Constructivist Grounded Theory Methodology Research Articles

Quality of life assessment among ethnically diverse Black prostate cancer survivors: a constructivist grounded theory approach.

Prostate cancer (CaP) is the most common cancer in Black men (BM), and the number of Black CaP survivors is rapidly increasing. Although Black immigrants are among the fastest-growing and most heterogeneous ethnic groups in the USA, limited data exist regarding their CaP experiences. Therefore, this study aimed to explore and model the experiences of ethnically diverse Black men with CaP. In-depth interviews were conducted with 34 participants: native-born BM (NBBM) (n = 17), African-born BM (ABBM) (n = 11), and Caribbean-born BM (CBBM) (n = 6) CaP survivors recruited through QR code-embedded flyers posted in Black businesses, clinics, social media platforms, and existing research networks within the USA. Guided by Charmaz's constructivist grounded theory methodology, the interviews were analyzed using constant comparison following key stages of initial, focused, and theoretical coding using Atlas.ti v23. Participants were thirty-four men aged 49-84years (mean ± SD, 66 ± 8). Most were married (77%), likely to be diagnosed at stage I (35%), and treated with radiotherapy (56%). Our study findings explored the complex trajectory of Black prostate cancer (CaP) survivors, unveiling a comprehensive model termed "Journeying through Unfamiliar Terrain." Comprising three phases and 11 sub-phases, this model uniquely captures the pre-diagnosis awareness and post-treatment adaptation among survivors. The resulting theoretical model delineates the entire CaP survivorship process among BM, providing contextual and conceptual understanding for developing interventions and enhancing patient-centered care for ethnically diverse CaP survivors, pivotal in bridging the gaps in survivorship research and healthcare practices. Black CAP survivors experience significant burdens and challenges that impact their overall quality of life.Understanding the factors that impact the complex survivorship journey can inform design and implementation ofinterventions to address the multiple challenges and thus improve quality of life.

P.111 The surgeon experience of flow

Background: Cognitive flow has been linked with enhanced performance, career satisfaction, and decreased burnout. However, while elite sport has long trained athletes to enter flow states, the concept has not been adopted strongly in healthcare. Flow has primarily been explored from a unidimensional (cognitive) perspective. The present study sought to understand the experience of flow among surgeons through a multidimensional lens. Methods: Using a constructivist grounded theory methodology, semi-structured interviews were conducted with 19 staff surgeons at the University of Toronto, purposively sampled. Data were coded and analyzed iteratively by three researchers until theoretical saturation was achieved. Results: Although many surgeons had not previously heard of cognitive flow, the phenomenon deeply resonated with most. Participants described different physical, cognitive, emotional, sociocultural, and environmental components that interacted to shape the subjective experience of flow: “I think that there are many different facets of [flow] that don’t always come together all at the same time, you may feel different parts of it… depending on what the kind of case is, who your help is, if you recently had a complication.” (P4) Conclusions: Understanding flow in clinical practice may lead to new avenues for enhancing career satisfaction and promoting physician wellness.

Striving for Improved Infection Prevention and Control Practice: A Grounded Theory of Healthcare Workers' Struggles in Implementing Infection Prevention and Control Guidance in Uganda.

There is a scarcity of qualitative research focusing on the implementation of infection prevention and control (IPC) guidance in low-income countries. This study aimed to address this gap by exploring the perspectives of healthcare workers (HCWs) regarding the implementation of IPC guidance at the healthcare facility level in Uganda. The study also sought to generate a theoretical understanding of the processes involved in implementing IPC guidance in these settings. This robust qualitative research employed a design based on constructivist grounded theory methodology, conducting individual interviews with 13 frontline health workers such as doctors, nurses, nurse interns, and laboratory staff. The key findings of the study revealed that HCWs undergo a process of 'striving for improved practice' in their efforts to implement IPC guidance. This process involved four phases: recognising the importance of IPC, playing a role, encountering challenges, and overcoming challenges. However, achieving full implementation proved difficult due to various individual and organisational barriers presented by the low-income setting. HCWs employed improvisation as a means to overcome these obstacles. Additionally, the study identified enabling factors that facilitated the implementation of IPC guidance within these settings. This study is significant as it applies robust qualitative research methods to provide valuable evidence of HCWs' perspectives on an important topic in an under-researched context, with findings transferable to similar settings.

Representing the experiences of charity peer leaders facilitating well-being interventions to their peers using a constructivist grounded theory methodology

PurposeThis study aims to generate theory that represented charity peer leader experiences, facilitating well-being interventions to two specific groups of people: new mothers and refugees.Design/methodology/approachPart 1 of this study used in-depth interviews (n = 8) and phone calls with experienced mothers (called “peer leaders”) who had facilitated well-being interventions to new mothers. These interviews were analysed using Constructivist Grounded Theory (CGT) (Charmaz, 2014) generating a theory. Following a systematic literature review using the theory categories as search terms, a training approach was devised: The Modelled Training Approach (MTA). Refugees (n = 16) were trained to facilitate another well-being intervention using the MTA followed by a further set of interviews (n = 6). These interviews were analysed using CGT.FindingsA theory was generated representing the “journey” the peer leaders took: their lived experience triggered empathic feelings towards their peers, which motivated them to build a rapport where they gave hope. As a result, the peer leaders felt rewarded.Originality/valueThe literature search did not find any studies looking at the experiences of peer leaders in the above settings. The theory generated could support mental health peer work offsetting statutory health costs.

Exploring Diversity, Equity, and Inclusion-Related Pedagogy Across Different Professions.

Diversity, equity, and inclusion (DEI) have become an important priority for academic medicine. However, several barriers challenge the effective implementation of DEI-related pedagogy. An exploration of the barriers to and enablers of DEI-related pedagogy-as they relate to professional contexts-can inform how to advance DEI in medical education. Shulman's notion of signature pedagogies offers a foundation for understanding and exploring the influence of such contexts on teaching and learning. Comparisons across professions may help make signature pedagogies more visible and may facilitate change. In this study, the authors aim to explore how the professional contexts of medicine, nursing, and teacher education approach DEI-related pedagogy. The authors conducted a qualitative exploratory study using constructivist grounded theory methodology. Using both purposive and theoretical sampling, 24 participants from across the United States and Canada were interviewed, including physicians, nurses, and K-12 teachers in practice as well as professional educators in each discipline (May-December 2022). Interviews included a case-based elicitation approach, and data were analyzed iteratively across the data collection period using constant comparative analysis. Medicine and nursing tend to prioritize objectivity and seek to avoid or neutralize emotions that are intrinsic to DEI-related learning, view DEI expertise as being outside the purview of their profession, and view time for DEI as limited in a clinical learning environment. In contrast, teaching is built on the assumption that DEI expertise is co-constructed and inclusive of community voices and lived experiences. DEI-related pedagogy in teaching allowed for exploration of deep assumptions and learning about structural inequities. Findings suggest that assumptions and values held in professions, such as medicine and nursing, that valorize objectivity and neutrality, while stigmatizing vulnerability and suppressing emotions, may constrain DEI-related teaching and learning in such contexts.

Role of family medicine physicians in providing nutrition support to older patients admitted to orthopedics departments: a grounded theory approach.

Care of older adults requires comprehensive management and control of systemic diseases, which can be effectively managed by family physicians. Complicated medical conditions in older patients admitted to orthopedic departments (orthopedic patients) necessitate interprofessional collaboration. Nutrition is one of the essential components of management involved in improving the systemic condition of older patients. Nutrition support teams play an important role in nutrition management and can be supported by family physicians. However, the role of family physicians in nutrition support teams is not well documented. This study aimed to investigate the role of family physicians in supporting nutrition management in orthopedic patients. This qualitative study was conducted between January and June 2023 using constructivist grounded theory methodology. Eight family medicine physicians, three orthopedic surgeons, two nurses, two pharmacists, four rehabilitation therapists, four nutritionists, and one laboratory technician working in Japanese rural hospitals participated in the research. Data collection was performed through ethnography and semi-structured interviews. The analysis was performed iteratively during the study. Using a grounded theory approach, four theories were developed regarding family physicians' role in providing nutrition support to orthopedic patients: hierarchical and relational limitation, delay of onset and detection of the need for geriatric care in orthopedic patients, providing effective family medicine in hospitals, and comprehensive management through the nutrition support team. The inclusion of family physicians in nutrition support teams can help with early detection of the rapid deterioration of orthopedic patients' conditions, and comprehensive management can be provided by nutrition support teams. In rural primary care settings, family physicians play a vital role in providing geriatric care in community hospitals in collaboration with specialists. Family medicine in hospitals should be investigated in other settings for better geriatric care and to drive mutual learning among healthcare professionals.

The Jewish religious heritage continuum: Jewish religious communities’ interactions with synagogues and ceremonial objects in Amsterdam

ABSTRACT This article explores how rabbis, directors and members of Amsterdam’s Jewish religious communities view the heritagisation of Jewish religious life by analysing how they interact with Amsterdam’s main synagogues and their collections of ceremonial objects. It focuses on the synagogues of the Jewish Cultural Quarter – the Portuguese Synagogue with its accompanying Sephardi community, and the former Ashkenazi synagogue complex, now the Jewish Museum. From a dynamic heritage perspective, this heterogeneous constellation raises questions about how and why heritage making occurs here. Following a Constructivist Grounded Theory methodology, concurrent data collection and analysis let emerge interrelated conceptual categories that explain how communities interact with these functioning and musealised synagogues and objects: Embodying the transmission of tradition; Instrumentalising the heritage of Jewish religious life; Transforming the beauty of holiness; and Assembling in heritagised synagogues. These categories intersect in the core category of the Jewish religious heritage continuum, which this article presents as a dynamic embodiment of remembering, reconnection, and revival of Jewish tradition. For the interviewees, these performances, and the deployment of functioning and musealised synagogues and collections, form a cultural apparatus that marks their present, diverse and living material culture and grafts a Jewish future onto a Jewish past.

‘She became this liaison’. Perspectives of a preschool community on coaches as brokers of assistive technology access, communication and support for teachers and caregivers of children with disabilities

ABSTRACT While AT has been well-documented as a valuable support for disabled and nondisabled children across developmental domains and settings, several barriers to access and implementation persist. Studies have described heightened barriers for community-based preschools, whose access to AT professional development, AT resources, and practitioners with AT experience may be limited. Researchers in this qualitative inquiry engaged twenty-seven participants (teachers, teacher assistants, caregivers and administrators) to learn about their experiences of an AT intervention programme over a 2-year period. Using Constructivist Grounded Theory Methodology, we analysed data from focus groups and semi-structured interviews, generating five themes. Members of the school community valued the programme’s AT coaches, whose presence, affective style and actions promoted their confidence using AT. While the COVID-19 pandemic impacted both programme delivery and participants’ experiences, the programme and its coaches helped bolster technology and communication access in unanticipated ways. Insights from this inquiry emphasise the important, yet often understated role of building relationships with all participants when delivering community-based preschool interventions, invaluable in meeting the holistic needs of children, as well as the practitioners and families who support them. Notably, AT coaches were perceived as liaisons, building rapport, providing technical assistance, and sustaining connections within a school learning community.

Systemic family therapists and dementia: A constructivist grounded theory study

AbstractThis article presents research that explored the ways that systemic and family therapists might approach the support of families living with dementia. A constructivist grounded theory methodology was used to interpret interviews with four systemic family therapists working in the United Kingdom. All participants had professional and/or lived experience of dementia. Transcript analysis and theoretical sampling led to the development of five categories, each related to different aspects of considering systemic therapy in a dementia context. These categories were further developed into a ‘systemically informed dementia orienteering’ conceptual framework, which is presented in this paper as a learning resource. Findings are related to existing literature, and recommendations for future research are made.

Exploring epistemic aspects of engineering for K–12 science and engineering education

AbstractBackgroundSince the advent of the Next Generation Science Standards (NGSS), there has been an increasing focus on engineering in K–12 education. As educators and researchers have gained a better understanding of the nature of engineering in the decade following the release of the NGSS, there are new opportunities for growth and complexity.PurposeThis study used an epistemological approach to seek insights from experts in the science and engineering communities about the prominent aspects of engineering for K–12 education.Design/MethodThis mixed‐methods study employed a three‐round Delphi study and a focus group meeting to elicit experts' opinions on the epistemic aspects of engineering that could shed light on the nature of engineering knowledge and practices. Constructivist grounded theory methodology was used to identify preliminary themes concerning the epistemic aspects of engineering and then to develop main themes by combining relevant themes together.ResultsThe analysis process yielded 21 preliminary themes that reflect key ideas about the engineering knowledge base, engineering design activities, and values and norms of the engineering community. Additionally, the current study identified eight main themes that captured the broader patterns in the data.ConclusionsThe outcome of this study, including the preliminary themes and main themes concerning the epistemic aspects of engineering, could serve as a conceptual tool for establishing and improving students' conceptions of engineering and as a guide for designing and implementing engineering design activities in K–12 education settings.

Situating data relations in the datafied home: A methodological approach

Studying datafication focusing on the microlevel of everyday life poses epistemological and methodological challenges. Indeed, the black-boxed nature of algorithms makes data inaccessible and unintelligible to the researcher. Therefore, this paper aims to advance a methodological proposal for addressing the situatedness of datafication in everyday life by framing mediatised relations as a proxy for data relations. In particular, this research adopts a “non-media-centric” approach and frames families as communicative figurations. By reporting a qualitative longitudinal study on the datafication of childhood and family life involving 20 families with at least 1 child aged 8 years or younger in Italy and by employing a mixed method constructivist grounded theory methodology that includes network methods, we analyse three families as exemplary of different network articulations. Such an approach, we argue, can help materialise the mediatised relations through, about, and around data that emerge in contemporary family life.

How the commercial virtual care industry gathers, uses and values patient data: a Canadian qualitative study

ObjectivesTo understand and report on the direct-to-consumer virtual care industry in Canada, focusing on how companies collect, use and value patient data.DesignQualitative study using situational analysis methodology.SettingCanadian for-profit virtual care...

More than the sum of its parts-A constructivist grounded-theory study on specialist palliative care during crises like the COVID pandemic.

The COVID pandemic is an example of a crisis challenging healthcare systems worldwide. The impact of the pandemic on providing high-quality palliative care calls for a deeper understanding of specialist services during crises. This is essential in preparation for further crises. To develop a conceptual understanding of the impact of the pandemic on specialist palliative care as an example for arising future crises. Qualitative interview study across Germany, following a constructivist grounded theory methodology. Eleven semi-structured interviews with experts with overarching knowledge of structures and processes in specialist palliative care between 05-07/2020 and between 02-06/2021, 23 semi-structured interviews with healthcare professionals working in a specialist palliative care setting. The complex system of palliative care provision during crises has properties that cannot be understood as separated parts of the care process. The pandemic led to unique structural and processual challenges characterized by interconnectedness, uncertainty, dynamic, underlying dilemmas, and unclear long-term goal. In response to the pandemic, teams experienced different phases, which enhanced adaption, innovation, and progress within complex care situations. Creative strategy approaches and dynamic responsiveness facilitated innovative development and could lead to long-lasting improvement within services. Availability of information, transparent communication, comprehensible instructions, participation in decision-making, and search for solutions contributed to teams' proactive development throughout the pandemic. Addressing the complex problems in specialist palliative care caused by crises requires system thinking and a learning mindset. This can facilitate teams to overcome the crisis and move forward rather than bounce back to normal.

Factors Affecting General Surgery Intern Wellness: A Qualitative Study

Background:Surgical training is demanding and presents numerous challenges to new interns including long working hours that can threaten their well-being. The factors affecting their well-being as reported by interns themselves, are however, poorly understood. This qualitative study aimed to determine the factors contributing to the wellness of general surgery interns, and identify potential areas that could benefit from intervention and policy reform.
 Methods:A comprehensive scoping review of the literature on resident wellness was initially performed, using "resident" and "wellness" as search criteria on PubMed, and encompassing articles published from 2013 onward. The results of this review were used for the development of an interview guide for in-person focus groups. General surgery interns at Indiana University participated in focus groups that were recorded and transcribed. Two coders coded the transcript independently to develop a code book. Thematic analysis was conducted using a constructivist grounded theory methodology to determine emergent themes.
 Results:Ten surgical interns participated in the focus groups. Qualitative analysis revealed five predominant themes that impact intern wellness: Lack of respect, inadequate facilities and resources, lack of fulfillment, work overload, and poor communication.
 Conclusions:The themes identified reveal numerous factors that impact intern wellness beyond working hours and pay and provide targets for interventions that can address them. Our results suggest that “one-size fits all” wellness solutions are unlikely to address the specific challenges faced by surgical trainees; multifaceted interventions are required to enhance intern well-being. Future research should focus on the development and implementation of targeted strategies to address these identified issues.

Constructing Identity Through Sex-Consumption: The Consumerist Narratives of Israeli Men Who Pay Women for Sex

ABSTRACT This study examined how consumerism shapes the identity construction processes of Israeli men who pay women for sex (MPWS). Using the theoretical framework of symbolic interaction and the theoretical concept of extended self, we explored how Israeli MPWS extend their selves through sex-consumption. To this end, we conducted in-depth semi-structured interviews with 23 Israeli MPWS. An interpretive epistemology and a constructivist grounded theory methodology guided the data-analysis. We conceptualized three dynamics of self-identity construction processes through sex-consumption: Extending the self through assimilation of products or experiences, Extending the self through the purchasing process, and Extending the self through consuming the imagined. The findings revealed a complex process, whereby MPWS attribute various and contradictory meanings to their possessions, their consumerist experiences, and their purchasing processes. We conclude that consumerism is central to the meanings that MPWS attribute to their engagement in the sex industry. Thus, the theoretical framework of consumerism should be further applied to future studies in this field in order to gain a nuanced and deeper understanding of MPWS and the phenomenon of sex consumption.

How Do Trainees Use EPAs to Regulate Their Learning in the Clinical Environment? A Grounded Theory Study.

Entrustable Professional Activities (EPAs) can potentially support self-regulated learning in the clinical environment. However, critics of EPAs express doubts as they see potential harms, like checkbox behaviour. This study explores how GP-trainees use EPAs in the clinical environment through the lens of self-regulated learning theory and addresses the question of whether EPAs help or hinder trainees' learning in a clinical environment. Using constructivist grounded theory methodology, a purposive and theoretical sample of GP-trainees across different years of training were interviewed. Two PICTOR interviews were added to refine and confirm constructed theory. Data collection and analysis followed principles of constant comparative analysis. Trainees experience both hindering and helping influences of EPAs and self-regulate their learning by balancing these influences throughout GP-placements. Three consecutive stages were constructed each with different use of EPAs: adaptation, taking control, and checking the boxes. EPAs were most helpful in the 'taking control' stage. EPAs hindered self-regulated learning most during the final stage of training as trainees had other learning goals and experienced assessment of EPAs as bureaucratic and demotivating. Regularly discussing EPAs with supervisors helped to focus on specific learning goals, create opportunities for learning, and generate task-oriented feedback. EPAs can both help and hinder self-regulated learning. How trainees balance both influences changes over time. Therefore, placements need to be at least long enough to enable trainees to gain and maintain control of learning. Supervisors and teachers should assist trainees in balancing the hindering and helping influences of EPAs.

Exploring Small-Scale Brewing from Sustainability, Economic, and Food Safety Perspectives: A Grounded Theory Approach

Innovation, economy of scale, and sustainability are the basis of the competitiveness of the rapidly evolving small-scale craft brewing market. This study aims to explore craft beer production by considering food safety and sustainability perspectives to enhance operational effectiveness and mitigate risks, negative impacts, and externalities. This research applies a qualitative approach, using constructivist grounded theory methodology. Fourteen in-depth interviews with European small-scale brewery managers were conducted. The results show that small-scale breweries' most notable production challenges are effectiveness and sustainability. This study suggests applying eco-innovations during craft beer production, such as recycling water, yeast, and carbon dioxide using separators and instant pasteurization to reduce waste. A further recommendation is enhancing automation, which may eliminate risks and failures and reduce operational costs. These measures can contribute to optimizing operations and making them more transparent, enhance efficiency, and thereby improve food safety and sustainability.

Undergraduate Medical Spanish: The Role of Assessment in Teaching and Learning

As courses and programs in medical Spanish continue to grow at higher education institutions across the United States, the need for research on the teaching and learning of medical Spanish as a field continues to expand. Acknowledging the importance of more evidence-based research, the current study’s purpose is to examine the role of assessment in undergraduate medical Spanish courses. To accomplish this goal, instructors of medical Spanish across the United States were interviewed individually or in focus groups. Interviews were recorded, transcribed, and coded following line-by-line coding. Using constructivist grounded theory methodology, the researchers grouped the resulting codes into categories into categories, and themes were created. Themes that emerged from the data related to the use of rubrics, challenges in assessment, community engagement, diverse language proficiency, and cultural competency. Participants indicate the need for standardized rubrics and assessments that go beyond traditional grammar and vocabulary components and even medical terminology, which expresses the need to include categories on pragmatic, sociolinguistic, and intercultural skills. The results of this study show that medical Spanish assessment at the undergraduate level needs more evidence-based research and collaboration in order to develop standardized evaluation tools to assess students’ linguistic and cultural skills. Implications regarding assessment in undergraduate medical Spanish courses are discussed below.

A Holistic Perspective towards Perils of and Pathways to Addiction Recovery in Pakistan: Exploring Indigenous Factors

A multi-angled approach and formation of a holistic body of insights about drug addiction relapse and recovery is the key objective of this qualitative study. Based on a Constructivist Grounded Theory methodology, a total 40 semi-structured interviews were conducted from 10 recovering persons, 10 relapsed person and 10 chief caregivers of each set of recovering and relapsed persons. Out 20 recovering and relapsed persons, 7 were within age of 18-25, 10 were within 26-35 years of age and 3 respondents were over 35 years of age. Their respective 20 chief caregivers included their parents, siblings, spouses and case managers. Furthermore, 2 Focus Group Discussions (FGDs) were conducted having 4 participants i.e., Psychiatrists, Psychologists, Psychotherapists and Case Managers hailing from Drug Rehab Centers in each group. The digitally recorded interviews were transcribed/translated and further analyzed in NVIVO – Windows. Following the processes of Open, Axial and Selective Coding, five core categories of Familial, Personal, Socio-cultural, Psycho-emotive and Treatment Factors emerged to form the theoretical framework of the substantive grounded theory titled as Perils of and Pathways to Addiction Recovery. The theory connects various dimensions of the causal factors and recovery-assuring remedial measures. This framework serves as an indigenous work for developing policy, interventions and treatment. This study reveals contributing factors for the efficacy of different treatment approaches and practices in Pakistan. This five factor theoretical model has high-resolution data driven insights collected from all possible stakeholders of the eco system of falling prey to addiction and recovering from it.

‘It’s like almost hypnotised people’: An exploration of vernacular discourses and social imaginaries of terrorism in the United Kingdom

Despite recent calls for ‘ordinary’ citizens to become active and responsible as individuals in preventing and countering terrorism and radicalisation in the United Kingdom, little is yet known about how members of the general public make sense of political violence, or about how they think it should be dealt with. Using a bottom-up vernacular security studies approach, this article examines what lay citizens believe about the causes of terrorism and what responses they think are appropriate. Based on qualitative data from one-to-one interviews with members of the public and an analysis based on constructivist grounded theory methodology, the article discusses three key figures that emerged from interviewees’ accounts of terrorism: the vulnerable subject, the radicalised individual and the radicaliser. Overall, the results reveal that a radicalisation framework is dominant in participants’ discourses on terrorism. The article argues that the dominant imaginaries of terrorism identified in this research draw consent towards pre-emptive security practices such as the Prevent duty and de-radicalisation interventions. The discussion problematises the depoliticisation of political violence and the normalisation of illiberal security measures that this conceptualisation of terrorism entails, while stressing the discriminatory character of the social imaginaries of terrorism.