Issue no.2/3, March/June 2006

Thoughts on the Literature Review and GT

Alvita Nathaniel, DSN Thinking about epistemic questions always reminds me of Socrates’ cave allegory. In Plato’s most famous book, The Republic, Socrates talks to a young follower named Glaucon. I would like to include here a short excerpt of their conversation and discuss how this relates to my thoughts about preceding a classic GT study with a thorough literature review. [Socrates] Imagine human beings living in a underground, cave like dwelling, with an entrance a long way up, which is both open to the light and as wide as the cave itself. They’ve been there since childhood, fixed in the same place, with their necks and legs fettered, able to see only in front of them, because their bonds prevent them from turning their heads around. Light is provided by a fire burning far above and behind them. Also behind them, but on higher ground, there is a path stretching between them and the fire. Imagine that along this path a low wall has been built, like the screen in front of puppeteers above which they show their puppets [Glaucon] I’m imagining it. [Socrates] Then also imagine that there are people along the wall, carrying all kinds of artifacts that project above it—statues of people and other animals, made out of stone, wood, and every material. And, as you’d expect, some of the carriers are talking, and some are silent. [Glaucon] It’s a strange image you’re describing, and strange prisoners. [Socrates] They’re like us. Do you suppose, first of all, that these prisoners see anything of themselves and one another besides the shadows that the fire casts on the wall in front of them? [Glaucon] How could they, if they have to keep their heads motionless throughout life? [Socrates] What about the things being carried along the wall? Isn’t the same true of them? [Glaucon] Of course. [Socrates] And if they could talk to one another, don’t you think they’d suppose that the names they used applied to the things they see passing before them? [Glaucon] They’d have to. [Socrates] And what if their prison also had an echo from the wall facing them? Don’t you think they’d believe that the shadows passing in front of them were talking whenever one of the carriers passing along the wall was doing so? [Glaucon] I certainly do. [Socrates] Then the prisoners would in every way believe that the truth is nothing other than the shadows of those artifacts. [Glaucon] They must surely believe that. [Socrates] Consider, then, what being released…. What do you think he’d say, if we told him that what he’d seen before was inconsequential…. …if we pointed to each of the things passing by, asking what each of them is, and compelled him to answer, don’t you think he’d be at a loss and that he’d believe that the [shadows] he saw earlier were truer than the [objects] he was now being shown? (Plato, trans. 1997) There is more to the story, of course. Light at the opening of the cave represents knowledge. The people chained at the bottom of the cave are situated as far from knowledge as they could possibly be. As they sit there, they begin to interpret meaningless clues and to attach meaning to them. Given enough time, they will surely develop theories and then, if released, go off somewhere to teach and write about them—or so I imagine. The other people in the cave are climbing to the opening, moving toward true knowledge....

NEW WAY OF USING LITERATURE IN GT?

Hans Thulesius, GP, Ph.D. After having read Antoinette McCallin’s paper on literature use in GT I find myself asking the following question. Is McCallin’s way of applying the literature letting the research area emerge in a literature search an important modification on how to use the literature in classic GT according to Glaser? McCallin shows how her way to a one core variable grounded theory went over a literature review in the beginning of her research. But this literature review was actually a general literature search for a problem area to explore since McCallin tells us that she did not have a finite area of research before screening the literature. Eventually, through a literature search she decided that she wanted to study interprofessional practice in health care. After having found this problem area McCallin did what is not recommended in classic GT – she began studying the scientific literature on interprofessional practice. However, the area was almost unexplored. In my opinion McCallin did not start her GT until she found the specific research area she wanted to explore. But this area was not found through a specific scientific literature search but by generally exploring what was going on in the health care scene in her part of the world. Then she could have been preconceived by too early reading the scientific literature, but the area was scientifically a virgin land to her luck. Fortunately, the literature revealed that there was little published research on the concept of interprofessional practice (Bishop & Scudder, 1985; Casto & Julia, 1994; Gabe, Kelleher & Williams, 1994; Leathard, 1994; Ovretveit, 1993; Petersen, 1994; Soothill, Mackay, & Webb, 1995). Most readings proved to be anecdotal accounts of interprofessional teamwork. (McCallin, 2003, p.66) McCallin then generated a useful grounded theory explaining how health care professionals through pluralistic dialogue overcome difficulties in working together. So the answer to the above question is no. McCallin just did what Glaser suggests, reading a lot, but not in the area of study. Her general literature search increased her theoretical sensitivity in discovering a relevant research area. As she tells us: “Perhaps long-term study within the discipline of nursing had de-sensitised me to the wider issues common to all health professionals working in the health reform environment?” (McCallin, 2003, p.65) So the recommended use of literature in Grounded Theory research according to Glaser fits with how McCallin used it in her Pluralistic Dialogue study. What may be somewhat new is that McCallin actually found her problem area in the general literature. Author Hans Thulesius, GP, Ph.D. Kronoberg County Research Centre Department of Community Medicine Vaxjo, SE Email:...

Aspects on McCallin’s paper, “Grappling with the literature in a grounded theory study”...

Helene Ekström, MD, Ph.D. I read Antoinette McCallin’s paper with interest and I have learned that there are problems which I have foreseen perhaps because I am, as many medical doctors are, unaware of the many “theories” or different perspectives that one can chose in undertaking a study. Kirsti Malterud, Professor of General Practice in Bergen, Norway, used to say that we are theoretically ignorant and instead focus on the pragmatic issues of how to survive the day and help the “sick” in an appropriate way. However, even if I feel like a real novice, I have some remarks about literature and grounded theory studies. A literature review as part of, for instance, a research proposal and one that is undertaken when actually performing a grounded theory study are two different issues in my opinion. When writing a research proposal or an application for research funding, the issue is (which I personally learned the hard way….) to follow the rules of the committees or funding agencies whether or not the review demanded is appropriate for what you plan to study. Here the discussion in the first part of McCallin’s paper is appropriate because when you write a research proposal or the like perhaps (although not necessarily) a discussion is needed of the different “GT methods”, their requirements, historical development, different opinions among researchers and so on as well as why you have chosen a particular approach. On the other hand, when actually doing a grounded theory study I believe the issue is to follow the rules of the method you have chosen; that is, either classical (Glaserian) GT, the Strauss and Corbin version or any other versions. To read the appropriate method books over and over again while collecting and coding data is the most important part of literature reading. Reading other GT studies done using the same method as you have chosen can also help and is essential for increasing your understanding of “how to do it” as well as in sensitizing your knowledge of theoretical codes that may enable you to reach a high enough level of abstraction in your own analysis. These issues of reading literature I miss completely in McCallin’s paper. In my own experience, just finding good grounded theories through the usual literature search databases is a challenge, certainly for those of us in the medical profession. It would have been helpful to have some guidance about this in the paper. I also miss a clear explanation of the two main aspects of literature review when the theory has evolved; that is, how to search for literature about other research in the same area of interest as well as literature dealing with concepts and theories similar to what has emerged in your grounded theory. In my own doctoral study, this meant looking both for other papers about how women experienced menopause as well as papers about “status passages” as these were my emerging categories and main concern. In summary, I feel that McCallin’s paper could have been improved by offering an outline as to what purpose literature reading serves at different times during a GT study. The example used in the paper did not reveal this to me but had it done so would have been of great value to many researchers new to GT. Author Helene Ekström, MD, Ph.D. Kronoberg County Research Centre Department of Community Medicine Vaxjo, SE Email:...

The Relationship between an Emerging Grounded Theory and the Existing Literature: Four phases for consideration...

Vivian B. Martin, Ph.D. The relationship between grounded theory researchers and the existing literature has become a red herring that even confuses some grounded theorists who have completed a study. Antoinette McCallin’s essay does a commendable job outlining the realities of the research terrain that make proceeding without some exposure to the literature unlikely and ill-advised in most situations. When embarking on my dissertation, I needed to know enough about the literature, both substantive and methodological, to argue for the use of classic grounded theory as opposed to many other choices within my field; yet my study benefited from the necessary tensions between the emerging grounded theory and the existing literature. In this brief essay I propose that the relationship between the existing literature and a developing grounded theory project goes through four discernible phases: noncommittal, comparative, integrative, and, if the analyst can push, a transcendent phase in which the theory is not simply one of a number of theories of a kind within the discipline’s literature. I explain the phases to make more explicit the under-recognized subversive potential of grounded theory to push pass disciplinary boundaries by broadening the ‘relevant’ literature. Barney Glaser has often admonished grounded theory researchers to put off the literature to avoid wasting time and energy with literature that may prove irrelevant. I have not found such literature to be irrelevant as much as limited, and in some cases restricted by what a particular discipline defines as the appropriate literature. Therefore, the question of what literature offers possibilities for literature review and comparisons that would allow for richer knowledge generation. I return to this matter toward the end of the essay. Four Phases of Relating Although many experienced grounded theorists explain the read-or-not-to-read quandary in grounded theory methodology as one of pacing, thinking of the initial phase as “noncommittal” helps focus on the principle Glaser wants to convey: a distancing from the predefined problems and concerns. Since some knowledge of the literature is presumed – one could not write or defend a dissertation proposal or grant application otherwise – a researcher needs to take explicit steps to refrain from committing to questions and concepts privileged in the literature. Writing memos of one’s preconceptions to make them more explicit, something Glaser recommends in his troubleshooting seminars, is one way. And I would humbly argue that viewing the necessary initial relationship as noncommittal would help novice researchers come up with other strategies that allow for them to graze the literature or know enough to fulfill certain requirements while making a conscious shift of mind to maintain openness to the field. Although I was familiar with the literature on news consumption in my field, I was aware of enough of the limitations to remain noncommittal. But when certain patterns from the literature started to show up in the field, albeit sometimes with a twist, I knew it was time to move back into the literature to start making the kind of comparisons that allowed me to get more selective with concepts. As part of selective coding, I applied some of my concepts to the existing literature, including some large surveys and industry reports. The integrative phase was a little trickier, perhaps reflecting the tensions between discovery of theory and the need to fulfill requirements within the discipline. The short explanation of what happened to me in this phase, at least initially, is that my pacing went awry when I let the literature get away from me. I...

Methodological Issues: Have we forgotten the place of thinking here?

Antoinette M. McCallin, Ph.D., RN The article “grappling with the literature in a grounded theory study” (McCallin, 2003) has stimulated a lively discussion in the international grounded theory research community. In this paper, I reply generally to my colleagues’ responses and raise some further issues that I do not believe have been addressed to date. In particular, I question if current discussions about the place of literature review are incomplete if methodological matters are debated in isolation from issues of thinking. The purpose of this paper is to argue that although literature review is preferably minimised initially, simply focusing a study, in reality timing does not matter, as long as the analyst is critically analytical of literature at all times, and does not allow existing knowledge to pre-empt identification of the research problem or formation of the emergent theory. In a less than perfect world, some researchers who do not have the luxury of grounded theory supervision will review literature in advance, and others will include a review as per the methodological ideals. What is important however, is how literature is managed and how the researcher thinks about the material he or she is exposed to. In other words, is literature integrated theoretically into a study or simply regarded as the received view of science and material to be accepted without question? The intent of the paper is not to remodel classical grounded theory but more to bring into the open some hitherto unexplained aspects of grounded theory thinking, which also affect what happens methodologically and ultimately, the rigor of the finished product. These issues are explored briefly. Background Originally, “grappling with the literature in a grounded theory study” (McCallin, 2003) was written as a teaching tool for masters’ students beginning grounded theory research projects. In one of my roles as a teacher I had noticed in grounded theory research supervisions that many students always asked the same questions. “Where should I begin? What should I read? What do I do about literature?” While the answers to those questions were available in the literature, ease of access to material was variable. In New Zealand most masters’ students work fulltime and study as well; time is precious. Some students were looking for shortcuts that could have saved them time as they organised study with hectic professional lives. Others, studying in distance learning situations, usually had immediate access to electronic databases, although library books had to be inter-loaned from various universities throughout the country, sometimes overseas. Coupled with this was a situation whereby the luxury of being a full-time scholar with unlimited time to review literature on methodology, seemed to be something of the past. In addition, there were, and still are few classical grounded theory researchers in New Zealand, so students studied with supervisors who did not understand the methodology and certainly few had the luxury of working through apprenticeship-style supervision in their research work. Therefore, the intent of the original paper was to provide a quick overview of significant issues and to highlight the practical problems that influenced research design. The paper has been well received by students and stimulated a lively discussion with more experienced grounded theorists, many of whom will be involved in supervisions as well. Responses Most of my colleagues are in agreement that a grounded theory researcher will look at some literature prior to a study. Vivian Martin’s notion of “phasing” is especially useful, reflecting the tensions between emergence and “the subversive potential of grounded...

Revisiting Caresharing in the Context of Changes in a Florida Retirement Community...

Eleanor Krassen Covan, Ph.D. Abstract In this paper I revisit the basic social process of caresharing whereby people engage in personal and communal strategies to maximize their pleasure and minimize their losses. I originally discovered caresharing in the context of Hollywood Falls, a Florida retirement community that provided no formal supportive services for its aging residents (Covan, 1998). There, hiding frailty was the most obvious caresharing strategy. In this community which has since become more diverse in terms of ethnicity and age, hiding frailty is no longer practical among the oldest residents. It has been surpassed by bolstering strength, a process which involves exposing need, expanding the caresharing network, stifling crises, and staking competence claims. In consequence of bolstering strength, the oldest residents are able to diminish the costs of help while augmenting opportunities for personal autonomy, thereby extending their period of residence within their ‘independent’ living community. Introduction Caresharing is a basic social process, originally discovered in the context of Hollywood Falls, a Florida retirement community (Covan, 1998). The process involves a combination of personal and communal strategies employed by residents of the community in order to maximize their pleasure and minimize their losses. Caresharing is no doubt an enduring universal social process, occurring in many contexts in which people decide to help one another in order to improve their lives. Caresharing is initiated from the ‘ground-up’by the people who themselves need some assistance and by the people who feel they can provide it, as opposed to services that are imposed by some larger more formal system of care, governed by codified regulations. The gerontological literature is replete with articles on “informal caregiving networks,” that could more appropriately be described in terms of their caresharing properties if researchers were to analyze the conditions in which caresharing alliances developed. Rousseau (1762) believed that citizens exchange natural liberty for something better, such as moral liberty. He posited that individuals would subject themselves to the moral order of formal communities for the common good of citizenry. In contrast, caresharing develops as a much looser network of voluntary exchanges such that surrender is inherently revocable, negotiable, and dependent on fluctuations in individual, communal, and environmental resources. Caresharing arrangements are selfserving, expandable, yet retractable social alliances, generated by functional needs as recognized by individuals. People elect to help one another because life is easier and thus ‘better’ this way. To the extent that caresharers perceive ‘surrender,’ it is surrender in the face of needs which they cannot meet on their own. They also understand that surrender may require reciprocating when others need help and that the help they receive may be provided by others who are reciprocating for services received in the past. When surrender occurs, it may be revocable when the need is no longer present or when the costs of providing or of receiving help are too great. Thus, caresharing alliances may involve individual considerations that social economists would recognize in terms of cost/benefit analyses. Of course, we are social beings and thus the endurance of caresharing alliances is dependent to some extent on the emotional and social bonds of kinship and or friendship. Within Hollywood Falls, such alliances in the past have been fostered by neighborliness, involving mutual respect for autonomy, reciprocity, and desperate personal struggles to remain in an independent living community. That caresharing benefited the Hollywood Falls community as a whole occurred in consequence rather than in motivation. As the residential population of Hollywood Falls has been changing,...