Nurse Researcher
Reflecting on the challenges of choosing and using a grounded theory approach Cite this article as: Markey K, Tilki M, Taylor G (2014) Reflecting on the challenges of choosing and using a grounded theory approach. Nurse Researcher. 22, 2, 16-22. Date of submission: August 6 2013. Date of acceptance: December 5 2013. Correspondence [email protected] Kathleen Markey RGN, MSc, PGCHE, BSc, DipHE is a lecturer at the Department of Nursing and Midwifery, University of Limerick, Ireland Mary Tilki RGN, PhD, MA, BA, RNT, former principal lecturer, Middlesex University, London, UK Georgina Taylor PhD, MSc, BA(Hons) is honorary researcher, School of Health and Education, Middlesex University, London, UK Peer review This article has been subject to double-blind review and checked using antiplagiarism software Author guidelines rcnpublishing.com/r/ nr-author-guidelines
Abstract Aim To explore three different approaches to grounded theory and consider some of the possible philosophical assumptions underpinning them. Background Grounded theory is a comprehensive yet complex methodology that offers a procedural structure that guides the researcher. However, divergent approaches to grounded theory present dilemmas for novice researchers seeking to choose a suitable research method.
approaches’ philosophical assumptions, such as those pertaining to ontology and epistemology. Researchers need to be clear about the philosophical assumptions underpinning their studies and the effects that different approaches will have on the research results. Conclusion This paper presents a personal account of the journey of a novice grounded theory researcher who chose a grounded theory approach and worked within its theoretical parameters.
Review methods This is a methodology paper. Data sources This is a reflexive paper that explores some of the challenges experienced by a PhD student when choosing and operationalising a grounded theory approach.
Implications for research/practice Novice grounded theory researchers need to understand the different philosophical assumptions that influence the various grounded theory approaches, before choosing one particular approach.
Discussion Before embarking on a study, novice grounded theory researchers should examine their research beliefs to assist them in selecting the most suitable approach. This requires an insight into the
Keywords Grounded theory, classic grounded theory, epistemology, ontology, methodology, research design, data collection
Introduction Grounded theory has seen increasing popularity in a range of disciplines. Since its creation (Glaser and Strauss 1967), it has evolved and has been reinvented in various ways, resulting in diversifications to Glaser and Strauss’s original approach (Buckley and Waring 2009, Ong 2011). There are now different approaches to grounded theory, which can cause many dilemmas for researchers attempting to choose approaches that best suit their proposed studies and personal research beliefs. 16 November 2014 | Volume 22 | Number 2
All grounded theory approaches offer the researcher a structured and rigorous methodology when used appropriately. However, it is apparent from the growing body of literature on grounded theory that many researchers have used it with immense diversity and have not always adhered to its critical components (Eaves 2001, Glaser 2004). This has resulted in a misinterpretation or at times misuse of the methodology (Backman and Kyngäs 1999, Charmaz 2000), which often is the result of a superficial understanding of the philosophical assumptions underpinning the different approaches. © RCN PUBLISHING / NURSE RESEARCHER
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Methodological decision making The challenge for novice grounded theory researchers is to use approaches consistent with their thinking, but this requires an understanding of the various approaches and their underpinning philosophical assumptions. The purpose of this paper is to explore some of the possible philosophical assumptions underpinning three different approaches to grounded theory: classic (Glaser 1992, 2002), Straussian (Strauss and Corbin 1990, 1998) and constructivist (Charmaz 2000, 2006). This paper shares a personal account of the journey of the primary author (KM), who worked within these theoretical parameters when conducting a study as part of her PhD. Furthermore, it aims to explore the challenges encountered in applying the methodology, as well as the innovations used to ensure that the critical tenets of the methodology were not jeopardised in any way. The PhD study set out to explore the challenges and concerns experienced by nurses and midwives when caring for individuals from diverse cultural and ethnic backgrounds and how these challenges are dealt with in practice. There is an urgent need to explore the conscious and subconscious behaviour underpinning the practices of nurses and midwives in such situations, as there are increasing reports globally of discriminatory practice in health care. The overall aim of the study was to generate a grounded theory that explains the experiences and concerns of nurses and midwives and to determine what influences their practice with individuals with diverse cultural, religious and linguistic needs. Understanding what is really going on when nurses and midwives provide care for a culturally diverse population base and how they resolve these issues and concerns was the focus of data collection and analysis. It is envisaged that through exploring such issues, the findings of this study will contribute to a richer understanding of the development of intercultural competence for healthcare and social care professionals.
Overview of grounded theory Grounded theory refers to a specific methodology that guides the researcher in moving from systematically collecting and analysing data to producing a conceptual theory. The grounded theory researcher attempts to discover patterns of behaviour to understand how a group of people define their reality (Stern et al 1980). In its broadest sense, the goal of grounded theory is to conceptualise how participants resolve their main concern, emphasising the importance of first identifying that concern. It is a methodology that is © RCN PUBLISHING / NURSE RESEARCHER
especially suited for areas where there is a gap in the available knowledge or when a new perspective or viewpoint is required (Glaser and Strauss 1967, Strauss and Corbin 1998). It was first developed by Anselm Strauss and Barney Glaser 1967, Glaser and Strauss 1967), when undertaking a study of death in hospitals. Glaser and Strauss later disagreed about the precise nature of grounded theory’s methodology. This split provided an opportunity for researchers to modify the original approach to address certain criticisms of the methodology. Glaser is generally recognised as having retained much of the original work involved during the inception of the methodology, which constitutes the classic approach to grounded theory (Glaser 2001, 2002, 2004). Strauss and Corbin (1990) suggested that they had developed a revised and improved version of grounded theory, while Charmaz (2006) suggested that her constructivist approach responded to what she felt were limitations of the original approach. However, Glaser (1998) disputed these modifications and argued that the newer approaches should be renamed as they are distinctly different. There are those who welcome this diversification, suggesting that researchers can now choose how to use grounded theory as a research method (Stern 1994, Annells 1997, Johnson et al 2001). However, Dunne (2011) argued that such variations have resulted in much ambiguity. There are those who argue that much of the criticism associated with grounded theory is because of its over-dilution (May 1996) and the growing body of literature on grounded theory often lacks adherence to essential aspects of the methodology (Becker 1996, Wilson and Hutchinson 1996, Eaves 2001, Ong 2011). Glaser (2004) asserted that the differences in the various grounded theory approaches are so distinct that it is impossible to pick and choose aspects from the different approaches and call it grounded theory. The authors of this paper concur with this view and although not advocating the use of any particular approach, suggest as a means of addressing the criticisms of grounded theory that the researcher should use one approach, while rationalising any deviations made. This suggestion is also advocated in the literature as a way of avoiding ‘method slurring’, which is a term used to describe the failing to adhere to key tenets of qualitative approaches when combing approaches. It is also a way of enhancing the credibility of the findings (Cutcliffe 2000, McCann and Clark 2003a, Bowen 2009, Chen and Boore 2009, Dunne 2011). Ong (2011) suggested that researchers should be more meticulous and specific November 2014 | Volume 22 | Number 2 17
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Art & science | acute care Nurse Researcher in the way they use their chosen approaches, to avoid confusion and harness their effectiveness.
The need to explore philosophical assumptions The authors strongly recommend that before beginning a grounded theory study, novice researchers should understand the different philosophical assumptions that underpin each of the grounded theory approaches and explore their own personal philosophical beliefs. Philosophical perspectives dictate how phenomena should be studied and what constitutes knowledge (Weaver and Olson 2006). Exploring philosophical underpinnings can help the researcher to refine and specify the types of evidence required, how it should be gathered and how it should be interpreted. This is an aspect of planning research that quite often gets forgotten and its value cannot be underestimated. An understanding of philosophical assumptions requires an exploration of the nature and form of reality (ontological positioning) and of how knowledge is developed (epistemological positioning). Once sensitivity to the ontological and epistemological assumptions of different approaches is achieved, it is fundamental for researchers to then examine their personal philosophical beliefs about their inquiries, to enable them to position their studies in a particular philosophical perspective (Annells 1996). The epistemological and ontological aspects underpinning a study therefore depend on the person who holds them (Bailey 1997), suggesting that the researchers’ philosophical positions should determine the approaches that they use (Mills et al 2006). These two steps are fundamental in enabling novice grounded theory researchers to choose approaches appropriate to their studies, acknowledge their personal views and inform their approaches to data collection and analysis.
Ontological assumptions Naive realism, critical realism and relativism are three of the major ontological positions that appear to have dominated contemporary discussions on social research. Crotty (1998) suggested that naive realism asserts that physical and social realities exist independently of our experiences, beliefs and descriptions. The naive realist often takes the position that concepts being explored are measurable and is concerned with a single reality that is mostly scientific fact. Similar to naive realism, critical realism holds a view of truth independent of perception (Weaver and Olson 2006), emphasising that the 18 November 2014 | Volume 22 | Number 2
researcher has no involvement in interpreting the data. The main difference between naive and critical realisms is that the critical realist’s philosophical position quite often recognises that all observation is fallible and has error: a critical realist is likely to believe that all theory is revisable (Bergin et al 2008 and is therefore more sceptical than a naive realist. In contrast to the realist view, the relativist ontology views the social world as constructed or interpretable, and that ‘truth’ can only be subjectively perceived (Guba 1990). Following determination of an ontological position, it is important to explore which approach to grounded theory will best suit the study’s needs. This requires an exploration of the possible ontological assumptions underpinning the various grounded theory approaches. The classic approach, despite Glaser’s (1992, 2004) suggestion that it does not fit neatly into any paradigm, alludes to a realist position. Classic grounded theorists believe that there is a single reality independent of researchers’ experiences, views and perceptions (Annells 1997, Crotty 1998), which resonates in some ways with the views of a realist. Glaser (1996) argued that the emphasis of classic grounded theory should be the emergence of data, suggesting that the participants’ main problem and how they resolve it emerges objectively from the data without any influence from the researcher. In contrast, Strauss and Corbin’s (1990) modified approach assumes an objective external reality, giving voice to respondents by acknowledging their views of reality. As a result, Annells (1997) and Ghezeljeh and Emami (2009) suggested that Strauss and Corbin’s approach is relativist. Charmaz’s (2006) constructivist approach views the social world as socially constructed. Ghezeljeh and Emami (2009) suggested that constructivists propose a view of reality that seeks respondents’ and researchers’ meanings, suggesting that it also is relativist.
Epistemological assumptions D’Cruz (2001) defined epistemology as a ‘theory of knowledge, which informs methodology, through consideration of the nature of knowledge, how what exists can be known and how we can know or validate what we know’. It is particularly important to explore epistemological assumptions when choosing a grounded theory approach, as there are distinct epistemological differences between the different approaches (Buckley and Waring 2009). Reseachers should choose approaches based on how they view their relationships with the data. © RCN PUBLISHING / NURSE RESEARCHER
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Methodological decision making Objectivism, subjectivism and constructivism are the major epistemological positions that have dominated contemporary discussions of social research. Objectivism suggests that if meaning exists in objects independently of any consciousness, then we can understand and comprehend the world in its totality, suggesting it is possible to produce ‘objective’ and ‘valid’ knowledge (Lincoln and Guba 2000). Implicit in this philosophy is a belief that it is possible to totally separate the researcher from the researched. This suggests that objectivists view knowledge and its production as disembodied. Subjectivism, on the other hand, suggests that the reality of all objects relies entirely on an individual’s subjective mindfulness of it, which emphasises the role and contribution the researcher plays. By contrast, constructivism argues that researchers generate knowledge from experience and reflection (Ghezeljeh and Emami 2009). Once researchers have examined their epistemological positioning, they should determine which approach accommodates it. When attempting to choose an appropriate approach, it is important to be aware that there are distinct differences in the epistemological assumptions that are implicit but not always explicit in each approach. There are many contradicting views, which leaves the researcher sometimes questioning whether grounded theory stems from an objectivist, subjectivist or constructivist epistemology (Glaser and Strauss 1967, Strauss and Corbin 1990, Glaser 1992, Charmaz 2000). Although Glaser (2004) did not specify that classic grounded theory is objectivist, he assumed an objective external reality, as he saw the researcher as an impartial onlooker who gathers data totally objectively (Glaser 1992, Annells 1997, Ong 2011). Implicit in taking the objectivist epistemology positioning is a belief that it is possible to completely separate the researcher from the object of analysis. Strauss and Corbin (1990) appeared to have a very subjective orientation when discussing the steps to follow when using their approach to grounded theory. Strauss and Corbin (1998) claimed that their approach allows for ‘interplay’ between the researcher and the data. In the constructivist approach, the researcher and the participant interact during data collection and thus the knowledge is constructed through the lens of the researcher’s interpretation of the data.
Choosing a methodology Classic grounded theory (Glaser 2002) seeks to systematically develop a theory by providing a highly structured, comprehensive, yet eminently flexible © RCN PUBLISHING / NURSE RESEARCHER
process. It uses a set of procedures, including constantly comparing the data during ‘open’, ‘selective’ and ‘theoretical’ coding, while maintaining theoretical sensitivity and analytical distance to enable the theory to emerge from the data. This method enables researchers to get close to the phenomena they are studying through extensive data collection and analysis, responding to latent patterns of social behaviour as they emerge and through conceptualisation, which serves as a guide for successive data collection. The methodology is emergent, with researchers entering the field with minimal biases to enable the main concerns of the participants to emerge. In contrast, Strauss and Corbin (1990) proposed a more complicated technique involving three major steps: ‘open’, ‘axial’ and ‘selective’ coding. Unlike Glaser’s (1998) approach, each of these steps involves numerous smaller steps that must be followed. The authors of this paper view this approach as challenging because of the number of steps that must be followed (Benoliel 1996, Melia 1996, Walker and Myrick 2006). Strauss and Corbin (1990) appeared to have a very subjective orientation when discussing the steps in their technique, as the researcher guides the direction of the data rather than allowing the theory to emerge from the data. Walker and Myrick (2006) and Buckley and Waring (2009) alluded to the confusion that can occur from using these steps and advocated taking care not to allow the steps to inhibit emergence of the theory. Charmaz’s (2000) constructivist approach aims to create a sense of reciprocity between the participant and the researcher, highlighting the role the researcher plays in interpreting the data. Charmaz’s (2000) writings on the application of her approach are logical and easy to follow. However, they do not explain the smaller steps between the major phases of analysis (Eaves 2001), which can be confusing for the novice researcher.
Reflecting on the journey of choosing a grounded theory approach For novice grounded theory researchers, philosophically positioning a study that is consistent with the ontological and epistemological assumptions underpinning their chosen approaches can be challenging, as these discussions are quite often omitted in grounded theory publications. The personal beliefs of this paper’s primary author (KM) and the objectives of her PhD study were explored when choosing an approach for the study. On reflection, KM’s beliefs suggested the need to ensure that the theory emerged from November 2014 | Volume 22 | Number 2 19
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Art & science | acute care Nurse Researcher the data. Implicit in these beliefs is the role the researcher has in seeking a non-judgemental understanding of the phenomenon being explored, by remaining open. Furthermore, the research objectives highlighted the need to explore what was happening in practice, which acknowledges the conscious and subconscious beliefs and values underpinning nurses’ and midwives’ care that may not yet have been exercised. For instance, nurses and midwives may have experience of caring for diverse cultures and understand the need to provide culturally competent care, but there is a need to explore independently the care being provided and to discover the mechanisms that may be producing discriminatory and insensitive care. Realist ontology permits the opportunity to uncover such issues and as a result this study was positioned within a realist paradigm. Crotty (1998) suggested that realism asserts that reality exists independently of our knowledge, beliefs and descriptions, suggesting that it is independent of consciousness. Furthermore, Bergin et al (2008) suggested that maintaining a realist ontological position is particularly important when studying issues that are not necessarily obvious or factors that are not measurable, such as the subconscious assumptions and prejudices that affect the delivery of care. Implicit in this belief is the aim of the researcher to maintain a neutral, non-judgemental approach to collecting and analysing data, regardless of the theory that emerges. Taking this epistemological positioning presented a challenge for KM as it did not fit easily into an objectivist, subjectivist or constructivist perspective. On reviewing the various epistemological positions, she questioned the ability to claim absolute objectivity, as a researcher may have unconscious biases; but to claim total subjectivity would suggest that the theory may be ‘forced’ or interpreted by her personal views. Unlike subjectivists and constructivists, KM felt it was impossible to view knowledge and its production as disembodied, and that to influence responses or to rely on interpreting the data from her perspective had the potential to undermine the credibility of the theory. Patton (2002) has presented a ‘middle’ epistemological perspective, which he refers to as ‘empathic neutrality’. Although this does not take a purist objectivist’s position, it does encourage the incorporation of strategies to remain as objective as possible during data collection and analysis. Empathic neutrality requires the researcher to adopt a position of neutrality, while being able to understand the 20 November 2014 | Volume 22 | Number 2
stances, positions, feelings and experiences of others (Patton 2002). On exploring the philosophical assumptions underpinning the various approaches, it appeared that the classic approach (Glaser 2002) – although no less rigorous than the other approaches – was the best choice as it accommodated a realist position and encouraged the researcher to remain neutral during data collection and analysis. Furthermore, the flexibility and simplicity of its procedural steps were a particular strength.
Overcoming the challenges In line with the classic approach to data collection, the researcher (KM) analysed data through open, selective and theoretical coding, while constantly comparing the data throughout the process. Open coding of the data began with line-by-line coding, where key statements used by the participants were noted. This was useful as it made the researcher confident that nothing was being omitted. The challenge for a novice researcher is the volume of codes that can emerge, which can result in confusion. After coding the first ten interviews, KM had more than 100 codes. She feared omitting something important, but with so many codes, further analysis of the data was. She realised that she had ‘over-fractured the data’ (Glaser 2004). During selective coding, KM went back to the data and predominantly asked two key questions, such as what were the participants’ main concerns and what participants did to help to overcome their concerns. This assisted her in reducing the number of codes, as codes that were irrelevant to the main concern were delimited. As further data were collected, new emerging categories were identified; the researcher then reconsidered previously analysed texts in light of the developing categories. This meant that the analysis became more focused as categories were developed and saturated. During open and selective coding, data became fragmented and difficult to manage. However, theoretical coding guided the researcher in weaving the data back together again. During this stage, she studied connections between each of the categories and attempted to create theoretical links between them. Glaser provided a number of theoretical coding families that can assist the researcher in making connections between categories and their properties (Glaser 1992, 1998). This stage of the technique proved particularly problematic as the researcher did not have a real insight into the various coding families; researchers are advised to © RCN PUBLISHING / NURSE RESEARCHER
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Methodological decision making first gain an awareness of the components of each of these theoretical coding families. ‘Theoretical memoing’ – writing specific memos on ideas about codes and their relationships and in particular how they relate to the emerging theory – also assisted in piecing the fractured data back together. Once categories started to emerge following initial data collection, the researcher incorporated theoretical sampling, as she went to different groups and asked different questions. As a result, the researcher was guided to further sources of data to constantly compare incidents. Glaser (2004) suggested that theoretical sampling guides the researcher in deciding what data to collect next. Similarly, Backman and Kyngäs (1999) and Neill (2006) argued that theoretical sampling suggests that data analysis serve as data collection in the next stage of the study. The researcher also agrees with this, as it enabled her to be more specific in her interviewing, by identifying emerging gaps in the theory. Theoretical sampling is the fundamental process that makes classic grounded theory flexible (Glaser 1998). The challenge in using this approach is the possible delay that can occur in obtaining ethical approval to interview another group of participants.
suggesting that it should be used to explain rather than derive the theory. There are those who argue against Glaser’s perspective (Strauss and Corbin 1990, Smith and Bailey 1997, Dunne 2011), suggesting that it is important at the very least to broadly review the literature before collecting data. KM agrees, feeling that some searching and reading of literature is required before collecting data, to enable the researcher to identify gaps and help contextualise the study. More practically, when undertaking a PhD study, the researcher was required to complete a research proposal; this required a review of the literature to identify consistencies, inconsistencies and gaps. Therefore, KM did undertake a broad, early review of the literature in the general areas of transcultural competence and transcultural education, to identify gaps. The intent was to situate the study in the broader context of current issues in transcultural care, providing context to position the study. A more detailed literature review took place once the theory had emerged, which is what Strauss and Corbin (1998) referred to as the second phase of the literature review.
How deviations from the ‘purist’ approach were implemented
A key tenet of implementing classic grounded theory is the use of theoretical sampling. This involves being guided by the data in determining what data needs to be collected next. Glaser (1998) asserted that researchers cannot know what to sample for and where it will lead them to, suggesting that the data should guide the researcher to whom to interview next. KM felt it necessary to choose a population with which to begin data collection, so purposefully sampled a group at the start of the study. Although she was unsure of the direction the study would take, it seemed logical to begin by exploring the experiences of nursing and midwifery students, which could be described as purposefully sampling. Glaser argued against selecting a sample, as entering the field with ‘pre-conceived ideas’ may force the theory. Instead, he asserted the need to incorporate theoretical sampling from the beginning of a classic grounded theory study. There are those who feel that research cannot begin with theoretical sampling as the researcher needs a starting point (Coyne 1997, Cutcliffe 2000). KM concurs with such views and so chose to purposefully sample nursing students and midwives at the beginning of this study; she then superseded this purposeful sampling with theoretical sampling in response to the developing categories and their properties.
Despite the documented value of using classic grounded theory, it is not without its critics (Strauss and Corbin 1990, Stern 1994), Annells 1997, Charmaz 2000). Although the researcher attempted to stick to the core tenets of the classic approach, in addressing some of these criticisms, she deviated from the purist approach in certain aspects. This is consistent with Buckley and Waring (2009), Chen and Bore (2009) and Dunne (2011), who suggested that such deviations are possible if they are appropriately justified.
When to undertake a literature review in classic grounded theory Unlike traditional qualitative methodologies, classic grounded theory does not require researchers to start their studies by searching the existing literature in depth. Glaser (2002) suggested entering the field with a completely open mind, which he asserted means not searching literature or having predetermined research questions at the start of the study. He argued that data collection and analysis should be entered with as few preconceived ideas as possible to try to ensure theory emerges from the participants. Chen and Boore (2009) supported Glaser’s position on reviewing literature, © RCN PUBLISHING / NURSE RESEARCHER
Use of sampling approaches in grounded theory
November 2014 | Volume 22 | Number 2 21
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Nurse Researcher
Methodological decision making
Conclusion Grounded theory is a useful but complex methodology, in which data collection and analysis can be challenging. Being sensitive to the philosophical assumptions underpinning some of the approaches to grounded theory can assist researchers to choose approaches that best suit their thinking.
This paper has attempted to present the views of the authors regarding the main ontological and epistemological propositions that influence the various grounded theory approaches. The authors advocate choosing one particular approach and then justifying any deviations from that approach while still adhering to the core tenets of grounded theory.
Online archive For related information, visit our online archive and search using the keywords
Conflict of interest None declared
References Annells M (1997) Grounded theory method, part 1: within the five moments of qualitative research. Nursing Inquiry. 4, 2, 120-129. Backman K, Kyngäs H (1999) Challenges of the grounded theory approach to a novice researcher. Nursing and Health Sciences. 1, 3, 147-153. Bailey PH (1997) Finding your way around qualitative methods in nursing research. Journal of Advanced Nursing. 25, 1, 18-22. Becker PH (1996) Common pitfalls in published grounded theory research. Qualitative Health Research. 3, 2, 254-260. Benoliel JQ (1996) Grounded theory and nursing knowledge. Qualitative Health Research. 6, 3, 406-428. Bergin M, Wells JS, Owen S (2008) Critical realism: a philosophical framework for the study of gender and mental health. Nursing Philosophy. 9, 3, 169-179. Bowen GA (2009) Supporting a grounded theory with an audit trail: an illustration. International Journal of Social Researcher Methodology. 12, 4, 305-316. Buckley C, Waring M (2009) The evolving nature of grounded theory: experiential reflections on the potential of the method for analysing children’s attitudes towards physical activity. International Journal of Social Research Methodology. 12, 4, 317-334. Charmaz K (2000) Grounded theory: objectivist and constructivist methods. In Denzin N, Lincoln Y (Eds) Handbook of Qualitative Research. Second edition. Sage Publications, Thousand Oaks CA. Charmaz K (2006) Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Sage Publications, London.
Chen HY, Boore JR (2009) Using a synthesised technique for grounded theory in nursing research. Journal of Clinical Nursing. 18, 16, 2251-2260. Coyne IT (1997) Sampling in qualitative research. Purposeful and theoretical sampling: merging or clear boundaries? Journal of Advanced Nursing. 26, 3, 623-630. Crotty M (1998) The Foundations of Social Research: Meaning and Perspective in The Research Process. Sage Publications, London. Cutcliffe JR (2000) Methodological issues in grounded theory. Journal of Advanced Nursing. 31, 6, 1476-1484. D’Cruz H (2001) The fractured lens: methodology in perspective. In Byrne-Armstrong H, Higgs J, Horsfall D (Eds) Critical Moments in Qualitative Research. ButterworthHeinemann, Oxford. Dunne C (2011) The place of the literature review in grounded theory research. International Journal of Social Research Methodology. 14, 2, 111-124. Eaves YD (2001) A synthesis technique for grounded theory data analysis. Journal of Advanced Nursing. 35, 5, 654-663. Ghezeljeh TN, Emami A (2009) Grounded theory: methodology and philosophical perspective. Nurse Researcher. 17, 1, 15-23. Glaser BG (1992) Basics of Grounded Theory Analysis: Emergent Versus Forcing. Sociology Press, Mill Valley CA. Glaser BG (Ed) (1996) Gerund Grounded Theory: The Basic Social Process Dissertation. Sociology Press, Mill Valley CA. Glaser BG (1998) Doing Grounded Theory: Issues and Discussions. Sociology Press, Mill Valley CA.
22 November 2014 | Volume 22 | Number 2
Glaser BG (2001) The Grounded Theory Perspective: Conceptualization Contrasted with Description. Sociology Press, Mill Valley CA. Glaser BG (2002) Constructivist Grounded Theory? www.qualitative-research.net/index. php/fqs/article/view/825/1792 (Last accessed: September 11 2014.) Glaser BG (2004) Remodeling grounded theory. The Grounded Theory Review: An International Journal. 4, 1, 1-24. Glaser BG, Strauss AL (1967) The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine De Gruyter, New York NY. Guba EG (1990) The alternative paradigm dialog. In Guba E (Ed) The Paradigm Dialog. Sage Publications, Newbury Park CA. Johnson M, Long T, White A (2001) Arguments for ‘British Pluralism’ in qualitative health research. Journal of Advanced Nursing. 33, 2, 243-249. Lincoln YS, Guba EG (2000) Paradigmatic controversies, contradictions, and emergig confluences. In Denzin N, Lincoln Y (Eds) Handbook of Qualitative Research. Second edition. Sage Publications, Thousand Oaks CA.
Melia KM (1996) Rediscovering Glaser. Qualitative Health Research. 6, 3, 368-378. Mills J, Bonner A, Francis K (2006) The development of constructivist grounded theory. International Journal of Qualitative Methods. 5, 1. Ong BK (2011) Grounded theory method (GTM) and the abductive research strategy (ARS): a critical analysis of their differences. International Journal of Social Research Methodology. 15, 5, 417-432. Patton MQ (2002) Qualitative Research And Evaluation Methods. Third edition. Sage Publications, Thousand Oaks CA. Smith K, Bailey F (1997) Understanding grounded theory: principles and evaluation. Nurse Researcher. 4, 17-30. Stern PN (1980) Grounded theory methodology: its uses and applications. Image. 12, 11, 20-23. Stern PN (1994) Eroding grounded theory. In Morse J (Ed) Critical Issues in Qualitative Research Methods. Sage publications, Thousand Oaks, CA. Strauss AL, Corbin J (1990) Basics of Qualitative Research: Grounded Theory Procedures And Techniques. Sage Publications, Newbury Park CA.
May KA (1996) Diffusion, dilution, or distillation? The case of grounded theory method. Qualitative Health Research. 6, 3, 309-311. McCann TV, Clark E (2003a) Grounded theory in nursing research: Part 1 – methodology. Nurse Researcher. 11, 2, 7-18. McCann TV, Clark E (2003b) Grounded theory in nursing research: Part 2 – critique. Nurse Researcher. 11, 2, 19-28. McCann TV, Clark E (2003c) Grounded theory in nursing research: Part 3 – application. Nurse Researcher. 11, 2, 29-39.
Strauss AL, Corbin J (1998) Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Second edition. Sage Publications, Newbury Park CA. Walker D, Myrick F (2006) Grounded theory: An exploration of process and procedure. Qualitative Health Research. 16, 4, 547-559. Weaver K, Olson JK (2006) Understanding paradigms used for nursing research. Journal of Advanced Nursing. 53, 4, 459-469. Wilson HS, Hutchinson SA (1996) Methodologic mistakes in grounded theory. Nursing Research. 45, 2, 122-124.
© RCN PUBLISHING / NURSE RESEARCHER
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Reflecting on the challenges of choosing and using a grounded theory approach Cite this article as: Markey K, Tilki M, Taylor G (2014) Reflecting on the challenges of choosing and using a grounded theory approach. Nurse Researcher. 22, 2, 16-22. Date of submission: August 6 2013. Date of acceptance: December 5 2013. Correspondence [email protected] Kathleen Markey RGN, MSc, PGCHE, BSc, DipHE is a lecturer at the Department of Nursing and Midwifery, University of Limerick, Ireland Mary Tilki RGN, PhD, MA, BA, RNT, former principal lecturer, Middlesex University, London, UK Georgina Taylor PhD, MSc, BA(Hons) is honorary researcher, School of Health and Education, Middlesex University, London, UK Peer review This article has been subject to double-blind review and checked using antiplagiarism software Author guidelines rcnpublishing.com/r/ nr-author-guidelines
Abstract Aim To explore three different approaches to grounded theory and consider some of the possible philosophical assumptions underpinning them. Background Grounded theory is a comprehensive yet complex methodology that offers a procedural structure that guides the researcher. However, divergent approaches to grounded theory present dilemmas for novice researchers seeking to choose a suitable research method.
approaches’ philosophical assumptions, such as those pertaining to ontology and epistemology. Researchers need to be clear about the philosophical assumptions underpinning their studies and the effects that different approaches will have on the research results. Conclusion This paper presents a personal account of the journey of a novice grounded theory researcher who chose a grounded theory approach and worked within its theoretical parameters.
Review methods This is a methodology paper. Data sources This is a reflexive paper that explores some of the challenges experienced by a PhD student when choosing and operationalising a grounded theory approach.
Implications for research/practice Novice grounded theory researchers need to understand the different philosophical assumptions that influence the various grounded theory approaches, before choosing one particular approach.
Discussion Before embarking on a study, novice grounded theory researchers should examine their research beliefs to assist them in selecting the most suitable approach. This requires an insight into the
Keywords Grounded theory, classic grounded theory, epistemology, ontology, methodology, research design, data collection
Introduction Grounded theory has seen increasing popularity in a range of disciplines. Since its creation (Glaser and Strauss 1967), it has evolved and has been reinvented in various ways, resulting in diversifications to Glaser and Strauss’s original approach (Buckley and Waring 2009, Ong 2011). There are now different approaches to grounded theory, which can cause many dilemmas for researchers attempting to choose approaches that best suit their proposed studies and personal research beliefs. 16 November 2014 | Volume 22 | Number 2
All grounded theory approaches offer the researcher a structured and rigorous methodology when used appropriately. However, it is apparent from the growing body of literature on grounded theory that many researchers have used it with immense diversity and have not always adhered to its critical components (Eaves 2001, Glaser 2004). This has resulted in a misinterpretation or at times misuse of the methodology (Backman and Kyngäs 1999, Charmaz 2000), which often is the result of a superficial understanding of the philosophical assumptions underpinning the different approaches. © RCN PUBLISHING / NURSE RESEARCHER
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Methodological decision making The challenge for novice grounded theory researchers is to use approaches consistent with their thinking, but this requires an understanding of the various approaches and their underpinning philosophical assumptions. The purpose of this paper is to explore some of the possible philosophical assumptions underpinning three different approaches to grounded theory: classic (Glaser 1992, 2002), Straussian (Strauss and Corbin 1990, 1998) and constructivist (Charmaz 2000, 2006). This paper shares a personal account of the journey of the primary author (KM), who worked within these theoretical parameters when conducting a study as part of her PhD. Furthermore, it aims to explore the challenges encountered in applying the methodology, as well as the innovations used to ensure that the critical tenets of the methodology were not jeopardised in any way. The PhD study set out to explore the challenges and concerns experienced by nurses and midwives when caring for individuals from diverse cultural and ethnic backgrounds and how these challenges are dealt with in practice. There is an urgent need to explore the conscious and subconscious behaviour underpinning the practices of nurses and midwives in such situations, as there are increasing reports globally of discriminatory practice in health care. The overall aim of the study was to generate a grounded theory that explains the experiences and concerns of nurses and midwives and to determine what influences their practice with individuals with diverse cultural, religious and linguistic needs. Understanding what is really going on when nurses and midwives provide care for a culturally diverse population base and how they resolve these issues and concerns was the focus of data collection and analysis. It is envisaged that through exploring such issues, the findings of this study will contribute to a richer understanding of the development of intercultural competence for healthcare and social care professionals.
Overview of grounded theory Grounded theory refers to a specific methodology that guides the researcher in moving from systematically collecting and analysing data to producing a conceptual theory. The grounded theory researcher attempts to discover patterns of behaviour to understand how a group of people define their reality (Stern et al 1980). In its broadest sense, the goal of grounded theory is to conceptualise how participants resolve their main concern, emphasising the importance of first identifying that concern. It is a methodology that is © RCN PUBLISHING / NURSE RESEARCHER
especially suited for areas where there is a gap in the available knowledge or when a new perspective or viewpoint is required (Glaser and Strauss 1967, Strauss and Corbin 1998). It was first developed by Anselm Strauss and Barney Glaser 1967, Glaser and Strauss 1967), when undertaking a study of death in hospitals. Glaser and Strauss later disagreed about the precise nature of grounded theory’s methodology. This split provided an opportunity for researchers to modify the original approach to address certain criticisms of the methodology. Glaser is generally recognised as having retained much of the original work involved during the inception of the methodology, which constitutes the classic approach to grounded theory (Glaser 2001, 2002, 2004). Strauss and Corbin (1990) suggested that they had developed a revised and improved version of grounded theory, while Charmaz (2006) suggested that her constructivist approach responded to what she felt were limitations of the original approach. However, Glaser (1998) disputed these modifications and argued that the newer approaches should be renamed as they are distinctly different. There are those who welcome this diversification, suggesting that researchers can now choose how to use grounded theory as a research method (Stern 1994, Annells 1997, Johnson et al 2001). However, Dunne (2011) argued that such variations have resulted in much ambiguity. There are those who argue that much of the criticism associated with grounded theory is because of its over-dilution (May 1996) and the growing body of literature on grounded theory often lacks adherence to essential aspects of the methodology (Becker 1996, Wilson and Hutchinson 1996, Eaves 2001, Ong 2011). Glaser (2004) asserted that the differences in the various grounded theory approaches are so distinct that it is impossible to pick and choose aspects from the different approaches and call it grounded theory. The authors of this paper concur with this view and although not advocating the use of any particular approach, suggest as a means of addressing the criticisms of grounded theory that the researcher should use one approach, while rationalising any deviations made. This suggestion is also advocated in the literature as a way of avoiding ‘method slurring’, which is a term used to describe the failing to adhere to key tenets of qualitative approaches when combing approaches. It is also a way of enhancing the credibility of the findings (Cutcliffe 2000, McCann and Clark 2003a, Bowen 2009, Chen and Boore 2009, Dunne 2011). Ong (2011) suggested that researchers should be more meticulous and specific November 2014 | Volume 22 | Number 2 17
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Art & science | acute care Nurse Researcher in the way they use their chosen approaches, to avoid confusion and harness their effectiveness.
The need to explore philosophical assumptions The authors strongly recommend that before beginning a grounded theory study, novice researchers should understand the different philosophical assumptions that underpin each of the grounded theory approaches and explore their own personal philosophical beliefs. Philosophical perspectives dictate how phenomena should be studied and what constitutes knowledge (Weaver and Olson 2006). Exploring philosophical underpinnings can help the researcher to refine and specify the types of evidence required, how it should be gathered and how it should be interpreted. This is an aspect of planning research that quite often gets forgotten and its value cannot be underestimated. An understanding of philosophical assumptions requires an exploration of the nature and form of reality (ontological positioning) and of how knowledge is developed (epistemological positioning). Once sensitivity to the ontological and epistemological assumptions of different approaches is achieved, it is fundamental for researchers to then examine their personal philosophical beliefs about their inquiries, to enable them to position their studies in a particular philosophical perspective (Annells 1996). The epistemological and ontological aspects underpinning a study therefore depend on the person who holds them (Bailey 1997), suggesting that the researchers’ philosophical positions should determine the approaches that they use (Mills et al 2006). These two steps are fundamental in enabling novice grounded theory researchers to choose approaches appropriate to their studies, acknowledge their personal views and inform their approaches to data collection and analysis.
Ontological assumptions Naive realism, critical realism and relativism are three of the major ontological positions that appear to have dominated contemporary discussions on social research. Crotty (1998) suggested that naive realism asserts that physical and social realities exist independently of our experiences, beliefs and descriptions. The naive realist often takes the position that concepts being explored are measurable and is concerned with a single reality that is mostly scientific fact. Similar to naive realism, critical realism holds a view of truth independent of perception (Weaver and Olson 2006), emphasising that the 18 November 2014 | Volume 22 | Number 2
researcher has no involvement in interpreting the data. The main difference between naive and critical realisms is that the critical realist’s philosophical position quite often recognises that all observation is fallible and has error: a critical realist is likely to believe that all theory is revisable (Bergin et al 2008 and is therefore more sceptical than a naive realist. In contrast to the realist view, the relativist ontology views the social world as constructed or interpretable, and that ‘truth’ can only be subjectively perceived (Guba 1990). Following determination of an ontological position, it is important to explore which approach to grounded theory will best suit the study’s needs. This requires an exploration of the possible ontological assumptions underpinning the various grounded theory approaches. The classic approach, despite Glaser’s (1992, 2004) suggestion that it does not fit neatly into any paradigm, alludes to a realist position. Classic grounded theorists believe that there is a single reality independent of researchers’ experiences, views and perceptions (Annells 1997, Crotty 1998), which resonates in some ways with the views of a realist. Glaser (1996) argued that the emphasis of classic grounded theory should be the emergence of data, suggesting that the participants’ main problem and how they resolve it emerges objectively from the data without any influence from the researcher. In contrast, Strauss and Corbin’s (1990) modified approach assumes an objective external reality, giving voice to respondents by acknowledging their views of reality. As a result, Annells (1997) and Ghezeljeh and Emami (2009) suggested that Strauss and Corbin’s approach is relativist. Charmaz’s (2006) constructivist approach views the social world as socially constructed. Ghezeljeh and Emami (2009) suggested that constructivists propose a view of reality that seeks respondents’ and researchers’ meanings, suggesting that it also is relativist.
Epistemological assumptions D’Cruz (2001) defined epistemology as a ‘theory of knowledge, which informs methodology, through consideration of the nature of knowledge, how what exists can be known and how we can know or validate what we know’. It is particularly important to explore epistemological assumptions when choosing a grounded theory approach, as there are distinct epistemological differences between the different approaches (Buckley and Waring 2009). Reseachers should choose approaches based on how they view their relationships with the data. © RCN PUBLISHING / NURSE RESEARCHER
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Methodological decision making Objectivism, subjectivism and constructivism are the major epistemological positions that have dominated contemporary discussions of social research. Objectivism suggests that if meaning exists in objects independently of any consciousness, then we can understand and comprehend the world in its totality, suggesting it is possible to produce ‘objective’ and ‘valid’ knowledge (Lincoln and Guba 2000). Implicit in this philosophy is a belief that it is possible to totally separate the researcher from the researched. This suggests that objectivists view knowledge and its production as disembodied. Subjectivism, on the other hand, suggests that the reality of all objects relies entirely on an individual’s subjective mindfulness of it, which emphasises the role and contribution the researcher plays. By contrast, constructivism argues that researchers generate knowledge from experience and reflection (Ghezeljeh and Emami 2009). Once researchers have examined their epistemological positioning, they should determine which approach accommodates it. When attempting to choose an appropriate approach, it is important to be aware that there are distinct differences in the epistemological assumptions that are implicit but not always explicit in each approach. There are many contradicting views, which leaves the researcher sometimes questioning whether grounded theory stems from an objectivist, subjectivist or constructivist epistemology (Glaser and Strauss 1967, Strauss and Corbin 1990, Glaser 1992, Charmaz 2000). Although Glaser (2004) did not specify that classic grounded theory is objectivist, he assumed an objective external reality, as he saw the researcher as an impartial onlooker who gathers data totally objectively (Glaser 1992, Annells 1997, Ong 2011). Implicit in taking the objectivist epistemology positioning is a belief that it is possible to completely separate the researcher from the object of analysis. Strauss and Corbin (1990) appeared to have a very subjective orientation when discussing the steps to follow when using their approach to grounded theory. Strauss and Corbin (1998) claimed that their approach allows for ‘interplay’ between the researcher and the data. In the constructivist approach, the researcher and the participant interact during data collection and thus the knowledge is constructed through the lens of the researcher’s interpretation of the data.
Choosing a methodology Classic grounded theory (Glaser 2002) seeks to systematically develop a theory by providing a highly structured, comprehensive, yet eminently flexible © RCN PUBLISHING / NURSE RESEARCHER
process. It uses a set of procedures, including constantly comparing the data during ‘open’, ‘selective’ and ‘theoretical’ coding, while maintaining theoretical sensitivity and analytical distance to enable the theory to emerge from the data. This method enables researchers to get close to the phenomena they are studying through extensive data collection and analysis, responding to latent patterns of social behaviour as they emerge and through conceptualisation, which serves as a guide for successive data collection. The methodology is emergent, with researchers entering the field with minimal biases to enable the main concerns of the participants to emerge. In contrast, Strauss and Corbin (1990) proposed a more complicated technique involving three major steps: ‘open’, ‘axial’ and ‘selective’ coding. Unlike Glaser’s (1998) approach, each of these steps involves numerous smaller steps that must be followed. The authors of this paper view this approach as challenging because of the number of steps that must be followed (Benoliel 1996, Melia 1996, Walker and Myrick 2006). Strauss and Corbin (1990) appeared to have a very subjective orientation when discussing the steps in their technique, as the researcher guides the direction of the data rather than allowing the theory to emerge from the data. Walker and Myrick (2006) and Buckley and Waring (2009) alluded to the confusion that can occur from using these steps and advocated taking care not to allow the steps to inhibit emergence of the theory. Charmaz’s (2000) constructivist approach aims to create a sense of reciprocity between the participant and the researcher, highlighting the role the researcher plays in interpreting the data. Charmaz’s (2000) writings on the application of her approach are logical and easy to follow. However, they do not explain the smaller steps between the major phases of analysis (Eaves 2001), which can be confusing for the novice researcher.
Reflecting on the journey of choosing a grounded theory approach For novice grounded theory researchers, philosophically positioning a study that is consistent with the ontological and epistemological assumptions underpinning their chosen approaches can be challenging, as these discussions are quite often omitted in grounded theory publications. The personal beliefs of this paper’s primary author (KM) and the objectives of her PhD study were explored when choosing an approach for the study. On reflection, KM’s beliefs suggested the need to ensure that the theory emerged from November 2014 | Volume 22 | Number 2 19
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Art & science | acute care Nurse Researcher the data. Implicit in these beliefs is the role the researcher has in seeking a non-judgemental understanding of the phenomenon being explored, by remaining open. Furthermore, the research objectives highlighted the need to explore what was happening in practice, which acknowledges the conscious and subconscious beliefs and values underpinning nurses’ and midwives’ care that may not yet have been exercised. For instance, nurses and midwives may have experience of caring for diverse cultures and understand the need to provide culturally competent care, but there is a need to explore independently the care being provided and to discover the mechanisms that may be producing discriminatory and insensitive care. Realist ontology permits the opportunity to uncover such issues and as a result this study was positioned within a realist paradigm. Crotty (1998) suggested that realism asserts that reality exists independently of our knowledge, beliefs and descriptions, suggesting that it is independent of consciousness. Furthermore, Bergin et al (2008) suggested that maintaining a realist ontological position is particularly important when studying issues that are not necessarily obvious or factors that are not measurable, such as the subconscious assumptions and prejudices that affect the delivery of care. Implicit in this belief is the aim of the researcher to maintain a neutral, non-judgemental approach to collecting and analysing data, regardless of the theory that emerges. Taking this epistemological positioning presented a challenge for KM as it did not fit easily into an objectivist, subjectivist or constructivist perspective. On reviewing the various epistemological positions, she questioned the ability to claim absolute objectivity, as a researcher may have unconscious biases; but to claim total subjectivity would suggest that the theory may be ‘forced’ or interpreted by her personal views. Unlike subjectivists and constructivists, KM felt it was impossible to view knowledge and its production as disembodied, and that to influence responses or to rely on interpreting the data from her perspective had the potential to undermine the credibility of the theory. Patton (2002) has presented a ‘middle’ epistemological perspective, which he refers to as ‘empathic neutrality’. Although this does not take a purist objectivist’s position, it does encourage the incorporation of strategies to remain as objective as possible during data collection and analysis. Empathic neutrality requires the researcher to adopt a position of neutrality, while being able to understand the 20 November 2014 | Volume 22 | Number 2
stances, positions, feelings and experiences of others (Patton 2002). On exploring the philosophical assumptions underpinning the various approaches, it appeared that the classic approach (Glaser 2002) – although no less rigorous than the other approaches – was the best choice as it accommodated a realist position and encouraged the researcher to remain neutral during data collection and analysis. Furthermore, the flexibility and simplicity of its procedural steps were a particular strength.
Overcoming the challenges In line with the classic approach to data collection, the researcher (KM) analysed data through open, selective and theoretical coding, while constantly comparing the data throughout the process. Open coding of the data began with line-by-line coding, where key statements used by the participants were noted. This was useful as it made the researcher confident that nothing was being omitted. The challenge for a novice researcher is the volume of codes that can emerge, which can result in confusion. After coding the first ten interviews, KM had more than 100 codes. She feared omitting something important, but with so many codes, further analysis of the data was. She realised that she had ‘over-fractured the data’ (Glaser 2004). During selective coding, KM went back to the data and predominantly asked two key questions, such as what were the participants’ main concerns and what participants did to help to overcome their concerns. This assisted her in reducing the number of codes, as codes that were irrelevant to the main concern were delimited. As further data were collected, new emerging categories were identified; the researcher then reconsidered previously analysed texts in light of the developing categories. This meant that the analysis became more focused as categories were developed and saturated. During open and selective coding, data became fragmented and difficult to manage. However, theoretical coding guided the researcher in weaving the data back together again. During this stage, she studied connections between each of the categories and attempted to create theoretical links between them. Glaser provided a number of theoretical coding families that can assist the researcher in making connections between categories and their properties (Glaser 1992, 1998). This stage of the technique proved particularly problematic as the researcher did not have a real insight into the various coding families; researchers are advised to © RCN PUBLISHING / NURSE RESEARCHER
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Methodological decision making first gain an awareness of the components of each of these theoretical coding families. ‘Theoretical memoing’ – writing specific memos on ideas about codes and their relationships and in particular how they relate to the emerging theory – also assisted in piecing the fractured data back together. Once categories started to emerge following initial data collection, the researcher incorporated theoretical sampling, as she went to different groups and asked different questions. As a result, the researcher was guided to further sources of data to constantly compare incidents. Glaser (2004) suggested that theoretical sampling guides the researcher in deciding what data to collect next. Similarly, Backman and Kyngäs (1999) and Neill (2006) argued that theoretical sampling suggests that data analysis serve as data collection in the next stage of the study. The researcher also agrees with this, as it enabled her to be more specific in her interviewing, by identifying emerging gaps in the theory. Theoretical sampling is the fundamental process that makes classic grounded theory flexible (Glaser 1998). The challenge in using this approach is the possible delay that can occur in obtaining ethical approval to interview another group of participants.
suggesting that it should be used to explain rather than derive the theory. There are those who argue against Glaser’s perspective (Strauss and Corbin 1990, Smith and Bailey 1997, Dunne 2011), suggesting that it is important at the very least to broadly review the literature before collecting data. KM agrees, feeling that some searching and reading of literature is required before collecting data, to enable the researcher to identify gaps and help contextualise the study. More practically, when undertaking a PhD study, the researcher was required to complete a research proposal; this required a review of the literature to identify consistencies, inconsistencies and gaps. Therefore, KM did undertake a broad, early review of the literature in the general areas of transcultural competence and transcultural education, to identify gaps. The intent was to situate the study in the broader context of current issues in transcultural care, providing context to position the study. A more detailed literature review took place once the theory had emerged, which is what Strauss and Corbin (1998) referred to as the second phase of the literature review.
How deviations from the ‘purist’ approach were implemented
A key tenet of implementing classic grounded theory is the use of theoretical sampling. This involves being guided by the data in determining what data needs to be collected next. Glaser (1998) asserted that researchers cannot know what to sample for and where it will lead them to, suggesting that the data should guide the researcher to whom to interview next. KM felt it necessary to choose a population with which to begin data collection, so purposefully sampled a group at the start of the study. Although she was unsure of the direction the study would take, it seemed logical to begin by exploring the experiences of nursing and midwifery students, which could be described as purposefully sampling. Glaser argued against selecting a sample, as entering the field with ‘pre-conceived ideas’ may force the theory. Instead, he asserted the need to incorporate theoretical sampling from the beginning of a classic grounded theory study. There are those who feel that research cannot begin with theoretical sampling as the researcher needs a starting point (Coyne 1997, Cutcliffe 2000). KM concurs with such views and so chose to purposefully sample nursing students and midwives at the beginning of this study; she then superseded this purposeful sampling with theoretical sampling in response to the developing categories and their properties.
Despite the documented value of using classic grounded theory, it is not without its critics (Strauss and Corbin 1990, Stern 1994), Annells 1997, Charmaz 2000). Although the researcher attempted to stick to the core tenets of the classic approach, in addressing some of these criticisms, she deviated from the purist approach in certain aspects. This is consistent with Buckley and Waring (2009), Chen and Bore (2009) and Dunne (2011), who suggested that such deviations are possible if they are appropriately justified.
When to undertake a literature review in classic grounded theory Unlike traditional qualitative methodologies, classic grounded theory does not require researchers to start their studies by searching the existing literature in depth. Glaser (2002) suggested entering the field with a completely open mind, which he asserted means not searching literature or having predetermined research questions at the start of the study. He argued that data collection and analysis should be entered with as few preconceived ideas as possible to try to ensure theory emerges from the participants. Chen and Boore (2009) supported Glaser’s position on reviewing literature, © RCN PUBLISHING / NURSE RESEARCHER
Use of sampling approaches in grounded theory
November 2014 | Volume 22 | Number 2 21
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
Nurse Researcher
Methodological decision making
Conclusion Grounded theory is a useful but complex methodology, in which data collection and analysis can be challenging. Being sensitive to the philosophical assumptions underpinning some of the approaches to grounded theory can assist researchers to choose approaches that best suit their thinking.
This paper has attempted to present the views of the authors regarding the main ontological and epistemological propositions that influence the various grounded theory approaches. The authors advocate choosing one particular approach and then justifying any deviations from that approach while still adhering to the core tenets of grounded theory.
Online archive For related information, visit our online archive and search using the keywords
Conflict of interest None declared
References Annells M (1997) Grounded theory method, part 1: within the five moments of qualitative research. Nursing Inquiry. 4, 2, 120-129. Backman K, Kyngäs H (1999) Challenges of the grounded theory approach to a novice researcher. Nursing and Health Sciences. 1, 3, 147-153. Bailey PH (1997) Finding your way around qualitative methods in nursing research. Journal of Advanced Nursing. 25, 1, 18-22. Becker PH (1996) Common pitfalls in published grounded theory research. Qualitative Health Research. 3, 2, 254-260. Benoliel JQ (1996) Grounded theory and nursing knowledge. Qualitative Health Research. 6, 3, 406-428. Bergin M, Wells JS, Owen S (2008) Critical realism: a philosophical framework for the study of gender and mental health. Nursing Philosophy. 9, 3, 169-179. Bowen GA (2009) Supporting a grounded theory with an audit trail: an illustration. International Journal of Social Researcher Methodology. 12, 4, 305-316. Buckley C, Waring M (2009) The evolving nature of grounded theory: experiential reflections on the potential of the method for analysing children’s attitudes towards physical activity. International Journal of Social Research Methodology. 12, 4, 317-334. Charmaz K (2000) Grounded theory: objectivist and constructivist methods. In Denzin N, Lincoln Y (Eds) Handbook of Qualitative Research. Second edition. Sage Publications, Thousand Oaks CA. Charmaz K (2006) Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Sage Publications, London.
Chen HY, Boore JR (2009) Using a synthesised technique for grounded theory in nursing research. Journal of Clinical Nursing. 18, 16, 2251-2260. Coyne IT (1997) Sampling in qualitative research. Purposeful and theoretical sampling: merging or clear boundaries? Journal of Advanced Nursing. 26, 3, 623-630. Crotty M (1998) The Foundations of Social Research: Meaning and Perspective in The Research Process. Sage Publications, London. Cutcliffe JR (2000) Methodological issues in grounded theory. Journal of Advanced Nursing. 31, 6, 1476-1484. D’Cruz H (2001) The fractured lens: methodology in perspective. In Byrne-Armstrong H, Higgs J, Horsfall D (Eds) Critical Moments in Qualitative Research. ButterworthHeinemann, Oxford. Dunne C (2011) The place of the literature review in grounded theory research. International Journal of Social Research Methodology. 14, 2, 111-124. Eaves YD (2001) A synthesis technique for grounded theory data analysis. Journal of Advanced Nursing. 35, 5, 654-663. Ghezeljeh TN, Emami A (2009) Grounded theory: methodology and philosophical perspective. Nurse Researcher. 17, 1, 15-23. Glaser BG (1992) Basics of Grounded Theory Analysis: Emergent Versus Forcing. Sociology Press, Mill Valley CA. Glaser BG (Ed) (1996) Gerund Grounded Theory: The Basic Social Process Dissertation. Sociology Press, Mill Valley CA. Glaser BG (1998) Doing Grounded Theory: Issues and Discussions. Sociology Press, Mill Valley CA.
22 November 2014 | Volume 22 | Number 2
Glaser BG (2001) The Grounded Theory Perspective: Conceptualization Contrasted with Description. Sociology Press, Mill Valley CA. Glaser BG (2002) Constructivist Grounded Theory? www.qualitative-research.net/index. php/fqs/article/view/825/1792 (Last accessed: September 11 2014.) Glaser BG (2004) Remodeling grounded theory. The Grounded Theory Review: An International Journal. 4, 1, 1-24. Glaser BG, Strauss AL (1967) The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine De Gruyter, New York NY. Guba EG (1990) The alternative paradigm dialog. In Guba E (Ed) The Paradigm Dialog. Sage Publications, Newbury Park CA. Johnson M, Long T, White A (2001) Arguments for ‘British Pluralism’ in qualitative health research. Journal of Advanced Nursing. 33, 2, 243-249. Lincoln YS, Guba EG (2000) Paradigmatic controversies, contradictions, and emergig confluences. In Denzin N, Lincoln Y (Eds) Handbook of Qualitative Research. Second edition. Sage Publications, Thousand Oaks CA.
Melia KM (1996) Rediscovering Glaser. Qualitative Health Research. 6, 3, 368-378. Mills J, Bonner A, Francis K (2006) The development of constructivist grounded theory. International Journal of Qualitative Methods. 5, 1. Ong BK (2011) Grounded theory method (GTM) and the abductive research strategy (ARS): a critical analysis of their differences. International Journal of Social Research Methodology. 15, 5, 417-432. Patton MQ (2002) Qualitative Research And Evaluation Methods. Third edition. Sage Publications, Thousand Oaks CA. Smith K, Bailey F (1997) Understanding grounded theory: principles and evaluation. Nurse Researcher. 4, 17-30. Stern PN (1980) Grounded theory methodology: its uses and applications. Image. 12, 11, 20-23. Stern PN (1994) Eroding grounded theory. In Morse J (Ed) Critical Issues in Qualitative Research Methods. Sage publications, Thousand Oaks, CA. Strauss AL, Corbin J (1990) Basics of Qualitative Research: Grounded Theory Procedures And Techniques. Sage Publications, Newbury Park CA.
May KA (1996) Diffusion, dilution, or distillation? The case of grounded theory method. Qualitative Health Research. 6, 3, 309-311. McCann TV, Clark E (2003a) Grounded theory in nursing research: Part 1 – methodology. Nurse Researcher. 11, 2, 7-18. McCann TV, Clark E (2003b) Grounded theory in nursing research: Part 2 – critique. Nurse Researcher. 11, 2, 19-28. McCann TV, Clark E (2003c) Grounded theory in nursing research: Part 3 – application. Nurse Researcher. 11, 2, 29-39.
Strauss AL, Corbin J (1998) Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Second edition. Sage Publications, Newbury Park CA. Walker D, Myrick F (2006) Grounded theory: An exploration of process and procedure. Qualitative Health Research. 16, 4, 547-559. Weaver K, Olson JK (2006) Understanding paradigms used for nursing research. Journal of Advanced Nursing. 53, 4, 459-469. Wilson HS, Hutchinson SA (1996) Methodologic mistakes in grounded theory. Nursing Research. 45, 2, 122-124.
© RCN PUBLISHING / NURSE RESEARCHER
Downloaded from RCNi.com by ${individualUser.displayName} on Apr 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCN Publishing Ltd. All rights reserved.
