The Discovery Power of Staying Open

Judith A. Holton, Mount Allison University, Canada Glaser (1978) emphasized three foundational pillars of GT that must be respected: emergence, constant comparison, and theoretical sampling.  While many qualitative researchers who claim to employ GT will assert their use of constant comparison and theoretical sampling, there is much less clarity around claims to respecting GT’s emergent nature.  Emergence necessitates that the researcher remains open to what is discovered empirically in the data “without first having them filtered through and squared with pre-existing hypotheses and biases” (Glaser, 1978, p. 3) or theoretical frameworks drawn from extant theory.  In many qualitative studies, however, emergence is restricted to the analysis phase (e.g., Corley & Gioia, 2004) and with data collection framed through an initial review of the literature (e.g., Partington, 2000), articulation of specific research questions or interview protocols for “consistency” (Xiao, Dahya, & Lin, 2004, p. 43). Staying open to emergent patterns in data offers surprising and exciting theoretical discoveries—what Glaser has termed the Eureka moment.  Even in studies otherwise framed with some level of preconception, as typical of most qualitative research studies, it is possible to remain open to such discoveries.  This was the case in a research study conducted in 2010-2011. The focus of this study was a leadership development needs analysis for a health services organization where leadership was aligned with fostering a healthy workplace.  The intent of the study was to explore the perspectives of middle managers regarding the overall organizational climate and their leadership development needs.  A qualitative approach was adopted with semi-structured interviews to elicit a variety of experiences, directly and indirectly related to leadership development needs.  Thirty-two middle managers participated in the interviews. Detailed findings were shared with the organization and also published (Grandy & Holton, 2013a, 2013b). As a grounded theorist and a co-investigator in this study, what interested me most as the interviews progressed were moments of self-reflection in which verbal confessions and body language revealed a growing discomfort and realization of disconnect between espoused corporate messages about a healthy workplace, their experience of the organizational culture, and their own realized unhealthy work practices.  While the organization and we as researchers were focused on identifying key leadership development needs, the grounded theorist in me recognized that this felt disconnect—not leadership development—was the main concern of these middle managers.  I wanted to explore this idea further. Following completion of the initial study, we went back and selectively coded the data to better understand this discovered main concern, subsequently developing the concept voiced inner dialogue to explain how managers are able to surface and process the disconnects they experience between the espoused goals of the organization and their own lived experiences of those goals. We identified and elaborated voiced inner dialogue as a three-stage process: Reacting, not reflecting Reacting, not reflecting wherein managers simply react in accordance with organizational norms and espoused values without stopping to reflect on the appropriateness or feasibility of such norms and values, particularly when attempting to demonstrate leadership in a context of constant crisis and “putting out fires” typical of most health care organizations.  These “go, go, go” cultures are reactive, not proactive; there is no catching up, no opportunity to be strategic; timelines are short and imposed deadlines unreasonable.  In reacting, not reflecting managers assume responsibility for this disconnect by questioning their own competence as effective leaders. “I find the more I model this go, go, go, go they [subordinates] pick up on it …. I shouldn’t underestimate the...

Growing Grounded Theory: Doing my Bit

Helen Scott, PhD, United Kingdom In Glaser’s recent book, The Grounded Theory Perspective: Its Origin and Growth (2016), Glaser writes of how he recorded and explicated the grounded theory perspective and disseminated the perspective as the grounded theory general method of research, over a period of 50 years. During this period he has monitored its use, embracing procedural developments (e.g. Nilsson, 2011; Scott, 2011), whilst vigorously defending and differentiating the grounded theory perspective from adaptions (e.g. Glaser, 1992, 2002). A scholastic endeavour of monumental proportions. Over the decades, his key tools in achieving the phenomenal worldwide growth of grounded theory[1] are his books and troubleshooting seminars. In this way, he empowers an army of PhD students to spread the use of grounded theory wider still. The result is the continuing diffusion of the grounded theory method geographically and across disciplines including medicine, business, technology, journalism, psychology, international relations, and education and many more substantive areas of interest, including construction, caring professions, careers advice, prison life, de-radicalisation, living on a volcano and so on. Since learning how to do grounded theory is best achieved by experiencing the method, a key teaching technique used in both books and seminars is “exampling”. In his readers, Barney publishes grounded theories that represent the current frontier in grounded theory research. Novices are encouraged to read the theories to develop understandings about how grounded theory studies are conducted and constructed i.e. to identify the theoretical code(s) which model the substantive codes and to experience how the theoretical codes shape the presentation of the theory. In seminars, exampling helps the novice GT researcher envision the trajectory of their own grounded theory by working with other grounded theories at later stages in the development process. Additionally, in hearing of the procedural issues of other participants, novices are able to anticipate or notice their own procedural issues. In discussion, novices also learn how the procedures support the grounded theory perspective and how modifying procedures can, wittingly or unwittingly, compromise the grounded theory perspective. Encouraged by Glaser, several of his troubleshooting alumni now also publish books (e.g. Gynnild & Martin, 2011; Holton & Walsh 2016) and run seminars: Hans Thulesius and Anna Sandren run troubleshooting seminars in Sweden; Foster Fei runs seminars in China and Tom Andrews and I run seminars in Ireland, the UK, Malta, and Australia. One of my problems when learning grounded theory was that coming fresh to grounded theory as a novice PhD student from a department dominated by quantitative methods, much of what I read in Glaser’s writings was telling me what grounded theory was not: the issues that were being defended or differentiated were not my issues. I needed to know what grounded theory is. This has led me, in my methodological mentoring work to focus on the grounded theory research process. This approach works well and has supported my mentees in their development of some truly excellent grounded theories (Krieger, 2014; Stevens, 2015). My natural style is one of facilitation rather than teaching and I prefer to model grounded theory practices. If a mentee feels a need to compromise a procedure (such as using a structured interview design for collecting data at interview) I take care to explain how that will inhibit development of their grounded theory and example how I would approach the issue. I focus on practical matters of progress. Previously I have had little patience with what Glaser (1998) terms the “rhetorical wrestle” (p. 35) preferring to focus on...

Remodelling the Life Course: Making the Most of Life with Multiple Sclerosis...

Milka Satinovic, Western Norway University, Norway Abstract The aim of the study was to develop a substantive grounded theory on how to live a life as good as possible with multiple sclerosis (MS). The question of how to improve the quality of life is of key importance when speaking of a chronic illness like MS. We still have little knowledge of this important question from the patients’ perspective. Classic grounded theory was used to explore patients’ experiences of living with MS. The aim was to identify their main concern and how they process this concern at different phases in their life course. Twenty-one interviews were conducted with 17 participants diagnosed with multiple sclerosis. Participant observation at five courses for people with a multiple sclerosis diagnosis generated field notes. The participants’ main concern was how to live a life as good as possible in spite of their deteriorating health. The participants met this challenge through a process of remodelling the life course, in four phases: postponing (keeping up a normal life), adjusting (moving on to a changed life), restructuring (doing the best of it in a changed life), and transforming (preventing illness from controlling life). The remodelling process is influenced by the individual context, like the current health situation, biography, relations, and structural conditions. The process of remodelling helps us understand what facilitates and what hinders patients with MS from living a good life. Keywords: multiple sclerosis, patient’s perspective, quality of life, chronic illness, nursing, grounded theory. Introduction Multiple sclerosis (MS) is still an incurable and unpredictable chronic disease that is moderated by medication, and the persons’ own lifelong balancing between the illness and life evolvement. MS is challenging for the persons living with MS and the health-care personnel (Maloni, 2013). For the person with MS the challenge is how to handle (manage) the unpredictable and lifelong bodily symptoms and changes, and at the same time try to live a life as good as possible within his or her own life context. For the health care personnel, the challenge is to understand the illness, the persons’ own management strategies, rehabilitation, and health promotion in order to support and optimise the persons’ potential to live a life as good as possible with MS (Ploughman et al., 2012). In the study of factors, influencing healthy aging with MS (Ploughman et al., 2012) found resilience to be one of four fundamental factors “relating to the participants’ abilities to adapt to changes and disease symptoms, seek out and gain new knowledge, pursue self-therapy, deal with uncertainty, resolve problems on one’s own and cope with and overcome barriers” (p. 29). Thus, understanding the subjective experience of people living as well as possible with multiple sclerosis (MS) is of core importance in nursing, medical treatment, rehabilitation, and health care planning. Quantitative measurements of quality of life (QOL) have earlier indicated lower quality levels for people with MS diagnoses compared to those with other chronic illnesses (Benito-Leon, Manuel Morales, Rivera-Navarro, & Mitchell, 2003; McCabe & De Judicibus, 2005; Nortvedt & Riise, 2003).  In contrast,  a study of the relationship between QOL and coping was evaluated by McCabe, Stokes & McDonald, 2009). The study, which extended over a period of two years, revealed that people with MS increase their global quality of life over time. They experience higher psychological QOL, higher level of detachment, and are more focused on the positive coping than the general population. Studies on quality of life in MS using qualitative methods have focused...

Intacting Integrity in Coping with Health Issues

Lene Bastrup Jørgensen, University of Aarhus, Denmark, Stine Leegaard Jepsen, University of Aarhus, Denmark, Bengt Fridlund, Jönköping University, Sweden, Judith A. Holton, Mount Allison University, Canada Abstract The aim of this study was to discover and elaborate a general substantive theory (GST) on the multidimensional behavioral process of coping with health issues.  Intacting integrity while coping with health issues emerged as the core category of this GST.  People facing health issues strive to safeguard and keep intact their integrity not only on an individual level but also as members of a group or a system.  The intacting process is executed by attunement, continuously minimizing the discrepancy between personal values, personal health, self-expectations, and external conditions as health- and culturally-related recommendations and demands. Multifaceted coping strategies are available and used as implements in the attuning process. Keywords: intacting, health issues, coping strategies, general substantive theory Background Creating an overview and a general explanation of how people cope with health challenges is difficult as the literature on the coping process is comprehensive and diverse.  This diversity may be due to a profound heterogeneity in literature when it comes to the conceptual structure of coping (Skinner, 2003).  Various concepts are used to explain the same complex behavioral coping processes, and no consistent structure-related terminology on coping is available (Skinner, 2003).  A fragile theoretical foundation and theoretical rationale for coping-supportive clinical actions may be a consequence of this inconsistency. Several grand theories (Bandura, 1977, 1995; Lazarus & Folkman, 1984) on coping often lay the theoretical foundation for educating healthcare professionals.  The ability and suitability of these grand theories to explain coping processes dealing with health issues has not been challenged in decades.  Healthcare professionals are consequently challenged by diversity in the structural understanding of coping and a rigidity in the theoretical understanding.  Consequently, the competencies of healthcare professionals in supporting coping behaviors, and thereby the clinical needs of understanding coping, may not be sufficiently met by using these grand theories. However, according to Glaser and Strauss (1967), moving away from “grand theories” to develop empirically grounded substantive theory gives the theory better fit while sufficiently matching clinical needs.  As there is already a plethora of research and substantive theories on coping within the healthcare field, largely differentiated by medical criteria, the aim is to raise the conceptual level by offering a more nuanced explanation and understanding of a variety of substantive areas through development of a general substantive theory of coping in healthcare.  Glaser (1978) referred to a general substantive theory as “more general than a substantive theory, but not completely general as a formal theory” (p. 52).  Holton and Walsh (2017) referred to this mid-range theory development as “substantive formalization” (p. 22) and proposed that, “The substantive formalization of a substantive theory may be obtained through sampling different substantive groups, contexts, and/or social units within the same setting/substantive area; it increases the scope of a grounded theory” (p. 22).  As such, this study of coping with health issues constitutes the first step in the process of generating a formal grounded theory on coping that could, through further theoretical sampling, be extended beyond the health domain. This general substantive theory (GST) of intacting integrity emerged from two substantive grounded theories: one developed with pulmonary patients dealing with breathlessness (Jørgensen, Pedersen, Dahl, & Lomborg, 2013a; Jørgensen, Lomborg, Dahl, & Pedersen, 2013b) and the second with patients dealing with a fast track total arthroplasty (THA) programme (Jørgensen & Fridlund, 2016).  Subsequently, comparing the two theories,...

Final Thoughts on Exampling

Barney G. Glaser, PhD, Hon PhD, USA The humble purpose of this book is to help novice researchers doing dissertation research to do good GT by emphasizing the learning of GT by example. There is much to learn as GT methods become developed in the literature every year. This book has focused so far on exampling GT from its inception in 1965 to the reader Methods of GT in 1994. In this chapter I will discuss exampling GT to 2007 when I put out a reader with Judith Holton of very well formulated GT papers. It was called the GT Seminar Reader. Since this reader was published in 2007 to today both method and substantive GT papers have burgeoned following the style and procedure examples given in this reader. One source of this perfecting of GT methodology was my grounded theory troubleshooting seminar started 14 years ago in Paris. Novices trying GT for a dissertation came from all over the world to get help in doing the PhD dissertation using GT. These seminars are given all over the world by my colleagues. I designed the seminar in 2002 expressly to tend to the myriad of problems that emerge when doing a GT for a dissertation. The rule of the seminar requires participants to be totally open to whatever they think. The participants are also allowed to interrupt at will, to the point of a free for all of emergent possible ideas. There is no such thing as a good question, just whatever emerges as questions leading to possible categories and to perfecting GT procedures. The goal was to get each novice one step further in his GT research and doing this step “right”. The seminar unstuck each researcher presenting. Each presentation unstuck by examples of several typical problems that occur when tempting a GT research. Observers learned much as well as the participants. The open talk on troubles and problems was nonstop. The seminar focuses on exactly where each participant is with the goal of moving him/her one step further in the research. Problem coverage is achieved by listening to the array of problems of eleven or twelve troubleshootees. And after listening engaging in free for all open discussion about the problems and related problems with procedures that will help the participant. I keep the discussion under control as best I can, keeping in mind the helpful benefit of free associations of participants. The motivation to participate in these seminars besides the ‘grab’ of discovery is producing an acceptable dissertation that contributes to a field and is rewarded by a PhD. It must meet the high standards of the academia wherever it is being done. Candidates are committing themselves to this critical career junction at great personal cost of time and money. The value enhancement of going from student to doctor is tremendous. Committing themselves to doing a GT dissertation is a very fateful decision. It is a mystical passage to surrounding laymen, based on the awe-inspiring magic of the GT methodology. It is normal for a candidate to worry if GT research in his hands will pass muster, thus they are highly motivated to get help in doing GT and the GT troubleshooting seminar provides the help they need. They are highly motivated to get on with their lives based on the PhD career rewards. The candidates often go to two or three seminars as their research advances and different problems emerge. The troubleshooting seminar offerings have proven...

Celebrating 50 Years of Grounded Theory: Onward and Forward Editorial

Astrid Gynnild, University of Bergen Welcome to this very special issue of the Grounded Theory Review.  In this issue we celebrate 50 amazing years of grounded theory during which it has become one of the fastest growing methods in the global research world. Five decades after The Discovery of Grounded Theory was first published, the seminal work of founders Barney G. Glaser and Anselm Strauss is cited more than 94,000 times on Google Scholar alone. We celebrate that after 50 years of researching, teaching, defending, explicating and clarifying grounded theory as a principally inductive approach to theorizing, co-founder Barney G. Glaser still produces books on grounded theory at an incredible pace. In the last three years alone, from 2014 to 2017, Dr. Glaser has produced six new books that discuss vital aspects of doing grounded theory. We also celebrate that the Grounded Theory Review, after two years of scholarly assessment, is accepted into the Emerging Sources Citation Index (ESCI) within the Web of Science. It is a valued endorsement of the quality of the Grounded Theory Review that will improve its visibility within the academic world. We further celebrate that grounded theorists from all continents have the opportunity to participate in a growing number of troubleshooting seminars. The seminar is a productive arena for bringing emerging theories another step towards publication. While writing this editorial, I find myself once again immersed in the exciting learning space of a troubleshooting seminar led by Dr. Glaser, this time in Mill Valley, California.  At the chronological age of 87 Dr. Glaser still runs the troubleshooting seminar with methodological rigor and reversal humor. And he keeps arguing that the discovery of theory from data is a major task confronting researchers today. Interestingly, when Glaser and Strauss wrote The Discovery of Grounded Theory back in 1967, they opened the first chapter in this way: Most writing on sociological method has been concerned with how accurate facts can be obtained and how theory can thereby be more rigorously tested. In this book we address ourselves to the equally important enterprise of “how the discovery of theory from data—systematically obtained and analyzed in social research—can be furthered. We believe that the discovery of theory from the data—which we call grounded theory—is a major task confronting sociology today, for, as we shall try to show, such a theory fits empirical situations, and is understandable to sociologists and layman alike. Most important it works—provides us with relevant predictions, explanations, interpretations and applications. The multitude of theories produced over the last 50 years confirm that Glaser and Strauss were right—GTs do provide us with relevant predictions, explanations, interpretations and applications. We celebrate these events by publishing a Special Issue of the Grounded Theory Review. In this issue scholars from many disciplines contribute with their ongoing research and reflections on doing grounded theory. These articles demonstrate the breadth of approaches within the global grounded theory community by providing a glimpse into the multifaceted theorizing using the procedures of classic grounded theory. Since grounded theory is a method aimed at conceptualizing patterns of human behavior, examples help us to understand the various steps in doing a grounded theory study. Thus, in this celebratory edition of the journal we follow Glaser’s predications  on the necessity of exampling, and provide more than 20 papers, short and long, from a great variety of disciplines. In his latest book, Grounded Theory: Its origins and growth, Dr Glaser invites us to share in his matured ideas on the...