May McCreaddie

Evolving Grounded Theory Methodology: Towards a discursive approach

Grounded Theory Methodology (GTM) is a widely cited research approach based upon symbolic interaction with a focus on interaction, action and processes. Relatively recently, Discursive Psychology; a language-based interaction research approach also based on symbolic interaction, emerged. At present Discursive Psychology is principally cited in the social sciences literature. Given Discursive Psychologys symbolic interaction foundations, what relevance does this approach have for evolving GTM? A number of methodological challenges were posed by a study looking at humour in Clinical Nurse Specialist-patient interactions. This paper will use the phenomenon of spontaneous humour in healthcare interactions to illustrate the potential for a new form of GTM drawing on discursive approaches; Discursive GTM. First, the challenges presented by a study looking at spontaneous humour in Clinical Nurse Specialist-patient interactions are presented. Second, the research approach adopted to meet these challenges - Discursive GTM (DGTM) - is explicated and the results of the study are outlined. Third, the different GTM approaches and Discursive Psychology are compared and contrasted in relation to the DGTM approach adopted. Finally, the challenges and tensions of using DGTM as well as the opportunities afforded by the use of naturally occurring data are reviewed. The authors contend that a DGTM approach may be appropriate in analyzing certain phenomena. In particular, we highlight the potential contribution of naturally occurring data as an adjunct to researcher-elicited data. Thus, when exploring particular phenomena, a DGTM approach may address the potentially under-developed symbolic interaction tenet of language.

Humour in health-care interactions: a risk worth taking.

Background  Humour is a complex, dynamic phenomenon that mainly occurs in social situations between two or more people. Most humour research reviews rehearsed as opposed to spontaneous humour and rarely review the patients’ perspective.

Recruitment, selection and retention of nursing and midwifery students in Scottish Universities

BACKGROUND High attrition rates from pre-registration nursing and midwifery programmes have been reported in both the UK and in other countries. OBJECTIVES A study was conducted to identify best practice in recruitment, selection and retention across Scottish Universities providing pre-registration programmes. DESIGN A survey of all universities providing pre-registration programmes in Scotland was conducted. Semi-structured interviews were conducted with key personnel in each university. Documentary evidence was collected to supplement interview data and evidence recruitment, selection and retention practices. SETTINGS All universities in Scotland providing pre-registration nursing and/or midwifery programmes. PARTICIPANTS All 10 identified universities agreed to take part and a total of 18 interviews were conducted. METHODS Semi-structured face to face and telephone interviews were conducted. Relevant documentary evidence was collected. All data were subject to thematic analysis. FINDINGS Universities are predominantly concerned with recruiting to the institution and not to the professions. Interviews are widely used, and are a requirement in the United Kingdom. However, there is no evidence base within the literature that they have predictive validity despite creating scales and scoring systems which are largely unvalidated. The study identified initiatives aimed at addressing attrition/retention, however most had not been evaluated often due to the multi-factorial nature of attrition/retention and difficulties with measurement. CONCLUSIONS Recruitment selection and retention initiatives were rarely evaluated, and if so, adopted a relatively superficial approach. Evidence from existing studies to support practices was mostly weakly supportive or absent. The study highlights the need for a coordinated approach, supporting the development of a robust evidence base through the evaluation of local initiatives, and evaluation of new strategies. Evaluation strategies must take account of the local context to facilitate transferability of findings across different settings.

The Isolating and Insulating Effects of Hepatitis C A Substantive Grounded Theory

Hepatitis C has a global prevalence of 3%, causing chronic infection in 75% of cases, and is currently the main cause of liver transplant in the United Kingdom. This study reviewed patients’ and service providers’ perspectives on hepatitis C as an enduring condition, using a constructivist grounded theory approach. A constant comparative approach to data collection and analyses incorporating a coding paradigm was applied to semistructured interviews, focus groups, and memos. Sixteen patients and three focus groups of staff (n = 17) were recruited via purposive theoretical sampling (February through August 2008). A negative synergistic relationship between the condition hepatitis C, patients, and service providers that creates isolating and insulating effects for the relevant parties emerged from the data as a middle-range theory. Stigma and contagion create a “real” or perceived sense of isolation for hepatitis C comorbid and itinerant patients, who require the right support at the right time. Healthcare staff adhere to professional demarcation lines to manage potentially untenable patient caseloads. In turn, patients and professionals perceive that a crisis may be required to bring about successful therapeutic intervention. A service that incorporates seamless outreach services and facilitates interdisciplinary working is needed to manage complex patients with this enduring condition.

Quality of life and well-being of people receiving haemodialysis treatment in Scotland: A cross-sectional survey

End-stage renal disease is a complex, progressive and debilitating illness that affects patients’ quality of life, physical and mental health, well-being, social functioning and emotional health. A cross-sectional survey was carried out in renal dialysis centres in Scotland to assess patients’ health status and the impact of haemodialysis treatment on quality of life and well-being. Participants scored considerably lower than the UK general population in all domains of health-related quality of life, although mental health components were nearer to general population norms than physical health components. However, nearly half of the participants achieved a score on a general well-being questionnaire that was indicative of stress and anxiety. Increasing age was associated with better overall mental health but worse physical functioning. Increasing levels of hope and support were associated with improved general well-being.