Data Analysis: Getting conceptual

Helen Scott, Ph.D. Abstract This paper will track my battle to ‘get conceptual’ in the production of a Grounded Theory. It will discuss early attempts at creating substantive codes through the process of open coding which, despite my best efforts, merely produced descriptive codes. It will illustrate the process by which these descriptive codes became more conceptual, earning the title of substantive code and how their presentation in essay form produced a perfect example of ‘conceptual description’. It will then describe the slow dawning of the purpose of ‘theoretical codes’ as organisers of substantive codes and the emergence of a Grounded Theory. Open Coding: The mechanics The substantive population1 of my study is adult online distance learners whose main concern (in descriptive terms) is finding the time to study. The process which addresses this concern is the ‘temporal integration of connected study into a structured life’ (Scott, 2007 a, b). An overview of the theory and its structure is offered in the Appendix to this paper. Participants were located all over the world, therefore most of the data for the study was collected online using email or chat2. Typically, the first emailed response from each person was the most detailed response with perhaps one or two emails received in reply to follow up questions. I would print and read the email or chat transcript for an overview. If I felt that I could understand what the participant was telling me, I started coding, otherwise I waited until subsequent emails or chat sessions improved my understanding. When open coding I had a piece of paper in front of me which asked: • What category does this incident indicate? • What property of what category does this incident indicate? • What is the participant’s main concern? (Glaser, 1998, p. 140) I asked these questions of every incident that I perceived and I wrote the codes in the margin. In addition, I used coding cards and wrote the indicators3 in full on the appropriate coding card(s) and referenced the indicator both on the printed, coded document and on the coding card. As a reference number, I used the initial of the person plus the incident number e.g. J-10. Coding to cards was cumbersome and time consuming but it helped me to get a feel for the process and to feel in control of my data. Actually I had too much control of my data; since I could record each and every code, the number of codes soon spiralled out of control. Thus the rhythms built into the method could not operate allowing the undesirable state of ‘full coverage’ over parsimony. Had I only coded in the margins, the relevant might have emerged more quickly, by the process of forgetting that which did not pattern out. Not yet understanding this, I would write the name of the code at the top of the card and in the body of the card write the reference number and the indicator. This was reassuring; as the cards became fuller, I could compare incident to incident easily. I could see how codes grew and became saturated. I could compare codes with codes and indicators between codes. I could see codes metamorphose into other codes and see the dimensions of codes emerge either across cards or within a card. For example, the coding card ‘Compliance’ listed indicators of ‘high compliance’ and ‘minimal compliance’. Indicators of ‘reducing compliance’ emerged, then ‘non compliance’ and then there were degrees of ‘non...

Demystifying Theoretical Sampling in Grounded Theory Research...

Jenna Breckenridge BSc(Hons),Ph.D.Candidate and Derek Jones, PhD, BA (Hons), Dip COT Abstract Theoretical sampling is a central tenet of classic grounded theory and is essential to the development and refinement of a theory that is ‘grounded’ in data. While many authors appear to share concurrent definitions of theoretical sampling, the ways in which the process is actually executed remain largely elusive and inconsistent. As such, employing and describing the theoretical sampling process can present a particular challenge to novice researchers embarking upon their first grounded theory study. This article has been written in response to the challenges faced by the first author whilst writing a grounded theory proposal. It is intended to clarify theoretical sampling for new grounded theory researchers, offering some insight into the practicalities of selecting and employing a theoretical sampling strategy. It demonstrates that the credibility of a theory cannot be dissociated from the process by which it has been generated and seeks to encourage and challenge researchers to approach theoretical sampling in a way that is apposite to the core principles of the classic grounded theory methodology. Introduction With the introduction of grounded theory, Glaser and Strauss (1967) challenged the prevailing hypothetico-deductive method of theory verification, questioning the gulf that existed between abstract theory and empirical research. They advocated that a theory developed in direct response to immediate problems under investigation would ultimately be more relevant to the studied area than any pre-existing theory. Thus proffered as a potential means of bridging the theory-practice divide, it is perhaps of little surprise that the grounded theory method has been embraced widely by the health professions. Grounded theory offers healthcare researchers a systematic and interpretive means of generating a theory from data that has the potential to explain, interpret and guide practice. However, a review of healthcare literature would suggest that while many authors profess to using grounded theory, they may only appear to have ‘borrowed’ a particular aspect of the method, most commonly the constant comparative approach to data analysis (Draucker et al 2007). Furthermore, ‘grounded theory’ studies have been criticised for possessing a somewhat “mystical” (Melia 1997 p.33) quality whereby: a sleight of hand produces a list of ‘themes’, and we are invited to take it on trust that theory somehow emerges from the data without being offered a step by step explanation of how theoretical insights have been built up (Barbour 2001 p.1116). Ultimately, this inconsistent application of grounded theory and the ambiguous way in which grounded theory studies are often presented within healthcare literature can pose several challenges to novice researchers. Without being able to refer to useful exemplars of grounded theory studies it is difficult to understand and prepare for the practicalities of carrying out one’s own grounded theory research. Similarly, when using grounded theory studies as evidence in practice or as part of a literature review it is difficult to ascertain the credibility of the research if the product cannot be linked explicitly with the process. This article has been written in response to the challenges faced by the first author whilst writing a classic grounded theory proposal, particularly in relation to theoretical sampling. As an active and ongoing process that controls and directs data collection and analysis, theoretical sampling is pivotal in ‘building up theoretical insights’. However, while many authors appear to share concurrent definitions of theoretical sampling, the ways in which the process is actually executed remain largely elusive and inconsistent. The purpose of this article is thus to...

Jargonizing: The use of the grounded theory vocabulary...

This paper is Chapter 1 of Dr. Glaser’s forthcoming book, Jargoning: The use of the grounded theory vocabulary (Sociology Press, 2009) Barney G. Glaser, Ph.D., Hon. Ph.D. When in doubt, jargonize. When you wish to belong, network, be collegial or be ‘a part of’, jargonize. When you want to sound knowledgeable, jargonize. When you wish to sound experienced, jargonize. Jargonizing is normal. All people, all human kind, jargonize in their lives to some degree or other. We use the vocabulary (jargon) of the area in which we act and talk. Jargon is a vocabulary of action by which to talk about what is going on. Most fields have their jargon. Few do not. Jargonizing cannot be stopped. It is needed. It can be very meaningful, properly so, for a field. In this book, however, I am writing about jargoning as just words with little or no real meaning, but sounding good and knowledgeable when talking about an area that one knows little or nothing about. In this way, jargonizing continually regenerates the GT (grounded theory) vocabulary wrongly as it is being applied to QDA (qualitative data analysis) concerns. Grounded theory is the buzzword in academic circles doing QDA research. Even though jargonizing cannot be stopped, it can be explained and seen for what it is and its consequences in eroding and remodeling GT as originated. I hope to mute the remodeling of GT to a significant degree. Paradoxically, jargonizing continually sells GT to the unknowing with the consequence they are buying into QDA as if it was classical GT. The resulting favorable attitude toward GT is therefore not really GT, but QDA. In this book, I shall deal with the jargonizing of qualitative data analysis (QDA) with the powerful grab of GT vocabulary in which jargonizing has lost the GT meanings behind the vocabulary. For most of the jargonizers, the true GT meanings of its vocabulary were probably never there to begin with. For an extreme jargonizing example, see The Sage Handbook (p.510)2: “Grounded theory has proven useful in orienting and sensitizing several generations of ethnographers.” Jargonizing seems to hide from the jargonizer as well as the listener, the fact that very often they simply do not know what they are talking about; especially when it is accompanied by a high degree of (unjustifiable) certainty. Furthermore, GT jargonizing is very much needed by QDA methodologists, as they have no vocabulary by which to talk about their methodology, I, Barney Glaser, have become known for a QDA methodology view that I did not discover or generate. How paradoxical. The vocabulary contribution of classical GT clearly goes far beyond the contributions of method and of its substantive products. Does jargonizing change GT as it remodels it? Absolutely No. It just remodels it for the people who jargonize QDA and do not know any better. The classical GT method may appear lost when talking about – jargonizing – QDA, but the classical GT method remains virtually the same and unchanged for its 40 years of existence. The remodeling of GT is actually a different, QDA method. Olavur Christiansen wants to stop the jargonizing but its grab will not let it happen, especially when it fills a vacuum (Christensen, 2007). Dropping original GT by QDA remodeling does not drop the classical method. Jargonizers do not realize this. Whoever might believe the jargonizing QDA as the “now” GT, does not know classical GT. Furthermore, jargonizing itself is accused as a jargon of “methodological rhetoric”...

Grounding the Translation: Intertwining analysis and translation in cross-language grounded theory research...

Svetlana Shklarov, MD, RSW, PhD Candidate Abstract Grounded theory research in cross-language, cross-cultural context is associated with the challenges of linguistic sensitivity of conceptualization. The author, a bilingual researcher, offers reflection on her experience of doing grounded theory research, assuming a dual role of a theorist and a translator. The reflection is based on self-observations. Grounding the translation is shown to be acheived through the strategy of intertwining the activities of translation and conceptual analysis, performed by one person. The two activities are inseparable in time and take place along with constant comparison across language boundaries. Intertwining requires that theoretical sensitivity of the researcher be enriched with the sensitivity to linguistic and cultural meanings. Intertwining, through revealing differences between linguistic meanings or language structures, facilitates the emergence of concepts and theoretical categories from the very act of translation. Combining the functions of translation and analysis and using the strategy of intertwining worked effectively for this researcher. Introduction Translation has been so much a part of qualitative research in multicultural settings that we rarely give heed to the depth of processes involved in cross-language data collection and analysis. Certain aspects are better understood than others. The most common, traditional concern is the accuracy and equivalency of information transferred from one language to another – the quality and ethics of translation (e.g., Houbert, 1998; Hunt & Bhopal, 2004). More recently researchers began to analyze the challenges of representation across languages, multiple interpretations, reflexivity, and the integral role of the translator (e.g., Friedrich, 1992; Mc Laughlin & Sall, 2001; Muula, 2005; Temple & Edwards, 2002). In this article I present a reflection on my experience of conducting grounded theory research, as a sole bilingual researcher with monolingual participants. Through analyzing my self-observations in this project, which I was conducting for my PhD, I examined the aspects of translation in cross-language grounded theory study. In this study I explored life stories narrated by Russian-speaking Holocaust survivors, recent émigrés from the Former Soviet Union. My research design involved a full combination of translation and analysis, in which I assumed the position of a bilingual investigator who performed both functions. In such setting, a theory emerges from the data written (or spoken) in the language of monolingual participants that is unknown to the audience (the source language). Research results are presented in the language of the audience (the target language). There are no specific prescribed procedures for translation in the context of grounded theory research. Therefore, I experimented in my study with some patterns of working in cross-language area, using my previous experiences in translation. I applied more systematically those patterns that worked for me, and observed how these patterns fit into the analysis. In my research, I have found that doing cross-language grounded theory involves strategies that differ from those involved in traditionally understood translation. My experimenting led me to the discovery of a strategy that emerged naturally in my work, namely, the intertwining of the activities of translation and conceptual analysis. Both translation and conceptual analysis were activities, or acts, which I performed as a bilingual person (in that, these were both my functions). Intertwining these activities was the strategy that I used to achieve better grounding of my translation in cross-language data, while discovering a grounded theory. In this article I analyze some properties of the strategy of intertwining, and reflect on the relevant features of language translation in this context. In my attempts to reflect on my experiences doing this research,...

On-the-Job Ethics – Proximity Morality Forming in Medical School: A grounded theory analysis using survey data...

Hans O. Thulesius, MD, Ph.D. Abstract On-the-job-ethics exist in all businesses and can also be called proximity morality forming. In this paper we propose that medical students take a proximity morality stance towards ethics education at medical school. This means that they want to form physician morality “on the job” instead of being taught ethics like any other subject. On-the-job-ethics for medical students involves learning ethics that is used when practicing ethics. Learning ethics includes comprehensive ethics courses in which quality lectures provide ethics grammar useful for the ethics practicing in attitude exercises and vignette reflections in tutored group discussions. On-the-job-ethics develops professional identity, handles diversity of religious and existential worldviews, trains students described as ethically naive, processes difficult clinical experiences, and desists negative role modeling from physicians in clinical or teaching situations. This grounded theory analysis was made from a questionnaire survey on attitudes to ethics education with 409 Swedish medical students participating. We analyzed over 8000 words of open-ended responses and multiplechoice questions using classic grounded theory procedures, but also compared questionnaire data using statistics such as multiple regression models. The paper gives an example of how grounded theory can be used with a limited amount of survey data. Background Medical ethics is different from other subjects taught at medical school and the importance of formal ethics courses has been questioned (Hafferty & Franks, 1994). Some medical schools combine instruction in bioethical principles with teaching of humanities programs (Andre, Brody, Fleck, Thomason & Tomlinson, 2003). The teaching of ethics varies in Swedish medical schools from interspersed lectures to formal ethics courses. We designed a questionnaire survey in order to elucidate how Swedish medical students view the ethics education in medical schools (Thulesius, Sallin, Lynöe & Löfmark, 2007; Lynöe, Löfmark & Thulesius, 2008). Many students gave input to the ethics course curriculum: Should ethics be taught in lectures or learned through group discussions? Should the ethics course be a separate course among others, or should it be part of other courses with lectures and group discussions interspersed? Should it come early or late in the medical school curriculum? Should the literature be specific ethics literature or novels and short stories with relevant ethical content? From multiple-choice responses we found that strong ethics interest was associated with frequent experiences of physician teachers as good role models and an absence of poor role models (Lynöe et al., 2008). In the present study we wanted to explore what was going on in medical schools regarding the medical ethics education by analyzing open-ended survey responses together with response data from multiplechoice items. Method We constructed a survey on attitudes towards the medical ethics education during 2005 as a request from the delegation of medical ethics of the Swedish Society of Medicine. Swedish medical students from the 1st, 5th and 11th (last) term participated. The survey consisted of 14 items, of which 10 had a total of 59 multiple-choice response options and generous space for open-ended comments, and 4 items were open-ended only, see Table 1. The overall response rate to the questionnaire survey was 36%, and varied between different centers from 13% to 83%, with a total of 409 respondents, 308 women (75%) and 101 men (25%). More than half (220/409) of the respondents gave one or more written open comments amounting to >8000 words. These comments were transcribed into Word from handwritten text. “Walking survey” data from informal interviews with four physicians, of which two has been teaching medical ethics at...

Unprivatizing: A bridge to learning

Virginia Leigh Hamilton Crowe, RN, MS, Ed.D. Jeanne Ellen Bitterman , MA, MA, Ed.D. Abstract Depression is a complicated condition situated in a cultural environment that often impedes learning. The purpose of this grounded theory study was to better understand depression from the perspective of those who are living with depression. Data were collected from many sources including document review and autobiographical literature; however, the primary data were collected through in-depth interviews. Fifteen individuals, thirteen women and two men, who felt they had learned both about and from their depression volunteered to participate in the primary interview process. Analysis of the data generated categories, properties and the core concept of unprivatizing. Through theoretical coding a process of learning about one’s depression emerged which suggests that learning about one’s depression can be experienced as a transitional and meaningmaking process that occurs over an extended period of time and facilitates development. Background The disease of depression remains a great mystery. It has yielded its secrets to science far more reluctantly than many of the other major ills besetting us. (Styron, 1990, p. 11) Depression, or depressive illness, is often referred to as a constellation of disorders that depict a condition or disease which disrupts a person’s mood, behavior, physical well-being, and thought (National Institute of Mental Health Depression Brochure, 2000; O’Connor, 1997; Thompson, 1996). Depressive illness is most often attributed to a complex interaction between physiological, psychological, and sociocultural factors (Mazure, Keita, & Blehar, 2002; Murthy, 2001; Surgeon General’s Report on Mental Health, 1999). Depression is not a rare phenomenon nor is it without significant cost. According to the National Institute of Mental Health (NIMH) (2000), in any given 1-year period, 9.5% of the population will suffer from a depressive illness. The World Health Organization (WHO) notes that major depression presents the greatest burden of disease for women and is a leading cause of disability globally for both males and females (Lopez et al., 2006; Murthy, 2001). In the United States, Major Depressive Disorder (MDD) is a leading cause of disability and produces one of the highest medical costs of all behavioral conditions (Goldman, Nielson, & Champion, 1999; Hasin, Goodwin, Stinson, & Grant, 2005). It is most difficult to calculate the significant personal and family costs associated with depressive illness, specifically given that one of the most indefinable and devastating of these costs is suicide (Dumais et al., 2005; Goldman, Nielson, & Champion, 1999). The Surgeon General’s Report on Mental Health (1999) states that more than 80% of people with depression can be treated successfully with medication, mental health therapy or a combination of both (Goldman, Nielson, & Champion, 1999; Mazure, Keita, & Blehar, 2002; Murthy, 2001; O’Connor, 1997). The difficulties dealing with depression include the underdiagnosis and cultural stigma associated with mental illness; the complex interaction between physiological, psychological, and sociocultural factors; and the numerous yet often elusive and compounding contributors and triggers to depressive episodes. Thus, to become aware of, acknowledge, and continue learning about depression and how it interacts with one’s life are daunting tasks (Beck, Tush, Shaw, & Emery, 1979; Burns, 1999; O’Connor, 1997). And while much is known about what the experts believe is important to teach the depressed individual (Beck, Tush, Shaw, & Emery 1979; Burns, 1999; O’Connor, 1997), little is known or understood about the essential process of learning about depression from the perspective of those living with and learning about their own depression. The purpose of this study was to explore the experiences...

The Constant Comparative Method of Qualitative Analysis...

[This paper was originally published in Social Problems, 12(1965), pp. 436-45 and later as Chapter V in Glaser, B.G. & Strauss, A.L. (1967). The Discovery of Grounded Theory: Strategies fro qualitative research. New York: Aldine DeGruyter.] Barney G. Glaser, Ph.D. Currently, the general approaches to the analysis of qualitative data are these: 1.) If the analyst wishes to convert qualitative data into crudely quantifiable form so that he can provisionally test a hypothesis, he codes the data first and then analyzes it. He makes an effort to code “all relevant data [that] can be brought to bear on a point,” and then systematically assembles, assesses and analyzes these data in a fashion that will “constitute proof for a given proposition.”i 2.) If the analyst wishes only to generate theoretical ideasnew categories and their properties, hypotheses and interrelated hypotheses- he cannot be confined to the practice of coding first and then analyzing the data since, in generating theory, he is constantly redesigning and reintegrating his theoretical notions as he reviews his material.ii Analysis with his purpose, but the explicit coding itself often seems an unnecessary, burdensome task. As a result, the analyst merely inspects his data for new properties of his theoretical categories, and writes memos on these properties. We wish to suggest a third approach to the analysis of qualitative data- one that combines, by an analytic procedure of constant comparison, the explicit coding procedure of the first approach and the style of theory development of the second. The purpose of the constant comparative method of joint coding and analysis is to generate theory more systematically than allowed by the second approach, by using explicit coding and analytic procedures. While more systematic than the second approach, this method does not adhere completely to the first, which hinders the development of theory because it is designed for provisional testing, not discovering, of hypotheses.iii This method of comparative analysis is to be used jointly with theoretical sampling, whether for collective new data or on previously collected or compiled qualitative data. Systematizing the second approach (inspecting data and redesigning a developing theory) by this method does not supplant the skills and sensitivities required in generating theory. Rather, the constant comparative method is designed to aid the analyst who possesses these abilities in generating a theory that is integrated, consistent, plausible, close to the dataand at the same time is in a dorm clear enough to be readily, if only partially, operationalized for testing in quantitative research. Still dependent on the skills and sensitivities of the analyst, the constant comparative method is not designed (as methods of quantitative analysis are) to guarantee that two analysts working independently with the same data will achieve the same results; it is designed to allow, with discipline, for some of the vagueness and flexibility that aid the creative generation of theory. If a researcher using the first approach (coding all data first) wishes to discover some or all of the hypotheses to be tested, typically he makes his discoveries by using the second approach of inspection and memo-writing along with explicit coding. By contrast, the constant comparative method cannot be used for both provisional testing and discovering theory: in theoretical sampling, the data collected are not extensive enough and, because of theoretical saturation, are not coded extensively enough to yield provisional tests, as they are in the first approach. They are coded only enough to generate, hence to suggest, theory. Partial testing of theory, when necessary, is...

Anticipatory Caring

[This paper was originally published as Sandgren, A., Thulesius, H., Petersson, K. & Fridlund, B. (2007). Doing good care ? A study of palliative home nursing care. International Journal of Qualitative Studies on Health and Well-Being, 2:4, 227-235 and is reprinted here with the permission of the publisher] Anna Sandgren, RN, MSc, PhD Candidate; Hans Thulesius, MD, PhD; Kerstin Petersson, RNT, PhD; Bengt Fridlund, RNT, PhD Abstract Today, more and more people die in own homes and nursing homes, which fundamentally affects community nursing. The aim of this study was to develop a grounded theory of palliative home nursing care and we analyzed interviews and data related to the behavior of community nurses caring for palliative cancer patients. Doing Good Care emerged as the pattern of behavior through which nurses deal with their main concern, their desire to do good care. The theory Doing Good Care involves three caring behaviors; anticipatory caring, momentary caring and stagnated caring. In anticipatory caring, which is the optimal caring behavior, nurses are doing their best or even better than necessary, in momentary caring nurses are doing best momentarily and in stagnated caring nurses are doing good but from the perspective of what is expected of them. When nurses fail in doing good, they experience a feeling of letting the patient down, which can lead to frustration and feelings of powerlessness. Depending on the circumstances, nurses can hover between the three different caring behaviors. We suggest that healthcare providers increase the status of palliative care and facilitate for nurses to give anticipatory care by providing adequate resources and recognition. Introduction The demographics of dying have changed with more people dying at home or in nursing homes. The number of hospital beds has declined and homecare has increased, and more own home deaths are expected in the future (Burge, Lawson & Johnston, 2003; Higginson, Astin & Dolan, 1998; Socialstyrelsen, 2006). The extension of palliative care varies in different parts of Sweden (Socialstyrelsen, 2006) and fewer hospital beds increases the strain for both acute hospital care and homecare (Fürst, 2000). The acute hospital care has a high pace and a “culture of quickness” (Andershed & Ternestedt, 1997) and this high pace was found to be one explanation to why nurses suffered emotional overload while caring for palliative cancer patients in acute hospitals (Sandgren, Thulesius, Fridlund & Petersson, 2006). In the contrast to the high pace in the acute hospitals, the hospice philosophy has a “culture of slowness” (Andershed & Ternestedt, 1997) and it has thus been suggested that the hospice philosophy should be spread to all care settings with dying people (Clark, 1993). At the same time, it has been proposed that palliative care should be available wherever the patient is. In addition, the patients and their families should receive the same standard of care irrespective of domicile and source of service delivery (Dunne, Sullivan & Kernohan, 2005; SOU, 2001). In homecare, the community nurses have a central position (Wright, 2002), but their work is in a way an invisible work, predominantly conducted in the patients’ homes (Goodman, Knight, Machen & Hunt, 1998; Luker, Austin, Caress & Hallett, 2000). Community nursing has shown to offer stimulation and appreciation, especially from patients and relatives, but also a possibility for nurses to use all their professional skills (Dunne et al., 2005; Goodman et al., 1998). However caring for palliative cancer patients in their homes has also been shown to be stressful (Berterö, 2002; Dunne et al., 2005), emotionally...