Rethinking theories: the basis of practical research and problems with paradigms

Chapter 1 reviews: social and biomedical influences through the centuries; positivist health research and then problems with it; interpretive research and some associated problems; differences between positivism and interpretivism; realist evaluation compared and contrasted with critical realism and discourse analysis. The detailed example is an evaluation of a community-based integrated care service. The chapter ends with questioning the present unhealthy state of social health research, which undermines the hope that sociology can be generally respected, convincing and useful in helping to resolve serious global problems of health and illness. This prepares for future chapters that show how critical realism draws on the strengths and overcomes the limitations of these paradigms by combining them into larger analysis.