Casey Bailey

November 3, 2014

Article Critique #3

Fenwick, C., Chaboyer, W., & St. John, W. (2012). Decision-making processes for the

self-management of persistent pain: A grounded theory study. Journal for the

Australian Nursing Profession is the property of eContent Management Pty. Ltd.,

42(1):53-66.

Keywords: grounded theory, theoretical sampling, decision-making, purposeful

sampling

Article Overview

The article referenced above was selected to critique, since it highly favored

Grounded Theory Method (a research method that can utilize quantitative or

qualitative data to enable the ability to develop a theory if the “Grounded Theory”

adheres to the constraints of the “Grounded Theory Method”, which the researcher will

engage in the process that will produce a theory that is grounded in data (Charmaz,

2014; Corbin & Strauss, 2008). This critique utilizes the following three criteria,

identified from the grounded theory literature (Charmaz, 2014; LaRossa, 2005; Strauss &

Corbin, 1998; Hachtmann, 2012. (1) The process of grounded theory construction

evolves coding methods, finding themes, identifying core categories, and arriving at

findings in the focus, the authors also utilized constant comparative analysis (an

inductive process of comparing data with data, data with code, code with code, code with

category, category with category, and category with concept, Charmaz, 2014, p.342) and

conditional/consequential matrix developed by Strauss & Corbin, 1998 (utilized to

locate a reciprocal action that emerges repeatedly in the data and then outline the

linkages from this through the micro and macro conditions that might influence it, Corbin

& Strauss, 2008) (2) theoretical sampling (a continuous data collection process that

refines, elaborates, and saturates conceptual categories in which compares people,

places, events, conditions, and settings, which the researcher collects, codes and analyzes

further cases to sample to determine what data is required to collect next as well as to

elaborate more and refine emerging theoretical categories in order to construct theory as

it emerges, Charmaz, 2014) and (3) rigor (consist of the theory’s ability to “fit” the

phenomenon under the study or to speak to the people hearing the theory, and to ‘work”

by means of explaining the experiences, interpreting, and predicting the phenomenon

Corbin & Strauss, 2008). The article summary will briefly describe and follow with the

application of each criterion in order to evaluate the research. Strengths and weakness

will parallel with the evaluation criteria, which will highlight and conclusions will be

drawn as to the alignment of grounded theory, ensued by possible recommendations for

improvement.

Article Summary

The authors examine the decision-making process for self-management of

persistent pain utilizing grounded theory and Charmaz’s (1983, 1991, 1994, 1995, 1999),

“Self and Identity” research study to understand the transformation of individuals’

decision-making process in response to the many and varied problems related to the

experience of persistent pain as well as to compare and contrast the current findings with

Charmaz’s prior findings. The authors believed that universal theories on decision-

making hadn’t sufficiently accounted for the many difficulties encountered by individuals
enduring persistent pain and the consequences for these experiences on the decision-

maker. The authors utilized grounded theory to explore the significance decision-making

had from the individuals’ perspectives, develop a rich, thick description (communicates

the findings and provides in detailed descriptions of the experience or setting, so once the

researcher collects or provide multiple perspectives about the theme, the results are more

realistic and rich, which adds value to the validity of the findings, Creswell, 2013) of

conceptual understanding of self-management of persistent pain, and identify with how

this was achieved within a “real world” environment.

Criterion 1: The process of grounded theory construction

The analysis of the data proceeds in stages in which the authors included in the

article by utilizing a basic level of open coding (forms the first basic unit of concepts

through separating data independently and assess through analysis, distinct concepts and

categories within the data, which will qualify those concepts in terms of their properties

or subcategories and dimensions, Corbin & Strauss, 2008), which was simultaneously

and continuous in shifting from identifying broad categories of persistent pain to

distinguishing the core category (represents a phenomenon, the main theme of the

research (Corbin & Strauss, 2008), which was identified as the various styles of decision-

makers and decision-making. According to LaRossa (2005), in opening coding, the

researcher for the most part, is developing variables that involve analyzing the data to

extract a set of categories and their properties, which the variables may be exceptionally

elaborate and how they are interconnected remains largely unexplored, 2013). Constant

comparative analysis was also utilized within the study to compare and analyze previous

collected data with new emerging data to enable theory development.

Criterion 2:  Rigor

In this study the authors applied three principles to support the study’s rigor, 1)

credibility, 2) auditability, and 3) fittingness during the theory development, which the

authors explicated in extensive detail. The rigor involved in this study included a number

of crosschecking of emerging concepts against participants’ experiences and meanings,

relating relevant and current research literature by Charmez, Corbin & Strauss, Chiovitti

& Piran, and Carpretner to determine if “fit” of the theory applied to their experiences,

and brief recording of memos was discussed in outlining analytical and sampling

decision, so some reflexivity was incorporated within the study.

Criterion 3:  Theory Construction

The authors utilized the grounded theory method as it facilitated theoretical

understandings and a creation of explanatory theory (the participants’ view or

perception of the world their within in which consist of what people in a given setting or

culture believe about the nature, cause, prevention, and response to an event or process),

which the authors were able to develop an in-depth understanding through the analysis of

participants’ responses, interactions, and processes at various levels of the persistent pain

level in three different styles of decision-making, which were identified and separated

into three categories, 1) judicious decision-making, 2) impulsive decision-making, and 3)

bargaining decision-making. Each decision-making category was developed through the

experience of persistent pain influences and the psychosocial processes of the

individuals’ interaction with self, others, and the environment, which the meanings were

generated from those interactions.

 The authors also utilized theoretical sampling (the continuation of collecting

and analyzing data and engaging in a process, Corbin & Strauss, 2008), as sources of

information provided by single participant directed the selection of further participants or

data sources in which refining or extending data collection and analysis, which was

continuing until the data collected became theoretical saturated (ensures the analysis

describes the data, but explains how the various codes, categories, and concepts

interconnect, so this is a well-developed process of concepts and linkages between the

concepts that form the theory and no additional data is required), which was evident

once the development of conceptual rich codes, categories, and theory emerged in regards

to how people made self-management choices regarding persistent pain.

Within the final stage of analysis, selective coding (conveys the story as a whole

and creates substantive theory from “core” categories”, which produces a category that

integrates all other categories) was utilized as a process where axial codes (consist of

establishing connections among codes and identifying relationships among the open

codes) were increasingly “selected” or advanced in relation to the core category with

intricate links connecting data together to form the substantive theory. The substantive

theory (is emergent in nature and can be classified as “middle-range” theories that

amides “minor working hypotheses” and “grand theories” in which are relevant to the

people concerned and are readily modifiable, Corbin & Strauss, 2008) was able to

construct further data analysis in developing categories and subcategories.

The authors utilized the conditional/consequential matrix as an analytical tool

developed by Strauss & Corbin (1998), which permitted the ability to examine and

identify actions/interactions, consequences, casual intervening and contextual conditions

to describe what people did in response to a problem or situation related to decision-

making for the self-management of persistent pain. Strauss & Corbin’s (1998)

conditional/consequential matrix is similar to Hachtmann’s matrix and the difference is

that Hachtmann’s matrix includes strategies (related to responses) and Strauss &

Corbin’s matrix does not include. Theauthors in this study relied heavily on Strauss &

Corbin’s matrix and combined the casual, intervening, and contextual conditions as

activities or events that formed problems relating to the participant’s “known self”, and

the consequences were the outcomes of the actions/interactions, which revealed an

emergent theory “the deciding of known self”. Hachtmann’s matrix consisted and

included lucid explanations of causal conditions (events and occurrences affecting the

occurrence of the phenomenon of interest), intervening conditions (events and

occurrences interfering with the phenomenon of interest), contextual conditions

(conditions under which the strategies and phenomenon occur), and outcomes

(occurrences resulting from implemented strategies), Hachtmann, (2012).

In applying the Strauss & Corbin’s matrix within the study, the casual condition

related to the experience of persistent pain, the contextual condition applied to the

manifold losses sustained by participants, the intervening conditions responded to the

participant’s age, gender, employment status, internal/external support, and level of

knowledge formed the problems that relate to the disruption of the “known self”, the

actions/interactions generated from responses to the problems identified as “disruption of

the known self” in which engaged in the three different decision-making styles listed

prior, and the consequences related to the three different decision-making styles in which
the development of three types of decision-makers, 1) susceptible decision-maker, 2)

adaptive decision-maker, and 3) expert decision-make.

Synthesis

In conclusion, the authors effectively established grounded theory in

conceptualizing the findings within the study, which identified those self-management

decisions in strengthen the understanding of decision-making of individuals’ self-

managing persistent pain. The theory indicated that knowledge about self-identity alters

responses to persistent or chronic illnesses by informing to what extent disrupts the

known self-impacts upon decision-making during self-management of persistent pain.

The authors initiated the process with comparison and contrasts of the study’s findings

with the review of various literature articles and study’s related to the self identity and

chronic illnesses, which provided focus on the theoretical sampling, purposeful sampling,

and took advantage of all emergent themes, categories, concepts, and demonstrated

comparisons with contrasting frameworks. The authors lacked elements of the method by

not achieving more reflexivity or memoing in the data analysis process as well as in the

conclusion. Overall this was an effective grounded theory article that explicated in great

detail the process of deriving at the proposed theory.

References

Charmaz, K. (2014). Constructing grounded theory (2nd ed.). Thousand Oaks, CA: Sage

Publications, Inc.

Corbin, J., & Strauss, A. (Eds.). (2008). Basics of qualitative research: Techniques and

procedures for developing grounded theory. Sage.

Creswell, J. W. (2013). Qualitative inquiry and research design: Choosing among five

approaches (3rd ed.). Thousand Oaks, CA: Sage Publications, Inc.

Hachtmann, F. (2012). The Process of General Education Reform from a Faculty

Perspective. The Journal of General Education, 61(1), 16-38.

LaRossa, R. (2005). Grounded Theory Methods and Qualitative Family Research.

Journal of Marriage and Family, 67(4), 837-57.