Encuadre conceptual

The best means to ensuring rigour is to follow the existing principles for high quality research studies in each of the chosen data collection techniques (Creswell 2014). Many of the aspects discussed throughout this chapter follow the analytical principles of specific research methodologies and approaches. The majority of the methodological principles used in this study come from either Grounded Theory (GT) or ethnography.

3.1.1.1 Grounded Theory

Grounded theory (GT) is an approach to research that is used to systematically explore data in order to develop new theories (Gray 2014, Charmaz 1990, Strauss and Corbin 1990, Glaser and Strauss 1967). The aim of GT is to construct theories through constant comparison of, mainly qualitative, data in order to identify similarities and differences between the concepts under exploration. Theories produced in GT should be explicitly evident in the data that are analysed and presented in the study’s findings. Many of the concepts and principles of GT are utilised in my study and these will be referred to throughout this methods chapter. However, there are four main aspects that differentiate this study from GT.

Two factors differentiating my study from GT are related to the use of existing literature and what my study aims to create. The main aim of GT is to create a “substantive” or “formal” theory that “emerges” from the data on a topic that is currently unknown (Glaser and Strauss 1967). Therefore, there would be little if any existing literature on the topic. In GT, literature is more commonly used after concepts are discovered during data collection; any literature used in GT before data collection usually works as a “beginning foothold”: a summary of concepts to help guide a study. The literature defining psychosocial needs was used in my study as such a tool, however, in GT, these footholds are considered irrelevant once data are obtained, whereas the psychosocial needs I identified from existing literature provided variables which were analysed during my study. Similarly, my analyses follow the GT approach in that they explore rather than evaluate the evidence (Glaser and Strauss 1967) but my aim was that the data act as an instrument for reflecting on practice and future research rather than creating a “substantive” theory. The main reasons for me not attempting to create a substantive theory are linked to funding constraints and can be considered alongside the two other factors differentiating my study from GT.

GT advocates a “theoretical” approach to sampling, whereby initial findings indicate which subsequent samples to use to explore the concepts emerging from analyses of collected data (Glaser and Strauss 1967, Corbin and Strauss 1990). In GT, new data are sought out by involving different participants from different settings to corroborate or disprove findings. In my study I followed the GT technique of analysing data concurrently to the collection of new data. I also focussed my areas of exploration on the concepts that were emerging from the data. However, I did not select my sample of nurses according to these emerging concepts. My sample, the nurses working day-duty on the ward, was identified at the beginning of the study. Which nurses participated was chosen by convenience sampling, guided by which nurses would be available to maximise the amount of data per case I could collect. Theoretical sampling contributes to the decision of when data collection is complete, which, in many qualitative studies, is when “saturation” – nothing new emerges from the data (Leinenger 1994, Glaser and Strauss 1967) – is reached. I did not have the resources to carry on until saturation. I did, however, obtain enough evidence to illustrate the reality of psychosocial support in this hospice ward. My findings are of value in future practice and research.

A final point is required in relation to GT’s use of quantitative data and how I applied it in this study. Although GT is commonly referred to as qualitative research (Creswell 2014, Cormack 2000), GT in its original form saw value in quantitative analyses by presenting percentages to discuss associations between variables (Glaser and Strauss 1967, Strauss and Corbin 1990). The inclusion of numerical findings in my study make the results clearer to the reader and support the qualitative data which were collected following many of the principles of the ethnographic approach to research.

3.1.1.2 Ethnography

Original definitions of ethnography consider it to be an in-depth written description of a culture, taking into account a number of aspects including: the individuals within the culture and how

they interact; their norms and habits; and the way the environment around them is shaped (Creswell 2014, Silverman 2011, Atkinson et al. 2001, Muecke 1994). Data were collected by researchers entering the site of research and observing what occurred. The term, ethnography, has subsequently been re-interpreted over the years so that some see it as an alternative name for observational fieldwork (Lofland et al. 2006, Bryman 2012).

As the main aim of this study was to explore whether psychosocial support is an inherent component of hospice ward nurses’ daily work, it was vital that the research focussed on nurses’ actual care. Self-report studies can only provide perceptions of care provided, therefore, observation was the method adopted to discover what was occurring in practice (Walshe et al. 2011, Lofland et al. 2006, Wolcott 1990, Silverman 1998). Many of the procedural challenges faced by ethnographic researchers concern their use of observation as a data collection technique. The use of observation, as the central mode of data collection in this study, indicates the value of ethnography in guiding many of the methodological decisions I made.

Similarly, my exploration of the influence of aspects of the ward culture on nurses’ psychosocial support could indicate my study is ‘ethnographic’ (Polit and Beck 2010, Atkinson

et al. 2001). However, I recognise that my study is not a pure ethnography as it focusses on the

minutiae of nurses’ psychosocial support rather than creating a thorough account of the ward and the culture in which the nurses work (Bryman 2012, Silverman 2011, Polit and Beck 2010).