GROUNDED

THEORY

Week 3 Lecture
Required Reading: Holloway & Galvin
(2017), Chapter 11
Outline
• Explore the history of grounded theory
• Who are Barney Glaser and Anselm Strauss and Julie
Corbin
• Discuss symbolic interactionism
• Data sources
• Explore the main features of grounded theory
• Theoretical sensitivity
• Theoretical sampling
• Data analysis: coding and categorizing
• Discovering the core category
• Constant comparison
• Use of the literature
• Integrating theory
• Theoretical memos and field notes
 Selecting a Qualitative Method
If you are interested in …

Understanding human Uncovering social Learning cultural

experience processes patterns

Then you will choose the …

Phenomenological Grounded theory Ethnographic

method method method

And you may pose a question that begins like …

What is the human How does this social How does this cultural
experience of …? group interact to …? group express its
pattern of …?

3
 History of Grounded Theory (GT)

• In the 1960’s Barney Glaser and Anslem Strauss (sociologists from the University of California, San Francisco)
conducted a research study on the interactions between health professionals and those who were dying.
• It was from this study that they developed what is referred to as ‘grounded theory’—the generation of a theory,
coming from data that researchers collect—the theory is ‘grounded’ in the data.
• Their seminal book in 1967 was titled “The Discovery of Grounded Theory”.
• Over the years Glaser & Strauss had differing viewpoints on the nature of method.
• It is thought that Glaser stayed faithful to the original ideas of GT
• Strauss began working with Julie Corbin (a nurse researcher), and together developed new ideas about the ‘how to’
develop grounded theory, writing several books together.
 Different types of grounded theory

Grounded Theory
Grounded Theory (Glasser & Strauss 1967)

Glasser Strauss & Corbin Charmaz

Branches of GT (1978) (1990, 1998) (2006,2014)

Constructing a
Developed GT Develop well
Focus that accounts for
all data
organized and
detailed GT
theoretical
understanding of
people

(Singh & Estefan, 2018)

Grounded Theory (GT)

The focus in GT is on:

• Interactions
• Communication
• Active engagement in social situations
 Structure of the study

– Research Questions
– Address basic social processes that shape
human behaviours
– Statement or a board question that allow for
explanation of the phenomenon
– Researcher selects a focus on an area of
interest

(Singh & Thirsk, 2022,)

 Symbolic interactionism

• When Glaser and Strauss first began developing the GT

method/methodology, it was tied to symbolic interactionism (SI)
• SI focuses on the actions of and interactions between people, exploring
human behaviour in social situations and the meanings that come from
them.
• Attention is also given to people’s perceptions, ideas and their intentions’
• The Thomas theorem states that ‘If men [sic] define situations as real,
they are real in their consequences’ (Thomas, 1928 as cited in Holloway
& Galvin, 2017, p. 181)

Video by Rachel Pan:https://www.youtube.com/@prachel

When is grounded theory
used?
• Suited to the study of processes, trajectories or journeys
through an illness condition
• The key aim is to offer explanation
• Interpretative in nature
 Example #1 of GT: Musto, L., & Schreiber, R.S. (2012). Doing the Best I Can
Do: Moral Distress in Adolescent Mental Health Nursing

The purpose of this research was to explore the process used by mental health nurses working with adolescents to
ameliorate the experience of moral distress. Using grounded theory methodology, a substantive theory was
developed to explain the process. All the incidents that led to the experience of moral distress were related to safety
and resulted in the nurses asking themselves the question, “Is this the best I can do?” Engaging in dialogue was the
primary means nurses used to work through the experience of moral distress. Engaging in dialogue was an ongoing
process, and nurses sought out dialogue with a variety of people as they tried to make sense of their experience.
Participants identified qualities of dialogue that were helpful or unhelpful as they sought to resolve their moral
distress. Participants who had a positive experience of dialogue were able to answer the “Is this the best I can do”
question satisfactorily and continue working with adolescents with a renewed focus on the therapeutic relationship.
Participants who had a negative experience of dialogue are unable to answer the question and either left the unit or
agency or talked about leaving.
 GT Example #2:
Knaak S, Patten S. (2016). A grounded theory model for reducing stigma in health professionals in Canada.

Objective: The Mental Health Commission of Canada was formed as a national catalyst for improving the mental health system.
One of its initiatives is Opening Minds (OM), whose mandate is to reduce mental health-related stigma. This article reports
findings from a qualitative study on anti stigma interventions for healthcare providers, which includes a process model
articulating key stages and strategies for implementing successful anti stigma programmes.
Method: The study employed a grounded theory methodology. Data collection involved in-depth interviews with programme
stakeholders, direct observation of programmes, a review of programme documents, and qualitative feedback from programme
participants. Analysis proceeded via the constant comparison method. A model was generated to visually present key findings.
Results: Twenty-three in-depth interviews were conducted representing 18 different programmes. Eight programmes were
observed directly, 48 programme documents were reviewed, and data from 1812 programme participants were reviewed. The
analysis led to a four-stage process model for implementing successful anti stigma programmes targeting healthcare providers,
informed by the basic social process ‘targeting the roots of healthcare provider stigma’.
Conclusion: The process model developed through this research may function as a tool to help guide the development and
implementation of anti stigma programmes in healthcare contexts.
What is the difference between Glaser
and Strauss’s approaches?
Stern (1994) summarizes the differences between
both approaches as…
“I think that Strauss, as he examines the data,
stops at each word to ask, ‘what if?’ Glaser keeps
his attention focused on the data and asks, ‘what
have we here?’ Strauss brings to bear every
possible contingency that could relate to the
data, whether it appears in the data or not.
Glaser focuses his attention on the data to allow
the data to tell their own story” (as cited in
McCann & Clark, 2003, p. 26)
 • Researchers write notes in the field, memos with
specific words, sentences or thoughts that were
expressed either through interview or observations.
• They are great memory aides and can be used to help
Data sources, with analysis, interpretations, questions to follow up
theoretical with or directions for where to move to next.
• As the researcher becomes more active in the data
memos and collection and analysis the memos become more
field notes theoretical in nature.
• Grounded theorists use several different methods to
collect data.
• Field Observations
• Participant Interviews
• Documents (journals, papers, diaries, incident reports,
newspaper clippings, researchers’ experiences, etc.)
• According to Glaser (1978), ”everything is data”….
 • Grounded theory is intended to explain rather than
Important describe
aspects of GT • The theory generated must apply to similar settings and
contexts.
• New perspectives are welcomed to help explain social
actions and the meanings that come from them.
• Data is coded and categorized (in tandem), then major
concepts and constructs are formed.
• Researcher searches for major themes that connect
ideas, searching for that ‘core category’ which links all
other categories, and when uncovered is described as
discovering the essence of the study.
 Sample and data collection

Sample Size Purposive Sampling Snowball Sampling Theoretical Sampling

• Sample size: Ranges • Selecting • Participants • Select experiences
between 20 to 30 participants with recommended by that help researcher
cases experience and other participants in to test ideas and
• Researcher will knowledge related to the study refine emerging
explain sampling the study domain findings
plan and limitations • Select events & • Used to clarify
incidents that are emerging concepts
related to the social
process of interest

(Singh & Thirsk., 2022)

Main features • Theoretical sensitivity
• Theoretical sampling
of GT • Data analysis: coding and categorizing
• Discovering the core category
• Constant comparison
• Use of the literature
• Integrating theory
• Theoretical memos and field notes
Theoretical • This means that researchers can differentiate between
data that is significant from that which is less
sensitivity meaningful.
• This is done by having insights into the meaning of the
data.
• Can be approached by trying to look at the many
meanings a piece of data can have for someone…
remember not everything means the same thing to all
people.
 While interviewing a pediatric nurse about why they
approached her colleagues to take over her assignment
she said…

Consider…. “I’m really not sure how to explain it. I just knew when I
walked into the room, that something didn’t feel right. I
knew that something was going to happen. Maybe it was
how the child looked, or perhaps it was my gut telling me
not to go to far away, and within an hour my patient was
in SVT…his heart racing at 257 beats a minute”.

What data do you think is important or has greater

meaning?
Are there multiple ways to consider this data (consider if
there could be multiple meanings)?
Is there a concept/idea forming in your mind about what
this data means?
 Theoretical sampling

• Sampling that is guided by significant ideas for the theory that is emerging.
• Through the process of collecting data and analyzing it, concepts (ideas) begin to emerge.
• The researcher must continuously decide what data to collect next, and from whom to advance
the theory.
• Time and continuance are unique nuances specific to GT which means that theoretical sampling
continues throughout the study rather than being pre-determined.
• ‘Theoretical sampling continues until data and theoretical saturation’.
 Data analysis: coding and categorizing

• Coding and categorizing continue throughout the research study.

• The process of coding consists of looking and analyzing the data then forming/labelling themes
(central ideas) or concepts.
• Data are reduced to build categories…they are named and provided a label
• As the categories emerge, theory can be evolved.
• Clusters are formed by concepts that relate to each other, not necessarily through descriptions
or themes but could be in the form of language such as certain words or phrases participants use
to describe a phenomenon.
Example of data analysis (excerpt from a grounded theory study) Sanford, J., Townsend-Rocchicciolli, J.,
Horigan, A., & Hall, P. (2011). A process of decision making by caregivers of family members with heart failure. Research and
Theory for Nursing Practice: An International Journal, 25, 55-70.

`
 Types of coding: Open coding
– The process of breaking down or attempting to figure out/think about what concepts (abstract ideas)
are in the data.
– All data are coded and researchers during open coding tend to go through the interview transcription
or field notes/memos/field observations etc. line by line trying to locate the concepts within.
– Through the process of open coding the researcher limits the chance of being influenced by
preconceived ideas.
– Level One Coding (Concepts)
– Level Two Coding-Developing Constructs
– Level Three Constructs –Major Categories
Discovering the core category

• The core category is that which connects all other

categories.
• It’s part of the overall pattern and when the core category
has been linked to all other categories it is termed
selective coding.
• The essence of the study has been uncovered and
researchers integrate all the aspects of the emergent
theory.
• For additional information on major characteristics fore
core categories see Holloway and Galvin, 2017, p. 188.
What is open, axial, and Selective Coding?
Constant comparison

• Data is coded and categorized by constant comparison.

• Data is collected  analyzed  codes and concepts are
developed  concepts and subcategories are compared
and grouped with labels into major categories.

• New data is collected  analyzed  codes and concepts

are developed  concepts and subcategories are compared
with those major categories that have been established to
determine if there is a ‘fit’. This process helps determine
those aspects that make up the properties and dimensions
of categories.
Image source: http://cfile5.uf.tistory.com/image/214E843B5461CC260FED52
 • There are mixed thoughts about the use of literature in
Use of the grounded theory.
literature • Glaser (1978) suggested that researchers’ prior
understandings are based on the general problem, they
can read widely but not before data is collected and
coded (Chen & Boore, 2009)
• Strauss (1987) suggested that self and literature are
early influences, past experience and literature may be
used to develop ‘working propositions’ or ‘provisional
hypothesis’ which would need to be compared against
incoming data.
 Highlight all features specific to grounded theory: From Sørensen, D., Frederiksen, K., Groefte, T., & Lomborg, K. (2013).
Nurse-patient collaboration: A grounded theory study of patients with chronic obstructive pulmonary disease on non-invasive
ventilation. Nursing Studies, 50(1), 26-33

Objectives: This paper provides a theoretical account of nurses’ collaboration with patients with chronic obstructive pulmonary disease during non-
invasive ventilation treatment in hospital.
Background: Despite strong evidence for the effect of non-invasive ventilation treatment, success remains a huge challenge. Nurse–patient
collaboration may be vital for treatment tolerance and success. A better understanding of how nurses and patients collaborate during non-invasive
ventilation may therefore contribute to improvement in treatment success.
Design: A constant comparative classical grounded theory.
Method: The data comprised sessions of qualitative participant observation during the treatment of 21 patients with non-invasive ventilation that
included informal conversations with the nurses and semi-structured interviews with 11 patients after treatment completion. Data were collected at
three intensive care units and one general respiratory ward in Denmark.
Results: Succeeding emerged as the nurses’ main concern in the nurse–patient collaboration during non-invasive ventilation treatment. Four
collaborative typologies emerged as processing their main concern: (1) twofold oriented collaboration; (2) well-being-oriented collaboration; (3)
outcome-oriented collaboration; and (4) absent collaboration.
Conclusions: This study offers a theoretical account of nurses’ main concern and how they activate different ways of collaboration to achieve
successful treatment. We offer a theoretical basis for developing complex interventions.

–
Integrating • Substantive Theory: theory that emerges from a
particular context or setting, such as a particular
theory hospital unit or patient population.

• Formal Theory: generated from many different

situations and settings, therefore is more conceptual in
nature and can be applied to a variety of situations.
Describing the
findings

• Findings should be
presented using
• Descriptive Language
• Diagrams of the process
• Goal: Generate a Theory
based on the reported
findings that is connected
to the data

(Singh & Thirsk., 2022; Sinclair et al., 2020)

This Photo by Unknown Author is licensed under CC BY
Summary: Grounded Theory Explained in Simple
Terms
 References
Chen, H.Y., & Boore, J. (2009). Using a synthesized technique for grounded theory in nursing research. Journal of Clinical
Nursing, 18, 2251-2260.
Engward, H. (2013). Understanding grounded theory. Nursing Standard, 28(7), 37-41.
https://doi.org/10.7748/ns2013.10.28.7.37.e7806
Holloway, I., & Galvin, K. (2017). Qualitative research in nursing and healthcare (4th ed). West Sussex, UK: Wiley & Sons Ltd.
McCann, T. V., & Clark, E. (2003). Grounded theory in nursing research: Part 2-critique. Nurse Researcher, 11(2), 7-18.
Musto, L., & Schreiber, R. (2012). Doing the best I can do: Moral distress in adolescent mental health. Issues in Mental
Health Nursing, 33(3), 137-144.
Sinclair, S., Hack, T. F., McClement, S., Raffin-Bouchal, S., Chochinov, H. M., & Hagen, N. A. (2020). Healthcare providers
perspectives on compassion training: A grounded theory study. BMC Medical Education, 20(1), 1-13.
Singh, M.D., & Thirsk, L. (2022). LoBiondo-Wood and Haber’s nursing research in Canada. Methods, critical appraisal, and
utilization (5th ed.). Toronto, Canada: Elsevier. ISBN:978-0-323-77898-5. https://doi.org/10.1186/s12909-020-02164-8