Constructivist Grounded Theory Methodology Research Articles

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.

Operating Theater Nurses' Main Concerns During Organ Procurement Procedures: AGrounded Theory Study.

The purpose of this study was to explore the experiences of perioperative nurses in Sweden (ie, operating theater nurses) associated with caring for a donor patient during organ procurement procedures. We sought to determine the nurses' main concerns and how they dealt with them. Using constructivist grounded theory methodology, our participant sample included 10 nurses, one of whom self-identified as male. The average age of the participants was 51.8years (range=38 to 63years). After interviewing the participants and coding their responses, we developed the core category of optimum organ procurement. The generated grounded theory comprises four main categories: brace oneself, facilitate, procurement, and completion. Commitment is the force that binds the perioperative nurse to a course of action. This theory may help guide a team-based approach to prepare nurses to care for donor patients with dignity and respect during procurement procedures.

Clinical nurses’ compassion fatigue psychological experience process: a constructivist grounded theory study

BackgroundClinical nurses are susceptible to compassion fatigue when exposed to various types of traumatic events in patients for extended periods of time. However, the developmental process, staging, and psychological responses distinct to each stage of compassion fatigue in nurses are not fully clarified. This study aimed to explore the processes of compassion fatigue and the psychological experiences specific to each phase of compassion fatigue among clinical nurses.MethodsCharmaz’s Constructivist Grounded Theory methodology was used in this qualitative research. Semi-structured interviews were conducted with 13 clinical nurses with varying degrees of compassion fatigue from December 2020 to January 2021. Interview data were analyzed using grounded theory processes.ResultsThe data were categorized into five separate categories and 22 sub-categories. This study found that the process of compassion fatigue is dynamic and cumulative, which was classified into five phases: compassion experience period, compassion decrement period, compassion discomfort period, compassion distress period, and compassion fatigue period.ConclusionClinical nurses who experience compassion fatigue may go through five stages that are stage-specific and predictable. The findings can shed light on local and global applications to better understand the problem of nurses’ compassion fatigue. The interventions for addressing compassion fatigue in clinical nurses should be stage-specific, targeted, and individualized.

It is Challenging to Shift the Norm: Exploring how to Anticipate and Address Microaggressions in Clinical Learning Environments.

Increased attention to improving a culture of belonging in clinical learning environments has led to various approaches to addressing microaggressions. However, most approaches in the literature focus on responding or reacting to microaggressions with insufficient attention to building trust before microaggressions might occur. Research on microaggressions in clinical learning environments suggests anticipatory or pre-emptive conversations about microaggressions may foster greater trust. In this study, the authors explored how diverse participants perceived the experience of anticipatory conversations about potential microaggressions. Overall, the authors sought to gain a deeper understanding of how pre-emptive and anticipatory conversations may influence an organization's approach to addressing microaggressions in clinical learning environments. The authors utilized constructivist grounded theory methodology and conducted individual qualitative interviews with 21 participants in an academic department within a larger health sciences center in the United States. Findings suggest that anticipatory conversations about microaggressions were challenging due to existing norms in dynamic clinical learning and working environments. Participants shared that the idea of anticipating microaggressions elicited dissonance. Conversations about microaggressions could potentially be facilitated through leaders who role model vulnerability, organizational supports, and an individualized approach for each team member and their role within a complex hierarchical organization. Anticipating and addressing microaggressions in clinical learning environments holds tremendous potential, however, any conversations about personal identity remain challenging in medical and healthcare environments. This study suggests that any attempts to address microaggressions requires attention to cultural norms within healthcare environments and the ways that hierarchical organizations can constrain individual agency.

Exploring the processes of evidence-informed decision-making in applied sport psychology

The purpose of the current study was to explore evidence-informed decisions involved in designing psychological interventions for performance enhancement. Employing a constructivist grounded theory methodology, 10 experienced and 10 early career sport psychology practitioners participated in semi-structured interviews. All participants gained their qualified status through the British Psychological Society and were registered practitioner psychologists with the Health and Care Professions Council within the UK. Accordingly, results are reflective of the participants’ training and practice experiences. Four key categories of decision-making processes were constructed: gathering information about the athlete, using research evidence, drawing on experience and tacit knowledge, and integration. Our findings demonstrated the interactions between research-based and practice-based knowledge when designing interventions that suit the needs of the athlete, work pragmatically within the applied context, and have the desired effect on the intervention goal. Our findings provide a better understanding of the interactions and processes used by sport psychology practitioners in applied practice. Such an understanding may inform the construction of evidence-informed interventions that lead to better performance outcomes. Lay Summary: This study explored the evidence-informed decision-making processes of 10 early career and 10 experienced, UK-based, sport psychology practitioners when designing interventions for athletes. Results highlighted the importance of integrating evidence from the athlete, research, and practice experiences to support evidence-informed decisions to enhance the performance of athletes.

Preclerkship Medical Students’ Use of Third-Party Learning Resources

Undergraduate medical education increasingly relies on asynchronous, virtual learning; and medical educators have observed students engaging in self-directed learning outside of their institutional curriculum using widely available third-party resources. If medical educators better understand how students are learning, they may uncover novel opportunities to improve preclerkship education. To explore how and why preclerkship medical students use third-party learning resources. This qualitative study recruited second-year medical students from 7 public and private allopathic US medical schools and conducted 7 virtual focus groups (1 per institution) from September 2022 to January 2023, exploring how and why students use third-party resources. Data were iteratively analyzed in parallel with focus groups using constructivist grounded theory methodology. Data analysis was performed from October 2022 to February 2023. Fifty-eight second-year US medical students who had used a third-party resource at least once participated; 36 (61%) identified as women; 13 (23%) identified as Asian, 6 (11%) as Black, 30 (53%) as White, 6 (11%) as multiracial, and 4 (7%) as other; 6 (10%) identified as Hispanic, Latino, or Spanish origin, and 52 (90%) identified as non-Hispanic, Latino, or Spanish origin; 48 (83%) were aged 23 to 25 years. Participants described engaging in a cyclical process of deciding whether and how to use third-party resources. Four broad themes were identified: (1) hearing about resources, (2) selecting resources, (3) using resources, and (4) tensions and possible solutions. Participants largely heard about third-party resources from peers and turned to resources out of dissatisfaction with some aspect of their medical school curriculum. Students used resources in various ways that were user-dependent and context-dependent. Participants endorsed multiple benefits over their in-house curricula, particularly efficiency, clarity, and concision. Tensions included navigating resource drawbacks and the perception of an antagonistic relationship between medical schools and third-party resources. Participants suggested that medical schools examine the resources, recommend specific ones, integrate them into the curriculum, and subsidize their cost. In this qualitative study of preclerkship medical student use of third-party resources, participants perceived that the resources had numerous benefits for learning and suggested that medical schools should more formally acknowledge and integrate their use.

“Fighting the invisible system”: A grounded theory study of the experiences of child protection social workers in England

AbstractThis article reports on an exploration of social workers' perspectives on the social policy and agency processes that shape their experiences of working in child protection services. A qualitative constructivist grounded theory methodology was employed, and 17 qualified social workers and managers were recruited. Social workers described working within an oppressive system, balancing unrealistic demands placed on them, and struggling to restore balance and hope. They shared how this filtered into the work they do with families and the role that relationality and peer support has in surviving the work.

Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada.

Those who detransition have received increased public and scholarly attention and their narratives are often presented as evidence of limitations with contemporary gender-affirming care practices. However, there are scant empirical studies about how this population experienced their own process of gaining access to gender-affirming medical/surgical interventions, or their recommendations for care practice. To qualitatively explore the care experiences and perspectives of individuals who discontinued or reversed their gender transitions (referred to as detransition). Between October 2021-January 2022, Canadian residents aged 18 and older with experience of stopping, shifting, or reversing a gender transition were invited to participate in semi-structured, one-on-one, virtual interviews. A purposive sample of 28 was recruited by circulating study adverts over social media, to clinicians in six urban centres, and within participants' social networks. Interviews ranged between 50-90 minutes, were audio-recorded, and transcribed verbatim. Following constructivist grounded theory methodology, interview data were analyzed inductively and thematically following a two-phase coding process to interpret participants' experiences of, and recommendations for, gender care. Participants were between the ages of 20-53 (71% were between 20-29). All participants identified along the LGBTQ2S+ spectrum. Twenty-seven out of 28 of the participants received medical/surgical interventions (60% were ages 24 and younger). A majority (57%) reported three or more past gender identities, with 60% shifting from a binary transgender identity at the time of initiating transition to a nonbinary identity later in their transition journey. To access medical/surgical interventions, most participants were assessed via the gender-affirming care model pathway and also engaged in talk therapy with a mental healthcare provider such as a psychologist or psychiatrist. Some participants experienced their care as lacking the opportunity to clarify their individual treatment needs prior to undergoing medical/surgical transition. Decisional regret emerged as a theme alongside dissatisfaction with providers' "informed consent" procedures, such that participants felt they would have benefitted from a more robust discussion of risks/benefits of interventions prior to treatment decision-making. Overall, participants recommended an individualized approach to care that is inclusive of mental healthcare supports. To optimize the experiences of people seeking and receiving gender care, a thorough informed consent process inclusive of individualized care options is recommended, as outlined by the World Professional Association of Transgender Health, standards of care, version 8.

The Taxonomy of Predict-Observe-Explain (POE) as a Teaching Strategy and Thinking Process of Chemistry Stakeholders

Predict-observe-explain (POE) is a strategy being used during scientific investigations and experiments. However, POE-related studies mainly focused on its validity and reliability as a teaching strategy in classrooms. Thus, this paper extends the context of POE strategy as science process skills, as cognitive thinking skills in performing experiments, and answering scientific inquiries among chemistry stakeholders: students, teachers, and chemists. The study sees POE as a way to develop critical thinking and builds the skills needed for further academic and professional endeavors in the different fields of science. Through a constructivist grounded theory methodology using focus group discussions for students and in-depth interviews with the teachers and chemists, the study: described how students, teachers, and chemists exemplified POE strategy in terms of its process, and identified mutual patterns of POE process from the chemistry stakeholders. The study revealed that: student POE taxonomy is focused on basic processes and structures of POE; teacher POE taxonomy is a guide in their lesson planning; and chemist POE taxonomy is based on local and international compliance during experimentation. Therefore, POE is a science process skill for chemistry stakeholders where the POE taxonomy used by the chemistry stakeholders are different based on experiences, needs, and context.