Action research...aims to contribute both to the practical concerns of people in an immediate problematic situation and to further the goals of social science simultaneously. Thus, there is a dual commitment in action research to study a system and concurrently to collaborate with members of the system in changing it in what is together regarded as a desirable direction. Accomplishing this twin goal requires the active collaboration of researcher and client, and thus it stresses the importance of co-learning as a primary aspect of the research process. (Cited by O'Brien, 1998).
It is a pity that the study was confined into one cycle. At least two cycles should have been done in order for the outcomes to become more validated. A single pass that involves only a few members of staff and patients might not initiate sustainable change in the system. A second cycle would have reinforced the findings of first cycle and given momentum to the change processes.
Another area that touches on collaboration is the fact that no one from the hospital staff or patients was involved in the design planning phase. The failure to get a co-researcher1 which is mentioned in the report undermines the process since it then appears to be an external intervention.
Only those who were interested among staff became reflective participants. They had their own reasons for 'volunteering' which was "an interest in developing their practice" (Tutton, 2005). This raises the difficulty of generalising their views since they are a self-selected group. They clearly had ulterior motives and two of them went on to present "three different papers at conferences" (Tutton, 2005)2. Although active research does not depend on statistical sampling there is a question of representativity of the results for such a sample. It is a fact that there was a problem with getting patients to participate since most of them were too frail. This means that those who participated may not be representative of all the patients since they come from a minority group of patients with capacity to communicate.
2.3 Data Collection
In the data collection the questions asked are vague. The investigator states that she let the interviewees control the discussion. This raises the question whether they would wilfully disclose information that is painful or embarrassing to them. The focus groups consisted of three people and we are not told how many different focus groups were involved. Also we are not told what the composition of focus group was. Did it mix staff and patients or were there different focus groups for each category. The fact that there were more staff (13) than patients (9) who participated in this study is borne