Contextual Sensitivity in Grounded Theory: The Role of Pilot Studies

Grounded Theory is an established methodological approach for context specific inductive theory building. The grounded nature of the methodology refers to these specific contexts from which emergent propositions are drawn. Thus, any grounded theory study requires not only theoretical sensitivity, but also a good insight on how to design the research in the human activity systems to be studied. The lack of this insight may result in inefficient theoretical sampling or even erroneous purposeful sampling. These problems would not necessarily be critical, as it could be argued that through the elliptical process that characterizes grounded theory, remedial loops would always bring the researcher to the core of the theory. However, these elliptical remedial processes can take very long periods of time and result in catastrophic delays in research projects. As a strategy, this paper discusses, contrasts and compares the use of pilot studies in four different grounded theory projects. Each pilot brought different insights about the context, resulting in changes of focus, guidance to improve data collection instruments and informing theoretical sampling. Additionally, as all four projects were undertaken by researchers with little experience of inductive approaches in general and grounded theory in particular, the pilot studies also served the purpose of training in interviewing, relating to interviewees, memoing, constant comparison and coding. This last outcome of the pilot study was actually not planned initially, but revealed itself to be a crucial success factor in the running of the projects. The paper concludes with a theoretical proposition for the concept of contextual sensitivity and for the inclusion of the pilot study in grounded theory research designs

Rethinking presence: a grounded theory of nurses and teleconsultation

Aims and objectives: To develop a theory that offered an evidence-based insight into the use of teleconsultation by nurses. Background: Teleconsultation is the use of video to facilitate real-time, remote interaction between healthcare practitioners and patients. Although its popularity is growing, there is little understanding of how teleconsultation impacts on the role of nurses. Design: The study adopted a constructivist grounded theory method, supplemented by the use of Straussian analytical approaches. Methods: Using selective and theoretical approaches, registered nurses with experience of using video in health care were sampled. Data were collected using semi-structured interviews exploring experiences, knowledge and feelings surrounding teleconsultation. Interviews were recorded, transcribed and subjected to three-stage, nonlinear manual analysis (open, axial and selective coding). Results: Theoretical saturation occurred after 17 interviews. The core category identified from the data was ‘nursing presence’ Four subcategories of nursing presence were identified: operational, clinical, therapeutic and social. The degree to which presence could be achieved was dependent upon three influencing factors – enablers, constraints and compensation. Conclusions: Nurses provide different types of presence during teleconsultation, with the degree of presence dependent on specific characteristics of video-mediated communication. Where the use of video constrains the delivery of presence, nurses use a range of compensatory mechanisms to enhance patient care. Relevance to clinical practice: Teleconsultation provides an innovative approach to enhancing the delivery of health care. This study provides nurses with insight into the impact of teleconsultation on their professional role, and an understanding of how best to use video-mediated communication to support patient care

Being Healthy: a Grounded Theory Study of Help Seeking Behaviour among Chinese Elders living in the UK

The health of older people is a priority in many countries as the world’s population ages. Attitudes towards help seeking behaviours in older people remain a largely unexplored field of research. This is particularly true for older minority groups where the place that they have migrated to presents both cultural and structural challenges. The UK, like other countries,has an increasingly aging Chinese population about who relatively little is known. This study used a qualitative grounded theory design following the approach of Glaser (1978). Qualitative data were collected using semi-structured interviews with 33 Chinese elders who were aged between 60 and 84, using purposive and theoretical sampling approaches. Data were analysed using the constant comparative method until data saturation occurred and a substantive theory was generated. ‘Being healthy’ (the core category) with four interrelated categories: self-management, normalizing/minimizing, access to health services, and being cured form the theory. The theory was generated around the core explanations provided by participants and Chinese elders’ concerns about health issues they face in their daily life. We also present data about how they direct their health-related activities towards meeting their physical and psychological goals of being healthy. Their differential understanding of diseases and a lack of information about health services were potent predictors of non�help seeking and ‘self’ rather than medical management of their illnesses. This study highlights the need for intervention and health support for Chinese elders

Mapping the information-coping trajectory of young people coping with long term illness: An evidence based approach

Purpose - Purpose: We explore the relationship between information and coping information from the experiences of young people coping with long term illness. Design/methodology/approach - Methodology: Situational Analysis was used as a methodological approach. It has roots in the Chicago Symbolic Interactionism School. Cartographic approaches enabled the analysis, mapping the complexities emerging from the data. Findings - Findings: As the young people became more informed about their health conditions, and gained knowledge and understanding both about their illnesses, their own bodies and boundaries, their confidence and capacity to cope increased. Gaining confidence, the young people often wanted to share their knowledge becoming information providers themselves. From the data we identified five positions on an information-coping trajectory (1) Information deficiency (2) Feeling ill-informed (3) Needing an injection of information (4) Having information health and (5) Becoming an information donor. Research limitations/implications - Research limitations/implications: The research was limited to an analysis of thirty narratives. The research contributes to information theory by mapping clearly the relationship between information and coping. Originality/value - Originality/value: The information theories in this study have originality and multi-disciplinary value in the management of health and illness, and information studies

Role and Discipline Relationships in a Transdisciplinary Biomedical Team: Structuration, Values Override and Context Scaffolding

Though accepted that "team science" is needed to tackle and conquer the health problems that are plaguing our society significant empirical evidence of team mechanisms and functional dynamics is still lacking in abundance. Through grounded methods the relationship between scientific disciplines and team roles was observed in a United States National Institutes of Health-funded (NIH) research consortium. Interviews and the Organizational Culture Assessment Instrument (OCAI) were employed.. Findings show strong role and discipline idiosyncrasies that when viewed separately provide different insights into team functioning and change receptivity. When considered simultaneously, value-latent characteristics emerged showing self-perceived contributions to the team. This micro/meso analysis suggests that individual participation in team level interactions can inform the structuration of roles and disciplines in an attempt to tackle macro level problems.Comment: Presented at COINs13 Conference, Chile, 2013 (arxiv:1308.1028

Inter-professional collaboration reduces the burden of caring for patients with mental illnesses in primary healthcare. A realist evaluation study

Background:The implementation of primary care for mental health is often insufficient, whichleaves its mark on staff. A team-based approach of mental healthcare prevents poor staff mor-ale. A community health centre (CHC), therefore, set up a project promoting interprofessionalcollaboration with a mental health team (MHT).Objectives:This study aimed to understand how an MHT would influence staff morale in a pri-mary care setting, aiming to formulate some recommendations for future projects.Methods:In 2017, interviews and a focus group discussion were conducted among the staff ofa CHC. Using a qualitative approach, we aimed to unravel contextual factors and mechanismsthat determine the effect of an MHT on staff morale.Results:The project relieved the burden of the patient encounters and staff members felt morevaluable to patients. Underlying mechanisms were recognition, altered attitudes towards patientsand role clarity. Facilitating factors were intercultural care mediators and a positive team atmos-phere, whereas inhibiting factors were inefficient time management and communicative issues.Conclusion:Our study elucidated mechanisms and the contextual factors by which an MHT ingeneral practice improves staff morale

"New" and distributed leadership in quality and safety in healthcare, or "old" and hierarchical? : An interview study with strategic stakeholders

Peer reviewedPostprin

Mapping domain characteristics influencing Analytics initiatives: The example of Supply Chain Analytics

Purpose: Analytics research is increasingly divided by the domains Analytics is applied to. Literature offers little understanding whether aspects such as success factors, barriers and management of Analytics must be investigated domain-specific, while the execution of Analytics initiatives is similar across domains and similar issues occur. This article investigates characteristics of the execution of Analytics initiatives that are distinct in domains and can guide future research collaboration and focus. The research was conducted on the example of Logistics and Supply Chain Management and the respective domain-specific Analytics subfield of Supply Chain Analytics. The field of Logistics and Supply Chain Management has been recognized as early adopter of Analytics but has retracted to a midfield position comparing different domains. Design/methodology/approach: This research uses Grounded Theory based on 12 semi-structured Interviews creating a map of domain characteristics based of the paradigm scheme of Strauss and Corbin. Findings: A total of 34 characteristics of Analytics initiatives that distinguish domains in the execution of initiatives were identified, which are mapped and explained. As a blueprint for further research, the domain-specifics of Logistics and Supply Chain Management are presented and discussed. Originality/value: The results of this research stimulates cross domain research on Analytics issues and prompt research on the identified characteristics with broader understanding of the impact on Analytics initiatives. The also describe the status-quo of Analytics. Further, results help managers control the environment of initiatives and design more successful initiatives.DFG, 414044773, Open Access Publizieren 2019 - 2020 / Technische Universität Berli