How do Researchers Address the Criteria for Quality of Action Research Studies in Healthcare: A Scoping Review

Abstract

Background: The challenges being experienced by health and care systems across the globe are not being adequately addressed by current research paradigms and approaches. The scientific literature has recommended that in order to understand complex interventions, such as the implementation of integrated care, in complex systems, longitudinal and qualitative research approaches are required. Action research approaches have the potential to be a transformative force in healthcare through its dynamic dual intention of action and research that facilitates organisational change, teamwork and the empowerment of heath care professionals in hospitals and communities thus contributing to improvements in the quality of care. Despite its potential value, there is no clear consensus on what constitutes ‘good’ action research with many empirical investigations appearing to insufficiently engage with quality criteria that has been described in some detail in the literature including four factors from Shani and Pasmore’s complete theory of action research.
 Objectives: The aim of this scoping review was to explore the extant literature on action research studies in healthcare and assess and synthesise how researchers addressed criteria for quality of action research studies in healthcare.
 Eligibility criteria: This scoping review considered qualitative and quantitative primary research utilising action research approaches, published in the English language between the years 2016 and 2021.
 Sources of evidence: The following databases were searched: PubMed, CINAHL and ProQuest. In addition, a manual search of key action research journals was performed.
 Data extraction was conducted using Rayyan software and a bespoke data extraction table was developed to produce a descriptive summary of the results, addressing the objectives and research question. The review used the Arksey, and O’Malley (2005) revised six-step framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR). As recommended, the findings are presented in narrative and tabular form with figures to support the data where appropriate.
 Results: 3263 articles were originally identified. 641 articles were identified as duplicates entries and were removed before screening. A further 2565 articles were excluded as they did not meet the inclusion criteria. A total of 57 articles were included in the review. Most publications were in 2016. Several different action research approaches were used. Most studies had nursing participants and were set in hospitals with most publications in Europe. Only 13 of the 57 articles considered all 4 of the Shani and Pasmore quality factors and none considered the integration of these factors.
 Conclusion: This Scoping review builds upon knowledge generated by previous systematic reviews and contributes to knowledge and practice by providing coherence on how best to approach an action research project and attend to quality. If action research is to fulfil its potential as a transformative power for change within health care, action researchers need to demonstrate the rigor in their work. The authors offer some guidance in this area. Just as AR has dual intention, researchers have a dual obligation, to do good and to do good action research.