Grounded Theory In Nursing Nursing Research and Grounded Theory

Grounded theory is a qualitative research methodology that has been widely adopted in nursing research to explore social interactional and structural phenomena. It provides a systematic yet flexible approach to collecting and analyzing data, with the ultimate goal of generating theory from the data itself. This article explores the fundamentals of grounded theory, its concerns, how it compares to other methods, its core focus, and its outcomes, especially within the context of nursing research.

Grounded Theory

Grounded theory refers to a method of qualitative research that seeks to explain variations in social interactional and structural problems and processes. The ultimate goal is to generate theory directly from the data and conceptual frameworks that emerge during analysis, rather than to impose pre-existing theories onto the data. Grounded theory is particularly useful in studying complex social phenomena where existing theories may not adequately explain the data.

Developed by sociologists Barney Glaser and Anselm Strauss in 1967, grounded theory has become a cornerstone of qualitative research. Its defining feature is that theories are “grounded” in the data rather than derived from existing theories or frameworks. Grounded theory assumes that fundamental patterns, known as core variables or basic social processes, can be discovered in social life, providing valuable insights into human behavior (Hutchinson, 1993; Wilson, 1993).

According to Glaser and Strauss, grounded theories should be relevant, practical, and able to explain, predict, and be modified in response to the phenomena under study. Rather than forcing data into predefined categories, grounded theory researchers develop rich, dense, and complex analytic frameworks that emerge from the data itself.

Concerns of Grounded Theory

Grounded theory emerged from the intellectual tradition of symbolic interactionism and pragmatism, both of which emphasize the importance of qualitative fieldwork and the continuous change inherent in human experience. This worldview contrasts with more positivist paradigms that emphasize stability and regularity in social life.

Grounded theory is particularly well-suited to nursing research, where the focus is often on understanding clinically relevant phenomena—such as chronic illness, caregiving, or end-of-life experiences—in real-world settings. Unlike experimental research conducted in controlled environments, grounded theory allows researchers to capture the complexity and dynamism of human experiences in natural settings.

Nurses using grounded theory aim to uncover the meaning of experiences like illness, recovery, and caregiving, and use these insights to inform both practice and research. The resulting theoretical frameworks not only explain human experience but also provide a basis for developing nursing interventions and guiding clinical practice.

Grounded Theory and Other Methods

Grounded theory has significantly influenced the evolution of nursing research, largely due to the involvement of Glaser and Strauss at the University of California, San Francisco in the 1960s. During this time, many nursing doctoral students collaborated with these sociologists, leading to the application of grounded theory in nursing research. Several early nursing researchers, including Jeanne Benoliel, Juliet Corbin, Sally Hutchinson, and Holly Wilson, played crucial roles in adapting grounded theory methods to the nursing context.

One of the strengths of grounded theory is that it departs from the linear, hypothesis-driven approaches that are common in other research methodologies. Rather than beginning with a preconceived theory and testing it through experimentation, grounded theory research involves the simultaneous collection and analysis of data. This iterative process allows researchers to remain open to the data, enabling new theories to emerge organically.

Grounded theory contrasts with more traditional quantitative research methods, which often rely on hypothesis testing, controlled variables, and large, statistically representative samples. Instead, grounded theory uses purposive sampling and theoretical sampling, where data collection continues until theoretical saturation is achieved—that is, until no new themes or concepts emerge from the data. This approach is particularly useful in qualitative studies, where the goal is to explore depth and complexity rather than produce generalizable results.

Focus of Grounded Theories

The focus of grounded theory research is on uncovering unarticulated social-psychological and social-structural problems that may not be immediately visible. Researchers using grounded theory aim to discover the basic social processes that underlie human interactions and experiences.

Grounded theory research typically begins with no preconceived hypotheses. Instead, the researcher starts by studying an area of interest under natural conditions, such as a clinical setting or a community environment. Data are usually collected through qualitative methods, including interviews, participant observation, and document analysis. These data sources provide rich, detailed insights into the social processes at work.

A key feature of grounded theory is the use of sensitizing questions, which guide the researcher in identifying what is relevant in the data. Sampling is not based on probability or statistical power but is instead determined by the emerging analysis. As new concepts and patterns are identified, the researcher engages in theoretical sampling, collecting additional data to refine the emerging theory.

How Grounded Theory Differs from Other Methods

One of the most distinctive features of grounded theory is the constant comparative method, which involves the continuous comparison of data throughout the research process. As soon as data are collected, they are analyzed to identify emerging themes, categories, and patterns. This process is recursive: data collection and analysis occur simultaneously, with each informing the other.

The analysis proceeds through several stages:

1. In Vivo Coding: In this stage, researchers identify themes and patterns in the participants’ own words. The goal is to capture the raw meaning of the data without imposing external frameworks.
2. Category Coding: The in vivo codes are grouped into broader conceptual categories that represent key aspects of the social processes under study.
3. Theoretical Coding: In this stage, the researcher identifies relationships among the categories, developing a theoretical framework that explains the underlying social processes.

Throughout this process, researchers write memos to document their thoughts, insights, and reflections. These memos help track the development of codes and categories, providing a clear record of the research process.

The grounded theory approach is also distinctive because sample size is not predetermined. Data collection continues until theoretical saturation is reached, meaning that no new themes or concepts are emerging from the data. This flexible approach allows researchers to adapt their study design based on the evolving analysis.

Outcomes of Grounded Theories

The outcome of grounded theory research is a dense, parsimonious, and integrative schema that explains most of the variation in a social-psychological situation. Grounded theory provides a rich, in-depth understanding of the social processes that underlie human behavior, making it particularly valuable in fields like nursing, where researchers seek to understand complex, real-world phenomena.

Grounded theories can be either substantive theories, which are context-bound and specific to a particular area of study, or formal theories, which are more conceptual and applicable across various settings and experiences (Glaser, 1978). In either case, the theory generated is grounded in the data and provides a detailed explanation of the processes at work.

Over time, grounded theory has undergone significant transformation as researchers have sought to refine and enhance its rigor. However, some of these changes have been criticized for moving away from the method’s original focus on generating theory directly from the data. For example, critics argue that some attempts to standardize the method have reduced researchers’ theoretical sensitivity, limiting their ability to remain open to the data.

Despite these criticisms, grounded theory continues to be a widely used and respected method in both qualitative research and nursing practice. Its focus on the interplay between data and theory, along with the constant comparative method, remains central to its application in a variety of disciplines.

Conclusion

Grounded theory is a powerful research method that has had a profound impact on nursing research. Its emphasis on generating theory from the data makes it particularly useful for exploring complex, real-world phenomena in health care settings. Grounded theory’s ability to uncover unarticulated social-psychological and structural problems allows nurses and researchers to gain deeper insights into the experiences of patients, caregivers, and health professionals.

As the field of nursing continues to evolve, grounded theory remains an important tool for understanding and addressing the social processes that shape health and illness. By generating theories that are directly grounded in the data, nursing researchers can develop more effective interventions, improve patient care, and contribute to the ongoing development of nursing knowledge and practice.

While grounded theory has evolved over time, its core principles—data-driven theory development, the constant comparative method, and theoretical sampling—continue to provide a valuable framework for qualitative research. Grounded theory’s flexibility, adaptability, and focus on real-world phenomena make it a crucial method for advancing nursing science and improving health care outcomes.