Book Review:Artinian, B. M., Giske, T., & Cone, P. H. (2009). Glaserian grounded theory in nursing research: Trusting emergence

Reviewed by Antoinette M. McCallin, RN, Ph.D.

This new research book focuses on Glaserian grounded theory and has been written specifically for nurse researchers. Although the many examples used to illustrate methodological issues are nursing related, the book will be of interest to grounded theory researchers across disciplines. The lead author, Professor Barbara Artinian, has researched using the method and supervised masters and doctoral students for over twenty years. The insights that come from her experience are combined with a strong commitment to endorsing classic grounded theory. The core category of the book could be identified as, “staying true” as per Glaser and Strauss (1967) and Glaser (1978, 1998).

The publication is impressive with multiple examples of grounded theory research that are critiqued rigorously yet sensitively. The end result is a resource that will be welcomed by students and supervisors alike. Differences between classic grounded theory, the axial coding model, and qualitative data analysis are addressed albeit succinctly. While purist Glaserian grounded theorists may be disappointed to see discussions on conceptual mapping, modes of grounded theory, and clinical intervention research, the key message is that researchers should strive to remain true to Glaser’s grounded theory.

This book is easy to read. Research issues are presented in a matter-of-fact manner. Rich practical examples and thoughtful responses promoting classic grounded theory abound. The writing is sincere yet unpretentious. The inclusion of wide-ranging research examples is a strength, which will be appreciated by grounded theory researchers keen to learn more about methodology. Practical matters that arise in any research project are considered along with the challenges of methodological application. Any deviation from classic methodology, as occurs in the instance of conceptual mapping, is addressed openly. Cone and Artinian acknowledge that they “differ completely from Glaser” (2009, p. 43) in identifying conceptual maps. These maps are seen as a useful tool for research students who are visual learners. While the conceptual map is possibly similar to Glaser’s diagrams, which may have a place in theory development (Glaser, 1978), it is offered as tool to move researchers from description to conceptualisation. There is a provision though: creating a map steeped in description is definitely not recommended. The purpose of mapping is to raise thinking to clarify the relationships between concepts in the emergent theory.

The chapter differentiating classic grounded theory from the Strauss and Corbin version is effective. Artinian (2009) suggests that “the emergent method of coding and writing memos about the emergent process is very different from the axial coding method described by Strauss and Corbin (1990) in which every category is fully dimensionalised” (p. 21). The example of axial coding is particularly interesting, as the frustrations of situational description, the complete missing of participant relevance, are discussed. What is helpful is that the example is taken a step further to show readers how a grounded theory researcher can return to the classic method and “lift” the data to generate a theory that is relevant, fits and works. Artinian confirms her commitment to classic grounded theory, emphasising the importance of putting preconceptions aside, and staying true to the data, so that the participant resolution of the main concern is allowed to emerge.

Another chapter, “Bending the directives of Glaserian grounded theory in nursing research” might make the purist classic grounded theorist nervous. You are encouraged to read on, however. In this chapter the common issue of staying true to grounded theory when members of dissertation committees do not understand the methodology, is addressed. Cone and Artinian argue that: “Through all phases of the research process, careful attention was given to classical GT methodological issues and Glaser’s reasoning behind each. Sometimes his directives were clear and were followed closely; others were not so clear and needed careful exploration of the thinking that led to the rules to follow them accurately” (2009, p. 35). Once again, as is typical of this book, arguments are thoughtful. There are few surprises, although the strategy to satisfy committees about reviewing the literature without doing a literature review is highly creative, and looks promising. Students designing grounded theory projects will find this chapter invaluable.

One more interesting contribution in the book is the theory of preparative waiting that is presented firstly in descriptive mode, and later in theoretical mode using balancing as the theoretical code. The first example is straightforward whereas the second example is more difficult to follow, possibly due to language inconsistency. Nonetheless, the illustrations demonstrate the different levels of thinking and abstraction. This is important because Artinian recognises that some students have problems with conceptualisation. While conceptualisation skills can be taught, there are always students attempting to use grounded theory who cannot think in the abstract. If at all possible those students should be redirected elsewhere (Glaser, 1998). Reality management is less straightforward. Because conceptualisation problems do not always become apparent until a student is well down the track in the research process, supervisors need retrieval strategies to manage such situations. Artinian et al (2009) offer some solutions by providing many examples of theory that vary from what they call the descriptive mode (describing a specific situation), to the gerund mode (the core category is a basic social process), to the emergent fit mode (extension of an existing theory). While the supervisory preference is that the student will conceptualise, the accurate labelling of description as description is surely better than passing off knowledge as an abstract theoretical explanation when analysis is at a lower level. The book goes some way to address this delicate issue and provide options for supervisors and students.

The final section of the book on interventionist grounded theory is quite different to previous discussions of classic grounded theory. According to Artinian “the purpose of the intervention mode is to test and modify an existing theory while improving clinical practice” (2009, p. 320). In nursing, evidence-based research dominates knowledge generation (Mateo & Kirchhoff, 2009) and the highest level of knowledge comes from a randomised control trial. Grounded theory does not lend itself to that type of development, hence this particular application. According to the author, interventionist grounded theory is a form of evaluation research that follows Glaser’s call for “grounded abstraction generates application” (2007, p. 106). It is debatable if Glaser intended that grounded theory be developed into this type of study. So while the interventionist application may be a liberal interpretation of grounded theory application, I have some sympathy for nurse researchers who want to use the methodology and are required to do so in a way that is responsive to the highly political context of research.

In conclusion, I highly recommend this book to researchers, grounded theory students and supervisors. The strength of the book is its unreserved adherence to fundamental principles of Glaserian grounded theory. It is a valuable resource for experienced and novice grounded theorists alike; its numerous examples providing practical illustrations for researchers keen to learn more about methodology.

Reviewer

Antoinette M. McCallin, RN, Ph.D.
Head of Research, Division of Health Care Practice
Faculty of Health and Environmental Sciences
AUT University
Auckland, New Zealand
Email: amccalli@aut.ac.nz

References

Artinian, B. M., Giske, T., & Cone, P. H. (2009). Glaserian grounded theory in nursing research: Trusting emergence. New York: Springer Publishing.

Cone, P. H., & Artinian, B. M. (2009). Bending the directives of Glaserian grounded theory in nursing research. In B. M. Artinian, T. Giske, T. & P. H. Cone, Glaserian grounded theory in nursing research: Trusting emergence (pp. 35-47). New York: Springer Publishing.

Glaser, B. G. (1978). Theoretical sensitivity: Advances in the methodology of grounded theory. Mill Valley, CA: Sociology Press.

Glaser, B. G. (1998). Doing grounded theory: Issues and discussion. Mill Valley, CA: Sociology Press.

Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory; Strategies for qualitative research. Chicago: Aldine Publishing.

Mateo, M. A., & Kirchhoff, K. T. (2009). Research for advanced practice nurses: From evidence to practice. New York: Springer Publishing.