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Grounded theory as a qualitative

research methodology ualitative research methods reflect an inductive mode of analysis or a process of moving from specific obser-

vations to a general theory.’ This mode of analysis is in contrast to quantitative research methods, which rely on deductive thinking or a process of moving from a general theory to specific obser- vations. Grounded theory, a mode of inductive analysis, can be thought of as a theory that is derived from or “grounded” in everyday experiences. Grounded theory strategies first were reported and attributed to sociol- ogists Barney Glaser and Anselm Strauss in 1967.2 The foundations of grounded theory are embedded in symbolic inter- actionism, which assumes that one’s communications and actions express meaning.

that meaning is dynamic and shared by group members. According to one author,

Grounded theorists assume

researchers’ purpose in using the grounded theory method is to explain a given social situation by identifying the core and subsidiary processes oper- ating in it. The core process is the guiding principle underlying what is occurring in the situa- tion and dominates the analysis because it links most of the other processes involved in an explanatory network.’

Examples of penoperative social situations that could be researched using grounded theo- ry include nurse and patient interaction, discharge planning, physician and nurse communica- tion, and management styles.

RESEARCH METHOD

sources include all resources that yield information regarding social interaction. Data may be collected by observing and recording interactions, examin- ing written documentation and literature, or obtaining perspec- tives from various people involved in the social interaction. How and when a review of liter- ature is performed is debated by grounded theory scholars.4

The method used to reach a grounded theory is termed the constant comparative method. During data collection, data usually are analyzed concurrent- ly. As the data are analyzed, the researcher searches for a core variable, which will serve as the foundation for theory genera- tion. The core variable usually has some of the following characteristics:

Grounded theory’s data

N

recurs frequently, links various data, has an explanatory function, has implications for formal theory, becomes more detailed, and permits maximum variation (ie, inclusion of people from various backgrounds) .s

Data typically are coded at

three levels. At the first level, the researcher examines data line by line, and at the second level, he or she compares and contrasts the data to create categories or clusters. At the third or final level, the researcher moves from data analysis to concept and the- ory development. Theory emerges with data reduction (ie, filtering information relevant to the topic and discarding extrane- ous information) and selective sampling. Data usually are col- lected until no further new infor- mation is found. This process is termed saturation and signals the end of data collection.

RESEARCH REPORT A research report has many

purposes, including communicat- ing research findings. For grounded theory research, the report also describes the theory derived from research. The report should include informa- tion regarding how data were collected and analyzed, as well as the concepts that were gener- ated. Guidelines for critiquing grounded theory research have been outlined by researchers.6 The following eight categories should be addressed in a ground- ed theory report:

m

statemen; of the phenomenon of interest; purpose; method; sampling; data generation; data analysis; empirical grounding of the

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study (ie, findings); and conclusions, implications, and recommendations. Many investigations of nurs-

ing practice have used grounded theory.’ The grounded theory method has been used to study how people live with HIV and manage their illness. It also has been used to explore how parents whose children are hospitalized in an intensive care unit cope with their feelings of uncertainty.

Additional study topics have included postpartum depression; communication processes; or liv- ing with diabetes, dialysis, or bone marrow transplantation.

SUMMARY Grounded theory as a qualita-

tive research approach provides nurses with strategies to build the- ories in areas previously unex- plored or under explored. Although similar to other induc-

NOTES 1. S Nonvood, Research Strategies for Advanced

Practice Nurses (Upper Saddle River, NJ: Prentice Hall Health, 2000) 382-385.

2. P Dempsey, A Deinpsey, Using Nursing Research: Process, Critical Evaluation, and Utilization (Baltimore: Lippincott, 2000) 138-146; C Baker, J Wuest, P Stern, “Method slurring: The grounded theorylphenomenology example,” Journal of Adiianced Nursing 17 (November 1992) 1355- 1360; J Cutcliffe, “Methodological issues in grounded theory,” Journal of Advanced Nursing 3 1 (June

tive processes, this methodology differs in that it emerges from the discipline of sociology. In addi- tion, strategies for data analysis differ according to each method- ologist. As with other qualitative methods, the researcher must link philosophy, methodology, and research method for rigorous and credible scholarship.

MICHELLE BYRNE RN, MS, PHD, CNOR

NURSING RESEARCH COMMI~EE

2000) 1476-1484. 3. Baker, Wuest, Stem, “Method slurring: The

4. Cutcliffe, “Methodological issues in grounded the-

5. H Streubert, D Carpenter, Qualitative Researck in

grounded theorylphenomenology example,’’ 1355-1360

ory,” 1476-1484.

Nursing: Advancing the Humanistic Imperative (Philadelphia: Lippincott, Williams, & Wilkins, 1999) 1 17- 143.

6. Ibid. 7. Ihid.

Awareness and Prevention Key to Preventing Stroke Women suffer approximately 43% of all strokes that occur per year; however, they account for 6 1 % of stroke deaths, according to an April 26, 2001, Internet Wire news release. Although stroke is an under-recognized problem among women, there is a need for greater awareness and precaution among both genders.

According to the National Stroke Association, stroke is one of the most preventable of all life- threatening health problems. Risk factors for stroke are either uncontrollable or controllable. Uncontrollable risk factors include

age-two-thirds of all strokes happen to people older than age 65; gender-males have a slightly higher stroke risk than females; race-African Americans have a greater stroke risk than most other racial groups; family history of stroke or transient ischemic attack (TIA); and personal history of diabetes.

Controllable stroke risk factors include high blood pressure, atrial fibrillation and other heart diseases, coronary heart disease and high choles- terol, sleep disordered breathing (eg, sleep apnea), and personal history of stroke or TIA. Lifestyle factors that increase stroke risk include smoking, excessive consumption of alcohol, and excess weight. Having one or more uncontrollable stroke risk factors does not destine a person to suffering a stroke; however, with attention to controllable risk factors, the effect of uncontrollable factors can be reduced, according to the association.

National Stroke Association: Setting the Record Straight on Strokes (news release, Englewaod, Colo: Internet Wire Medical/Health News, April 26, 200 1, hffp://wwwl . internetwire. com/iwire/medical (accessed 26 April 2001).

“sfroke risk factors and their impact, “ (Nafional Stroke Association, h t t p : / W , stroke. org/stroke-risk. cfm (accessed 27 April 200 1).

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