This article explores the need for a clear understanding of fourth generation evaluation as a necessary requirement for those hoping to achieve an effective analysis of health services. The weaknesses of the traditional approaches to evaluation are fully examined so that an effective choice of evaluation methodology can be made. Current health service thinking highlights the need to recognize the importance of both consumer and professional stakeholders, allowing each an equal voice. The authors aim to assist evaluators to select a methodology that will be the most effective medium for allowing this to occur.
Get full access to this article
View all access options for this article.
References
1.
Appleton, J. V. , & King, L. (1997). Constructivism: A naturalistic methodology for nursing inquiry. Advances in Nursing Science, 20(2), 13-22.
2.
Biklen, S. K. , & Bogdan, R. (1986). On your own with naturalistic evaluation. In D. D. Williams (Ed.), Naturalistic evaluation (New directions for program evaluation, No. 3, pp. 93-101). San Francisco: Jossey-Bass.
3.
Bruster, S. , Jarman, B., Bosanquet, N., Weston, D., Erens, R., & Delbance, T. L. (1994). National survey of hospital patients. British Medical Journal, 309, 1542-1546.
4.
Department of Health . (1990). NHS and Community Care Act 1990. London: HSMO.
5.
Department of Health . (1995). The patients’ charter. London: HSMO.
6.
Department of Health . (1997). NHS white paper. London: HSMO.
7.
Department of Health . (1998). Health in partnership research initiative. London: Department of Health, Research and Development Division.
8.
Eisner, E. (1981). On the difference between scientific and artistic approaches to qualitative research. Educational Researcher, 10(3), 5-9.
9.
Ewles, L. , & Simnett, I. (1992). Promoting health: A practical guide (2nd ed.). London: Scutari.
10.
Greene, J. C. (1994). Qualitative program evaluation: Practice and promise. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (pp. 530-544). Thousand Oaks, CA: Sage.
11.
Guba, E. G. , & Lincoln, Y. S. (1981). Effective evaluation. San Francisco: Jossey-Bass.
12.
Guba, E. G. , & Lincoln, Y. S. (1989). Fourth generation evaluation. Newbury Park, CA: Sage.
13.
Guba, E. G. , & Lincoln, Y. S. (1994). Competing paradigms in qualitative research. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (pp. 105-117). Thousand Oaks, CA: Sage.
14.
Hudson, R. (1997). Demonstrating effectiveness: Compiling the evidence. Health Visitor, 70(12), 459-461.
15.
King, R.A.L. (1998). Levels of expertise in surgical ward and intensive care nurses: A qualitative study. Unpublished doctoral dissertation, King’s College London, University of London.
16.
Koch, T. (1994a). Beyond measurement: Fourth generation evaluation in nursing. Journal of Advanced Nursing, 20, 1148-1155.
17.
Koch, T. (1994b). Establishing rigour in qualitative research: The decision trail. Journal of Advanced Nursing, 19, 976-986.
18.
Koch, T. , & Webb, C. (1996). The biomedical construction of ageing: Implications for nursing care of older people. Journal of Advanced Nursing, 23, 954-959.
19.
Lincoln, Y. S. , & Guba, E. G. (1985). Naturalistic inquiry. London: Sage.
20.
Muir Gray, J. A. (1997). Evidence-based healthcare: How to make health policy and management decisions. London: Churchill Livingstone.
21.
National Health Service Management Executive . (1993). New world, new opportunities. London: Department of Health.
22.
Patton, M. Q. (1990). Qualitative evaluation and research methods (2nd ed.). London: Sage.
23.
Porter, S. (1996). Qualitative research. In D.F.S. Cormack (Ed.), The research process in nursing (3rd ed., pp. 113-122). Oxford, UK: Blackwell Science.
24.
Powers, B. A. , & Knapp, T. R. (1990). A dictionary of nursing theory and research. Newbury Park, CA: Sage.
25.
Redfern, S. J. , & Norman, I. J. (1990). Measuring the quality of nursing care: A consideration of different approaches. Journal of Advanced Nursing, 13, 1260-1271.
26.
Scammell, J.M.E. (1996). Reflective practice in medical nursing: A descriptive study. Unpublished master’s thesis, King’s College London, University of London.
27.
Schwandt, T. A. (1997). Qualitative inquiry: A dictionary of terms. Thousand Oaks, CA: Sage.
28.
Stake, R. E. (1995). The art of case study research. London: Sage.
29.
Stringer, E. T. (1996). Action research: A handbook for practitioners. Thousand Oaks, CA: Sage.
30.
Thorne, S. (1997). The art (and science) of critiquing qualitative research. In J. M. Morse (Ed.), Completing a qualitative project: Details and dialogue (pp. 117-132). Thousand Oaks, CA: Sage.
31.
World Health Organization . (1978). Report on primary health care conference: Alma Ata Declaration. Geneva, Switzerland: Author.
