Judy Kendall

Axial coding and the grounded theory controversy.

The purpose of this article is to describe the similarities and differences between two approaches to grounded theory research: grounded theory as espoused by Glaser and grounded theory as espoused by Strauss and Corbin. The focus of the article is the controversy surrounding the use of axial coding. The author proposes a resolution to the controversy by suggesting that one does not need to view either approach as right or wrong; rather, the qualitative and grounded theory researcher can choose an approach, and that choice is based on the goal of the researcher’s study. Examples of both approaches, from the author’s research study on the experiences of living in a family with a child with attention deficit hyperactivity disorder (ADHD), are provided.

Children's accounts of attention-deficit/hyperactivity disorder

As a postmodern illness, attention-deficit/hyperactivity disorder (ADHD) is embedded in controversy, reflective of the cultural times in which we live. Within this debate, 2 perspectives, ADHD as myth and ADHD as behavioral disorder, are most frequently voiced. This article describes these 2 differing perspectives and reports qualitative data from 39 children and adolescents with a diagnosis of ADHD regarding their perceptions, meanings, and experiences of living with this disorder. None of the participants in this study denied that they had difficulties and many of the difficulties they described corresponded to DSM-IV-R criteria and the scientific literature. Given these discoveries, the continual debate about the authenticity of ADHD only further victimizes families who are in desperate need of services.

Racism as a source of health disparity in families with children with attention deficit hyperactivity disorder.

Although poverty and health are inextricably linked, one cannot assume that simple poverty and low socioeconomic status are the primary causes of health disparity among racial groups. Examining the roles of racism and discrimination in access to health care and in the health experiences of people of color is fundamental to the goal of eliminating health disparities by 2010. Data from ethnic minority groups on how race influences health and health care services are absent from much of the nursing research literature. This article explores racism as a source of health disparity and discusses methodological implications for research, using attention deficit hyperactivity disorder (ADHD) research as an example.

Fighting back: Prompting emancipatory nursing actions

Poverty, education, and social problems are inextricably linked to health concerns and cannot be addressed in isolation from each other. Nurses are being challenged to care for clients who are socially, politically, and economically disadvantaged. The model of emancipatory nursing actions is derived from the work of Freire, Habermas, and Katz and presented as a practice model in guiding nurses to begin choosing actions that seek to help people fight back from the depths of their despair, rather than helping people cope and adapt to their oppression. Emancipatory interventions are provided to help nurses launch a new direction toward freeing their clients, rather than herding them through an uncaring and disjointed health and social service system.

Modeling ADHD Child and Family Relationships

Little information is available on how to help families manage common negative sequelae of attention deficit/hyperactivity disorder (ADHD). This article is a report of the extent to which a theoretical formulation of child behavior, maternal distress, and family conflict was explained by data obtained from a community sample of families with children and adolescents with ADHD. Structural equation modeling was used to test the theoretical model. The primary variables of interest were (a) child behavior problems, (b) maternal distress, and (c) family conflict. The results suggest that maternal distress may mediate the relationship between child behavior problems and family conflict, indicating the critical importance of mothers in ADHD families and the need to provide them with additional support.

Latino parents' accounts of attention deficit hyperactivity disorder.

Although researchers have conducted a vast amount of research about attention deficit hyperactivity disorder (ADHD), few have addressed how Latino families experience ADHD. The purpose of this qualitative study was to explore how Latino parents managed their child’s ADHD within the sociocultural context of their everyday lives. This article presents a grounded theory of how Latino parents ( N = 24 families) managed their child’s ADHD. The following five themes emerged from the data analysis: (a) finding out about ADHD, (b) taking on a biomedical meaning, (c) living between two cultures, (d) caring for a child with ADHD, and (e) looking toward the future with ADHD. Although some of the circumstances encountered by Latino parents resemble those typically found in the literature about ADHD and families, their experience is rendered inordinately complex by multiple overlapping sociocultural, linguistic, and parental circumstances.

A Typology of Management Styles in Families with Children with ADHD

Although studies have demonstrated that family dysfunction is common in families with attention deficit hyperactivity disorder (ADHD) children and that family members often suffer serious psychological effects, knowledge is lacking as to how to intervene to help these families manage the negative sequelae common to this disorder. This grounded theory study explored the effects of ADHD on family life and describes four family management styles exhibited in 15 families with children and adolescents with ADHD: the chaotic family, ADHD-controlled family, the surviving family, and the reinvested family. Descriptions and clinical recommendations are provided that addresses each family management type. By describing an initial typology of family management styles in this population, specific health-related issues and family assessment and intervention strategies can be more specifically directed.

Expanding the Praxis Debate: Contributions to Clinical Inquiry

Nursing science continues to debate the adequacy of various philosophic paradigms for their ability to forward the discipline. Nursing must embrace multiple paradigms, methodologies, and their philosophic assumptions to adequately address the complex and multifaceted human phenomena that is the focus of clinical inquiry in nursing. This article examines the differences in interpretive and critical approaches to clinical inquiry relative to praxis, expanding how praxis can be used to inform nursing practice. Differences in the nature of knowledge, goals of inquiry, and claims to praxis between the interpretive and critical traditions are discussed. Praxis, realized through clinical inquiry in both the interpretive and the critical paradigms, may contribute important pieces of the puzzle to improve the human condition. Expanding the praxis debate challenges nurses to consider the emancipatory possibilities of clinical inquiry within both interpretive and clinical paradigms.

Service Needs of Families With Children With ADHD

This article describes service use, perceived helpfulness of services, and the services requested of 157 families living with a child or adolescent with attention-deficit/hyperactivity disorder (ADHD) and specifically asks if service use and service need is a function of certain social demographic factors. Whereas these data suggest that ADHD is a fairly universal experience, as indicated by the high rate of service use across ethnic groups, income status, sex, and family composition, single-mother families used the most services, Hispanic families used the fewest, and families with boys with ADHD used more services than families with girls with ADHD. Income was not a significant factor in any services used or services requested. This study lends strength to the argument that more specialized services for certain groups are needed in venues with local community services, such as schools, where the majority of these children and families are already seeking help.

Self-Concept in Children and Adolescents With Attention Deficit Hyperactivity Disorder

Children with attention deficit hyperactivity disorder (ADHD) struggle with behavioral symptoms, yet little research has provided information about how behavioral symptoms impact their self-concept, especially in terms of gender, age, and ethnicity. Data were collected from 145 children and adolescents with ADHD and their mothers. African Americans, Hispanic Americans, and Caucasians were nearly equally represented in the sample, with approximately one third each. The Child Behavior Checklist was used to assess ADHD symptom severity, and Piers--Harris Childrens Self-Concept Scale was used to measure self-concept. Older ages and more internalizing behavior problems predicted lower self-concept. There were no significant differences between ethnic groups on behavior problem and self-concept scores, although post hoc analyses revealed a trend for Caucasian children with ADHD to have lower self-concept scores than those of African American or Hispanic children. The findings indicate that there is a need to assess self-concept in children and adolescents with ADHD, especially those who are older and have comorbid conditions of anxiety and depression.