Potentializing Wellness to Overcome Generational Trauma...

Cynthia D. Stirbys, the University of Windsor Abstract The Indian residential school (IRS) system is part of Canada’s colonial history: Indigenous children who attended IRS suffered immensely at the hands of the school administrators, staff, and students. How Indigenous females cope with the intergenerational transmission of trauma was explored. Indigenous women in this classic grounded theory study aimed to resolve their main concern of kakwatakih-nipowatisiw, a Cree term used to identify learned colonial (sick) behaviours that weaken familial ties. Analysis resulted in a substantive theory of potentializing wellness, which explains the varied behaviours of how Indigenous women cope with the legacy of IRS. Discoveries suggest that effective strategies to deal with trauma can emerge when (w)holistic health is followed by, or accompanies reclaiming cultural norms grounded in community and spiritual life. With the generalizability of this substantive theory, this paper concludes with implications for future research. Keywords: Indian residential schools, Intergenerational trauma, Indigenous women, classic grounded theory, and potentializing. Introduction In Canada, when settlers first arrived, it was part of the colonial governments agenda to clear the land of all Indigenous Peoples. Part of this agenda included development of different assimilation policies aimed to eliminate Indigenous Peoples’ rights and Treaties, eliminate Indigenous governments, and cause Indigenous peoples “to cease to exist as distinct legal, social, cultural, religious, and racial entities in Canada” (TRC Summary of Final Report, 2015, p. 1). Given these on-going attacks, Indigenous Peoples have been dealing with compounding trauma at the hands of church and state for well over 150 years. When assimilation did not happen fast enough, Indian residential schools were mandated. Residential schools were part of Canada’s assimilation policy intended to civilize and convert Indigenous children towards Eurocentric ideals (Milloy, 2006). As a result, the residential schools’ grim realities and conditions of constant abuse, malnutrition, and neglect, coupled with the children’s need to survive had many children conforming to the “might makes right” (Stirbys, 2016, p. 127) mentality that subconsciously was carried into their family and community life. Underlying this study is the assumption that Indigenous peoples have an on-going unease regarding the intergenerational transmission of trauma. My interest to support Indigenous Peoples comes from my personal and professional life. I am a fourth generation descendant of three generations of Indian residential school survivors and I worked in Indigenous health where I regularly heard the (literal) cries of Indigenous Peoples wanting to address trauma from the residential school experience. Prior to starting my PhD, my mother and I attended a residential school survivors gathering in August, 2009 but we were not wholly prepared for the ways in which trauma could emerge as many felt a level of pain manifesting itself physically, emotionally, and/or spiritually. That experience never left me. During the years leading up to my thesis proposal I began to learn more about what a grounded theory was; I also began questioning what it is that Indigenous women do to overcome the traumatic legacy of Indian residential schools. More specifically, I wanted to uncover Indigenous women’s main concern regarding their experiences at IRS as a direct survivor or as a descendant of a survivor. A basic social process (BSP) conceptualized as potentializing wellness was discovered and explains the changing and evolving behaviours of what Indigenous women do to cope with intergenerational trauma. That is, Indigenous women focus on building personal competencies, moral compassing, and fostering the virtues. The three separate but interrelated phases of this social process have sub-processes and a typology that...

Resigning: How nurses work within constraints...

Claire O’Donnell, University of Limerick Tom Andrews, University College Cork Abstract This study explores and explains how nurses care for patients with stroke in the acute care setting and how they process these challenges to enable delivery of care. Using a classic grounded theory methodology, 32 nurses were interviewed who cared for patients with stroke and twenty hours of observations were undertaken. Nurses’ main concern is how to work within constraints. In dealing with this challenge, nurses engage in a process conceptualised as resigning and do so through idealistic striving, resourcing and care accommodation. Resigning acts as an energy maintenance and coping strategy, enabling nurses to continue working within constraints. This theory has the potential to enhance nursing care while reducing burnout and making better use of resources, while advocating for stroke care improvements. Keywords: Care provision, constraints, classic grounded theory, nursing, resigning, stroke Introduction Quality and safety of patient care is a continued area of concern in healthcare services where constraints on health expenditure prevail (Aiken et al., 2014; Kirwan et al., 2019). Work environments influence patient outcomes where limited nursing staff and resources have a resultant negative impact on patient care outcomes (Aiken et al., 2014; Griffiths et al., 2021; Jangland et al. 2018; Rochefort & Clarke, 2010; Schubert et al., 2009). Stroke care in designated specialised stroke units is associated with improved patient outcomes (Langhorne et al., 2020) however, despite international consensus on optimum stroke care, wide variations in the delivery of stroke care across Europe persist (Stroke Alliance for Europe, 2020). Such variations in the location of stroke care adversely influence care delivery and patient mortality and morbidity (West et al., 2013; Stroke Alliance for Europe, 2020). Background    Constraints in the work environment such as reduced staff, lack of time and a lack of resources are reasons for concern regarding their negative impact on patient care delivery (Chan et al. 2013; Winsett et al., 2016; Blackman et al., 2018; Griffiths et al., 2021). Nurses caring for patients with stroke are aware of what optimum stroke care entails however, they often provide a reduced level of care due to the presence of constraints (Clarke & Holt, 2014; Seneviratne et al., 2009). One constraint commonly reported as a barrier to optimal nursing is a lack of time (Blackman et al., 2018; Chan et al., 2013; Clarke & Holt, 2014) and this includes the area of stroke care (Seneviratne et al., 2009). Reduced nurse staffing levels is another constraint associated with increased levels of mortality (Cho et al., 2015; Department of Health, 2018; Fagerström et al., 2018; Griffiths et al., 2016). Morality also increases with incidence of pressure ulcers and nosocomial infections reported when inadequate nurse staffing levels are present (Cho et al., 2015; He et al., 2016). In addition, increases in nurses’ workloads demonstrate statistically significant increase in mortality (Aiken et al., 2014; Fagerström et al., 2018). Limited availability of space, time and interprofessional support in stroke care has a similar effect (Seneviratne et al., 2009). Stroke unit care addresses all elements of the staffing and infrastructure required to create safe specialized care delivery for patients with stroke. Despite the benefits of stroke unit care, many patients continue to be cared for in the general acute setting. A national audit of stroke services in Ireland found 29% of patients were cared for on wards other than stroke units (National Office of Clinical Audit, 2020), similar to other European countries (Kings College London, 2017). Stroke care provided...

Transforming Loyalty: A Classic Grounded Theory on Growth of Self-Acceptance Through Active Parenting...

Renee Rolle-Whatley, Rolle Integrative Healing Solutions, LLC, USA Kara Vander Linden, Saybrook University, USA Abstract The experiences of parents who daily participate in the rearing of their children framed this investigation into the maturation of selflessness using Glaser’s classic grounded theory. The theory reveals vulnerabilities, lessons, and rewards gleaned from continuous immersion in parenting. Viewed as a process, transforming loyalty discloses the circuitous route parents travel as parenting experiences shift focus towards a broadened awareness about the impact of allegiance and trust in caregiving. Releasing self-interest, embracing detachment, and living nonattached define transforming loyalty. In releasing self-interest, emotional balance eases egocentric perspectives; in embracing detachment, maturing selflessness validates the autonomy of others; and in living nonattached, emotion regulation heralds a broadened self-in-relationship. As egocentricity is confronted through engaged parenting, loyalty evolves to reveal the hidden gem of the parenting process—self-acceptance­—conceptualized as a growth continuum transitioning loyalty to self into loyalty to family and onward towards a loyalty to all life. Keywords:  parenting, loyalty, self-awareness, classic grounded theory, autonomy, self-acceptance, presence Introduction The existence of Covid-19 has overwhelmed parents as they attempt to deal with an ever-expanding list of national crises (Patrick et al., 2020). For parents who are Black, indigenous, and people of color, these crises, when combined with lifetime trauma load, predispose post-traumatic-stress syndrome conditioning (Knipscheer et al., 2020). Disempowered by unpredicted unemployment, lost childcare, and potential eviction, parents have struggled to cope. But could a person effectively parent and generate family harmony when joblessness, loss of health insurance, racial tensions, and food insecurity are at all-time highs and even the air is the enemy? This research offers parents an experiential pathway that harnesses loyalty as the essential ingredient of effective daily parenting and crisis management. With evolving emotion regulation, a clarity of purpose is conferred that not only guides the prioritization of resources but also proffers an unexpected reward, namely self-acceptance. Glaser’s classic grounded theory (CGT) method provided the systematic structure through which Transforming Loyalty emerged as a pathway to reboot selfishness into selflessness through experiences of parenting.  The Basic Social Process (Bigus et al., 1982; Glaser, 1978) that arose is grounded in data, conceptualizing experiences of parents for parents. Source data included 30 items inclusive of interviews, first-person recollections from books and web pages, and audio recordings all addressing the grand tour question: “Tell me about your experiences as a parent.”   Method   The purpose was to develop a theory that offers a richer conceptual explanation, beyond the obvious rearing of offspring, for the experiences of active parenting.  A broad sampling of perspectives was gathered. Classic grounded theory was adopted for its methodical rigor, systems perspective, and ability to extract abstract conceptual theory from data involving complex social conditions (Glaser, 1978). Eligible participants were 21 years of age or older and a parent with custody of at least one child who was actively parented by the participant. Among the participants, years of parenting experience ranged from a minimum of three years to over four decades.  Study participants were also single, married, and divorced, and provided parenting in situations that included neurotypical children and children with autism spectrum disorders. In order to identify the boundaries of the theory, data collection outside the group of study (e.g., parents over 21 years of age who do not actively parent) was conducted. The foundation of this CGT’s development was conceptualization of empirical data (Holton, 2007). Focused in-depth interviews were recorded via digital sound recording software and transcribed. All study...

About the Authors

Dr. Tom Andrews, PhD, MSc; PGDE; BSc (Hons) School of Nursing & Midwifery, Brookfield, College Road, University College Cork, Cork, Ireland, although now semi-retired, has worked in Higher Education since 1991.  He has been trained in Classic Grounded Theory by Dr Barney Glaser, one of its originators.  He has supervised seven PhD students using Classic GT to successful conclusion and examined a total of twenty PhDs and two MSc by research.  He is a Fellow of the Grounded Theory Institute and on the editorial board of “The Grounded Theory Review”. He has been involved in several studies using Classic GT and has written extensively on the methodology.  He has been involved in and conducted several Grounded Theory troubleshooting seminars and has lectured extensively on the methodology.  He continues to review for several international nursing journals. Email: t.andrews@ucc.ie Emily Cashwell, Ph.D., received her doctoral degree in Psychology with a specialization in Consciousness, Spirituality, and Integrated Health from Saybrook University in Pasadena, California. She learned classic grounded theory under the mentorship of Dr. Kara Vander Linden. Currently, Emily is using classic grounded theory to expand on the theory of coming home that was developed during her doctoral research. She is a former middle school special educator and holds graduate degrees in both special education and nutrition and integrative health. Her current research is focused on the experience of becoming more authentic, particularly as it relates to individuals who identify as queer or neurodiverse. Email: dremilycashwell@gmail.com Michael Leger, PhD, MBA, BSN – University of Texas Medical Branch, School of Nursing, was introduced to Classic Grounded Theory (CGT) during his Ph.D. program under the guidance of Dr. Carolyn Phillips. He is currently an Associate Professor and Assistant Dean at the University of Texas Medical Branch (UTMB) – Galveston School of Nursing where he teaches in the graduate program and serves as a committee member for Ph.D. students using qualitative research methods, particularly CGT. Dr. Leger received his Doctor of Philosophy in Nursing from UTMB in 2016. A highlight of his research career thus far was being selected to attend Dr. Barney Glaser’s CGT Troubleshooting Seminar in May 2015. Email: jmleger@utmb.edu Elizabeth Kellogg, PhD, received her doctorate in Psychology with a specialization in Consciousness, Spirituality, and Integrated Health from Saybrook University. She is a clinician, DEI facilitator, and an adjunct professor in the Expressive Arts Therapy graduate program at Lesley University. Research interests include embodied cognition and justice, equity and inclusion. Email: ekellog2@lesley.edu Dr. Claire O’Donnell, PhD, MSc., BSc., Department of Nursing & Midwifery, Faculty of Education and Health Sciences, Health Sciences Building, North Bank Campus, University of Limerick, is 14 years working in Higher Education at the University of Limerick, Ireland, as a lecturer in nursing and midwifery and more recently in the role as the Department International Coordinator where she is the lead for Internationalisation, contributing towards managing and further developing the internationalisation agenda within the department and faculty.  Under the supervision of Dr Tom Andrews, Claire used Classic Grounded Theory as the chosen methodology for her PhD which explored the area of how nurses care for patients with stroke in the acute care setting.  Research and supervision experience to date include international and national involvement in both qualitative and quantitative projects on the areas of missed care, stroke, transcultural care, breastfeeding and internationalisation. Email: claire.odonnell@ul.ie Carolyn A. Phillips, PhD, MSN, BSN – University of Texas Medical Branch, School of Nursing and Graduate School of Biomedical Sciences, is a faculty member of the...

From the Editor’s Desk

How to Read Classic Grounded Theory Have you wondered how to best read and evaluate grounded theory studies?  Contrary to what some people believe, grounded theories are neither stories, lists of themes, nor descriptions, rather they consist of parsimonious rigorously extracted concepts bound by inductively derived theoretical relationships. The network of concepts and theoretical relationships may be invisible to one who is unfamiliar with the method. The purpose of this editorial is to discuss some of the clues a reader might use to determine the quality of a classic grounded theory study. Grounded theory is a general method that can use either quantitative or qualitative data, however qualitative data are most often used, so this paper will focus on qualitative research. The Grounded Theory Review focuses solely on classic grounded theories and methodological papers. Novice or lay readers may be unaware of the subtle elements that indicate a good classic theory. Peer reviewers, on the other hand, are experienced classic grounded theorists, who learned from Barney Glaser, co-originator of the method. The reviewers know what to expect in a classic grounded theory study and what red flags indicate a study might not have adhered to the classic grounded theory method. Here, I describe some elements to help readers know what to expect when reading each section of a classic grounded theory paper and some red flags that indicate the method was not closely followed. Background Section When reading a published classic grounded theory, you may notice that the background, research problem, literature review, and research question are very general in nature. Although familiar with the substantive area, a classic grounded theorist should not enter a study with preconceptions, biases, and prior hypotheses. Inasmuch as it is possible in an academic system, the grounded theorist should avoid in-depth previous research and conceptual/theoretical literature on the phenomenon of interest. An investigator wants to enter the study as nearly tabula rasa as possible. In fact, the investigator will enter the study not even knowing what phenomenon might emerge—thus a pre-investigation pertinent and focused literature review is not possible. Because classic grounded theory is a method of discovery, studies begin when an investigator becomes curious about a given aspect of a substantive area—asking simply, “What is going on” with this group of people in this situation. So, the background section of a grounded theory paper should be focused on a general discussion of the substantive area, rather than an in-depth discussion of a specific phenomenon. The in-depth literature review occurs only after the theory is discovered. The introductory section of a grounded theory paper should identify the substantive area along with what the general issue of interest. What to expect An indication of the author’s familiarity with a substantive area and unbiased curiosity about something that is not known. Red flags Explicit or implicit statements are present that indicate the author began the study with preconceived notions, received professional issues, a very specific research question, hypotheses, or other indications of bias. Theoretical Perspective Dissertation and thesis criteria, journals’ author guidelines, ethics protocols, and grant applications often require a discussion of the theoretical perspective or conceptual framework that guide research studies. These elements can present a problem for grounded theorists. As an originator of the method, Glaser stated that classic grounded theory was not developed with a specific theoretical perspective. With this idea in mind, there are three potential paths an investigator might choose when required to address the theoretical perspective of a study....

Theoretical Writing

Barney G. Glaser Editor’s note: This paper addresses common questions about the particular way in which grounded theorists should write about their classic grounded theory. This important chapter has been excerpted and lightly edited for clarity and context from chapter 8 in Glaser’s Theoretical Sensitivity (1978). The goal of grounded theory methodology, above all, is to offer the results to the public, usually through one or more publications. We will focus on writing for publication, which is the most frequent way that the analyst can tell how people are “buying” what really matters in sociology, or in other fields. Both feedback on and use of publications will be the best evaluation of the analyst’s grounded theory. It will be his main source of criticism, constructive critique, and frequently of career rewards. In any case, he has to write to expand his audience beyond the limited number of close colleagues and students.  Unless there is a publication, his work will be relegated to limited discussion, classroom presentation, or even private fantasy. The rigor and value of grounded theory work deserves publication. And many analysts will have a stake in effecting wider publics, which makes their substantive grounded theory count. The best form to publish in sociology is through a monograph. The highest rewards, in general, go for writing books, for they probably reach the most diverse public with the maximum amount of material. Journal articles, of course, run a close second. One solution which many analysts take is to write chapters into articles, while fewer combine articles into books. We shall mainly focus here on the chapter form, which is similar to the article form with minor adjustments. In this final stage of grounded theory methodology, writing is a “write up” of piles of ideas from theoretical sorting. Writing techniques are, perhaps, not as crucial as the techniques characteristic of the previous stages, but they are still crucial. Since writing sums up all preceding stages, but they are still crucial. Since writing sums up all the preceding work, it cannot be left uncontrolled, perhaps to scuttle it. Rather, writing must capture it. It must put into relief the conceptual work and its integration into a theoretical explanation. So very often in qualitative research, the theory is left implicit in the write-up as the analyst gets caught up in the richness of the data. Below we shall discuss the logic of construction of shape of and conceptual style of a monograph and a chapter. Then we discuss the reworking of initial drafts, in order to sharpen the shape and style. We briefly indicate our view of uses of the literature, and close with recommendations for the analyst’s theoretical pacing. It must be underlined that the write-up of sorts is a theory of a core variable which freezes the ongoing for the moment. It is unfortunate, perhaps, that writing has this “slice of reality” character. We have covered this problem as best as possible by using concepts and processes that have duration and are independent of time and place. We also construct a theory that is readily modifiable. The analyst should underscore these points in his writing because his writing probably will read mainly as a fixed conceptual description, not an explanation, by most readers. We are in essence stuck with this paradox. Logic of Construction Typically, sociological monographs are constructed on the bases of a “little logic.”  It is the main building idea of the book, hence the ensuing chapters. The...

Becoming an Expert: A Classic Grounded Theory Study of Doctoral Learners...

Barry Chametzky, American College of Education, City University of Seattle, USA Abstract The theory of Becoming an Expert is about the transformation from a student who consumes knowledge to expert and scholar-researcher who creates knowledge.  However, more conceptually, the theory is equally applicable to anyone who progresses from novice to expert in a specific endeavor or field.  The process may start with an innocuous idea as “I would like to learn more about ABC.”  Through a series of trials and tribulations—referred broadly as juggling in the theory—the person gains necessary experience in this area.  These needed trials and tribulations are what help the person transform to an expert.  Without these troubling incidences, these people would not necessarily have the opportunities to reflect and grow.  As proficiency and knowledge are gained, as the person reflects on tumultuous events, he or she transforms into an expert. Keywords: doctoral learners, attrition, classic grounded theory, success, juggling, novice, expert Introduction German people have an interesting expression about the word if: Wenn das Wort wenn nicht wäre, wenn mein Vater millionäre.  The translation is “If the word ‘if’ didn’t exist, my father would be a millionaire.”  By that analogy, if doctoral programs were easy, everyone would do them.  Yet, to explain why some students or candidates do not succeed, that analogy is not satisfying.  Thus, it is important to understand the situation from a deeper perspective given that the attrition rate of doctoral students varies between 40-50% (Terrell, Snyder, Dringus, & Maddrey, 2012); in online programs, the attrition rate is higher–up to nearly 70% (Gardner, 2010; Maul, Berman, & Ames, 2018). Doing doctoral studies is supposed to be transformative as the work changes a person from a learner to an autonomous scholar (Yazdani & Shokooh, 2018).  Yet, from the aforementioned statistics, anywhere from only 30-60% of the students who enter a doctoral program succeed and it is not entirely clear why.  Though research certainly exists on doctoral attrition in numerous fields, what is not known is what doctoral students and candidates believe they need to succeed in their programs.  It is the objective of this author to explain what doctoral students and candidates need to succeed.  Additionally, it will be valuable to understand in a more nuanced manner what some positive and negative elements that help and hinder doctoral learners.  With this new knowledge, educators, post-secondary administrators, and even doctoral students and candidates themselves will be able to understand more clearly why attrition is so high and what could be done to lower those alarming and disappointing statistics. Methodology As the research design for this study, the author used classic grounded theory.  The objective of this design is to understand the behaviors of participants as they attempt to address their main concern.  In the case of this study, the main concern is (presumably) how students and candidates successfully complete their doctoral program. Following the tenets of classic grounded theory (Glaser, 1965), from a procedural perspective, this author created gerund codes from the raw data, constantly compared codes with each other, and wrote memos to uncover any heretofore undiscovered connections.  As codes developed into categories, the categories were constantly compared with other codes and categories and additional memos were created.  Memos were constantly compared with each other, then sorted, and the data were conceptualized with the ultimate goal of developing a theory. Instrument The objective, in any classic grounded theory study, is to “instill a spill” (Glaser, 2009, p. 22): a way to get participants...

Grounded Theory through the Lenses of Interpretation and Translation...

Maria Mouratidou, University of Cumbria Mark Crowder, Manchester Metropolitan University Helen Scott, Grounded Theory Online, Grounded Theory Institute Abstract This paper explores interpretation and translation issues that arose during a grounded theory study of the Greek health sector.  It highlights problems that were encountered when working in two languages and demonstrates how these were overcome. This is important because Grounded Theory (GT) research, in cross-cultural contexts, is associated with the linguistic challenges of conceptualisation. The authors offer their suggestions on how to conduct a GT research project within a diverse team based upon their experiences of undertaking such a study. Our paper supports Glaser’s work and contributes to GT methodology by offering guidance on how interpretation and translation can be incorporated in a multi-lingual research design with system and rigour to provide extra levels of constant comparison.  Hence, this paper will be of value to future researchers who are working in diverse teams and/or are undertaking studies in multiple languages. Keywords: Grounded theory, translation, interpretation, method, Greek, English Introduction This paper is the result of our experiences of using grounded theory (GT) to discover the concerns of nurses working within the Greek health sector. We studied nurses working in hospitals and nurses working in GP surgeries.  The main concern of both groups was workplace stress.   However, the way in which stress impacted on our participants was significantly different, despite many of the daily and weekly duties being identical in each setting.   Hospital nurses experienced burnout (Maslach & Jackson, 1981), but GP nurses experienced boreout (Stock, 2015).  This is important because both boreout and burnout can significantly affect the health of those affected and impact on the quality of service they provide (Lehman et al., 2011).  The results of this study will be published separately. Our team consisted of two researchers. The first author is bilingual, a native Greek speaker and fluent in English, whilst the second author is monolingual being a native English speaker learning Greek. Greek was the language of the data and the analysis for the first author, whilst English was the language of analysis for the second author. Integrating the linguistic needs of participants and researchers led to a plethora of practical and methodological issues that are explored in this paper. When working in a multicultural team, interpretation of the spoken word and translation of the written word are the instruments which allow non-native researchers to engage with and conceptualise the data.  Glaser’s (2004) maxim “all is data” (p. 2) is a bedrock of GT. Indeed, Gynnild (2006) argued that the importance of this concept “[cannot] be overestimated” (p. 61).  ‘Data’ are not only ‘words’ or ‘facts’: they are also cultural beliefs, behaviours and perceptions (Fairhurst & Putnam, 2018) which need to be understood if data are to reveal their meaning, and enable conceptualisation (Glaser, 1978). Translation must therefore not be neglected or mismanaged, as flawed translation processes can lead to a loss of meaning (van Nes et al., 2010), or the misunderstanding of culturally-important nuances (Venuti, 1995), which can impact upon the research and fundamentally affect the foundations of the study itself (Al-Amer, Ramjan, & Glew, 2016). Our paper is highly relevant because cross-language research has become increasingly popular (Fersch, 2013). For instance, a major international conference brought together the topics of GT and translation in a stream of its own (IATIS, 2018). Previous authors have made recommendations about the way in which translation might take place within qualitative research generally (see for instance Bradby,...