Opting in and opting out: a grounded theory of nursings contribution to inpatient rehabilitation

Aim: To develop a grounded theory of nursing’s contribution to patient rehabilitation from the perspective of nurses working in inpatient rehabilitation.

Design: Grounded theory method, informed by the theoretical perspective of symbolic interactionism, was used to guide data collection and analysis, and the development of a grounded theory.

Setting: Five inpatient rehabilitation units in Australia.

Participants: Thirty-five registered and 18 enrolled nurses participated in audio-taped interviews and/or were observed during periods of their everyday practice.

Findings: The analysis revealed a situation whereby nurses made decisions about when to ‘opt in’ and when to ‘opt out’ of inpatient rehabilitation. This occurred on two levels: with their interaction with patients and allied health professionals, and when faced with negative system issues that impacted on their ability to contribute to patient rehabilitation. The primary contribution nurses made to inpatient rehabilitation was working directly with patients, enabling them to self-care. Nurses coached patients when their decisions about ‘opting in’ and ‘opting out’ were based on assessment of the person in their particular context. In contrast, the nurses mostly distanced themselves from system-based problems, ‘opting out’ of addressing them. They did this not to make their working lives easier, but more manageable.

Conclusion: System-based problems impacted negatively on the nurses’ ability to deliver comprehensive rehabilitation care. As a consequence, some nurses felt unable to influence the care and they withdrew professionally to make their work lives more manageable.

Blended learning in entrepreneurship education in the Asia-Pacific : a grounded theory approach to entrepreneurship pedagogy

Using a grounded theory approach, this pedagogical study explores “What are the key content areas and pedagogical interventions around which to build a blended learning method for Generation Y (also known as the Net Generation) entrepreneurship students (as opposed to other business students)?” The study uses a variety of “information-rich cases” and presents the argument that entrepreneurs learn
differently from other students. The author develops the Etappe Method of Training Entrepreneurs, a blended learning approach for the technology-savvy generation under the motto “Teaching is best done online and learning is best done in the classroom”. Drawing upon the theory of experiential learning as concretised by learning styles inventories, this learning method provides entrepreneurs, in their unique teachable moments, with active and concrete pedagogical interventions that can be enhanced through a blended learning environment of online and face-to-face modalities leading them step-by-step through deepening learning in the theory, process and practice of entrepreneurship. In conclusion, the author presents suggestions for further research that can verify this emerging theory in an empirical fashion.

Grounded theory of nursing's contribution to inpatient rehabilitation

There is growing awareness of the benefits of rehabilitation both in Australia and overseas. While the provision of rehabilitation services is not new, recognition of this type of health service as an integral part of health care has been linked to changes in the provision of acute care services, advances in medical technology, improvements in the management of trauma and an ageing population. Despite this, little attention has been paid to nursing's contribution to patient rehabilitation in Australia. The aim of this grounded theory study, therefore, was to collect and analyse nurses' reports of their contributions to patient rehabilitation and to describe and analyse contextual factors influencing that contribution. Data were collected during interviews with registered and enrolled nurses working in five inpatient rehabilitation units in New South Wales and during observation of the nurses' everyday practice. A total of 53 nurses participated in the study, 35 registered nurses and 18 enrolled nurses. Grounded theory, informed by the theoretical perspective of symbolic interactionism, was used to guide data analysis, the ongoing collection of data and the generation of a substantive theory. The findings revealed six major categories. One was an everyday problem labelled incongruence between nurses' and patients' understandings and expectations of rehabilitation. Another category, labelled coaching patients to self-care, described how nurses independently negotiated the everyday problem of incongruence. The remaining four categories captured conditions in the inpatient context which influenced how nurses could contribute to patient rehabilitation. Two categories, labelled segregation: divided and dividing work practices between nursing and allied health and role ambiguity, were powerful in shaping nursing's contribution as they acted individually and synergistically to constrain nursing's contribution to patient rehabilitation. The other two categories, labelled distancing to manage systemic constraints and grasping the nettle to realise nursing's potential, represent the mutually exclusive strategies nurses used in response to segregation and role ambiguity. From exploration of the relationship between the six categories, the core category and an interactive grounded theory called opting in and opting out emerged. In turn, this grounded theory reveals nursing's contribution to inpatient rehabilitation as well as contextual conditions constraining that contribution. The significance of these findings is made manifest through their contribution to the advancement of nursing knowledge and through implications for nursing practice and education, rehabilitation service delivery and research.

Exploring the dynamics of accountability relationships : a grounded theory approach

Examines accountability relationships within the organisational context of a local council. Results indicate that accountability is an intensely personal, complex, and context-bound phenomenon. A framework of accountability is suggested, linking the context and characteristics of accountability relationships with particular cognitive and emotive accountability outcomes.

A grounded theory for teaching entrepreneurship using simulation games

A practical teaching difficulty provided the opportunity to turn a problem into a useful case study with generic implications for the pedagogical effectiveness of simulation games in teaching entrepreneurship. Students playing the simulation game submitted written assessments that became the units of analysis for a single-case research project. Analysis produced a grounded theory consisting of four attribute categories and associated properties required of a simulation game to make it an effective teaching device in entrepreneurship contexts. The theory provides at the very least a useful checklist for teachers of entrepreneurship and, potentially, a basis for developing a quality standard for educational simulation games.

Crash landing at INSEAD : initiating a grounded theory of the pedagogical effectiveness of simulation games for teaching aspects of entrepreneurship

A practical teaching difficulty arising in a conducive environment provided opportunity to turn the particular problem into a case study with generic implications. Little research has been conducted on the use or effectiveness of simulation games for teaching entrepreneurship. In the context of established literature critiquing the effectiveness of simulation games as teaching devices in managerial contexts and at a point where problems in using a simulation game as part of entrepreneurship course became evident, the authors designed and executed a single-case research project to generate initial theoretical propositions about the pedagogical effectiveness of simulation games for teaching various concepts and aspects of entrepreneurship. The case analysed the perceived learning environment created when the Sky-High simulation was played by 41 MBA students taking an elective entrepreneurship course at INSEAD. The research design embodied the established methodological principles specified by Yin (1989), for effective case research. Theory building was based upon the grounded-theorizing procedures articulated by Glaser and Strauss (1967). Analysis and synthesis produced a grounded theory, in the form of a normative argument, containing four attribute categories and associated properties required of a simulation game to make it an efficacious teaching device in entrepreneurship contexts. The establishment of this grounded theory has made it both desirable and feasible to contemplate creation of an ISO quality standard for educational simulation games.

A grounded theory of intuition among occupational therapists in mental health practice

Objectives: This study aimed to explore occupational therapists’ understanding and use of intuition in mental health practice.
Method: Using a grounded theory approach, a theoretical sample of nine occupational therapists practising in mental health settings participated in semi-structured interviews. Data were analysed using the constant comparative method.
Findings: Intuition was found to be embedded within clinical reasoning. From the data, intuition was defined as knowledge without conscious awareness of reasoning. The participants viewed intuition as elusive and underground, and suggested that professional experience led to a more comfortable use of intuition. Using intuition relied on therapists’ understanding of their own and others’ emotions, and intuition partnered analysis within their clinical reasoning. A grounded theory of the use of intuition in mental health settings is proposed.
Conclusion: Occupational therapists practising in mental health settings understand intuition to be an instinctive understanding of situations, resulting from their professional experience and the understanding of emotions.

Using grounded theory in sport management research

This paper argues for Grounded Theory (GT) to be more widely used to allow emergence of socially constructed sport related processes. The aim of GT is to explain social phenomena and the resources that are required to support social processes. GT is attractive to researchers as it uses the natural setting where the phenomena studied takes place to examine and understand social constructions. This paper demonstrates the importance of using GT by using a sport management study to exemplify GT processes and assess its efficacy in the discipline. Integration of GT method will strengthen sport management research and enable researchers understand social constructions associated with sport.

Providing continence care in residential aged care facilities: a grounded theory study

This thesis resulted in a grounded theory that described and explained how Australian residential aged care residents’ continence care needs were determined, delivered, and communicated. The researcher identified a basic social problem that influenced overall care, and a basic social process staff used to deal with the problem.

Accessibility and autonomy preconditions to ‘our’ inclusion: a grounded theory study of the experiences of secondary students with vision impairment

In this paper, I report core findings of a small-scale qualitative study that I conducted with a group of young people with vision impairment who attended an inclusive secondary school in the Australian state of Queensland. My objective was to capture their voiced experiences of their schooling through face-to-face interviews and to develop a substantive theory that was grounded in the collected data. Relevant to the study was my status as an insider researcher, which impacted both data collection and analysis. Here, I develop the methodological process that I followed and present core findings of the study. These findings shed light on the practices within schools that are designed to promote inclusion yet perpetuate exclusion for students with impaired vision.

Grounded theory and leadership research: a critical realist perspective

The methodology of grounded theory has great potential to contribute to our understanding of leadership within particular substantive contexts. However, our notions of good science might constrain these contributions. We argue that for grounded theorists a tension might exist between a desire to create a contextualised theory of leadership and a desire for scientifically justified issues of validity and generalizable theory. We also explore how the outcome of grounded theory research can create a dissonance between theories that resonate with the reality they are designed to explore, and the theories that resonate with a particular yet dominant 'scientific' approach in the field of leadership studies - the philosophy of science commonly known as positivism. We examine the opportunities provided by an alternative philosophy of science, that of critical realism. We explore how conducting grounded theory research informed by critical realism might strengthen researchers' confidence to place emphasis on an understanding and explanation of contextualised leadership as a scientific goal, rather than the scientific goal of generalization through empirical replication. Two published accounts of grounded theory are critiqued candidly to help emphasise our arguments. We conclude by suggesting how critical realism can help shape and enhance grounded theory research into the phenomenon of leadership. © 2010.