Qualitative study design

Grounded theory

Purpose

Theory development.

Definition

Grounded theory proposes that careful observation of the social world can lead to the construction of theory (Rice & Ezzy, 1999). It is iterative and evolving, aiming to construct new theory from collected data that accounts for those data. It is also known as the “grounded theory method”, although the terms have become interchangeable (Bryant & Charmaz, 2007).

Grounded theory characteristics include:

• Data collection and analysis occurring simultaneously, with one informing the other.
• Data grouped into concepts, categories and themes.
• A data collection process influenced by the simultaneous development of those concepts, categories and themes.

Notably, data collection is cyclical and reflective. This is different from the more linear processes occurring in other methodologies.

Methods

Theoretical sampling is a key aspect of the sampling stage of grounded theory. Recruitment continues until the sample finally represents all aspects that make up the theory the data represent (Starks & Brown Trinidad, 2007). Participants are recruited based on their different experiences of a phenomenon.

Researchers collect participant data using these methods:

• Observation
• Examination of documents
• Focus groups and interviews

Focus groups and interviews are typically being more practical in health research than observation (Starks & Brown Trinidad, 2007).

After the initial phase of data collection, researchers repeat the following cycle of steps:

Researchers’ developing understanding of the concepts, categories and relationships informs their actions at each step. These elements result in a theoretical framework explaining the data. 

This cycle reflects two crucial components of grounded theory:

• The process of coding, sorting and organising data. This aims to increasingly move towards more abstract terms in order to develop a related theory for the data
• The principle of constant comparison. This refers to the process of noting issues of interest in data and comparing them to other examples to identify similarities and differences.

Strengths

• Widely used across a wide range of disciplines (Bryant & Charmaz, 2007).  
• Facilitates theory construction and the construction of fresh concepts. It also avoids assuming structures are stable (Charmaz, 2017). 
• Useful for when researchers wish to explain a process, not to test an existing theory. 

Limitations

• Inherently not useful for the application of received theory. 
• Not useful for testing hypotheses. 
• Analysis of data involves elements of researcher’s own subjective judgement.

Example questions

• How do perioperative nurses foster a culture of safety and risk aversion? 
• What is the impact of hand nerve disorders on a person’s function, activity and participation? 
• What are the barriers to health care access for a refugee population? 

Example studies

Attree, M. (2001). Patients' and relatives' experiences and perspectives of 'Good' and 'Not so Good' quality care. J Adv Nurs, 33(4), 456-466. doi: 10.1046/j.1365-2648.2001.01689.x 

Lingard, L., Reznick, R., Espin, S., Regehr, G., & DeVito, I. (2002). Team communications in the operating room: talk patterns, sites of tension, and implications for novices. Acad Med, 77(3), 232-237. doi: 10.1097/00001888-200203000-00013 

Pettersson, S., Ekstrom, M. P., & Berg, C. M. (2013). Practices of weight regulation among elite athletes in combat sports: a matter of mental advantage? J Athl Train, 48(1), 99-108. doi: 10.4085/1062-6050-48.1.04 

References

Bryant, A., & Charmaz, K. (2007). The SAGE handbook of grounded theory: SAGE Publications Ltd.

Charmaz, K. (2017). An introduction to grounded theory: SAGE Publications Ltd. 

Lingard, L., Albert, M., & Levinson, W. (2008). Grounded theory, mixed methods, and action research. BMJ, 337, a567. doi: 10.1136/bmj.39602.690162.47 

Rice, P. L., & Ezzy, D. (1999). Qualitative research methods: a health focus. South Melbourne, Australia: Oxford University Press. 

Starks, H., & Brown Trinidad, S. (2007). Choose Your Method: A Comparison of Phenomenology, Discourse Analysis, and Grounded Theory. Qualitative Health Research, 17(10), 1372-1380. doi: 10.1177/1049732307307031