Collegian (2008) 15, 103—107

avai lab le at www.sc iencedi rec t .com

Challenging convention: Symbolic interactionismand grounded theory

Barbara Newman, RN, MHPEd, PhD, FRCNA ∗

Sydney Adventist Hospital, 185 Fox Valley Road, Wahroonga, 2076 NSW, Australia

Received 10 October 2007; received in revised form 28 November 2007; accepted 4 December 2007

KEYWORDSSymbolicinteractionism;Glaserian groundedtheory;Theoreticalperspective;Method

Summary Not very much is written in the literature about decisions made by researchersand the justifications on method as a result of a particular clinical problem, together with anappropriate and congruent theoretical perspective, particularly for Glaserian grounded the-ory. I contend the utilisation of symbolic interactionism as a theoretical perspective to informand guide the evolving research process and analysis of data when using classic or Glaseriangrounded theory (GT) method, is not always appropriate. Within this article I offer an analysis ofthe key issues to be addressed when contemplating the use of Glaserian GT and the utilisationof an appropriate theoretical perspective, rather than accepting convention of symbolic inter-actionism (SI). The analysis became imperative in a study I conducted that sought to explorethe concerns, adaptive behaviours, psychosocial processes and relevant interactions over a 12-month period, among newly diagnosed persons with end stage renal disease, dependent onhaemodialysis in the home environment for survival. The reality of perception was central tothe end product in the study. Human ethics approval was granted by six committees within New

South Wales Health Department and one from a university.© 2008 Royal College of Nursing, Australia. Published by Elsevier Australia (a division of Reed

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Introduction

Essentially, Glaserian or classic grounded theory (GT) devel-oped by Glaser and Strauss (1967) provides systematicinductive guidelines for collecting and analysing data to

produce middle range theoretical frameworks that explaincollected data (Charmaz, 2000). Even though the intent ofGlaserian GT is clear, discord prevails within the literatureon where Glaserian GT and Strauss and Corbin’s (1990) refor-

∗ Tel.: +61 2 9489 2526.E-mail address: barbaran@sah.org.au.

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1322-7696/$ — see front matter © 2008 Royal College of Nursing, Australia. Published by Elsevie

doi:10.1016/j.colegn.2007.12.002

y Ltd). All rights reserved.

ulated GT method are located within the constructivist,ositivist, postpositivist or neo-positivist paradigms. In myiew, this concern has to be sorted out in the researcher’sind before GT, either Glaserian GT or Strauss and Corbin’sT is automatically paired with symbolic interactionism (SI).supply a rationale in this article as to why I repudiate theystematic use of symbolic interactionism without consider-ng alternatives and relate this to the study identified above.

brief discussion on the justification for using Glaserian GT,

comparison between Glaserian GT and the more contem-

orary, reformulated, grounded theory of Strauss and Corbin1990) is also included. These compatibilities are seminal iny view to ‘‘getting it right’’ so that the aim of the research

n a useable product can be fulfilled.

r Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.

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Firstly, I briefly outline the rationale for choosing Glase-ian GT as the method and one of Glasers theoretical familyodes in a study that explored concerns, and adaptiveehaviour of persons commencing on haemodialysis in theome environment.

ackground to convention of GT andheoretical perspective

ccording to Denzin and Lincoln (2005), three intercon-ected, generic activities define the qualitative researchrocess and what type of paradigm of inquiry is applied:ntology, epistemology and methodology. They ask the fol-owing key questions in determining:

(i) Ontology — what is the nature of reality?(ii) Epistemology — what is the relationship between

inquirer and the known?iii) Methodology — how do we know the world, or gain

knowledge of it?

The combination of these premises (i, ii and iii), accord-ng to Denzin and Lincoln (2005), constitute a paradigmbout inquiry. These are important in fundamentally under-irding the researcher’s selection of method and theoreticalerspective. It is my belief the method of Glaserian GTs neo-positivist in paradigmatic location and objectivist inntent through closely providing for the emergence of ‘real-ty’, particularly when the researcher does not force theata in order to explicate a middle-range theory.

Glaserian GT offers many advantages to the researcherut was not chosen without thoughtful justification. Impor-antly, justification was based on the aim of the research: toroduce an explanatory product. Moreover, it reflected theerceived reality of persons living as dependents on dialy-is in their home environment, over a 12-month period as anccessible and useful substantive theory to guide renal nurseractice, research and policy development. It is from thisort of product that nurses can gain knowledge regardinghe person’s spiritual, social and psychological dimensionsf being (Annells, 2005). Human action and interaction arentrinsic to how persons approach and respond to healthssues in their lives (Annells, 2005). Understandings derivedrom such findings resultant from the study cited above, canssist renal nurses, gain meaningful insights for practice. I,ike Baroness Jean McFarlane (1977), believe nursing is aractice-based discipline reliant upon theory to enable therovision of quality care however, reflection on compatibleheoretical perspective to advance theory development isssential.

As previously alluded to, the selection of an appropriateethod and theoretical perspective to fit the problem toe studied was driven by the problem itself and the aimsf the research—–in addition to the researcher’s paradig-atic beliefs. Concomitant to this were characteristics ofmethod that I considered to be ‘best fit’ for the prob-

em at hand. The ideal ‘best fit’ between researcher andesearch topic under investigation is postulated by Annells1996) as a ‘congruent paradigm’. My selection of GlaserianT with its embedded positivist underpinning was congruento the objective of being immersed from the researcher’s

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B. Newman

oint of view and digging for the reality of adaptive pro-esses within these persons’ lives. Glaserian GT providesystematic tools within the constant comparative methodor analysing processes (Charmaz, 2005; Hall & Callery, 2001)nd enables a pragmatic view. However, as Annells (1996)as determined, the influence of the ‘worldview’ of theesearcher about the study assists in establishing the for-ulation of the research question, and the nature of reality

ctually is embedded within the researcher’s philosophicalelief. Therefore, Glaserian GT was deemed the best fit forhe research focus at the time of deciding what methodould be employed, together with the theoretical perspec-

ive of ‘cause and consequence’ selected from Glaser’s‘family’’. This was in response to the multidimensionalactors needing consideration when congruence of methodnd theoretical perspective are required and essential toroduce the best product. It is worth reflecting on the histor-cal dimensions to truly become familiar with the argumentresented.

Glaser and Strauss developed grounded theory methodn 1967 amidst the modernist phase (Denzin & Lincoln,005) and encouraged social scientists investigating humanehaviour, social beliefs and social interactions to employhe method where substantive or formal theory was theutcome or product required. Congruence between theesearch focus, research method, underpinned by a theo-etical or philosophical perspective to which the researcherubscribes, completes and links the ontological and epis-emological assumptions (Annells, 1996). Thus, the goaln this study was to represent the reality of concernsxperienced by persons’ diagnosed with end stage renalisease, dependent on home dialysis and their respectiveartners, by use of an appropriate research method thatould enable the empirics of concepts to be generated into

heory.Over a number of years since its development in 1967,

laserian GT method has encountered postmodernism, post-tructualism and various other challenges along the way,ut remained unadulterated and pure to its roots. How-ver, various incantations have been developed, such astrauss and Corbin’s (1990) GT and versions thereof by otheresearchers, of whom a significant number have been/areurse researchers. Influences generally to qualitative inquirypproaches, including to GT, have resulted in changes in thedvancement of qualitative methods and have been cate-orised by Denzin and Lincoln (2005) into eight ‘moments’:

The first ‘moment’ or ‘traditional period’ commencedin the 1900s and continued to World War II—–researcherswrote ‘objective’ accounts of field experiences, reflectiveof the positivist scientific paradigm;The second ‘moment’ or ‘modernist phase’ included thepost war years to 1970s (when GT first was explicated);The third ‘moment’, an age of enlightenment (acknowl-edgment of the vigor and creativity of qualitative methodsand the criteria for quality achieved), commenced in 1970and extended to 1986—–an age of blurred genres with a full

complement of paradigms, methods and strategies;The fourth ‘moment’ arose in the mid 1980s and wassuperimposed by elements from the fifth ‘moment’ in par-allel with the increased popularity of qualitative methods(competing evaluative criteria offered; positivist stance

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Symbolic interactionism and grounded theory

made redundant [Annells, 1996])—–a time of crisis of rep-resentation, more reflexivity and called into questionissues of gender, class and race;

• The fifth moment, or postmodern period of experimentalethnographic writing, struggled to make sense of thesecrises—–narratives were replaced by local, small scale the-ories fitted to specific problems and specific situations;

• The sixth moment of post-experimental inquiry (1995—2000)—–burgeoning of qualitative books and journals;

• The seventh moment of methodological contest (2000—2004);

• The eighth moment is now, the future (2005-)—–backlashexperienced by scholars resulting from ‘bush science’ andthe evidence-based social movement.

During the modernist phase, that is the years from post-war period to 1970s, Glaser and Strauss (1967) developedGlaserian GT from their research experience and cast itwithin an inductive, interpretive paradigm underpinned bya positivist perspective (Annells, 1996). This was a signifi-cant period due to the formalisation of various qualitativeresearch methods (ethnography, phenomenology) that led tomodified or changed views of qualitative methods and theembedded epistemology. Positivism was valued by the scien-tific community for rigour and applied in experimental andsurvey designs, these being examples of objectivism. Pos-itivism is highly systematic, representing a well-organisedworld with regularities, constancy’s, uniformities, abso-lute principles and universal laws (Crotty, 1998; Cutliffe& McKenna, 1999). Positivism, a tenet of rigorous scien-tific method, was displaced by the postpositivist ontologyof critical realism (Annells, 1996). Objectivity was, andcontinues to be a valued quality within the positivist orscientific paradigm. However, as dualism became unrealis-able, objectivism was modified to be a regulatory ideal forgrounded theory researchers (Annells, 1996). Bryant (2003,p. 2) argued that the dominance of objectivism in the 1960’swas understandable but it ‘‘has become less comprehensiblesince then, given the extensive critiques of positivism thathave emerged . . . Any guarantee of neutrality these days canonly be given once objectivism grounded theory can be seento have engaged with constructivist arguments.’’

The relationship between the researcher and participantsor those who were the focus of the research remained objec-tivist (Annells, 1996), consistent with the rigorous criteriarequired of quality research (Hall & Callery, 2001). Disagree-ments continue amongst research methodologists on theepistemology and paradigm perspective of Glaserian GT asto whether positivist, neo-positivist or post-positivist posi-tions apply. Paley (2001) for example, has stated there aredifferent permutations of ideas, with no single view termed‘positivism’ for GT. Positivism incorporates objectivism, thenotion that truth and meaning reside in their objects inde-pendently of any consciousness (Crotty, 1998).

Glaserian GT has been subject to paradigmatic shifts;it was originally positioned within the positivist tradition(Glaser & Strauss, 1967), and later viewed as a post-

positivist theoretical position (Benoliel, 1996; Denzin, 1994;Guba & Lincoln, 1994). However, more recently Annells(1996) and Crotty (1998), despite what Glaser contends,have claimed Glaserian GT method should be more appro-priately positioned within the neo-positivist classification.

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he justification for this re-positioning of Glaserian GT cane attributed to late Twentieth Century social scientistsho have become more modest in their interpretation of

objectivity’ and a genuine shift in rigidity. Moreover, theyuggest there is a certain level of objectivity, rather thanbsolute objectivity, probability rather than certainty, andsearch to approximate the truth, rather than grasp it in

ts totality (Crotty, 1998). Despite the many controversiesurrounding the location of Glaserian GT, in my view, thereas to be congruence and fit between research problemnd method, and further more, I claim it is located withinhe neo-positivist position. In the above named study, fitetween method and theoretical perspective is enhancedy the employment of one of Glasers theoretical codeshat has synergy with Glaserian GT and the aim of thetudy.

The neo-positivist stance differs from a positivist stancen that it is believed that the essence of reality may not beully known (Annells, 1999). Grounded theory researcherspholding the positivist paradigm characterise reality asmore than what can be seen, sensed and measured’ (Paley,001, p. 375). In other words, the product is not strictly airror of reality. This is evident from Glaser’s (1978, 1992)

laims that concepts resulting from Glaserian GT are treateds reproductions of reality with ‘nothing pre-conceived’y the generation of hypotheses, explanatory behaviour,onceptually abstract from time, place and person, and mit-gating reality (Glaser, 2001). Therefore, it is not strictly airror of reality, but rather a generalisation with the objec-

ive of producing a combined inventory of possible situationsnd patterns (Baszanger & Dodier, 1997), cohesively andoherently woven into a product or theory (Morse, 1991) evi-enced by hypotheses within a substantive or formal theory.

Researchers following a neo-positivist theoretical per-pective seek to find reality in the participants’ experiencesnd views in evidence of patterns of phenomena thatnables the conceptualisation of middle-range theory. Paley2001) argues the notion that quantification, normally asso-iated with ‘hard science’, is an inevitable concomitantf GT, and therefore, objective and within a positivistaradigm. It is a fact that Glaserian GT, I believe, reliesn the empirics and aesthetics of the researcher, who inter-rets classification of data into codes, sub-categories andategories. This process is directed by early identifica-ion of a core variable, theoretical sampling and memoing,nd then woven into a substantive conceptual pattern ofypotheses that form a scientific theory. All becomes datancluding observations, feelings of participants, and otherdditional circumstantial evidence perceived in the main byhe researcher but in partnership with participants (Hall &allery, 2001). The theoretical perspective or lens is integral

n finding participants reality by the researcher.Glaserian GT method is durable because it accounts for

ariation; it is flexible because researchers can modify theirmerging or established analyses as conditions change orurther data are collected (Charmaz, 2000). This is impor-ant for renal nurses and/or other health professionals

anting to understand and improve the lives of personsn dialysis, nursing care and support for dialysing personsnd their families in the home environment. Glaserian GTositioned within the neo-positivist stance offers this oppor-unity.

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In my view, Glaserian GT does not conform to tenetsf the constructivist paradigm, where knowledge is cre-ted from interpretations and constructions are dialecticallyransacted (Guba & Lincoln, 1994). By contrast GlaserianT is an evolutionary, conceptualised and ordered processhat relies on the core variable that may or may not be

basic social process (Glaser, 1992) and progressively isefined into tiers of abstracted levels. An existing conceptust earn its way into the analysis (Glaser, 1978) with ini-

iation of sub-categories reliant upon evoked numeration ofodes. Codes eventuate to become apprehensible elementsithin sub-categories and categories through synthesis and

nterpretative conceptualisation by the researcher. Accord-ng to Bowers (1988) the grounded theorist’s task is tondergird the former by identifying the conditions underhich particular phenomenon occur that comprehensivelyovers all aspects of situations and processes as perceivedy in this case, persons on dialysis. Charmaz (2000) onhe other hand, claims researchers from the constructivistT perspective recognise the mutual creation of knowl-dge by the viewer and the viewed and aim towards annterpretative understanding of participants’ meanings. Iny view, Glaserian GT places more emphasis on the mod-

fied objectivist approach, erring towards neo-positivistpistemology.

Glaser (2005) claims that grounded theory is an ana-ytic inductive research methodology, where data analysisnd product, a substantive or formal theory resulting fromnalysis, is influenced by one or several of his ‘theoreticalamily codes.’ He suggests using one or several of the fam-ly codes from his identified eighteen possibilities can bemployed—–although he acknowledges that this list of 18 isot necessarily exhaustive of possibilities. However, Glaser2005) rejects the notion of using a theoretical perspec-ive as a theoretical framework for Glaserian GT research.ften qualitative researchers think that a theoretical per-pective/lens can give useful direction to the researcherEllis & Crookes, 1998) and according to Charmaz (2000),esearchers starting from vantage points such as those ofeminism, can use GT.

In many published GT studies where either, Glaserian GTr Strauss and Corbin’s grounded theory method has beensed, Blumer’s (1969), SI perspective has acted as the lens orheoretical perspective undergirding the analysis (Charon,995). However, recent work by Glaser (2005) has refutedecessity for use of SI, or any other theoretical perspec-ive, to guide analysis. Within Glaserian GT method, Glaser2005) claims theory resulting from the reality of persons’ehaviour and concerns should be allowed to emerge with-ut adherence to a theoretical orientation, such as SI. Glaser2005) argues that if SI institutionalises Glaserian GT as itswn, this reduces the power of Glaserian GT by ignoringts roots based in a concept-indicator model. Glaser (2005)laims there is a perceived tension between Glaserian GTethod and symbolic interactionism because:

A researcher does not need to use SI to use Glaserian

GT method because SI is NOT the foundation of groundedtheory—–SI does not have a legitimising role in partnershipwith Glaserian GT.One or several of the offered coding families available, assuggested by Glaser (2005), may be used appropriately in

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B. Newman

the integration of the grounded theory hypotheses (andother forms of coding families are acceptable too).SI stultifies and biases GT method; it imposes astraightjacket of conformity when interpreting emerg-ing concepts and does not lend itself to the freedomof discovery in the inductive process that is required byconventions of constant comparison method.SI closes the researcher down to being open to the fullrange of theoretical codes that can or may emerge duringanalysis.If SI is used, this risks the researcher, when analysingdata, to be allied only to the SI perspective of interac-tion, rather than being open and mindful as demandedby GT regarding conceptualisation.SI is viewed as a structural and deflecting the focus fromrelevant structural categories and structural sensitivity,as is required of Glaserian GT.

As a consequence of the above justifications, a theoreti-al perspective such as SI was not used within the researchtudy identified above. I preferred to use one or severalf the Glaserian coding families compatible with GlaserianT method to ensure congruence was maintained. One ofhe Glaserian GT theoretical families of ‘cause and conse-uence’ was viewed as compatible with what was emergingrom data analysis in my study. I came to this realisationollowing initial coding, as it was evident that ‘cause andonsequence’ most closely represented the reality of whatappens in the lives of dialysing persons in an indirect and/orirect response to ESRD and dependency on dialysis in theome environment. In my experience much can be gained byesearchers before they launch into a research study utilis-ng Glaserian GT or Strauss and Corbin’s grounded theory ashe method, and automatically marrying this with SI. In con-lusion, compatibilities between the objective of the studyre central to cohesiveness and the product produced in evi-ence when not only deciding on a clinical research topic,ut also the theoretical perspective and method. Each playsn integral role in ensuring congruence of a ‘best fit’ productf quality in the form of a substantive or formal theory.

cknowledgement

would like to acknowledge the Royal College of Nursing,ustralia for the granting of research money through theyrtle Ivy Quick Scholarship.

eferences

nnells, M. (1996). Grounded theory method: Philosophical per-spective’s, paradigm of inquiry, and postmodernism. QualitativeHealth Research, 6(3), 379—393.

nnells, M. (1999). Evaluating phenomenology: usefulness, qualityand philosophical foundations. Nurse Researcher, 6(3), 5—19.

nnells, M. (2005). Grounded theory. In Z. Schneider, D. Elliott,G. LoBiondo-Wood, & J. Haber (Eds.), Nursing Research Meth-

ods, Critical Appraisal and Utilisation (2nd ed., pp. 163—177).Sydney, Australia: Mosby/Elsevier. Ch.11.

aszanger, I., & Dodier, N. (1997). Ethnography: Relating the parts tothe whole. In D. Silverman (Ed.), Qualitative research: Theory,method and practice (pp. 8—23). London, UK: Sage Publications.

E

G

G

G

G

G

G

H

M

M

Paley, J. (2001). Positivism and qualitative nursing research. Schol-

Symbolic interactionism and grounded theory

Benoliel, J. Q. (1996). Grounded theory and nursing knowledge.Qualitative Health Research, 6(3), 406—428.

Blumer, H. (1969). Symbolic interactionism, perspective andmethod. Englewood Cliffs, New Jersey: Prentice Hall.

Bowers, B. J. (1988). Grounded theory. In B. Sarter (Ed.), Pathsto knowledge innovative research methods for nursing (pp.33—58). New York: National League for Nursing, USA.

Bryant, A. (2003, January). A constructive/ists response to Glaser.Forum, Qualitative Social Research, 4(1). Retrieved January 12,2006, from http://www.qualitative-research.net.fhs/

Charmaz, K. (2000). Grounded theory: Objectivist or constructivistmethods. In N. Denzin & Y. Lincoln (Eds.), Handbook of qualita-tive research (2nd ed., pp. 509—535). Thousand Oaks, CA: SagePublishing.

Charmaz, K. (2005). Grounded theory in the 21st century, appli-cations for advancing social justice studies. In N. Denzin & Y.Lincoln (Eds.), The sage handbook of qualitative research (3rded., pp. 507—529). Thousand Oaks, CA: Sage Publications. Ch.20.

Charon, J. M. (1995). Symbolic interactionism: An introduction, aninterpretation, an integration. Upper Saddle River, New Jersey:Prentice Hall.

Crotty, M. (1998). The foundations of social research. Sydney, Aus-tralia: Allen and Unwin.

Cutliffe, J. R., & McKenna, H. P. (1999). Establishing the credibilityof qualitative research findings: The plot thickens. Journal ofAdvanced Nursing, 30, 590—598.

Denzin, N. K. (1994). The art and politics of interpretation. In N. K.Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research.

Thousand Oaks, CA: Sage Publications.

Denzin, N., & Lincoln, Y. (2005). Introduction: The discipline andpractice of qualitative research. In N. K. Denzin & Y. S. Lincoln(Eds.), The sage handbook of qualitative research. ThousandOaks, CA: Sage Publications.

S

107

llis, L., & Crookes, P. (1998). Philosophical and theoretical under-pinnings of research. In P. Crookes & S. Davies (Eds.), Researchinto practice (chap. 4, pp. 85—101). Bailliere and Tindall pub-lished in association with the Royal College of Nursing, London,UK.

laser, B. G. (1978). Theoretical sensitivity advances in methodol-ogy of grounded theory. Mill Valley, CA: Sociology Press.

laser, B. G. (1992). Basics of grounded theory analysis: Emergencevs. forcing. Mill Valley, CA: Sociology Press.

laser, B. G. (2001). The grounded theory perspective: Conceptu-alisation contrasted with description. Mill Valley, CA: SociologyPress.

laser, B. G. (2005). The grounded theory perspective. Vol. 111:Theoretical Coding. Mill Valley, CA: Sociology Press.

laser, B. G., & Strauss, A. L. (1967). The discovery of groundedtheory: Strategies for qualitative research. Mill Valley, CA: Soci-ology Press.

uba, E. G., & Lincoln, Y. S. (1994). Competing paradigms in quali-tative research. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbookof qualitative research. Newbury Park, CA: Sage Publishing.

all, W. A., & Callery, P. (2001). Enhancing the rigor of groundedtheory: Incorporating reflexivity and relationality. QualitativeHealth Research, 11(2), 257—272.

cFarlane, J. K. (1977). Developing a theory of nursing: The rela-tion of theory to practice, education and research. Journal ofAdvanced Nursing, 2, 261—270.

orse, J. M. (1991). Approaches to qualitative-quantitative method-ological triangulation. Nursing Research, 40(2), 120—123.

arly Inquiry for Nursing Practice, 15(4), 371—387.trauss, A., & Corbin, J. (1990). Basics of qualitative research:

Grounded theory procedures and techniques. Newbury Park, CA:Sage Publications.