'For Want of a Nail': developing a transparent approach to retroduction and early initial programme theory development in a realist evaluation of community end of life care services

Int J Soc Res Methodol. 2023 Mar 12;27(4):417-430. doi: 10.1080/13645579.2023.2184920. eCollection 2024.

Abstract

A crucial part of theory-driven realist thinking is retroduction, the process of looking backwards for explanation of how and why things may be. Conducted early in the realist evaluation process, it provides a foundation for evidenced 'theory gleaning'. Despite retroduction being an inherent part of the realist process, it is often 'hidden' in realist reports. This paper explains the thinking behind, alongside an example of, a framework created by the authors to make transparent the retroductive process as used in a realist evaluation of two community End of Life Care services. The approach makes visible the application of the 'sociological imagination' and lends robustness to hypotheses by establishing how the authors utilised: wide-ranging potential generative causation; stakeholder and Patient and Public Involvement feedback; literature scoping; and substantive theories at the middle range, specifically Transitions Theory. These stages led to the development of Initial Programme Theories, with a clear history of genesis.

Keywords: Realist evaluation; end of life care; realist methodology; retroduction; transitions theory.

Grants and funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was carried out with funding from Marie Curie grant number [MC-19-903].