1. Journal of Advanced Nursing, 2000, 31(6), 1476±1484 Methodological issues in nursing research
Methodological issues in grounded theory
John R. Cutcliffe RMN RGN BSc(Hons)
Doctoral Student, Lecturer in Mental Health Nursing
and Practice Development Co-ordinator, Shef®eld University,
Shef®eld, and RCN Institute, Oxford, England
Accepted for publication 9 December 1999
CUTCLIFFE J.R. (2000) Journal of Advanced Nursing 31(6), 1476±1484
Methodological issues in grounded theory
Examination of the qualitative methodological literature shows that there
appear to be con¯icting opinions and unresolved issues regarding the nature
and process of grounded theory. Researchers proposing to utilize this method
would therefore be wise to consider these con¯icting opinions. This paper
therefore identi®es and attempts to address four key issues, namely, sampling,
creativity and re¯exivity, the use of literature, and precision within grounded
theory. The following recommendations are made. When utilizing a grounded
method researchers need to consider their research question, clarify what level
of theory is likely to be induced from their study, and then decide when they
intend to access and introduce the second body of literature. They should
acknowledge that in the early stages of data collection, some purposeful
sampling appears to occur. In their search for conceptually dense theory,
grounded theory researchers may wish to free themselves from the constraints
that limit their use of creativity and tacit knowledge. Furthermore, the interests
of researchers might be served by attention to issues of precision including,
avoiding method slurring, ensuring theoretical coding occurs, and using
predominantly one method of grounded theory while explaining and describing
any deviation away from this chosen method. Such mindfulness and the
resulting methodological rigour is likely to increase the overall quality of the
inquiry and enhance the credibility of the ®ndings.
Keywords: grounded theory, methodology, rigour, nursing, sampling, creativity,
re¯exivity, precision
therefore be wise to consider these con¯icting opinions.
INTRODUCTION
This paper begins with a brief overview of grounded
Since Glaser and Strauss' discovery in 1967, and its theory in order to identify the rudiments of the method.
application within sociological study, grounded theory Then it identi®es and addresses four key issues, namely,
has been used in many other ®elds including anthropol- sampling, creativity and re¯exivity, the use of literature,
ogy and nursing. Many authors have written about the and precision within grounded theory.
method, and scrutiny of this literature shows that there
appear to be con¯icting opinions and unresolved issues Brief overview of grounded theory
regarding the nature and process of grounded theory.
Researchers proposing to utilize this method would A grounded theory is a theory that is induced from the
data rather than preceding them (Lincoln & Guba 1985).
Correspondence: John R. Cutcliffe, 11 Blackthorne Close, Kilburn, Glaser & Strauss (1967 p. 3) provide an initial de®nition of
1 Derbyshire DE56 0LF, England. E-mail: john.cutcliffe@shef®eld.ac.uk grounded theory. They state that it is a theory that will:
1476 Ó 2000 Blackwell Science Ltd
2. Methodological issues in nursing research Methodological issues in grounded theory
¼ ®t the situation being researched and work when put into use. changeable. Patton (1990) argues that all types of sampling
By ®t we mean that the categories must be readily (not forcibly) in qualitative research can be termed purposeful
applicable to and indicated by the data under study; by work we sampling. Interestingly, in his list of 15 different sampling
mean that they must be meaningfully relevant and be able to strategies Patton does not list or de®ne theoretical
explain the behaviour under study. sampling. This apparent confusion only serves to confuse
neophyte qualitative researchers (Coyne 1997). However,
It is rooted in symbolic interactionism, wherein the
if the researcher can describe his/her sampling strategy in
researcher attempts to determine what symbolic mean-
suf®cient detail, this should minimize any confusion
ings, artifacts, clothing, gestures and words have for
regarding sampling (Morse 1991b), improve the quality of
groups of people as they interact with one another.
the research (Coyne 1997), avoid method slurring (Baker
Symbolic interactionists stress that people construct their
et al. 1992) and provide some clari®cation of the use of
realities from the symbols around them through interac-
theoretical sampling in nursing research.
tion, therefore individuals are active participants in
Glaser (1978), Sandelowski et al. (1992), Becker (1993)
creating meaning in a situation (Morse & Field 1995).
and Coyne (1997) each delineated theoretical sampling
Grounded theory both describes and explains the system
from purposeful/selective sampling, in as much that,
or behaviour under study and consequently is a method-
purposeful sampling involves the calculated decision to
ology for developing theory that is grounded in data
sample a speci®c locale according to a preconceived but
systematically gathered and analysed (Strauss & Corbin
reasonable initial set of dimensions. In contrast, theoret-
1994). Consequently, grounded theorists search for social
ical sampling has no such initial calculated decisions. The
processes present in human interaction (Hutchinson
grounded theory researcher seeks further interviewees/
1993). They aim to discover patterns and processes and
sources of data in order to add to the fullness of the
understand how a group of people de®ne, via their social
understanding of the concept. Hence, theoretical sampling
interactions, their reality (Stern et al. 1982).
is an integral part of the process of grounded theory.
A central feature of grounded theory is its method of
However, it should be noted that before the researcher has
constant comparative analysis (Glaser & Strauss 1967), in
begun to collect and analyse data, the researcher has no
that data collection and analysis occur simultaneously
evolving theory which can act as a guide for further
and each item of data is compared with every other item of
theoretical sampling.
data. The theory induced is conceptually dense (Strauss &
Baker et al. (1992) maintained that the researcher using
Corbin 1994), that is theory with many conceptual rela-
grounded theory initiates the sampling process by inter-
tionships, and these relationships are embedded in a
viewing signi®cant individuals. Perhaps it is these signi-
context of descriptive and conceptual writing.
®cant individuals that Morse (1991b) is referring to when
she describes a good informant as one who has the
SOME RESEARCH DESIGNS knowledge and the experience the researcher requires, has
the ability to re¯ect, is articulate, has the time to be
Sampling in grounded theory interviewed and is willing to participate in the study.
Glaser (1978) asserted that in the initial stages of theoret-
Grounded theory uses non-probability sampling. In order
ical sampling, decisions for collection of data are based
for concepts and categories to emerge during the data
only on a general sociological perspective and on a general
analysis, the need for sampling of speci®c data sources
subject or problem area. Morse (1991b) submitted that the
continues until each category is saturated. Therefore, at
researcher initially chooses interviewees with a broad
the beginning of the study, there are no limits set on the
general knowledge of the topic.
number of the participants, interviewees or data sources.
These positions and arguments thus appear to indicate
The researcher continues selecting interviewees until they
that individuals are chosen initially who can provide a
are saying nothing new about the concepts being explored.
relevant source of data, and this relevance is determined by
Thus the selection of participants (and other sources of
the requirements for generating and delimiting the theoret-
data) is a function of the emerging hypothesis/hypotheses
ical codes (Hutchinson 1993). Therefore, when a grounded
and the sample size a function of the theoretical complete-
theorist is commencing his/her data collection, it appears
ness (Baker et al. 1992).
that they do enter into a process of purposeful sampling,
Sampling within grounded theory is therefore described
which is then superseded by theoretical sampling as the
as `theoretical' rather than purposeful (Glaser & Strauss
data/theory highlight the direction which further sampling
1967, Glaser 1978, Becker 1993) in that it is driven by the
needs to follow. This argument is supported by Sande-
emerging theory. However, other authors of qualitative
lowski et al. (1992) and Coyne (1997 p. 625) who states:
research methods do not make such a distinction (Lincoln
& Guba 1985, Morse 1991b). Indeed, they suggest that the ¼ theoretical sampling does involve the purposeful selection of a
terms theoretical and purposeful sampling are inter- sample in the initial stages of the study.
Ó 2000 Blackwell Science Ltd, Journal of Advanced Nursing, 31(6), 1476±1484 1477
3. J.R. Cutcliffe
A second issue in sampling that warrants attention is that subsequent theoretical sampling would also re¯ect the
of the choice between a wide and diverse sample or a more limited experience. The data obtained from such an
`focused', narrow, concentrated sample. It is reasonable to individual, when analysed and coded, is unlikely to
say that the literature on this issue is confusing and indicate the lines of inquiry, the necessary sources of data,
con¯icting. Hutchinson (1993) argues in favour of a wide, which would then lead ultimately to the `fullest' or most
diverse sample in that this ensures extensive data that cover complete understanding of the social process. It should be
the wide ranges of behaviour in varied situations. Lincoln & noted that it is possible that the fullness of the phenom-
Guba (1985) make similar arguments. They advocate, since enon may be uncovered during subsequent interviews
the purpose of sampling will most often be to include as (Hutchinson 1993). However, this argument does appear
much information as possible, maximum variation to highlight the importance of selecting an appropriate
sampling to be the usual sampling mode of choice. gatekeeper, and therefore also indicates a degree of
Another argument may be constructed that reasons in a-priori sample selection.
favour of a more narrow or focused sample, rather than Yet Lincoln & Guba (1985) deliberate that there can be
maximum variation. Since the researcher in grounded no a-priori speci®cation of the sample and that initially
theory is concerned with uncovering the situated, contex- any sample unit will do as well as any other. Nevertheless,
tual, core and subsidiary social processes, the social Morse (1991b p. 129) highlighted that selection of an
processes need to be shared and experienced by the adequate and appropriate sample is critical in qualitative
individuals who make up the researched group. Other- research and that the eventual quality of the research is
wise, if an individual has no experience of the social or contingent upon the appropriateness and adequacy of the
psychosocial process, how can they comment on it? sample. Furthermore she states:
Consequently, grounded theorists using a more narrow
¼ it is essential for the researcher to discover who will be the
or focused sample seek out participants who have experi-
most appropriate informant before beginning interviews and that
ence, the most experience, in the topic of interest (Morse
informants must be carefully selected or carefully chosen
1998). Indeed, Lincoln & Guba (1985) point out that
according to speci®c qualities.
grounded theory has been termed `local theory' as it brings
together and systematizes isolated, individual theory. It is She sums up her arguments regarding sample selection
an aggregate of local understandings. Selection of a sample by stating:
of participants who have only a limited experience of the
¼ informants must be knowledgeable about the topic and experts
social process, or put another way, a sample that isn't
by their virtue of their involvement in speci®c life events and/or
local, is thus likely to provide data and a subsequent
associations.
theory that has a partial or limited understanding of the
process being studied. Glaser & Strauss (1967) highlight The author of this current paper is not advocating strict
how the choice between sampling narrow or wider adherence to sample criteria set prior to commencing data
substantive groups is directed by the conceptual level of collection. Such rigidity is only likely to limit theoretical
the theory that the researcher intends to induce. They sampling (Morse 1991b). Yet, it appears to be logical for
indicated that if the researcher intends to induce a the researcher to consider criteria for sample selection
substantive theory that is applicable to one substantive prior to starting to collect data. Therefore the author
group, then the researcher needs to sample groups of the argues that this purposeful sampling should be considered
same substantive type (e.g. a narrow sample). A more for the ®rst interview (especially as this individual occu-
general, or wider substantive theory would thus be pies the role of `gatekeeper') and possibly the second
induced by sampling wider substantive groups, and if interview. Following this theoretical sampling to guide
the researcher is concerned with inducing a formal theory, sample selection would be more appropriate.
he/she will select dissimilar substantive groups from the
larger class, and thus increase the theory's scope.
Creativity and re¯exivity in grounded theory
Lincoln & Guba (1985) argue that the purpose of
maximum variation within theoretical sampling is best A further issue that warrants consideration is that of
achieved by selecting each unit of the sample only after creativity and re¯exivity. Few would dispute that qualit-
the previous unit has been taped and analysed. Conse- ative methods invariably involve interaction between the
quently the ®rst unit of the sample (®rst interviewee) often researcher and the data. Turner (1981) reasoned that in
acts as a `gatekeeper'. This ®rst set of data and subsequent social inquiry there is an interaction between the
analysis can set the `tone' or highlight the direction for researcher and the world that they are studying. Indeed,
further theoretical sampling. The notion of a `gatekeeper' Lipson (1991) expounded that re¯exivity refers to
again raises the sampling issues identi®ed in this paper. If researchers being part of, rather than separate from, the
the ®rst unit of a sample only has a limited experience of data. Altheide & Johnson (1994) argue that theories
the social process being studied, one could argue that the induced from qualitative methods always include some-
1478 Ó 2000 Blackwell Science Ltd, Journal of Advanced Nursing, 31(6), 1476±1484
4. Methodological issues in nursing research Methodological issues in grounded theory
thing of the researcher. Hutchinson (1993 p. 187) made be seen in attempts to establish the credibility of qualit-
speci®c remarks concerning re¯exivity and grounded ative ®ndings by using criteria developed for establishing
theory: the credibility of quantitative ®ndings (Hammersley 1992).
Also, it can be seen in attempts to translate these quan-
¼ because grounded theory research requires interpersonal
titative criteria into terms more in keeping with the
interaction, the researcher is inevitably part of his or her daily
qualitative paradigm (Cutcliffe & McKenna 1999).
observations.
Attempts to discount the researcher's values, know-
However, while there appears to be little argument that ledge, beliefs and experiences could also be regarded as an
grounded theory inevitably involves interaction between attempt to gain credibility with scientists who use quan-
the researcher and the world they are studying, how this titative or positivistic methods by decreasing any chance
interaction affects the emerging theory remains a matter of personal bias. Such endeavours appear to be upholding
for debate. Morse (1994) contends that qualitative the philosophical position that there is one true reality,
methods (including grounded theory) have been plagued and that personal values, knowledge and experience
with con¯icting advice concerning the application of prior would only serve to contaminate the researcher's repre-
knowledge (including the researcher's previous experi- sentation of this reality.
ence and knowledge which they bring to the study). However, the philosophical position of qualitative
Berger & Kellner (1981) and Hutchinson (1993) advocate methods is dissimilar to that of quantitative methods.
that the qualitative researcher needs to become aware of Qualitative researchers believe that reality is constructed
their own personal preconceptions, values and beliefs and from human perspectives, shared (social) and individual
then hold them in abeyance. These authors add that if interactions and meanings of given situations and
these processes are not carried out, the scienti®c enter- phenomena. To strive to attain more credibility according
prise collapses and the researcher will perceive a mirror to an alternative philosophical standpoint appears to be at
image of hopes/fears and not the social reality. best inappropriate and at worst, a distraction from the
A vigorous counter-argument exists that posits it is the potential that creativity can bring.
re¯exivity and the researcher's creativity within this That is not to say that the grounded theorist has license
re¯exivity that makes grounded theory valuable. Turner to invent concepts, categories and posit these as a theory
(1981 p. 227) stated: that represents the meanings that a group of individuals
ascribe to their shared interactions and social world.
¼ an advantage of grounded theory is that it directs the researcher
However, what it does is legitimize the researcher's
immediately to the creative core of the research process, and
creativity as an integral part of the grounded theory
facilitates the direct application of both the intellect and the
inductive process; liberating the restrictions on the
imagination to the demanding process of interpreting research
researcher's tacit knowledge that discounting such know-
data.
ledge creates. Turner (1981 p. 228) stated:
Stern (1994 p. 217) supports this viewpoint:
¼ competent development of grounded theory rests in part upon
¼ it is the creativity in the act that brings the real truth of a social a sensitivity to these often tacit processes of perceiving and
situation into being, and following grounded theory techniques is understanding, and upon a willingness and an ability to bring
one way to approach this creative process. them into the open for discussion.
Morse (1994) encourages qualitative researchers to take Lincoln & Guba (1985 p. 208) constructed similar
more risks in their theory development. It is worth arguments when they stated:
considering whether or not such a movement could
¼ admitting tacit knowledge not only widens the investigator's
involve transition from a position where concerns for
ability to apprehend and adjust to phenomenon in context, it also
holding prior knowledge and beliefs in abeyance predom-
enables the emergence of theory that could not otherwise have
inate, to an alternative position more concerned with
been articulated.
creativity. Perhaps consideration of why some researchers
advocate the need to acknowledge and discount any prior Hence there is a need for the grounded theory researcher
knowledge and beliefs may shed some light on this issue. to acknowledge his/her prior knowledge and tacit know-
It is reasonable to say that for many years qualitative ledge, to bring such knowledge into the open, to discuss
research methods have been regarded by many scientists how it has affected the theory development (Turner 1981)
who use quantitative or positivistic methods as a `poor and allow the interplay between the researcher's know-
relation' of quantitative methods. Consequently, some ledge, values and beliefs and the data to occur; to allow
qualitative researchers have been anxious to be seen as the researcher's creativity to explore and articulate
credible in the eyes of their such scientists. Evidence of theoretical links.
this can be seen in some of the language used to describe The choices of which facts and lines of inquiry to
and explain early qualitative methods (Morse 1994). It can follow and which not to follow are guided, to some
Ó 2000 Blackwell Science Ltd, Journal of Advanced Nursing, 31(6), 1476±1484 1479
5. J.R. Cutcliffe
extent, by the subconscious perceptual and intellectual enon, and therefore have already decided that a grounded
processes of the researcher's mind (Turner 1981). Conse- theory method would be suitable'. Consequently Lincoln
quently, to deny a researcher who is using grounded & Guba's (1985) and Stern's (1994) arguments appear to
theory access to this knowledge and to restrict the occupy a position further along the continuum of know-
creativity necessary to utilize it, is likely to limit the ledge generation. Given these considerations both argu-
depth of understanding of the phenomenon and impose ments appear to be cogent and not necessarily
unnecessary, rigid structures. As a consequence, the contradictory of one another.
researcher would be left questioning themselves each Many proposed research questions require conceptual
time they draw upon their tacit knowledge, or when they clarity. For example, within the author's doctoral study,
experience a moment of insight into the world they are having identi®ed that there is an absence of literature that
investigating. The researcher would be left asking them- explains if or how hope is inspired in bereavement
selves: counselling and thus a grounded theory method would
be indicated, it may still be appropriate and indeed
Does that thought originate from my knowledge, experience or
prudent, to review the available literature that focuses on
beliefs or does it belong to the interviewees?
hope and the literature that focuses on bereavement
Yet, importantly, the mechanism for checking the counselling. Such a review may help provide a sense of
authenticity or representativeness of such knowledge the key elements of hope that are implicit in the literature,
and insight exists within the grounded theory method, it may help provide some conceptual clarity of the nature
whereby such trustworthiness is achieved by exploring of hope and the nature and practice of bereavement
the possible or emerging concepts/categories in further counselling and this examination of the relevant literature
interviews. If the hunch belongs solely to the researcher, would help the researcher to differentiate hope from
and is not a part of the world being investigated, this will similar and related concepts.
have no meaning for the interviewees and can be If there is a need for a review of the literature in order to
discarded in due course. clarify concepts and de®ne terms, the key questions that
need to be asked appear to be, how rigorous and thorough
should this literature review be and at what point in the
Literature reviews in grounded theory
theory induction should this literature review occur?
It is well documented that when utilizing a grounded Smith & Biley (1997 p. 20) acknowledged that a detailed
theory method the researcher should avoid conducting a and comprehensive literature review is not the ®rst stage
literature review prior to commencing data collection and in grounded theory. However, they go on to point out that
analysis (Stern 1980, Stern et al. 1982, Stern & Allen 1984, some reading may occur prior to data collection. They
Lincoln & Guba 1985, Stern 1994, Strauss & Corbin 1994, state:
Hickey 1997). By avoiding a literature review at the
General reading of the literature maybe carried out to obtain a feel
beginning of the study it is more likely that the emergent
for the issues at work in the subject area, and identify any gaps to
theory will be grounded in the data.
be ®lled in using grounded theory¼ but it is important that the
Another view is proffered by Hutchinson (1993), who
reading is not too extensive.
suggests that a literature review should proceed data
collection and analysis in grounded theory. In that, it is Their justi®cation for this technique is that the
the review of the literature that can identify the current researcher then approaches the subject area with some
gaps in knowledge, or help provide a rationale for the background knowledge. It is the opinion of the author of
proposed research. Perhaps the apparent disagreement the current paper that such statements may confuse
between these two positions can be explained if one potential researchers who are contemplating using
considers the longitudinal nature of the generation of grounded theory. Just how much reading is `extensive'
knowledge, and the different positions that these argu- and similarly `too extensive'? To advocate that the
ments appear to occupy on this longitudinal continuum. researcher approaches the ®eld of study with this back-
Hutchinson's (1993) arguments can be located in a ground knowledge may produce the situation where the
position that has a starting point: `What do we know about researcher has already begun to form tentative conceptual
this phenomenon?' Therefore, at this point, she has not and theoretical links. This, as discussed earlier, is inap-
begun to consider what is the most appropriate method- propriate for grounded theory.
ology. That will be indicated by the current extent and However, no potential researcher is an empty vessel, a
depth of knowledge available regarding the phenomenon, person with no history or background. Further, as it is
whereas, Lincoln & Guba's (1985) and Stern's (1994) common for many researchers to pursue a particular
argument can be located in a position that has the starting theme throughout their research activity, they may already
point, `We already recognize that there is a distinct dearth possess some background knowledge of the substantive
or even absence of knowledge concerning the phenom- area they intend to study. Indeed, the researcher and all
1480 Ó 2000 Blackwell Science Ltd, Journal of Advanced Nursing, 31(6), 1476±1484
6. Methodological issues in nursing research Methodological issues in grounded theory
his/her knowledge and prior experience is bound up with clarify the concepts, before going on to induce a theory that
the interactive processes of data collection and analysis. explicates and explains how they relate to one another.
As Strauss & Corbin (1994 p. 278) indicated, the analyst is The other issue regarding literature reviewing in
also a crucially signi®cant interactant and Glaser (1978) grounded theory is: When should the second review of
offered similar remarks when he argued that everything is the literature occur? Hutchinson (1993) argued that
data. Thus, the researcher would perhaps be unwise to because the preliminary literature review can sensitize
carry out reading that provides him/her with anything concepts (i.e. add to the conceptual clarity) and increase
more than, as Glaser & Strauss (1967) term, a partial an awareness of the gaps in the knowledge, this second
framework of local concepts, which designate a few review turns to an entirely new body of literature. Stern
principal or gross features of the situations that he/she (1980), Stern & Allen (1984) and Strauss & Corbin (1994)
will study. As such knowledge becomes part of the argue that selective sampling of the second body of
researcher and consequently becomes part of the inter- literature should be woven into the emerging theory
active process. Instead of allowing the theory to emerge during their third stage on grounded theory induction,
from the data, the researcher albeit implicitly, is likely to the stage they term concept development.
enter into a deductive process. Comparing the data However, in contrast to these arguments, Glaser (1978)
provided by the interviewees with the knowledge (and asserts that the researcher should refrain from accessing
pre-formed conceptual frameworks) already present in this second body of literature until the theory has emerged
his/her mind. Therefore, as indicated earlier, there may be from the data. Therefore it occurs at a later stage. What this
value in reading literature that assists in concept clari®- difference of opinion indicates is that there are funda-
cation. To draw upon Glaser & Strauss (1967) explanation mental differences between Glaser's and Strauss' version
of these principal or gross features of the area of study, of grounded theory (and these are explored in the next
they suggest that if a researcher intends studying hospi- section of this paper). Consequently, the stage at which
tals, he knows there will be doctors, nurses, and admis- the researcher begins to weave in the second body of
sion/discharge procedures. Indeed, having this initial literature appears to depend upon which version of
conceptual clarity prior to entering the study, perhaps grounded theory is being used.
helps the researcher to reach conceptual density, enhance
the richness of concept development (Strauss & Corbin
Precision in grounded theory
1994) and subsequently the process of theory development.
To return to the example of hope inspiration in bereave- There appear to be several issues regarding precision and
ment counselling. If the researcher wishes to investigate if clarity in grounded theory and each of these warrants
the concepts are linked, and if so, how? it might be consideration. These issues can be described as method
worthwhile to begin by highlighting the current concep- slurring with other similar yet different qualitative meth-
tualization of both hope and bereavement counselling odologies, e.g. phenomenology (Baker et al. 1992). The
within the relevant empirical literature. As there is an absence of theoretical coding in some studies which
absence of substantive or formal theory that indicates how propound to be grounded theory (Strauss & Corbin 1994,
such concepts may be related, neither of the reviews of Melia 1996). Additionally, does the term grounded theory
literature provide the researcher with an implicit theory represent but one single method or, alternatively encom-
which could be tested during the data collection. pass several methods (May 1996, Melia 1996).
However, what it can do is provide an understanding of Stern (1994) af®rmed that although there may be simi-
the concepts and thus provide ®rm conceptual clarity and larities in all interpretative methods, the frameworks
an understanding upon which the rest of the emergent underlying the methodologies differ. Baker et al. (1992)
theory can be built. constructed similar arguments and further reasoned that
This process may not be appropriate for certain types of failure to explicate qualitative methodologies is resulting
research question. For example, factor isolating questions in a body of nursing research that is mislabelled. Morse
such as `What is caring?'. What appears to become evident (1991a p. 15) warned of this mixing of methodologies and
is that the decision whether or not to conduct a review of stressed that:
literature to help conceptual clarity may depend upon
¼ the product is not good science; the product is a sloppy
what the research question is, but more importantly the
mishmash.
2 level of theory (Dickoff & James 1968) to be induced.
Thus, if the researcher is concerned with inducing factor Thus by paying attention to the resolution or precision
isolating theory, it may be disadvantageous to carry out of qualitative research methodology the researcher is
such a review of the literature. In contrast if the researcher endeavouring to ensure rigour (Baker et al. 1992, Cutcliffe
is concerned with factor relating theory, it could be 1997). Such rigorous studies should `stand up' better to
advantageous to carry out the literature review in order to critique by enabling the reader to examine whether or not
Ó 2000 Blackwell Science Ltd, Journal of Advanced Nursing, 31(6), 1476±1484 1481
7. J.R. Cutcliffe
the chosen methodology was appropriate to the nature of most demand upon the grounded theorist's creativity.
the research study. Further, it is perhaps theoretical coding and the postu-
However, Stern (1994) acknowledged that she is lating of previously undiscovered or unarticulated links
comfortable with the evolution of a methodology, and that enables the development of the theory.
that she does not regard researchers `tinkering with' a If the grounded theorist concentrates on substantive
given method as problematic. Further, she highlights the coding as the chief and almost exclusive feature (Strauss &
advantages of combining different qualitative methodolo- Corbin 1994) then it is possible that this limits the
gies. Therefore the dif®culty does not lie with blending researcher to inducing factor isolating theory, in as much
one qualitative methodology with another, indeed the as substantive coding facilitates the researcher in asking
resulting methodology may produce a more thorough, the questions, `What is this?', `What are the components of
multidimensional understanding of the phenomenon. In this social process?'. Introducing theoretical coding
support of this position, Wilson & Hutchinson (1991) enables the researcher to induce factor relating theory.
propose the triangulation of Heideggarian hermeneutics Theoretical coding facilitates the researcher in asking the
and grounded theory. For example, these methods could questions, `What is happening here?', `How do the
be combined in order to examine the nature of hope substantive codes relate to each other as hypotheses?'.
inspiration in bereavement counselling. The grounded To ignore the central feature of the methodology (Strauss &
theory would enable the researcher to ask, `How does this Corbin 1994) and then subsequently call the methodology
inspiration occur?', `What if ``X'' were to happen here?', grounded theory is a clear indication of imprecision.
`What symbolic meanings, gestures, words or behaviours Another issue of precision is whether or not the term
explain the social reality of the process of hope inspiration grounded theory encompasses more than one methodo-
in bereavement counseling?'. The Heideggarian phenom- logy. If so, is it appropriate to call a methodology
enology would enable the researcher to ask the questions, grounded theory or would another term have to be used?
`What is the lived experience of receiving such hope in a As indicated in the introduction grounded theory was
bereavement counselling setting?', `What meanings do both discovered by Glaser & Strauss (1967), both of whom had
the counsellors and the client ascribe to this experience?'. distinctly different academic backgrounds. It maybe no
The crucial issue then, even when using combined surprise then that the subsequent development of the
methodologies, is that there is still precision. The method- methodology since then has taken a different path for each
ologies are combined purposefully and with intention, and author.
the researcher subsequently makes explicit what she/he According to Stern (1994), Glaser, who has a back-
has done and why. The mixing of methodologies does not ground in statistical analysis, insists on allowing the
occur by accident. Similarly, the researcher does not call theory to emerge, whereas Strauss, whose sociology was
the product of this mixing grounded theory or phenome- ®rmly rooted in the Chicago school (i.e. a school of
nology, but tells the researcher the methodology is some- sociology which has its roots in the symbolic interac-
thing different, e.g. a combination of two methodologies. tionist tradition, Robrecht 1995), prefers a method that is
The second issue regarding precision in grounded tightly prescriptive. Stern (1994) and Melia (1996) also
theory is that of substantive coding and theoretical coding. suggest that Glaserian grounded theory would be expected
Strauss & Corbin (1994 p. 277) were adamant that some to be immediately applicable to individuals and groups
researchers who: who shared the problem under study and would be
expected to be testable. However, theory produced using
¼ think they are doing grounded theory studies often seem to
Strauss' version of grounded theory has its applicability
concentrate on substantive coding as the methodology's chief and
downplayed (Stern 1994). The crux of the dichotomy is,
almost exclusive feature, but do not do theoretical coding.
according to Glaser (1992) the fundamental difference
Few would dispute that substantive coding is an integ- between emerging and forcing. Stern (1994) argued a key
ral part of data analysis within grounded theory, but if the difference is the questions each author asks of the data. As
intellectual rigour halts at substantive coding, then it is Strauss examines the data, he stops at each word and asks,
debatable that the researcher used a grounded theory `What if ?', whereas Glaser keeps his attention on the data
methodology. The author of the current paper would argue and asks, `What do we have here?'.
not. Glaser (1978) argues that it is the theoretical coding, According to Stern (1994 p. 20):
the conceptualization of how the substantive codes may
Strauss brings to bear every possible contingency that could relate
relate to each other as hypotheses, which enables the
to the data, whether it appears in the data or not. Glaser focuses
substantive codes to be integrated into a theory. It is this
his attention on the data to allow the data to tell their own story.
theoretical coding that can provide the full and rich
understanding of the social processes and human interac- Glaser (1978) went as far as to claim that Strauss'
tions which are being studied. The author of this current evolution is a departure from the original methodology
paper suggests that theoretical coding perhaps places the and represents an erosion of grounded theory (Melia
1482 Ó 2000 Blackwell Science Ltd, Journal of Advanced Nursing, 31(6), 1476±1484
8. Methodological issues in nursing research Methodological issues in grounded theory
1996). Indeed he asserts that the two methodologies sion. The author concludes by making the following
should have different names, with Strauss' version being recommendations.
termed, full conceptual description. When utilizing a grounded method researchers should
If the crux is in the different questions asked of the data, consider their research question and clarify what level of
what happens if the researcher asks both questions? theory is likely to be induced and then decide when they
Further, if the researcher asks another question, is he/ intend to access and introduce the second body of litera-
she using another different version of grounded theory? ture. They should acknowledge that in the early stages of
For example Turner (1981 p. 232) asked: data collection, some purposeful sampling appears to
occur. They may wish to free themselves from the restraints
¼ what categories, concepts or labels do we need in order to
that limit their use of creativity and tacit knowledge. The
describe or account for the phenomena discussed in this para-
researchers might be served by attention to issues of
graph?
precision, including avoiding method slurring, ensuring
Stern (1980 p. 281) proposed that the researcher exam- theoretical coding occurs, and predominantly using one
ines the data, line by line, and produce substantive codes: method of grounded theory while explaining and
describing any deviation away from this chosen method.
These codes are called substantive codes, because they codify the
Such mindfulness and the resulting methodological
substance of the data, and often use the very words used by the
rigour is likely to increase the overall quality of the
actors themselves.
inquiry and enhance the credibility of the ®ndings.
If the nature of the grounded theory is determined in
part by the questions asked of the data, then does the
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