From the Editor’s Desk: The Value of Modifiability

I have been thinking about the value of modifiability as a criterion of classic grounded theory rigor.  In June 2020, I wrote about the need for research, and especially grounded theory research focused on changing social processes. What I couldn’t foresee was that we were on the mere cusp of multi-year virulence and social upheaval.  I wrote, “These are troubling days of pandemic illness, cultural upheaval, racial animus, international disruption, and political turmoil. . . .  We are in uncharted territory.  In response, particularly to Covid-19, structural and psychological social processes are changing.  Education, family life, health care, work life, business, consumerism, sports, trade, entertainment, government institutions, and travel are all changing.  People are assuming new roles or are adjusting their roles to fit new life circumstances.  This is a time of great upheaval—a time particularly ripe for grounded theory research.”  As a call for action, I urged grounded theorists and PhD students to turn aside from tired and over-studied phenomena and consider this wide-open opportunity to advance important knowledge.  What I did not suspect at the time was that global society was at the mere beginning of a swirling maelstrom of change and that theories discovered in 2020 might need to be modified in order to be useful in the future. Modifiability, one of four criteria of rigor in classic grounded theory, suggests that theories are not precious or inviolate.  This criterion requires that theories be reshaped as new data emerges.  Glaser (1978) wrote that even though basic social processes remain in general, their variation and relevance is ever-changing in our world.  A grounded theory must be constantly ready for quick modification in order to help explain surprising variations. Glaser further proposed that through this approach, the tractability of a grounded theory over social life is maintained and the theory secures its continuing relevance.  Let me give an example.  Many issues of the Grounded Theory Review over the years include papers written by health care professionals, the majority of which focus on nurse and physician relationships, decision making, and direct patient care.  Today, some of these theories may be less relevant because the Covid-19 pandemic has brought into sharp focus the tenuous connection between health care ethics and practical reality.  The stark reality today is that hospital staff must balance the traditional duty to care for individual patients against the duty to protect themselves and their families from the dangers of Covid-19.  In addition, the harrowing choices forced upon health care professionals during this pandemic has created an ethical turning point whereas the duty of health care workers to focus on each patient has sometimes necessarily pivoted to a utilitarian view of maximizing the collective good (i.e., who has the greatest need for this last this bed, this last ventilator, this last infusion. . .).  New data from the changing healthcare workforce, when applied to extant theories, can modify them to improve their usefulness in today’s world.  In addition to discovering new grounded theories, the challenge today is for researchers and PhD students to examine extant grounded theories in the light of changing social and structural processes and modify the theories to fit the new data; work to explain, predict, and interpret what is happening; and maintain relevance when new core problems and processes continue to emerge. In this issue you will find Glaser’s The Practical Use of Awareness Theory that focuses on the importance of writing a grounded theory that can be applied in a useful manner. ...

The Practical Use of Awareness Theory

Barney Glaser, PhD Editor’s note: Through examples found in their seminal theory, Awareness of Dying, Glaser and Strauss (1965) demonstrated how to develop and write a classic grounded theory in a way that is applicable to practice. Awareness of Dying was one of four monographs that culminated from a six-year funded research program titled Hospital Personnel, Nursing Care and Dying Patients (Glaser & Strauss, 1968). In Awareness of Dying, Glaser and Strauss identified different levels of awareness of impending death and the effects these have on patients, families, nurses, and physicians.  They discovered four distinctly different awareness contexts: closed awareness, suspected awareness, mutual pretense awareness, and open awareness.  In other words, to what degree does the patient know that he or she is dying and how do others participate in that knowledge.  Glaser and Strauss found that awareness contexts affected many elements of medical and nursing care and relationships among staff, patients, and families. In discussing their theory, Glaser and Strauss emphasized the importance of usefulness, clarity, and parsimony in the development of grounded theories.  Indeed, through a review of the literature, Andrews and Nathaniel in 2009 confirmed that the theory continues to be useful in practice. Glaser and Strauss’s chapter has been edited and reprinted several times. In various forms, this paper was published as a chapter in in Awareness of Dying (1965) and subsequently in The Discovery of Grounded Theory: Strategies for Qualitative Research (1967).  As reprinted here, the chapter has been gently edited for clarity and context from the version found in Applying Grounded Theory: A Neglected Option (Glaser, 2014) and includes Glaser and Strauss’s original footnotes. It is included in this issue of Grounded Theory Review as an example of the practical usefulness of a substantive grounded theory. In this chapter we shall discuss how our substantive sociological theory has been developed in order to facilitate applying it in daily situations of terminal care by sociologists, by doctors and nurses, and by family members and dying patients.  The application of substantive sociological theory to practice requires developing a theory with (at least) four highly interrelated properties. The first requisite property is that the theory must closely fit the substantive area in which it will be used.  Second, it must be readily understandable by lay persons concerned with this area.  Third, it must be sufficiently general to be applicable to a multitude of diverse, daily situations within the substantive area, not just to a specific type of situation.  Fourth, it must allow the user partial control over the structure and process of the substantive area as it changes through time.  We shall discuss each of these closely related properties and briefly illustrate them . . . to show how our theory incorporates them, and therefore why and how our theory can be applied in terminal care situations.[1] Fitness That the theory must fit the substantive area to which it will be applied is the underlying basis of the theory’s four requisite properties.  It may seem obvious to require that substantive theory must correspond closely to the data, but actually in the current ways of developing sociological theory, there are many pitfalls that may preclude good fitness.[2]  Sociologists often develop a substantive theory—theory for substantive areas such as patient care delinquency, graduate education—that embodies without his realization, the sociologist’s ideas, the values of his occupation and social class, as well as popular views and myths, along with his deliberate efforts at making logical deductions from some formal...

Personalizing Wellness: A Grounded Theory Study

Kari Allen-Hammer, Saybrook University Abstract The impetus for exploring how people created wellness using classic grounded theory rose from an interest in understanding behavior that shaped a health-conscious lifestyle. The grand tour question was, “what does wellness look like to you; how do you see yourself cultivating that in your life?” Thirty-three data samples were collected from interviews, a diary, and field observations. The substantive theory of personalizing wellness outlined three stages in forming a health-conscious lifestyle. Stage 1, Awakening a Vision of Wellness, begins the change process through experiencing disruption and personal discovery. Stage 2, Integrating Strategies, involves assuming responsibility by prioritizing wellness and handling complexity associated with one’s inner and social life. Stage 3, Living Wellness, represents mastery levels of personal responsibility maintained through lifelong learning, sustaining energy resources, radiating vibrancy, and sharing wisdom. Coach-practitioners may utilize this theory for determining stage-appropriate interventions that support health-conscious behaviors. Keywords: autonomy, coaching, health-conscious, self-determination, flow Introduction Personal responsibility in health has gained traction during the last three decades as individuals take ownership of their wellbeing by increasing health-conscious behaviors (Kraft & Goddell, 1993; Wiese et al., 2010). Health-conscious refers to “individuals who lead a ‘wellness-oriented’ lifestyle [and who] are concerned with nutrition, fitness, stress, and their environment. They accept responsibility for their health” (Kraft & Goddell, 1993, p. 18). A consumer-driven market for health-promoting goods and services prompted the healthcare industry, albeit hesitantly (Fulder; 1993), to take notice of shifting trends from disease management (Fulder, 1993; Kraft & Goddell, 1993; Wiese et al., 2010) to “using medical knowledge to prevent disease by altering lifestyle behaviors such as eating, sleeping, exercising, and smoking” (Kraft & Goddell, 1993, p. 19). Some researchers have highlighted the concern that research focusing continually on disease rather than on the experience of health or wellness will only continue to spotlight the disease process and experience and hinder understanding of the process and experience of health and wellness (Antonovsky, 1987; Fulder, 1993). Antonovsky (1987) addressed the fundamental differences between studies that focus on the science of disease versus the science of health, mainly concluding that whatever the study focuses on will determine the questions, hypotheses, methods, and conclusions that guide the study. The motivation behind this study was initially to understand the health behaviors of people who, hypothetically, contributed to and helped sustain the “historic change in public choice” (Fulder, 1993; p. 108) in their quest for wellness. It became evident from the data that the main concern for participants in the study was relieving suffering by personalizing their approach to creating wellness to meet individual needs, preferences, interests, and wellness values, forming a dynamic relationship-to-self. Relationship-to-self refers to recognizing and responding to meeting needs, preferences, interests, and wellness values. Personalizing wellness introduces a three-stage process of developing a personal approach to living a wellness lifestyle. Theory Development This classic grounded theory study was conducted by a doctoral student at Saybrook University (Author, 2018). Wellness lifestyles were the topic area of research. Preconception was limited by not conducting a preliminary literature review and journaling to set aside personal biases and preconceptions, as Glaser (1998) recommended. Also, under the mentorship of the dissertation committee chair, when preconceptions appeared in the doctoral students’ work, the mentor addressed the issue, and the student corrected course. In this manner, preconceptions and personal biases were acknowledged and let go to reduce and eliminate interference in the study. Criteria for selecting adult participants were based on observing the participant exhibiting behaviors that...

Collaborative Grounded Theory

Kara L. Vander Linden, Ed.D. Institute for Research and Theory Methodologies, USA Catherine J. Tompkins, Ph.D., MSW, George Mason University, USA Abstract This article describes how two researchers’ professional relationship began as a mentor/mentee relationship and transformed into co-researchers using grounded theory. We explain how we navigated each stage of the process of conducting a GT study using a collaborative and interdisciplinary approach. The article also presents some key takeaways for researchers to consider when working collaboratively. Keywords: collaborative, co-researchers, interdisciplinary, grounded theory Introduction This article presents how two researchers’ professional relationship evolved from a mentor/mentee relationship into co-researchers using grounded theory (GT). While the topics of collaborative and interdisciplinary research teams have been extensively researched and written about for many years (Abramo et al., 2009; Oliver et al., 2018; Tkachenko & Ardichvili, 2020), little is written on collaborative, interdisciplinary research teams using GT. Authors have cited many reasons for the increased use of collaborative and interdisciplinary research teams. Some reasons include the increased pressure to publish within academia, the need to address increasingly complex problems, and access to resources to name a few (Abramo et al., 2009; Oliver et al., 2018; Tkachenko & Ardichvili, 2020). There are also numerous articles that focus on the advantages and drawbacks of the use of collaborative and interdisciplinary research teams (Oliver et al., 2018; Tkachenko & Ardichvili, 2020). The experiences of the authors of this article align with the previous findings but this article focuses on the unique aspects of collaborative and interdisciplinary research teams using GT. In this article, the authors described how our relationship began as a mentor/mentee relationship and transformed into co-researchers. We present how we navigated the various stages of the process of conducting a GT study using a collaborative and interdisciplinary approach. The article ends with some key takeaways for researchers to consider when working collaboratively. How Our Relationship Began From 2007 to 2009, Dr. Cathy Thompkins[1] was a John A. Hartford Foundation Geriatric Fellow who provided resources for faculty development. With these resources, she decided to become skilled in a different research method, grounded theory, for a study she was preparing on grandparent-headed households. As a gerontologist, she was interested in the relationships between grandparents and grandchildren when a grandparent was the primary care provider. Through the fellowship, she had funds to hire a mentor to teach her GT. She first contacted Dr. Simmons who referred her to Dr. Kara Vander Linden, who at the time was a recent graduate and mentee of Dr. Simmons. While Kara had been mentoring doctoral students using GT for 2 years, she had never mentored an experienced researcher. With Cathy’s understanding of this, Kara mentored Cathy using the same approach she used with her students. Cathy in turn taught what she was learning to her research assistant. Later Cathy served on GT dissertations committees with Kara. Now, 14 years later, Kara and Cathy are still collaborating. The Mentor/Mentee Relationship As Kara does with all her mentees, she recommended that Cathy read the seminal books, specifically the Discovery of Grounded Theory: Strategies for Qualitative Research (1967), Theoretical Sensitivity (1978), and Doing Grounded Theory: Issues and Discussions (1998). Kara and Cathy met regularly to discuss Cathy’s questions about the books. Kara said, “My goal was and still is to be an experienced role model, who provides encouragement, advice, coaching and moral support to learners who want to learn, and more importantly, DO grounded theory” (Vander Linden & Tompkins, 2021). The real way...

Absenting: Fathers of Children with Autism Face the Future

Kianna Marie McCoy, Ph.D., MOT, OTR/L, ICDL Susan Braude Stillman, EdD, Six Seconds Abstract Absenting is defined as the father’s fear of what will happen to his child with autism when he is no longer living. The core variable, absenting, was discovered from data based on the main concern of fathers of children with autism. This is the first time in the literature that absenting has been used in association with fathers of children with autism. Fathers of children with autism face the future to resolve absenting in three ways: 1) preparing financially, 2) preparing for future living, and 3) preparing the child to live life to the fullest. Conditions affecting absenting are the severity of the disability and gender of the child. During the process of resolving their main concern, fathers experience self-transformation. This process includes three linear stages: 1) reaching out to the community, 2) balancing family relationships, and 3) helping others. Understanding the theory of absenting can help guide treatment and support for the child and family. Keywords: fatherhood, autism spectrum disorder, caregiving, classic grounded theory   Introduction Fatherhood is underrepresented in academic philosophy and even less prevalent when considering the roles and experiences of fathers who are raising children with autism (Mitchell & Lashewicz, 2016). Gaining information on the perspectives of fathers is key to understanding what it is like to raise a child with autism. Furthermore, the information contributes to a framework in which clinicians can understand and support fathers more effectively. Flippin and Crais (2011) suggested that perceiving and highlighting the “role of fathers” (p. 25) is important due to the unique contribution that they make to the child’s development. Having the father’s perspective can offer insight that provides clinicians with information on resilience, family and childhood development, and positive aspects of parenting. While many research studies have focused on the role of the mother in parenting a child with autism, obtaining information from fathers can provide a more holistic view of how autism affects the family unit. Understanding the perspectives of fathers through a classic grounded theory study provided insight and understanding about how fathers contribute to raising children with autism, how they are coping, and what they are gaining from the experience. The discovered core variable, absenting, which was the main concern of fathers in this study is defined as the fear of what will happen to the child with autism when his or her parents are no longer living. In other words, when the parents are absent, will the child be cared for in the same way he or she was while the parents were living? The fear of absenting consumed the father’s thoughts and actions. The resolution to absenting led each father to face a future full of unknown variables and then begin to prepare for that future. Each father wanted to ensure that their child had enough money for future expenses, a safe place to live, and a good quality of life. As fathers attempt to resolve this life-long concern, they go through a process that brings about self-transformation. This process begins as the father first reaches out to his community for help and support, second turns inward to focus on family and marital relationships, and third shifts his focus to helping others. Methodology The purpose of this study was to gain insight into the experience of father’s raising a child with autism. Classic grounded theory was applied to gain insight into the main concerns of fathers, what...

Recruitment and Data Collection in the 21st Century: Implications for Grounded Theory...

Emily J. Cashwell, Institute for Research and Theory Methodologies Abstract For many people, many aspects of daily life now occur online. Most individuals are well-versed in communication via email and social media, and many are experienced with audio and video conferencing software as a means to hold business meetings and to connect with family and friends. In addition, the coronavirus pandemic has shifted many aspects of modern life, and some universities have imposed research restrictions that prohibit face-to-face interviews. Because of these changes in the structure of modern social and professional life, researchers are faced with new opportunities and challenges in recruiting research participants and collecing data for their studies. Grounded theorists, in particular, are faced with challenges implementing the research design as it was originally developed within the context of these modern circumstances. This article explores social media and audio and video conferencing software as tools that a grounded theorist might consider for virtual participant recruitment and interviewing. Keywords: recruitment, data collection, virtual interviews, virtual research environments Introduction Technology has opened new avenues for conducting research across vast distances. Within the last decade, researchers have begun to use one form of technology, social media, as a cost-effective way to recruit participants (Fenner et al., 2012) and an effective way to recruit people from within hard-to-reach populations (Gorman et al., 2014; Martinez et al., 2014). It is estimated that in the United States about 72% of people use social media (Pew Research Center, 2021); that number is 57.6% worldwide (Global Webindex, 2021). Further, as of 2016, 79% of internet users in the United States use the most popular social media site, Facebook, and research shows that usage is similar across demographic groups (Pew Research Center, 2016). While not a sole strategy for participant recruitment for every research study, social media may provide researchers with easy access to broad populations of interest and a non-coercive way to recruit interested participants. Classic grounded theory (GT) is a research design in which all forms of data may be valuable (Glaser, 1978). However, many grounded theorists rely heavily on interviews as primary sources of data. Glaser (1998) described interviewing participants in person without recording interviews or taking notes and then, afterwards, recording field notes, coding, and memoing to prepare for the next day’s research. However, while some researchers today have dedicated time to devote to research as a primary responsibility, many academics, students, and other researchers are trying to fit research into already full schedules and cannot devote time to research every day. Additionally, participants may be extremely busy, and it is not always realistic for researchers to expect people to be available for in person interviews. Further, for grounded theory students, recording and transcribing interviews may be a requirement of their doctoral programs; in the era of the coronavirus pandemic, virtual data collection and interviewing may be another requirement. Therefore, it is important for researchers, including GT researchers, to learn about possibilities for and successful application of virtual recruitment and data collection strategies. This article is based on personal experiences conducting a classic GT dissertation study, as well as subsequent grounded theory research, using social media and audio and video conferencing software platforms. In the sections that follow, I will address some of the ethical and practical issues that relate to virtual recruitment and data collection that may be relevant to researchers in general to provide context for a discussion about how these topics relate to grounded theorists specifically. Deciding to Recruit...