Use Of Grounded Theory In Medical Research By Patrick Dunn, Ph

Use of grounded theory in medical researchBy Patrick Dunn, Ph.D.January 14, 2016

Medical researchBig dataRegistriesClinical trailsLongitudinal studiesBig ideasHypothesis drivenSurveysObservational trials

Role of Qualitative research in the medical literature

Inductive vs. deductive approachesResearcher tests or verifies a theoryResearcher tests a hypothesis from the theoryInductiveUsed to form explanation or theoryQualitativeBased on observationGood when little is knownRare in medical researchResearcher defines and operationalizes variablesGeneralizations, or theories are developedResearcher measures variables using an instrumentResearcher looks for patterns, or theoriesDeductiveHypothesis drivenQuantitativeBasic on logic and factGood when a lot is knownCommon in medical researchResearcher analyzes data into themes or categoriesResearcher asks open ended questionsResearcher gathers information

Topics in healthcare where more information is neededMedication adherenceHealth literacyPreventing readmissionsNavigating the healthcaresystemUse of digital toolsMotivation, engagementand behavior change

NavigationVideoCommunicationHealth LiteracyPrintHeart diseaseNumeracyHeart failureCholesterolPersonalized, interactive, social, & relevantWearablesHealth appsProseDecision makingTrusted sourcesChronic conditionsKnowledgeDocumentBlood pressureLinguisticsAudioHealthcare professionalsEducationDiabetesWhat is health literacy?Connected health devicesDigital tools & technology

Why grounded theory?Why use grounded theory in medical research?Grounded theory goes beyond the description of thephenomena to a theoretical explanation – or theoryThe theory or model can be used to better understand theprocess and actions, including:- the sequence of activities- including actions by people- including interactions by peopleleading to better hypotheses, tools, and interventions

Key Characteristics of Grounded Theory Design Theoretical sampling Simultaneous collection and analysis of data Constant comparisonUse of grounded theory in medical research

A Brief History of Grounded Theory Designs 1967 Glaser and Strauss book Discovery of Grounded Theory Glaser, 1992, Basics of Grounded Theory Analysis 1990, 1998, 2008, & 2015 Strauss & Corbin; Basics of QualitativeResearch, a prescriptive form with predetermined categories andconcerns about reliability and validity 2000, 2008, & 2014 Charmaz introduces Constructing GroundedTheory, a “Constructivist” method 2005 Clarke introduces Situational Analysis: Grounded theory afterthe postmodern turn, a “Post-Modern” methodlUse of grounded theory in medical research9

Use of grounded theory in medical research

Types of Grounded Theory Design: Emerging design: A theory is grounded in the data andnot forced into categories – Glaser Constructivist: Theorist explains feelings of individualsas they experience a phenomenon or process- Charmaz Systematic: More structured process using open, axial,and selective coding-Strauss (and Corbin)Use of grounded theory in medical research

Use of grounded theory in medical research

Which interpretation of GT?Medical researchers are trained in thescientific methodThe Corbin and Strauss interpretation ofgrounded theory is more structured;While this may be limiting to some, it isthe one most likely to be accepted bya medical researcher

Understanding Health Literacy Skillsof Patients With CardiovascularDisease and DiabetesUse of grounded theory in medical research

Grounded TheoryPatientsInterviewsProfessionalsAnalytic memosTheoretical SamplingDataDeductionConstant comparisonCodingOpenValidationInductive elaborationTheoretical saturationTheoretical explanationUse of grounded theory in medical researchSelectiveAxial

Theoretical SamplingClinical sourcesPrimary careOnline sourcesCardiologyPatient Centered ProgramsDiagnosed with cardiovasculardisease or diabetes?Social networkingHeart diseaseHeart failureWithin pastyear?HypertensionLipid disorderYesDiabetes

Data collection/Data analysisPatient interviews Healthcare provider interviews Observation of individualand group ductiveelaborationValidationDataOpen codingCorbin & Strauss (2007)InductiveelaborationValidationDataAxial codingTheoryValidationDataSelective coding

Constant Comparison Procedures inGrounded TheoryCode ATranscribedCategory AInterviewsOpenCodingRaw dataTheme ACode BTheme BCode CMemosTheoryCategory BCategory CCode DAnalyticalMethodologicallUse of grounded theory in medical research18

CodingData from interviews was transcribed into aWord document and uploaded to m CodesTeachingmethodsEmotions andbehaviorsUse of grounded theory in medical researchProgramsand interventionsLine by line codingusedInfluencersPersonalizedCoding approachwas process andevaluation coding

Axial CodingContextSupport systemAccess to resources and technologyFormatCausal ConditionsHeart diseaseHeart velopment of knowledge and skillsIntervening ConditionsEmotional state Stages of lossInfluencersBehavioral approach Readiness for change Hierarchy of needsUse of grounded theory in medical researchStrategiesSupport systemPrograms and interventionsTraits Personalized Relevant InteractiveConsequencesHealthy distrustSelf-directedPersonal experienceTech confusionDigital divideConfidenceReduced anxiety

Theoretical explanation:Health literacy instructional modelUse of grounded theory in medical research21

Implications?What is needed?Better understanding of the relationship between socialand emotional support and health literacyDevelopment of more effective tools and programsDevelopment of more effective strategies for healthcareprofessionalsNeed for better options for unmotivated, non-self-directedlearners – leaving no patient behind.

Criteria for Evaluating a Grounded Theory Design Are the categories based on the data? Has enough data been collected for dimensions toemerge and for saturation to occur? Does the theory emerge from the data? Does the theory provide an explanation of the process? Can the theory be modified as conditions change? Has the theory been validated?Use of grounded theory in medical research

Thank you! Questions?Contact information: pat@yourheartscore.com

Use of grounded theory in medical research l 9 A Brief History of Grounded Theory Designs 1967 Glaser and Strauss book Discovery of Grounded Theory Glaser, 1992, Basics of Grounded Theory Analysis 1990, 1998, 2008, & 2015 Strauss & Corbin; Basics of Qualitative