great deal of public interest regarding this development (United Nations, 2009). Policy and practice decisions regarding how to address this phenomenon should be as informed as possible, and data regarding International Poi and health may be of interest as the young-old balance shifts  throughout the world. The implications of the data generated by this research for future research, policy, and practice are discussed in the concluding chapter of this thesis.

Ontology and methodology

Ontology is the branch of philosophy dealing with the nature of being and the nature of reality, or judgments of what is real or what exists (Burkhardt & Smith, 1991; Grossmann, 1992; Johansson, 1989; Killam, 2013). Because the nature of reality is crucial to the perspective and design of research, ontology is at the heart of methodological decisions. There are two overarching ontological approaches to methodology, which can take on various labels such as objectivism and subjectivism, positivism and phenomenology, or positivism and interpretive alternative or more simply interpretivism (Holden & Lynch, 2004). Although there is no universally agreed upon taxonomy of these terms, interpretivism is often used as a broad term that includes social constructivism, phenomenology and hermeneutics, and therefore this thesis will include both positivism and interpretivism (Collins, 2010, p. 38).
In general, interpretivism maintains that reality is subjective. This means that human beings construct reality and construct meaning based on their experiences (Krauss, 2005). Interpretivist research typically investigates a small sample over time, and relies on qualitative methods such as non-standardized interviews and observations (Holden & Lynch, 2004). The goal of interpretivism is to understand and explain what is happening, the quality of experience, motivations, feelings and meanings, and involvement of the researcher is actively encouraged (Holden & Lynch, 2004).
In general, positivism maintains that reality is objective. This means that there is one reality, and it does not change because it is being observed (Krauss, 2005). Positivist research is predominant in natural science, and relies on the scientific method/quantitative methods such as experiments and statistical analyses. The goal of positivism is to simply observe, measure and describe what we experience. The data and its analysis strive to be value-free, and thus the researcher is distanced from her/his subjects so as to avoid bias as much as possible.
This thesis primarily takes a positivist methodological approach via a clinical study, in order to best fulfil the research aims of filling a void in poi, health and ageing research, and providing data for researchers, policy makers, and practitioners. Because positivism has been the ontology of most research and practice for the past century, and because most policy makers are positivists (Morçöl, 2001), emphasizing this approach will, hopefully, maximize the impact of this thesis.
In addition to the clinical study, an interpretivist method (for Questionnaire 3) was employed to augment the data generated by the clinical study, in the hopes of generating greater understanding of the data and therefore providing the researcher with greater explanatory power. This thesis follows the philosophy that methodology should be chosen based on what one is trying to do rather than a commitment to a particular paradigm, and different modes of research allow us to understand different phenomena for different reasons (Krauss, 2005).

Epistemology and methodology

Epistemology is the branch of philosophy dealing with the nature of knowledge (for example judgments of truth and rationality, how we come to know what we know), and the relationship between knowledge and the researcher during discovery (Alston, 1989; Chisholm, 1989; Dancy, Sosa,  Steup, 1993; Killam, 2013,). Knowledge can be acquired in two ways: from the mind or a priori, meaning knowledge is independent of experience and requires only the use of reason, and, secondly, from sensory experience or a posteriori, meaning knowledge is dependent on experience, and requires data from our senses (Müller-Merbach, 2007). There are a number of main theories of knowledge acquisition, primarily that of empiricism, rationalism, constructivism, and idealism (Mastin, 2008).
As with ontology, the epistemology of this thesis was influenced by the prior axiological decision to use this thesis to provide data for researchers, policy makers, and practitioners. Because empiricism has been the dominant scientific paradigm for the past century (McLeod, 2008) and because most studies concerned with policy are empirical (Gehring & Galston, 2003), it was decided that the methodology of this study should rely primarily on empiricism via a clinical study. Empiricism in the philosophy of science emphasizes evidence, especially as discovered in experiments (Alston, 1989; Sober, 1993; van Fraassen, 2002). Hypotheses and theories must be tested against observations of the world rather than resting solely on logic, intuition, or revelation. The emphasis on empiricism in this thesis will hopefully maximize the chances of its acceptance amongst its intended audience.
In addition to the clinical study, one of the follow-up questionnaires (Questionnaire 3) was based on a constructivist epistemology. This epistemology asserts that researcher and research are “interactively linked so that the ‘findings’ are literally created as the investigation proceeds” (Guba & Lincoln, 1994, p. 111). Moreover, a constructivist epistemology acknowledges that researchers possess unique experiences and perspectives which influence their research and in fact strengthen it. Thus, this researcher’s past experiences with and current perspectives toward poi are inextricably intertwined with her interpretations of the data generated by questionnaires and indeed lend additional credence to them (Eisner, 1998).
The remainder of this chapter details the methodological considerations and protocols behind the clinical study and the follow-up questionnaires.

Clinical study

Introduction

The following section will detail the methodological considerations and protocols of the clinical study. The clinical study involved the random allocation of seventy-nine participants (60 – 86 years) to a International Poi or Tai Chi group. Physical and cognitive function were measured one month before, immediately before, immediately after, and one month after the intervention (2 lessons a week for 4 weeks). The aim of this section is to provide transparency so the reader can evaluate the soundness of the methodological considerations and protocols, and to provide sufficient detail for replication of this study.

Methodological considerations

Determining the poi style

While conducting a study involving Māori Poi is recommended for future research, International Poi was a better fit for the parameters of the present study for the following reasons:
As this was the first scientific study on poi, health, and older adults, it was important to isolate the fundamental act of spinning a weight on the end of a flexible cord, in order to see if this act alone had an effect on health. Practicing Māori Poi in isolation separates the poi from its cultural context, which violates the fundamental concepts and principles of Māori Poi. In International Poi style, practicing in isolation does not violate any fundamental principles of the style.
The time available for this study was not sufficient for the trial participants to understand and master all of the cultural elements necessary to practice Māori Poi.
The experise of the principal investigator and poi teacher lies in International Poi.

Determining the control group activity

A control group in an experiment or clinical study is a group of participants that resembles the treatment group as closely as possible, but does not receive the same treatment (Pithon, 2013).
Because the treatment is the factor being studied, the control group serves as a comparison group when results are being analyzed. Control groups are an extremely important part of scientific research, and influence virtually all aspects of a clinical study:
The choice of control group is always a critical decision in designing a clinical study. That choice affects the inferences that can be drawn from the trial, the ethical acceptability of the trial, the degree to which bias in conducting and analyzing the study can be minimized, the types of subjects that can be recruited and the pace of recruitment, the kind of endpoints that can be studied, the public and scientific credibility of the results, the acceptability of the results by regulatory authorities, and many other features of the study, its conduct, and its interpretation. (ICH Topic E 10, 2001, p. 5) It would be best to compare a poi treatment group to a control group which is participating in an activity closely related to poi that has a substantial amount of scientific research demonstrating its efficacy. Comparing the treatment group to an active, or positive control group (as opposed to a negative control group which, in this case, would not participate in any activity or would participate passively, e.g. reading information about how to practice poi) is a good tactic when researching a new therapy or intervention. This is because active control trials can show efficacy of the new treatment by demonstrating it is as good as a known effective treatment (ICH Topic E 10, 2001). This method also poses fewer ethical issues, as all the study participants are receiving some form of active treatment (ICH Topic E 10, 2001).
With the aforementioned information in mind, the control group activity was determined through a three step process:
Determine the fundamental and essential characteristics of International Poi;
Use these characteristics to find other activities that most closely resemble International Poi; and, Of the activities that most closely resemble International Poi, determine which one is the most feasible in the context of the present study.

Table of Contents
Abstract
Acknowledgements 
List of figures 
List of tables 
List of appendices 
1. INTRODUCTION 
1.2 Preface
1.3 Context: ageing, quality of life, and poi around the world
1.4 Aims and objectives
1.5 Significance
1.6 Methodology overview
1.7 Assumptions, limitations, and delimitations
1.8 Definition of terms
1.9 Thesis overview .
2. REVIEW OF LITERATURE 
2.1 Chapter overview
2.2 Ageing
2.3 Poi
2.4 Tai Chi
2.5 Summary
3. METHODOLOGY 
3.1 Chapter overview
3.2 Philosophy and methodology
3.3 Clinical study
3.4 Follow-up questionnaires
3.5 Summary
4. RESULTS 
4.1 Introduction
4.2 Clinical study
4.3 Follow-up questionnaires
4.4 Summary
5. DISCUSSION 
5.1 Chapter overview
5.2 Findings
5.3 Reflection on methodology
5.4 Summary
6. CONCLUSION 
6.1 Chapter overview
6.2 Implications for future research
6.3 Implications for policy and practice
6.4 Summary
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The effects of International Poi on physical, cognitive, and emotional health in healthy older adults