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.  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 (1965) identified different levels of patients’ awareness of their impending death and the effects these levels of awareness have on patients, families, nurses, physicians, and their ensuing interactions.  They discovered four distinctly different awareness contexts: closed awareness, suspected awareness, mutual pretense awareness, and open awareness.  Using Awareness of Dying as an example, Glaser calls for a reality-focused approach that includes real-life illustrations and comfortable language familiar to those for whom the theories apply, thus making the theories more accessible and useful when applied to practice.  As I write this, I think about the millions who have died from Covid-19 in hospitals worldwide.  I also think about the health care workers at those bedsides and the burdens they carry when patients are dying all around and families are not allowed to visit. I remember how a nurse supported a family member who had difficulty accepting her mother’s impending death, even though the awareness context was open.  According to another nurse who watched, the nurse “put on her PPE, entered the room, and video called the daughter. She talked for a few minutes and then laid down on the floor and slid under the patient’s bed so the woman could see her mother’s face one last time” (Anonymous, personal communication, March 21, 2021).  New data like this can serve to modify, strengthen, or extend the theory of awareness of dying.

Also included in this issue are seven methodological and theory papers from grounded theorists around the globe.  We are pleased to disseminate these papers in the hope that they can be useful in application and helpful to those who are novice grounded theorists.

Emily Cashwell’s timely paper, Recruitment and Data Collection in the 21st Century describes how she used electronic media to recruit and interview participants.  Cashwell suggests that even though certain topics of study and certain populations or people may make it inherently easier to recruit online and to approach with the option of using audio and video conferencing software, the coronavirus pandemic increased restrictions on researchers’ in-person data collection activities.

Kara Vander Linden and Patrick Palmieri propose that current qualitative evaluation guidelines are too general to identify a manuscript with an inadequate study design.  Vander Linden and Palmieri’s paper identifies essential methodological criteria for reporting a classic grounded theory study.  They further suggest that the classic grounded theory criteria outlined in their paper should be incorporated into existing guidelines and included as a classic grounded theory study design extension in the EQUATOR framework to support the existing qualitative reporting guidelines.

In a short paper entitled, Collaborative Grounded Theory, Kara Vander Linden and Catherine Tompkins describe how the researchers’ professional relationship began as a mentor/mentee one and transformed into co-researchers using grounded theory. They explain how they navigated each stage of the process of conducting a grounded theory study using a collaborative and interdisciplinary approach. The paper also presents some key takeaways for researchers to consider when working collaboratively.

In a paper entitled Personalizing Wellness: A Classic Grounded Theory Kari Allen-Hammer explains how individuals create wellness.  Allen-Hammer discovered a three-stage process which revealed a voluntary, self-led learning and change process toward a personal vision of wellness.  She found that wellness is not a stagnant objective to be obtained but rather an alive and dynamic interaction of experiences and processes to be lived.

Kianna Marie McCoy and Susan Braude Stillman studied fathers of children with autism.  In the paper entitled, Absenting: Fathers of Children with Autism Face the Future, the authors define absenting as the father’s fear of what will happen to his child with autism when he, the father, is no longer living. McCoy and Stillman found that fathers of children with autism anticipate their future absence in three ways: 1) preparing financially, 2) preparing for future living, and 3) preparing the child to live life to the fullest.

In a study with universal implications, Alan Kim-Lok Oh discovered A Theory of Securing. Oh’s theory explains the role of our feelings of insecurity in forming selfhood. He proposes that when feelings of insecurity are explored honestly with trusted-others and acted upon with their guidance, we continuously become a better version of ourselves.

Judith Wright, Robert Wright, and Gordon Medlock’s theory, Evolating: A Grounded Theory of Personal Transformation, describes the phases of learning and transformation that emerged from the study of historic transformers and exceptional students.  The authors discovered a multiphase process through which individuals consciously engage in their own transformation and attain otherwise improbable levels of human potential. The data indicate that evolating among exceptional students who engage in all the phases predictably leads to a deeper, more accomplished life of greater meaning and purpose. The theory also provides a framework for strategizing learning and growing as well as explaining periods of stagnancy and ineffectual efforts to change attempted by both individuals and institutions.

For those who are interested in learning more about modifiability and other aspects of classic grounded theory, Glaser’s books are available for purchase through the Sociology Press website at

Alvita Nathaniel, PhD



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

Glaser, B. G., & Strauss, A. L. (1965). Awareness of dying. Aldine Publishing.

Glaser, B. G., & Strauss, A. L. (1968). Time for dying. Aldine.