Grounded Theory Study Research Articles

The POE paradigm in architecture: practices and perspectives of Canadian practitioners

ABSTRACT The benefits of and barriers to post-occupancy evaluation (‘POE’) in industry are regularly described in the literature as relating to building performance and sustainable design. However, the perspectives of architects on the value of POE to design practices or processes are rarely included. The purpose of this grounded theory study was to address this gap, contributing Canadian practitioners’ perspectives to stagnate conversations on the lack of architects’ engagement with POE. Semi-structured interviews were conducted with 25 practitioners from 20 different architecture firms across the country as well as 5 POE specialists working in academia and/or industry. The main finding of this study indicates that Canadian practitioners see theoretical value in POE; however, they are sceptical about its practical application and value to their design work in its present state. This has engendered disciplinary paralysis when it comes to embracing this research pathway and establishing their role in it. Further analysis indicates a need to improve the value proposition of POE in the industry with implications for researchers, architects, policymakers and professional organizations. This includes rebranding and rescoping POE, cultivating methodological richness, refocusing on the user experience, building safeguard mechanisms and building tolerance through precedent.

Identifying the causes and consequences of pregnancy in Iranian Kurdish women under the age of 18: A grounded theory study.

Since teenage pregnancy is one of the major challenges for healthcare systems worldwide and can pose risks to the health of young mothers and their infants, the present study was conducted to identify the Identifying the causes and consequences of pregnancy in Iranian Kurdish women under the age of 18. The present qualitative research was conducted using the grounded theory method among women with experience of pregnancy under the age of 18 and key informants who had experience and knowledge in this field. Data were collected through semi-structured face-to-face interviews with 26 women and 17 key informants who were selected through purposive, snowball, and theoretical sampling methods. Sampling continued until theoretical saturation. The data were collected and analyzed for 8 months, from November 2021 to June 2022. Data analysis was performed based on the approach of Strauss and Corbin in the MAXQDA-2018 software environment. The Guba and Lincoln criteria were observed to ensure the trustworthiness of the data and results. After the data analysis and coding process, the conceptual model of causes and consequences of pregnancy in adolescents emerged, including 1) predisposing conditions (sociocultural factors: Social learning, misconceptions about fertility and childbirth, preventing stigma), 2) causal conditions (individual factors: lack of knowledge on how to prevent pregnancy, improper use of contraceptives, inadequate knowledge about the risks of pregnancy in adolescence, fear of the side effects of using contraceptives, filling the vacuum of loneliness, family factors: husband's and his family's pressure, committing her husband to life, consolidating her position in family), 3) intervening conditions (structural factors: no barriers to pregnancy, difficult access to contraceptives), 4) strategies and interactions (positive reactions: trying to prepare herself for raising a child, taking better care of herself and her child, negative reactions: trying to kill herself and the kid, fear and concealment), and 5) consequences (destructive consequences: threats to the health of the child, threat to mother's health, inadequate access to health services, constructive consequences: increase of support, strengthen the sense of empowerment). Pregnancy in adolescence is influenced by socio-cultural, family, personal, and structural factors that can lead to positive and negative consequences for women, which in most cases make the lives and health of them and their children difficult. The findings of the study can be used in the areas of health and social policy, program planning, and designing interventions and educational programs aimed at changing beliefs and cultural attitudes related to pregnancy under the age of 18at the individual, family, and societal levels.

Living with the delusion of autism recovery: A grounded theory study on the experiences of mothers.

Living with the delusion of autism recovery: A grounded theory study on the experiences of mothers.

Uncovering essential skills for effective rheumatoid arthritis management: A qualitative grounded theory study

BACKGROUND: Effective management of rheumatoid arthritis (RA) relies on patients acquiring a specific set of skills. Patient education is a promising approach to achieve this. Despite extensive research in this area, a complete understanding of the necessary skills for persons living with RA remains elusive. This study aims to identify the essential skills required for individuals with RA, develop a hierarchical framework, and provide insights for targeted therapeutic education programs. MATERIALS AND METHODS: A qualitative approach using constructivist grounded theory was employed. Semi-structured interviews were conducted with (23) medical professionals specializing in RA and (16) RA patients. The data were analyzed using Atlas.ti software. RESULTS: Six major themes emerged: self-care and coping, emotional and psychological resilience, knowledge and literacy in RA, personal development, communication and relationship building, and self-learning and problem-solving. These themes suggest a hierarchical structure, with knowledge serving as the foundation and progressing to more complex skills such as problem-solving and communication. CONCLUSION: This study provides an overview of the multifaceted nature of the skills required for optimal RA management. The proposed hierarchical structure offers a robust framework for developing targeted therapeutic education programs. The findings highlight the significance of a patient-centered approach in the effective management of RA.

Lost in translation? How context shapes the implementation of Competence by Design in operative settings.

Given the complexity of the transition to competency-based medical education (CBME) and the diversity of systems and learning contexts, the literature has acknowledged the need for principled yet contextual approaches to implementation. There is a need for research that examines these adaptations and their consequences, both intended and unintended. We performed a constructivist grounded theory study to explore how the theory of CBME translated to practice in operative settings in a Canadian approach to CBME: Competence by Design (CBD). Program contexts both enabled and hindered how CBD translated into practice. The operative context was aligned with the principles of competency-focused instruction and allowed for frequent, direct observation and formative feedback. Time, personnel, and technology constraints unique to the patterns of practice in operative settings hindered programmatic assessment. Adaptations to CBME that are responsive to the context of programs can support the intended conceptual learning conditions of CBME.

Perceptions of moral capital by marketers: a grounded theory study in Yazd traditional market

Perceptions of moral capital by marketers: a grounded theory study in Yazd traditional market

Patient perceptions of persistent symptoms after mild traumatic brain injury and their influence on mental health treatment-seeking: a grounded theory study

Purpose Mental health conditions after mild traumatic brain injury (mTBI) are common and can complicate injury outcomes, but are under-treated. According to the Common Sense Model of Self-Regulation, the way patients perceive their health conditions can influence the way they manage them, including if, when, and how they seek treatment. This study explored how individuals perceive persistent symptoms after mTBI, in order to develop a grounded theory about what motivates and demotivates them to seek mental health treatment after their injury. Methods Seventeen adults experiencing persistent symptoms after mTBI participated in semi-structured interviews, which were analyzed using constructivist grounded theory. Results An explanatory model of patient perceptions was developed with three interrelated categories: (1) Symptom persistence and uncertainty result in life challenges; (2) Self-advocating for answers through extensive treatment-seeking; preference for biomedical treatment; (3) Mental health problems are caused by symptom persistence, therefore mental health treatment is supplementary. Conclusion Findings suggest a potential barrier to seeking mental health treatment during complicated mTBI recovery: if patients do not consider mental health as an important cause of their ongoing symptoms, they may feel less motivated to prioritize mental health treatment.

Surgeon Fear in the Operating Room and Its Link to Identity; A Constructivist Grounded Theory Study

Objective: We aimed to gain a deeper understanding of the underpinnings of surgeon fear in the operating room (OR). Summary Background Data: Fear can affect judgement, risk-tolerance, and decision-making, all of which may impact surgeon performance, yet there is little research on surgeon fear in the OR. Methods: Using constructivist grounded theory, we conducted semi-structured interviews with 18 attending surgeons from 14 surgical subspecialties affiliated with the same large, urban, academic institution. Snowball and purposive sampling were used to achieve diversity in sampling. Data collection and analysis were iterative and guided by theoretical sampling. A conceptual framework was generated from the data. Surgeons ranged from 1-40+ years in practice. Results: Most surgeons in this study experienced fear in the OR. Themes related to identity, identity enmeshment, and identity resilience were identified during coding; data were reanalyzed deductively using these categories, and findings suggested that surgeons who more intensely experienced fear in the OR potentially had lower identity resilience and were experiencing the fearful stimuli as identity threat. While this impacted the surgeon’s experience inside the OR, surgeons with identity enmeshment were impacted beyond the OR: events, good or bad, that occurred in the OR seeped into the surgeon’s personal life, thereby extending the experience of the event. Conclusion: Most surgeons in this study experience fear in the OR. This study offers a glimpse into the rarely explored experience of surgeon fear in the OR, highlighting the importance of identity management and emotion regulation in surgical education and practice.

Recovery process of patients with iliac vein compression syndrome after stenting: a grounded theory study

BackgroundIliac vein compression syndrome (IVCS) impedes venous blood return from the lower extremities due to iliac vein compression, manifesting as leg swelling, varicose veins, and thrombosis. These symptoms significantly degrade quality of life. Although iliac vein stenting provides symptomatic relief, the recovery process is protracted and fraught with challenges such as in-stent restenosis and psychological distress. This study aims to deepen our understanding of patient coping strategies by exploring the entire journey from diagnosis through stenting to recovery in individuals affected by IVCS.MethodsThis qualitative study employed a grounded theory approach, conducting in-depth, semi-structured interviews with 16 patients who had undergone stenting for IVCS. Participants were recruited from a teaching hospital in Taiwan and interviewed between August 2022 and July 2023.ResultsThe recovery process for the patients involved five stages and 11 subcategories, which outlined a journey toward a new direction of health. The stages were (1) exacerbation—worsening symptoms that disrupt daily life, compelling the patient to finally address the issue; (2) seeking help—medical professional help sought; (3) despondency—ongoing pain and recurring symptoms after surgery; (4) adjustment—self-directed health promotion with support systems aiding in recovery; and (5) health preservation—suitable health care and beneficial exercise habit development.ConclusionsThe recovery process was depicted in a linear diagram of living with a new direction for health. Careful attention should be paid to the importance of clarifying patient expectations after stenting, addressing post-treatment physical discomfort and emotional anxiety issues, and enabling patients to confidently undergo follow-up and rehabilitation to achieve their recovery goals.Clinical trial numberNot applicable.

A grounded theory study on medical students’ proxy online health information seeking behavior

BackgroundAlthough Internet has become the main way of access to health and medical information for most young people today, it might not be the case with older people. The elderly that have difficulty using the Internet rely largely on their family members to obtain and evaluate online health and medical information.ObjectiveThe purpose of this study is to investigate medical students’ proxy health information seeking behavior for their family members, and to look into how they search, evaluate, and even apply health information from the Internet. The paper is going to explore the influencing factors of health information seeking behavior of medical students as well as the concerns and difficulties they might encounter during the searching process.MethodsBased on grounded theory, this study conducted semi-structured interviews with 30 medical students, from whom data were collected for analysis. Through the procedure of three-level coding, the theoretical framework of medical students’ proxy online health information seeking behavior was constructed.ResultsFindings of this study include the factors influencing medical student’ proxy online health information seeking, the emotional attitudes of the interviewees, and the results of proxy information seeking behavior. Students’ individual traits, information itself and the search platform all exercise influences on their seeking behavior. Interviewees mainly stay doubtful about the authenticity of health information and feel concerned over their parents’ physical conditions. Proxy seeking results are generally marked by positive feedback and negative feedback.ConclusionsIt satisfies the family members’ demand for health information that medical students seek online health information for them, and such behavior has a positive impact on the family members’ physical condition. Still, to evaluate the quality of health information from the Internet remains a major challenge that medical students face. Only through the joint efforts of both medical students and the related departments could high quality health information be obtained. Besides, for effective delivery of health information, medical students should also stay patient while communicating with their family members.

Bridging Experience and Practice: A Grounded Theory Study of Nurses' Hospitalisation Experiences as Patients or Family Members.

This study aimed to develop a grounded theory that explains how nurses' experiences as patients or family members influence their provision of patient-centred care. A grounded theory approach. Twenty clinical nurses in South Korea participated; nine had experiences as patients and 11 as family members during hospitalisation. Data were collected through semi-structured, in-depth interviews from January to October 2021. Participants were purposively sampled for diverse experiences, and all interviews were audio-recorded and transcribed verbatim. Data analysis followed grounded theory using the constant comparative method, with theoretical saturation reached after 20 interviews. The theory developed was built around the core category of 'transforming nursing practice through empathy and reflection in hospitalization experiences'. Participants experienced healthcare services in a wide range of areas, including nursing interactions, patient rights, the healthcare delivery system and hospital facilities. Based on these experiences, participants developed a deep understanding and empathy for the emotions and needs of patients and families, gaining new insights and reflections on their nursing practice. It led to a transformation in participants' attitudes and behaviours towards patient-centred care. This study demonstrates that reflective practice and empathy developed through personal hospitalisation are important factors in leading to the shift towards patient-centred care. These findings provide a theoretical framework for emphasising experiential learning opportunities in nursing education and training to apply patient-centred approaches in practice. Experiential learning approaches, such as simulation, role playing or caregiver training, can bridge the gap between clinical practice and patient expectations. Supportive work environments that encourage reflection on patient experiences help nurses maintain patient-centred practices despite challenges, leading to professional growth and improved patient outcomes. This study adhered to the COREQ checklist for reporting. No patient or public involvement.

A grounded theory study of Chinese female spouses of problem gamblers in Hong Kong: emergence of a multiple-paradigm coping model

ABSTRACT Although gambling disorder is a widespread problem among Chinese communities across the globe, coping by Chinese female spouses of problem gamblers is under-researched. AIM: To explore the lived experiences of Chinese female spouses of problem gamblers. Semi-structured interviews were held with 23 Chinese female spouses of problem gamblers in Hong Kong. Interviews were audio-recorded, transcribed, and coded in NVivo. Grounded theory method was used to build categories, themes and model. A total of 17 coping strategies, and three distinct coping paradigms are identified. The three coping paradigms emerged are compared with existing themes of coping identified in other coping studies. Implications on couple counselling to facilitate coping with adaptive paradigm shifts are discussed.

How Do Nurses Decide on Missed Nursing Care? A Grounded Theory Study of Grassroots Arrangement of Nursing Care.

To explore the complete decision-making process and action logic of nurses making autonomous decisions that result in missed nursing care. The complex characteristics of patients in Intensive Care Units place higher demands on the allocation of nursing resources, as well as on the professional skills, resilience and ethics of nursing staff. Preventing missed nursing care is particularly crucial in Intensive Care Units. A theory construction qualitative study using grounded theory. Semistructured face-to-face interviews were conducted with 20 nurses, including three head nurses and 17 bedside nurses. Head nurses provided insights into counselling and management practices. The theoretical model of nurses' decision-making processes comprise four strategies: setting priorities, seeking help, delaying nursing care and omitting nursing care. The latter two constitute missed nursing care. Inadequate staffing, task urgency and negative emotions can lead to omitting nursing care. This study proposes an original concept: grassroots arrangement of nursing care (GANC). Grassroots arrangement of nursing care includes the autonomous and adaptive decision-making process used by bedside nurses to optimise workflow in busy environments. It includes specific strategies and quality implications, enabling a nuanced balance between limited nursing resources, increasing patient needs and maintaining the best possible quality of care. Nursing managers should consider the dual aspects of grassroots arrangement of nursing care, support nurses' grassroots autonomy and streamline decision-making processes. This study follows the Consolidated Criteria for Reporting Qualitative Studies (COREQ). No patient or public contribution.

A Model for Psychological Consultation to Childcare and Preschools

ABSTRACT As nonparental care became increasingly common, the need for understanding young children’s behaviors and emotions called for psychological support for teachers and caregivers in early childhood education and center-based care. In Sweden such a development took place during the 1980s and 1990s. Relationship-building, self-development, and a salutogenic perspective are aspects which were considered central to the promotion of children’s learning, health, and well-being. A Swedish model of consultee-centered consultation was developed to assist teachers and care providers in infant and early childhood education in their endeavor to not only care for the children, but also promote their emotional and intellectual development. This article will report on this Swedish practice and describe a grounded theory study in which the process and dynamics of consultee-centered consultation, as utilized in schools, preschools, and childcare centers were conceptualized and analyzed, resulting in greater understanding of process and evidence of the efficacy of outcomes.

Nurses' Perceptions of Patients With Co-Occurring Psychiatric and Substance Use Disorders in Psychiatric Settings: A Grounded Theory Study.

To explore psychiatric and mental health nurses' perceptions of patients with co-occurring psychiatric and substance use disorders in psychiatric settings. An exploratory qualitative study design based on grounded theory, employing Straussian analytic procedures. Semi-structured interviews were conducted with 11 psychiatric and mental health nurses. Participants were recruited at a public psychiatric hospital located in the Paris metropolitan area of France. Face-to-face interviews took place between February 2024 and May 2024. Field notes and interview data were continuously analysed during open, axial and selective coding phases. The core category identified was 'waiting for a patient's will to change to emerge' when caring for patients with co-occurring substance use disorders. This active waiting period involved a balancing strategy between two discrete care objectives: stabilising the patient's clinical status and keeping the nurse-patient relationship intact. Identifying a patient's will to change provided an opportunity to reconcile these two aspects of psychiatric nursing through the addition of a collaborative component to the relationship. The substantive theory generated by our findings contributes to understanding the interactional and relational processes that occur between nurses and patients presenting with co-occurring substance use disorders in the context of psychiatric care. Implications of our study include the need for further emphasis on collaborative approaches that can be applied even in early or pre-contemplative stages of recovery. Organisational policies should systematically include training in the field of addiction care, given the high prevalence of co-occurring substance use disorders in psychiatric settings. Our findings can assist nurses in critically examining the challenges they experience when engaging with patients with co-occurring substance use disorders. This research adheres to the COREQ (COnsolidated criteria for REporting Qualitative research) Checklist. No patient or public contribution.

Constructing a model of the factors related to the job wellbeing of preschool teachers in China: a grounded theory study.

As educational management research evolves, leadership styles are increasingly recognized as crucial managerial skills. Among various leadership approaches, empowering leadership has been found to significantly enhance employee job performance and satisfaction. However, there is limited research exploring the relationship between empowering leadership and the job wellbeing of preschool teachers in the educational sector. This study examines the relationship between empowering leadership and preschool teachers' job wellbeing using the Job Demands-Resources (JD-R) model. Semi-structured interviews were conducted with 12 preschool teachers and 12 kindergarten leaders in China. The qualitative data collected were analyzed using grounded theory to identify themes and construct a systematic model. The findings suggest that empowering leadership of kindergarten principals is positively related to preschool teachers' job wellbeing. This relationship is mediated through stress pathways, such as work pressure and burnout, as well as through enhanced organizational support and a positive work environment. Furthermore, empowering leadership influences teachers' personal motivation and work engagement, which in turn impacts their job wellbeing. The study highlights the importance of empowering leadership in improving preschool teachers' wellbeing. By addressing stress factors, enhancing organizational support, and promoting personal motivation, empowering leadership can foster a more supportive and engaging work environment. These findings have practical implications for leadership practices in early childhood education settings.

Fragments of anarchism in higher education critical art pedagogies

Higher Education (HE) continues to find itself subject to neoliberal doctrines of competition, standardisation, managerialism and marketisation. This paper presents selected findings from a grounded theory study in which creative arts practitioners working in HE institutions shared their understandings of the arts and the critical pedagogies inherent in their discipline within the context of a neoliberalised educational economy. The research shows that arts pedagogies and anarchist principles have similitude between them, with anarchist ideals directing and informing teaching practices through non-hierarchical modes of exchange, fluid approaches to teaching and co-operative learning practices in educational spaces. This perhaps indicates that despite the prevalence of neoliberal marketised governance infiltrating and influencing pedagogic practice in the arts there is still resistance to managerialist, stratified notions of education within this discipline.

“I’m still a me:” challenges and changes to the relational-self following the onset of aphasia, a grounded theory study

Purpose People with post-stroke aphasia experience relationship changes which can lead to an altered relational self. The aim of this research was to explore the experiences of a group of people with post-stroke aphasia regarding changes to the relational self. Method A constructivist grounded theory approach was used. Ten people with post-stroke aphasia were interviewed on two occasions. Participants were 34–74 years old, with aphasia ranging from mild to severe. Data was coded and categorised to identify themes and sub themes. Results We identified three overarching themes and related subthemes on the development of the relational self. The first was “developing self-knowledge” and involved building knowledge around communication difficulties and needs, personal attributes and life roles. The second theme was “relationship specific experiences impacting the self” which described experiences specific to significant others. The final theme, the “Who am I with Aphasia?” comprised aspects of a generalised relational self, conceptualisations of a life with aphasia and the continuity of the self. Conclusion The relational self changes over time and is multifaceted. People with post stroke aphasia need to redevelop a relational self and supporting a positive relational self could be the focus of therapeutic interventions.

Negotiating a physically active life in tune with ageing: a grounded theory study of older persons’ experiences of participating in high-intensity interval training

BackgroundPhysical activity and exercise are promoted worldwide as effective interventions for healthy ageing. Various exercise initiatives have been developed and evaluated for their efficacy and effectiveness among older populations. However, a deeper understanding of participants’ experiences with these initiatives is crucial to foster long-term activity and exercise among older persons.MethodsA constructivist grounded theory study was conducted to explore the experiences of older persons participating in a supervised group supramaximal high-intensity training (HIT) programme. Four focus groups were held, involving 28 persons aged 65 to 78. The focus groups were analysed inductively, followed by an iterative process of abstraction, abduction, and theory generation using a constant comparative method. A conceptual framework comprising three theoretical concepts—stereotype embodiment, ageist practices, and self-efficacy—was employed during the abductive phase as an analytical lens.ResultsThe core category of our grounded theory, Negotiating a physically active life in tune with ageing, encapsulates the complex processes and actions influencing older persons as they engage in physical activities in their daily lives and in relation to HIT. This core category was created from the conceptual framework and the four categories: Grit in the moment and overall life, Empowered by the training group, Navigating one’s physically active self, and Committing to exercise for duty and pleasure. Participants reported feeling invigorated by the exercise, enjoying the challenge, and valuing the group setup for its social connectedness and structure. The generated theory illustrates how participants’ engagement with physical activity and exercise is shaped by various perspectives accumulated over their lifespan. The findings provide a plausible explanation of how participation in HIT groups can challenge negative age stereotypes and ageist practices while enhancing self-efficacy for high-intensity exercise.ConclusionsOur grounded theory underscores that physical activity and exercise should be regarded as multifaceted processes, which must be considered when promoting physical activity initiatives for older persons. By considering the older person and societal norms and values, we can gather knowledge to design physical exercise interventions that are not only effective but also enjoyable and capable of transforming how individuals perceive themselves as exercising persons.

Perspectives of Secondary School Educators Teaching Gender and Sexuality in Health Education

High-quality health education in schools plays a critical role in the formation of young people by developing the attitudes, beliefs, and skills needed to adopt and maintain healthy behaviours throughout their lives. Curriculum reform processes ensure that health education is adequately preparing adolescents for the world today and in the future. However, there is little consideration given to the teachers implementing these curriculum reforms, and their ability to integrate changes as they shape their learning and teaching. In this paper, we discuss the worldviews and beliefs of the teachers delivering health education in Western Australia. We present findings from a doctoral grounded theory study within secondary schools to explain the process teachers use as they approach curriculum, particularly after a reform. We investigate how teachers struggle to decide how to present themselves and the new curriculum content in class. Our findings evidence that teachers have determined gender and sexuality content to be controversial, uncomfortable, difficult to teach but also a favourite to teach. Teachers have expressed uncertainty as to what to say in class and have called for further guidance to teach these important life lessons. Curriculums need to constantly change to keep pace with a changing world, so how do we do this in a way that supports teachers and ultimately produces the best education for young people?