Grounded Theory: Study of Aboriginal Nations...

Gary L. Evans, University of Prince Edward Island, PEI, Canada Abstract Recently, Elers (2016) published an article stating the importance of using Classical Grounded Theory (CGT) when researching indigenous populations.  This article puts forward CGT as a viable and necessary tool for researching this complex subject as it requires researchers to utilize multiple data sources and, as in this particular project, can be used by multiple disciplinary teams. Canada has much to do to rebuild the trust of the indigenous people of Canada. CGT shows promise as a methodology that gets to the root of the issues and offers one of the best opportunities to develop a theory that can be part of the constructive healing process going forward. Keywords: Aboriginal, indigenous, TRC, labour readiness, grounded theory, research teams. Introduction The project started eight months ago and continues to be a work in progress.  This short analysis provides some insights of the challenges and importance of classical grounded theory (CGT) for a critical area of Canadian research.  It is not possible to highlight all the findings at this stage therefore the purpose of this paper is to put forward some of the lessons learned. The first and most important lesson to be shared is Glaser’s dictate that “All is Data” (Glaser, 2007). Study outline The study started with a call from a Canadian research government funded agency looking at pathways to improve education and labour opportunities for Aboriginal youth.  The process required interviews and focus groups to be conducted across a region.  Concurrently some team members explored literature looking for existing and past insights of specific challenges and opportunities for education and employment.  The research team consisted of professors from different universities and backgrounds. The team included Psychology, Anthropology, Education and Business researchers. The literature review material, while being collected concurrently during interviews, was not shared with the research interview teams until after the groups had completed their initial comparative analysis. One challenge faced by the research team was the diverse level of individual knowledge members had on Aboriginal culture and history. From a researcher’s perspective, the flexibility of the CGT methodology was key to researching the job and education phenomena.  Ehigie and Ehigie (2005) highlight that in certain areas of research it is important for team members to have an understanding of the participants they are studying.  As put forward by Elers (2016), indigenous research is well suited to CGT and this view is supported by his personal comment received from Barney Glaser “It is all just data with patterns in it” (Elers, 2016, p. 114) Past quantitative research of education and employment, does not answer the question, why Aboriginal education and employment levels fall far below the national average.  During data collection, it became clear the issue was complex and went beyond poor education and labour statistics.  CGT provides a framework that supports multiple data sources and allows the data to lead the researcher forward. It was important that all members approach the phenomena with an open mind and willingness to allow the data and process to drive the direction of the study.  Classic grounded theory (CGT) researchers need to ask themselves the questions: “What perspective do I represent?” and “How may this perspective influence my reading?” (Deady, 2011, p. 51) The goal of improving labour and education opportunities was the primary focus, but to understand the phenomena it is necessary to understand the history of Canadian Aboriginal people.  Since before confederation the Aboriginal people in Canada...

Negotiated Re-orienting: A Theory Generated through International Collaborative Research...

Tom Andrews, University of Cork, Ireland Introduction The theory presented here was generated from a research project that involved researchers in five countries.  To our knowledge, this is the first classic grounded theory generated by such an international collaborative effort.  This article starts by describing the collaborative process, then the theory is presented. The project This research project was co-ordinated by researchers in the United Kingdom (UK).  They were quantitative researchers, quite unfamiliar with qualitative research in general, but decided to use grounded theory without any knowledge of the methodology other than being aware that it is effective at generating theory.  I was invited to join the project and together with colleagues from Brazil, Germany, Ireland, Palestine, and the UK, we held our first meeting in the UK.  It became clear that everyone had a different view as to what GT is.  The Brazilians were intent on using constructionist GT, the Germans advocated that situational analysis GT should be used, while the Palestinians and British did not know anything about the methodology.  To ensure that we were collecting data and doing data analysis in a similar way, I gave a presentation on classic GT.  The quantitative researchers thought of qualitative research as weak and non-scientific.  However, following the presentation, they had changed their minds and became even more convinced that classic GT was very suitable to investigate the substantive area of Intensive Care nurses’ perception of their role in end-of-life care. Semi-structured interviews were conducted and included 51 participants in five countries.  Although contrary to classic GT, this is a compromise that at least initially had to be made for the sake of the study.  Nonetheless, researchers in each country were encouraged to use theoretical sampling by following up on what was said at previous interviews.  The project team in each country participated in-person or via Skype in a two-day analysis workshop at the University of Surrey in order to discuss analysis of each country’s dataset.  It involved a lot of discussion and convincing others that what seemed like differences were in fact not so when the data were conceptualised.  This was not surprising given the different ways that researchers were approaching analysis.  This proved to be a very effective way of analysing and agreeing on the core and other categories.  Memos with supporting quotes and full transcripts of three interviews from each country were prepared and circulated to all team members.  Researchers in each country independently read all of the transcripts and coded them separately, looking for patterns. An additional two meetings took place in the UK, in person or via Skype where the team discussed patterns relating to the core category.  Following these two meetings, a template was circulated with sections of memos and interviews from each country in order to reach consensus.  At the team meeting in Ireland we finalised the core concept and discussed dissemination of the results. The theory Nurses’ main concern in Intensive Care end-of-life care is to shift the emphasis from active treatment to palliative care.  However, this is problematic given the uncertainty surrounding prognosis.  Patients in ICU are often in what Glaser and Strauss (1967) referred to as uncertain death and unknown time when the question will be resolved.  This idea is central through negotiated re-orienting.  The shift from uncertainty to a greater certainty of impending death implies that activities orientate to curing are now ending and replaced by activities prompted by the dying process.  Nurses actively seek to bring this...

Patterns of Theoretical Similarity

Kara L. Vander Linden, Saybrook University, USA Abstract Classic grounded theories explicate patterns of behavior used by individuals within a substantive area to address problematic areas that they are working to address.  Through the brief examination and explanation of two classic grounded theories conducted by the author, overlapping patterns of theoretical similarity are discussed despite the theories’ emergence from different substantive areas. The future development of formal grounded theories from these and other substantive grounded theories is discussed. Keywords: theoretical similarity, grounded theory, navigating new experiences, surviving the complexity. Years of conducting classic grounded theory (CGT) research and overseeing CGT research by doctoral students have reinforced Glaser’s (1978) statement that “The goal of grounded theory is to generate a theory that accounts for a pattern of human behavior which is relevant and problematic for those involved” (p. 93).  Due to the theoretical nature of the patterns of behavior discovered, theories developed using CGT often depict overlapping patterns of behaviors and concepts despite emerging from different substantive areas. This article will exemplify this by examining two CGT studies conducted by the author in two different substantive areas: adult learning experiences and grandparent-headed households.  First, a summary of each study will be provided.  Then a discussion of areas of theoretical similarity between the two studies will be presented. Finally, next steps in the development of formal grounded theories are presented. Navigating new experiences Navigating (Vander Linden, 2005) explains three cyclical stages of going through a new experience and factors that may affect the process.  In the mapping stage, people engage in locating (assessing one’s location in relation to a goal), surveying (information gathering), and plotting (creating a plan).  In the embarking stage, people move through the experience using normalizing (creating a new normal) and strategizing (overcoming obstacles encountered).  In the reflecting stage, people reflect on the experience.  These stages are affected by properties of the experience (complexity, newness, structure and control, a catalyst, etc.) and factors that affect the person (emotions, goals, competency, obligations, perception, perspective, modus operandi, etc.). Surviving the complexity Surviving the complexity (Tompkins & Vander Linden, 2016) is a survival process of taking on the caregiving role and doing what one can despite multiple factors that make the situation difficult.  The theory introduces three types of complexity: situational, relational, and emotional.  Throughout the process, the caretaker engages in surviving behaviors to do what he/she can within a complex situation.  The process begins with a trigger event (tragic or destabilizing) that leads to the caregiver (parent) abdicating the role to another.  Stage 1, rescuing, is engaging in temporary, emergency action (helping-out, stepping-in, and taking-in) to save others from harm.  Within rescuing the new caregiver engages in adjusting (figuring out the new role and aspects contributing to the complexity of the situation) and accepting (coming to terms with the situation).  Rescuing ends as the new caregiver is faced with the decision to abdicate the role or move to stage 2, taking-on, where the caregiver consciously commits to take-on the caregiver role and the inherent complexity it brings for a longer duration. While taking on, the caregiver engaged is quieting the chaos (bringing order to confusion through stabilizing and normalizing), doing one’s best, and problem solving. Areas of commonality Both theories identify common patterns of behavior used by individuals resolving problematic aspects within the substantive area and factors that influence these behaviors.  Significant concepts that emerged in common between the two theories included: complexity, emotions, power and control, obstacles and problem...

Complexities in Palliative Cancer Care: Can Grounded Theories be Useful to Increase Awareness?...

Anna Sandgren, Linnaeus University, Sweden This paper includes first a summary of a grounded theory “Living on hold”, which was one of four different grounded theories in my dissertation (Sandgren, 2010). The theory is then explained in relation to the other grounded theories to give an example of how different grounded theories can be integrated, which leads to an increased awareness of what is going on in a research area. Keywords: palliative cancer care, increase awareness, grounded theories, living on hold. Living on hold The aim of this study was to develop a classic grounded theory of palliative cancer patients and their relatives. Interviews and data related to behavior of patients and relatives were analyzed. Being put on hold emerged as the main concern for palliative cancer patients and their relatives. Being put on hold means that their normal existence is falling apart; normality is breaking down and with it a loss of control. Living on hold consists of three modes of behaviors: the fighting mode, the adjusting mode, and the surrendering mode. Mode being, an individual’s current mode, depends on, for example, age, personality, diagnosis and prognosis, social network, earlier experience of crisis, continuity of care, and professional competence. During the disease trajectory, there may be triggers that start a process of reconciliation that can lead to mode shifts, so modes are not fixed. No mode is better than another. The process of reconciling Regardless of mode, patients and relatives evaluate not only their lives and their current situation, but also the past and the near future. Mode shifting can happen at anytime during the disease trajectory through the reconciling process. Mode shifting triggers, such as receiving bad news, dependency experience, and feelings of uncertainty, can trigger the reconciling process and lead to a change in behavioral mode. Patients and relatives often evaluate life differently, which may lead to individuals experiencing different behavioral modes within a patient’s group. Depending on their different moods, shifting between modes can happen quickly over a short period of time, which could be energy draining for all involved. Fighting mode In the fighting mode, patients and relatives are striving to renormalize their lives; no change to their previous way of life is desired. Through renormalizing, they strive to return to normal, managing themselves, and keeping track as before. Potential powers are discovered and unrealized innate powers may emerge when needed. Rebelling means not only protecting and fighting the whole situation, but also fighting the disease. Through blaming, patients and relatives seek reasons or causes for the disease, and finding something or someone to blame. In the fighting mode, they appreciate foreseeing, since this gives them full control over life, even if it is put on hold. Since individuals are hyper-sensitive, they are scrutinizing everything around them. Adjusting mode In the adjusting mode, patients and relatives are adjusting to a new normality and to new routines. Even though they are adjusting, they do not let the disease take over or control their lives. Adjusting to a life on hold involves moment living, which means maintaining a total presence here and now and involves planning for daily life but not for the future. Disease diminishing, which means not letting the disease affect their lives, is achieved through re-routining where new routines are created. Adjusting also involves façading, which means keeping an emotional facade and staying emotionally strong. Surrendering mode There are two different ways of being in the surrendering mode: resigning, which means giving up,...

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...

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,...

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...

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...