International Journal of Qualitative Studies on Health and Well-being.

2006; 1: 188 192

BOOK REVIEW

Constructing grounded theory. A practical guide through qualitative analysis Kathy Charmaz, 2006, 208 pp. London: Sage. ISBN 2005928035 This is a very useful book on constructing grounded theory for both untrained and more experienced researchers, which we warmly welcome and recommend to colleagues and students on different university levels. The different steps of grounded theory, from data collection to analysis of qualitative data, are clearly described and discussed in the book. We, i.e. the authors of this review paper, have all used the grounded theory method in our recent doctoral theses in medicine, psychology, public health, and odontology, respectively. We were grateful for the possibility to read and learn from this excellent new book, which fills a gap in the existing arsenal of qualitative method books. Constructivist grounded theory has emerged as a promising approach between positivism and postmodernism with an assumption that multiple realities exist rather than one and only real reality. Our aim is also to give the readers of the International journal of qualitative studies on health and well-being *QHW a brief summary of the content of the book, chapter by chapter. Chapter 1. An invitation to grounded theory This chapter gives an excellent review of the historical development of grounded theory. Charmaz shows her reflective respect for earlier grounded theory researchers combined with introducing her newer constructivist approach to grounded theory. Glaser and Strauss talked about a grounded theory as separated from the observer, whereas Charmaz argues that, just as the world, grounded theories are constructed by subjects. Construction of grounded theories is influenced by interactions between the people involved in the research process. Charmaz social constructivist perspective assumes that grounded theories are interpretative descriptions of the studied world rather than exact pictures of it. Her perspective relies on the pragmatist philosophical tradition informed by symbolic interactionism. Grounded theory methodology is viewed as flexible, but systematic, guidelines for collecting and analysing data. When analysing data, the researcher asks himself/herself what occurs in the specific setting and what the lives of the participants are like. The researcher further asks what sense the participants

make of their own statements and actions and what analytic sense that can be made of it all. The analysis generates categories that are made more and more abstract as data are gathered to refine the emerging theory. In grounded theory, codes and analytic categories are constructed from data and not deduced from established but ungrounded theory. Important criteria for evaluating a grounded theory study are presented in terms of credibility, originality, resonance and usefulness. Charmaz stresses that without passion, curiosity, openness and care, no advanced knowledge will be constructed. According to Charmaz, the engagement of the researcher combined with the constant comparative method constitutes the core of grounded theory. Chapter 2. Gathering rich data Charmaz guides the reader through different tools for gathering data and she explores benefits and limits for each tool. The methods exhaustively and instructively discussed are ethnographic methods, intensive interviewing, and textual analysis in relation to grounded theory. Practical guidelines are given concerning each of the methods that are of valuable help for researchers when gathering rich data for a grounded theory study. Some questions that need to be focused before entering data collection are also stressed by Charmaz: What do we want to study? Which research problem might we pursue? Which tools will help us to proceed? How do we gather rich data? Rich data goes beneath the surface of social and subjective life. Thus, according to Charmaz, an inquiring mind, persistence and an innovative data-gathering approach can bring a researcher into new worlds and in touch with rich data. Rich data will give the researcher a solid material for building a significant analysis. According to Charmaz, the grounded theory adventure starts as the researcher enters the field where data will be gathered. The researcher steps forward from his/her disciplinary perspective with a few tools and provisional concepts. From this first step, a grounded theory journey may take several varied routes, depending on where the researcher wants to go and in what direction the analysis takes him/her. Charmaz means that qualitative researchers have (at least) one great advantage over quantitative colleagues. The former can add new pieces to the research puzzle or conjure entire new puzzles while gathering data and that can even occur late in the analysis. The flexibility of

ISSN 1748-2623 print/ISSN 1748-2631 online # 2006 Taylor & Francis DOI: 10.1080/17482620600881144

Book review qualitative research permits the researcher to follow leads that emerge during the simultaneous process of data collection and data analysis. It is stressed that during the entire process of collection and analysis of data the researchers critical view is essential. Charmaz states: By studying your methods, you will improve both your methodological skills and the quality of data. Subsequently, your scrutiny may lead you to realize later that collecting another kind of data with a different method may answer questions in your emerging analysis. For large projects such as theses, several data-gathering approaches may be necessary in order to answer the research questions raised (p. 35). Chapter 3. Coding in grounded theory practice In this chapter, Charmaz deals with coding or as she calls it the bones of theory. In an encouraging fashion, she states that the logic of discovery becomes evident as the researcher begins to code data. In other words coding in grounded theory aims at discovering what the theoretical meaning of data might be. Coding for theoretical meaning contrasts grounded theory from mere sorting or sifting which is the usual purpose of qualitative coding. The substance of theoretical meaning immanent in data could be illustrated by the result from coding data line-by-line or incident-by-incident, which then can be compared with the impression the grounded theorist once got from just reading field-notes or an entire interview as one narration. The handicraft of coding line-by-line, word-by-word or incident-byincident simultaneously also helps the researcher to free him/her from the temptation to merge with the world-view of the informants in the sense that this world-view is not questioned. Simultaneously, Charmaz underlines that being critical or asking questions does not mean being critical of informants but having a critical stance towards data. Data should be anticipated, or acted upon, asking analytic questions and this process should be stamped by that the researcher both stops in order to ask questions to data and simultaneously adopts a stance of speed and spontaneity. While coding, unexpected ideas, that is codes, might emerge. Data and codes should be compared to each other and then codes stemming from one section of data could be used to explore and throw light upon other sections of data. Charmaz leans towards Glaser and argues that in coding gerunds are preferable to nouns since gerunds reflect process and not topic. Gerunds lend us a sense of action or sequence. She further recommends grounded theorists to have an open mind when looking at data and in a humorous fashion she quotes Dey (1999, p. 251) who states, There is a difference between having an open mind and an

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empty head. This means that in chapter 3 the question of preconceptions is also thoroughly dealt with. Preconceived conceptions should not be feared but instead serve as a starting-point for looking at data. A subsection of chapter 3 is named Wrestling with preconceptions. Regarding preconceptions, Charmaz recommends that the researcher becomes familiar with the phenomenon that he/she studies including in-depth knowledge of the people that contend to the phenomenon. The researchers understanding must at the same time move him/her beyond what the participants take for granted. This in turn forces the researcher to wrestle with the participants frames of reference and his/her own at the same time. In the subsection on preconception, Charmaz especially and importantly warns researchers of using theoretical extants as intention and motivation and ascribe these to the experiences of the informants. She emphasizes that researchers do not know what other people think. Instead, the context of a statement from a participant might be more of interest to a grounded theorist than the statement itself. A researcher busy coding ought to ask a question about why a participant makes a certain statement in a certain context. If the researcher interprets the unstated purpose of a participant telling him/her something this might illuminate a research questions implicit meaning. Making comparisons between what people say and what they do also mean grounding interpretations on implicit meaning in data. Charmaz comes to the researchers aid regarding sources of failure when trying to make use of data. She recommends that researchers consider for example the possibilities of having coded on a too general level or having used codes to summarize instead of analysing data. Also in this respect, chapter 3 constitutes great help to both the novice and the experienced grounded theorist. Chapter 4. Memo-writing Charmaz gives memo-writing high priority in the process of constructing a grounded theory and gives the reader insight into why it is important to write memos during the entire research process. Memowriting is, according to Charmaz, the pivotal step between data collection and the draft. When the researcher gets an idea, he/she is encouraged to pause and to write a memo: It prompts you to analyze your data and codes early in the research process (p. 72). The methods of producing memos are well illustrated and several examples are given in the book that helps the reader to understand the proposed techniques. Memos explicate analytic notes, fill out categories and allow the researcher to make comparisons between data and data, data and

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Eva Brink et al. pling also aims at improving the analysis through specifying properties of categories, increasing precision of categories, distinguish between categories, providing data to move from description to analysis, making analysis more abstract and generalizable, grounding conjectures, clarifying and explicating analytic links between or among categories, identifying variations in a process and, finally, increasing the parsimony of theoretical statements. Thereby Charmaz clearly explains that theoretical sampling is more than follow up intriguing earlier codes. Based on the constructivist view of grounded theory, Charmaz briefly discusses how the researcher can influence the directions in theoretical sampling. The researchers understanding and interest have pivotal importance for these decided directions. Therefore, the directions and decisions taken should be explicitly described and discussed in a grounded theorypaper. But this is not an easy issue and Charmaz only gives limited guidance here. Theoretical saturation is another crucial, and often criticized, concept in grounded theory. Charmaz explicates her standpoint, and refers to other researchers views of the concept of saturation. In line with Glaser, Charmaz holds the idea that saturation is not the same as repetition of the same events or stories, rather the conceptualisation of comparisons of these incidents which yield different properties of the pattern, until no or new properties of the pattern emerge. This yields the conceptual density that when integrated into hypotheses make up the body of the generated grounded theory with theoretical completeness (Glaser 2001, p. 191). Alternatively, in the words by Charmaz, categories are saturated when gathering fresh data no longer sparks new theoretical insights, nor reveals new properties of these core theoretical categories. Charmaz also points to problems of small sample size in relation to saturation in a grounded theory study. A study of 25 interviews may suffice for certain small projects but invites scepticism when the author claims are about, say, human nature or contradict established research (p. 113). She also points at how sorting and diagramming data can be helpful in the theoretical development of analysis by providing logic for organizing data. This also implies that the researcher has to describe carefully how the process of analysis has proceeded. Charmaz also discusses the criticized conditional/consequential matrix developed by Strauss and Corbin (1990) with the purpose to help researchers to move their thinking from micro social structures into meso- and macro-level conditions and consequences. In a credible manner, Charmaz concludes that this predefined structure, in line with similar other coding families suggested by, e.g. Glaser (1978), may be helpful in organizing data.

codes, and so on. Charmaz gives an example of how noting suffering in a memo, exploring the relationship between suffering and moral status, led her to construct the category suffering as a moral status and also guided an abstract analysis of this category that stayed close to the data. There are differences between formal, bureaucratic memo-writing, e.g. in business communication, and writing memos in a grounded theory study. In a grounded theory study, it is important that memos be produced spontaneously rather than mechanically. Writing memos in grounded theory is based on the researchers analytic purpose and should be done using unofficial language for personal use or as Charmaz says, I wrote the memo to catch my fleeting ideas about the code and to probe data, not to share with you (p. 80). The methods of memo-writing are divided into two types, early memos, which record what is happening in the data, fill out codes and direct further data collection and advanced memos, which are used in describing how categories emerge and in making comparisons. Charmaz suggests that the untrained researcher starts with prewriting exercises. Two pretraining techniques that can be used are clustering and free writing. The notion that memo-writing is essential in constructing a grounded theory is well explored in the book. Chapter 4 gives the reader an excellent direction in how to produce memos in different phases of the research process. Chapter 5. Theoretical sampling, saturation, and sorting Theoretical sampling is one of the fundamental strategies when conducting a grounded theory study. Charmaz gives rich descriptions, both concretely and illustratively, of how theoretical sampling should be understood and performed in a grounded theory study. Here, it is easy to agree with Charmaz *she essentially follows earlier central grounded theory ideas about theoretical sampling. She also gives several examples, which will help the more inexperienced researcher to understand the logic of theoretical sampling. Although authors of grounded theory-papers claim they have sampled theoretically, there is often too little information about how it is actually done. Alternatively, the theoretical sampling may not follow the logic of grounded theory. Charmaz means that the usual misunderstandings are that theoretical sampling addresses initial research questions, reflects population distributions, finds negative cases and continues until no new data emerge. She argues that the purpose of theoretical sampling is to obtain data to explicate emerging categories, advance the analysis of tentative categories and directs where to go. Theoretical sam-

Book review Chapter 6. Reconstructuring theory in grounded theory studies The aim of a grounded theory study is to create a theory and the potential strength of grounded theory lies in its analytic power to theorize how meanings, actions, and social structures are constructed (p. 151). Charmaz draws firm lines between positivist and interpretive inquiry, i.e. between objectivist and constructivist modes of grounded theory. She points out different definitions of theory and of what a theory should be or not be in her opinion. Charmaz uses examples from her own study on changing identity during long-term sickness. According to constructivist grounded theory, she argues that a theory should emphasize understanding rather than explanation. The theory is dependent on the researchers interpretation of the data and the data received from the participants concern their interpretations of their lifeworlds. The theory is contextually situated in terms of time, place culture and situation. According to the objectivist grounded theory, the result is not influenced by the researcher, who is neutral; rather the result represents objective facts from a real reality. However, this approach is criticized by Charmaz. Charmaz also criticizes many other grounded theorists and argues that the majority of the published grounded theory work is of descriptive rather than of theoretical kind. The researchers are coding for themes instead of coding for actions and thereby theory generation is most often lacking Chapter 7. Writing the draft Charmaz states that writing qualitative research is an ambiguous process (p. 153). Therefore, she tries to give hands-on advices on how to write a draft. Writing, reading, and rewriting are essential components in this process, according to Charmaz. Instead of preparing a text for a given purpose, Charmaz means that the author should create a draft with all its components and decide later where and how to publish. Writing should be looked upon as a continuation of the discovery process where the author allows ideas to emerge, after which he/she can construct a draft. It is suggested that sections covering material and the discovered theory is written first, and that the author starts on introduction and conclusions after that. The rational for this approach is the same as before *to be able to be broad sighted and not limited in any way. In writing, effort should also be made to find arguments for the theory. It is essential to catch the readers interest in the study and its results, and the arguments should not only make the reader interested but also make him/her accept the writers viewpoints. It may be difficult to find and to formulate the arguments, but the writer can often find the arguments right in front of him/her,

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embedded in the analysis. One important part in writing is the process where the author refines the theory. The author is advised to go over categories and subcategories; do they follow the argumentation and what power do they have? Categories should not be too general or too obvious. Subcategories should not be considered included until they are evident in a way that they can actually serve as explicit headings that explain new ideas. If they do not fit this purpose, the author is advised to collapse subcategories, and to condense descriptions. The draft and its description of categories and subcategories should be obvious and clear to attract the reader. A draft also includes a literature review and a theoretical framework. Here, Charmaz advises the author to study the audience, to look at the journal where the study should be published, to learn more about standards and expectations. Preferable, a literature review should not only be summarizing important findings, but also serve as an argumentation for the report as such. The literature review is also the right place to disclose gaps in existing knowledge and to position the authors study in a wider context. In the theoretical framework, the author is encouraged to inform on specific arguments in the report rather than on the entire project. The author puts the concepts and theoretical codes to work in the theoretical framework and thus helps the reader to locate the report in relevant disciplines and discourses. One way to walk the fine line is to ask for critique on the report from close colleagues. Constructive critique helps the author to identify vague statements, over-generalizations, logic gaps, etc. This kind of help is inevitably useful as it helps the author to go over the report again, to improve it and to have a more mature manuscript when it is time for submission to a scientific journal. Chapter 8. Reflecting on the research process In this last chapter, Charmaz is looking back on the steps taken in the grounded theory journey described in the earlier chapters of the book. Questions also arise about what stands at grounded theory and when the method is evolving. She states that the researcher is part of what he/she studies, not separate from it, and that the core of the grounded theory method is the use of the constant comparative method as well as the researchers engagement. Charmaz concludes that the strength of grounded theory method lies in its flexibility. She assumes that grounded theory must not necessarily be tied to a single epistemology or a specific theoretical perspective. According to Charmaz, as researchers, we can use grounded theory methods as a tool without subscribing to a prescribed theory of knowledge or

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Eva Brink et al. Ulrika Hallberg Nordic School of Public Health, Goteborg, Sweden ulrika.hallberg@nhv.se Kajsa Henning Abrahamsson Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at Goteborg University, Goteborg, Sweden kajsa.h.abrahamsson@odontologi.se Gunilla Klingberg National Orofacial Resource Centre for Rare Disorders The Sahlgrenska Academy at Goteborg University, Sweden gunilla.klingberg@vgregion.se Kerstin Wentz Department of Internal Medicine, Sahlgrenska University Hospital/Molndal, Molndal, Sweden kerstin.a.wentz@vgregion.se

view of reality (p. 178). In her book on a constructivist mode of grounded theory, Charmaz attempts to bring the Chicago school of grounded theory back into the foreground in an attempt to enrich the current discussion of the method.

References
Dey, I. (1999). Grounding grounded theory. San Diego: Academic Press. Glaser, B. G. (1978). Theoretical sensitivity. Mill Valley, CA: Sociology Press. Glaser, B. G. (2001). The grounded theory perspective: Conceptualization contrasted with description. Mill Valley, CA: The Sociology Press. Strauss, A. L., & Corbin, J. (1990). Basics of qualitative research: grounded theory procedures and techniques. Newbury Park, CA: Sage.

Eva Brink Department of Nursing, Health and Culture, University West, Sweden eva.brink@hv.se Lotta Dellve Department of Public Health and Community Medicine, The Sahlgrenska Academy at Go teborg University, Sweden lotta.dellve@amn.gu.se