Applying Meta-Theory to Qualitative and Mixed-Methods Research: A Discussion of Critical Realism and Heart Failure Disease Management Interventions Research

Meta-theory refers to broad perspectives, which make claims regarding the nature of reality. Meta-theories philosophically underpin research and practice. Despite this centrality of meta-theory to research and practice, research studies seldom have a strong articulated philosophical basis. There are persuasive philosophical arguments for invoking meta-theory in qualitative and mixed-methods research. We argue that selecting and applying a particular meta-theory is a matter of personal expression and historicity. In this article, we describe the meta-theory of critical realism (CR), which underpins our research around complex heart failure disease management interventions. CR posits that reality is mind independent and views this reality via a stratified ontology. Its explanatory focus, generative logic, multifactorial and open systems approach, and its openness to a variety of methods make it a viable meta-theory for research in a variety of disciplines, utilizing qualitative, quantitative, and mixed methods. CR hermeneutics, ethnographies, grounded theories, mixed-methods studies, and critical realist reviews follow the meta-theoretical assumptions of CR; these are extremely useful in exploring complex interventions holistically, including their components, contexts, and mechanisms.