Chapter 10: Grounded Theory
Darshini Ayton
Learning outcomes
Upon completion of this chapter, you should be able to:
- Identify the three approaches to grounded theory research.
- Define the key terms and concepts used in grounded theory research.
- Discuss the advantages and disadvantages of grounded theory research.
What is a grounded theory study?
The key concept of grounded theory is building theory.
Grounded theory studies, developed by Barney Glaser and Anselm Strauss, aim to build theory ‘from the ground up’ – meaning ‘from the data’.1,2 For many people, the idea of developing a theory can be intimidating.3 However, the theories generated from grounded theory studies are rarely grand theories at the level developed by, for example, philosophers Foucault or Hegel. Rather, the focus is on discovering concepts that explain social processes, actions and interactions from the collected data.1,2 In health and social care research, this can typically take the form of a framework or typology.
Since Glaser and Strauss initiated the grounded theory approach in the 1960s, multiple competing methods have arisen from different ontological and philosophical foundations, which are outlined in Table 10.1.
Table 10.1. Grounded theory approaches
| Classic Grounded Theory – Glaser and Strauss (1967) | Straussian Grounded Theory – Strauss and Gorbin (1990) | Constructivist grounded theory – Charmaz (2006) | |
|---|---|---|---|
| Philosophical perspective4 | Positivist realist ontology | Pragmatist and symbolic interactionist | Constructivist stance, relativist ontology, subjective epistemology |
| Role of the researcher4,5 | Independent and separate - objective Few to no predetermined thoughts No initial literature review |
Active, with an interpretive role The researcher’s experience influences the research questions that are asked, the generation of the hypothesis and theoretical sensitivity – it is the researcher that conducts data collection and analysis and hence discovers the relationship between data categories to construct the theory. |
Co-construction – the researcher influences the research in the data collection and analysis process through interactions. The researcher’s experience is a valued part of the process, hence researcher reflexivity is important (see Chapter 30). |
| Data and data analysis4,5 | Open, selective and theoretical coding | Open, axial and selective coding | Line-by-line conceptual coding with focused coding to synthesise large amounts of data. Inductive, deductive and abductive logic – the process of moving back and forth between data and conceptualisation. Abductive logic is the process of exploring different theoretical explanations for what the researcher observes in the data to then arrive and the most likely explanation. |
To ensure that the theory is derived from the data, researchers undertaking Classical or Straussian Grounded Theory should have no preconceived theories before starting the research – which means they should not be seeking to test a theory – they should not be constrained by the literature when coding data and they should not impose prior concepts on the data.3 Grounded theory is therefore inductive – it generates theory – as opposed to deductive – which tests theory.4 Theories about social processes and actions should be generated systematically through research, and ‘discovered’ from the data rather than hypothesised and tested against data.6,2 Hence, grounded theory studies suit research topics in which little is known about the ‘how and why’ of social processes.5
Multiple forms of data collection can be employed in ground theory studies, with data collection and data analysis occurring concurrently to inform theory development.1 For example, the researcher may conduct 20 interviews, undertake the analysis and begin to form a theory, and then, based on this theory, develop an interview guide that will elicit further theoretical development as more data is collected. This process happens across multiple cycles of data collection; analysis and data collection usually stops when theoretical saturation is reached.7 Hence, the research is iterative and evolves through the collection and analysis of data. Theoretical saturation is when all the domains or aspects of the theory have been thoroughly examined.1 Grounded theory studies can draw on other qualitative designs – for example, a researcher can conduct a grounded theory phenomenology study or a grounded theory case study. The approach to analysis is typically the constant comparative approach.1,2
Advantages and disadvantages of grounded theory
The advantages of grounded theory studies include that the researcher is able to be immersed in the data at a detailed level, and this immersion occurs early in the research process, to enable the constant interplay between data collection and analysis. The concept of theoretical saturation ensures that the data accounts for all elements of the theory that is generated. However, the process of theoretical sampling and the iterative nature of going back and forth between data collection and data analysis can take a long time. In creating the theory, the context of the social processes may be lost and the overall theory may lack nuance. Consequently, it can be difficult to scale up the theory to different contexts.4,8-10 Examples of studies employing grounded theory are shown in Table 10.2.
Table 10.2. Examples of grounded theory studies
| Title | Motivating change: a grounded theory of how to achieve large-scale, sustained change, co-created with improvement organisations across the UK11 | A taxonomy of dignity: a grounded theory study12 |
|---|---|---|
| First author and year | Breckenridge, 2019 | Jacobson, 2009 |
| CC Licence | CC BY NC 4.0 | CC BY 2.0 |
| Aim | 'sharing knowledge about sustaining large-scale change' [abstract methods] | To 'describe and classify the forms of dignity, the elements that comprise these forms, and the relationships among the elements, thus expanding understanding of the concept and providing an empirical base from which to develop strategies for enhancing human well-being' [last paragraph of background] |
| Why a grounded theory study was conducted | The authors wanted to develop a theory of 'what works when implementing and sustaining individual initiatives and they did this using a participatory approach so that the theory was co-created and co-owned' | 'grounded theory is an excellent methodology to use when investigating concepts like dignity that are simultaneously extremely abstract and strongly rooted in tangible aspects of social life. In addition, because grounded theory “fosters [the integration of] subjective experience with social conditions,” it is a valuable tool for social justice research' [second paragraph of methods] |
| Study setting and country | Scottish Improvement Science Collaborating Centre | Toronto, Canada |
| Data collection, sampling and participants | Data collection involved 42 staff across 3 organisations: Unicef UK, NHS Highland and Healthcare Improvement Scotland. Three full-day consultations were held with small group discussions in which participants worked in groups to create their theory of ‘what works’ when implementing and sustaining individual initiatives. Groups compared their different theories and collectively identified similarities and differences and then compared group theories with existing improvement models, theories and frameworks. | 64 semi-structured interviews were held with people who were marginalised because of their health or social status, individuals who provide health and social care services and people working in the area of health and human rights. Interview questions and whom to recruit evolved as the analysis was conducted. demonstrating the iterative nature of the research. |
| Analysis | The authors applied a classic grounded theory analysis approach, consisting of open coding of the core category identified as motivating change. Selective coding was used to expand the core category and related categories and theoretical coding examined relationships and created an integrated theory. According to grounded theory principles, theory development was discussed with a second researcher and relevant literature was reviewed following theory development. The final theory was presented to the three organisations. | 'Schatzman's formulation of dimensional analysis, constant comparison of concepts and conditions derived from the data, development of higher order categories to encompass and link these concepts and conditions, and extensive memo writing to track and explore developing ideas.'(para7) |
| Results | The final theory was presented to the three organisations. The theory of motivating change consists of three main domains: (1) The psychological conditions for sustained large-scale change – internalised motivation (intrinsic and extrinsic motivators for change identified); (2) the social conditions for sustained large-scale change – a flow of trust; and (3) the structural conditions for sustained, large-scale change.(p5-7) |
A taxonomy of dignity identifying: – Form of dignity: human dignity and social dignity – Elements of dignity: dignity encounters, dignity violation and dignity promotion – Objects of violation and promotion – The consequences of violating dignity. |
Summary
Grounded theory is an appropriate research design to explain a process through a theory. The design incorporates multiple forms of data collection and is iterative in approach, with cycles between data collection and analysis.
References
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- Breckenridge JP, Gray N, Toma M, et al. Motivating Change: a grounded theory of how to achieve large-scale, sustained change, co-created with improvement organisations across the UK. BMJ Open Qual. 2019;8(2):e000553. doi:10.1136/bmjoq-2018-000553
- Jacobson N. A taxonomy of dignity: a grounded theory study. BMC Int Health Hum Rights. 2009;9:3. doi:10.1186/1472-698X-9-3
